a brief presentation on moral development for nursing students.

2. THEORY OF MORAL DEVELOPMENT
PRESENTING BY-
DISHA SINHA
M.SC.NURSING 1ST YEAR
ROLL-2088011

3. HISTORY OF THOERIST
OBJECTIVES
MORAL DEVELOPMENT AND THEORY
LEVELS OF MORAL REASONING
STAGES OF MORAL REASONING
QUALITIES AND NURSING IMPLICATION

5. Lawrence kohlberg (1968) stages of moral
development are not closely tied to specific age
groups. Research was conducted with males ranging
in age from 10- 28 years. Kohlberg believed that each
stage is necessary and basic to the next stage and
that all individuals must progress through each stage
sequentially. He defined 3 major levels of moral
development, each of which is further subdivided
into 2 stages each.

6. 1
HISTORY

7. • Lawrence kohlberg was born on October 15, 1927.
• In 1948, he enters the university of Chicago and completes his
bachelor’s degree in psychology in one year.
• In 1949, he began his doctoral work in university of Chicago.
• He completes his dissertation research on the moral development of
children from 1957 to 1958.
• As a result of his dissertation research, kohlberg found professional
fame in the year 1968.
CONT.

8. • Influenced by Kibbutz In 1969, in his travel in Israel, Kohlberg returns to
US and founds several “just communities”. while conducting cross-
cultural work in Bezile in 1971, Kohlberg contracts a tropical disease that
plague him physically and mentally for the next 16 years.
• In 1987, on leaving from Massachusetts hospital where he seeking
treatment for the above illness, he commits suicide by drowning himself
in Boston harbour. He was 59years old then.
CONT.

9. Moral development is the process through
which children develop proper attitudes and
behaviors toward other people in society,
based on social and cultural norms, rules, and
laws.
MORAL DEVELOPMENT

10. • Kohlberg used Piaget’s theory of story telling
technique to tell people stories involving moral
dilemmas.
• He based his theory upon research and interviews
with groups of young children.
• A series of moral dilemmas were presented to these
participants and they were also interviewed to
determine the reasoning behind their judgement of
each scenario.
THEORY OF MORAL DEVELOPMENT

12. LEVELS OF MORAL REASONING

13. PRE-CONVENTIONAL LEVEL

14. PRE-CONVENTIONAL LEVEL
• Age 4 to 10 years
• A person is motivated by obedience to authority
• Commonly associated with young children
• Involves little thought of morality
• Moral code is shaped by the standards of adults and the consequences
of the following or breaking their rules
• 2 Stages

15. (STAGE -1) PUNISHMENT AND OBEDIENCE
ORIENTATION

16.  The individual is responsive to cultural guidelines of good or bad and right and
wrong, but primarily in terms of the known related consequences.
 Children sees rules as fixed and absolute.
 Obeying rules is important to avoid punishment.
 Morality is motivated solely by punishment.
 (example- “I’ll do it, because if I don’t I cant watch TV for a week”).
(STAGE -1) PUNISHMENT AND OBEDIENCE
ORIENTATION

17. (STAGE -2) INSTRUMENTAL RELATIVIST
ORIENTATION

18.  Behavior is guided by ego centrism and concern for self.
 For the most part, decisions are based on personal benefits derived.
 Children recognizes that there is not just one right view and that different
individuals and have different viewpoints.
 The goal is to avoid punishment. Judges actions based on how they serve
individual needs.
 (example- “I’ll do it if I get something in return”).
(STAGE -2) INSTRUMENTAL RELATIVIST
ORIENTATION

19. CONVENTIONAL LEVEL

20.  Age 10 to 13 years and into adulthood
 People focus on following social norms and customs
 Begin to internalize the moral standards of valued adult role models
 reasoning is based on the norms of the group to which the person
belongs
 Two basic stages
CONVENTIONAL LEVEL

21. (STAGE -3) INTERPERSONAL
CONCORDANCE ORIENTATION

22.  also known as “good boy good girl orientation”. They consider how choice
influence relationship.
 Behaviour at the interpersonal concordance orientation stage is guided by the
expectation of others.
 They emphasize on maintenance of happy interpersonal relationships and
pleasing others and a need to avoid rejection, dissatisfaction or disapproval
from others.
 (example- “I’ll do it because you asked me to,”
… because it will please you”.)
(STAGE -3) INTERPERSONAL
CONCORDANCE ORIENTATION

23. (STAGE -4) LAW AND ORDER ORIENTATION

24.  there is “personal respect for authority”. Rules and laws are required and
override personal principles and group mores.
 The belief is that all individuals and groups are subject to the same code of
order and no one shall be exempted.
 They consider society as a whole when making judgment. They please
individuals to maintain social order by following social norms, customs and
laws.
 They become aware of the wider rules of the society to avoid guilt. They have
a need not to be criticized by a true authority figure.
 (example- “I’ll do it because it is the law”.)
(STAGE -4) LAW AND ORDER ORIENTATION

25. POST-CONVENTIONAL LEVEL

26.  Adolescent or adulthood
 People look beyond convention to determine moral norms and
appropriate social interaction
 Judgement is based on self-chosen principles
 Moral reasoning is based on individual rights and justice
 Two basic stages
POST-CONVENTIONAL LEVEL

27. (STAGE -5)SOCIAL CONTRACT LEGALISTIC
ORIENTATION

28.  Individuals who reach stage 5 have developed a system of values and principles
that determine for them what is right or wrong;
 behaviours are acceptably guided by this value system, provided they do not
violate the human rights of others.
 They believe that all individuals are entitled to certain inherent human rights, and
they live according to universal laws and principles.
 However, they hold the idea that the laws are subject to scrutiny and change as
needs within society evolve and change.
 (example- “I’ll do it because it is the moral and legal thing to do,
even though it is not my personal choice”.)
(STAGE -5)SOCIAL CONTRACT LEGALISTIC
ORIENTATION

29. (STAGE -6)UNIVERSAL ETHICAL PRINCIPLE
ORIENTATION

30.  It is directed into internalized principles of honour, justice and respect for human
dignity.
 They are not the concrete rules established by the society. The conscience is the
guide, and when one fails to meet the self-expected behaviours, the personal
consequence is intense guilt.
 The allegiance of these ethical principles are so strong that the individual will
stand by them even knowing that negative consequences will occur.
 Here, reasoning is based on universal ethical principles and abstract reasoning.
 (example- “I’ll do it because I believe it is the right thing to do,
even though it is illegal and I will be imprisoned for committing it”.)
(STAGE -6)UNIVERSAL ETHICAL PRINCIPLE
ORIENTATION

31. LEVEL/AGE STAGE DEVELOPMENTAL FOCUS
1. Pre-
conventional
(common from
ages 4-10 years)
A) Punishment and
obedience orientation
Behavior motivated by fear of
punishment
B) Instrumental relativist
orientation
Behavior motivated by ego centrism
and concern for self
2.Conventional
(common from 10-
13 years, and into
adulthood)
C)Interpersonal
concordance orientation
Behavior motivated by expectations of
others, strong desire for approval and
acceptance
D)Law and order
orientation
Behavior motivated by respect for
authority
3.Post-
conventional(can
occur from
adolescence on)
E)Social contract legalistic
orientation
Behavior motivated by respect for
universal laws and moral principles,
guided by internal set of values
F)universal ethical
principle orientation
Behavior motivated by internalized
principles of honor,justice and respect
for human dignity guided by conscience

32.  Stage development is steady
 Subjects cannot comprehend moral reasoning at a stage
more than one stage beyond their own
 Subjects are cognitively attracted to reasoning one level
above their own main level
 Movement through the stages is effected when cognitive
uncertainty is created
QUALITIES OF MORAL
DEVELOPMENT

33. Moral development has relevance to psychiatric nursing in
that it affects critical thinking about how individuals ought to
behave and treat others.
Moral behavior reflects the way a person interprets basic
respect for other persons, such as the respect for human life,
freedom , justice or confidentiality.
Psychiatric nurses must be able to assess the level of moral
developments of their clients in order to be able to help them
in their to advance in their progression towards a higher level
of developmental maturity.
RELEVANCE OF MORAL DEVELOPMENT THEORY
TO NURSING PRACTICE

36. Lawrence Kohlberg’s theory gives structure to an otherwise difficult to
understand phenomenon. His work finds value not only in the world of
psychology but also in nursing and education. Comprehension of his
stages of moral development is important when attempting to
understand the behaviour and decisions made by clients and students.
Ultimately, the theory provides the nurse and teacher with the tools
necessary to manage the client and students respectively, thus enhancing
the potential success of the betterment of the client and students.

38.  Morgen townsend, psychiatric mental health nursing , 9th edition, jaypee
brothers medical publishers 2020, pp-33-35.
 R.sreevani, a guide to mental health and psychiatric nursing, 3rd edition,
jaypee brothers medical publishers 2019,pp- 46-47.
 Theo stickley and nicola wright, theories of mental health nursing: a guide
for practice, 1st edition, sage publications 2013, pp-103-107.
 https://www.slideshare.net/Davis_1304/moral-development-45527384
 https://nursing-theory.org/theories-and-models/theories-of-moral-
development.php#:~:text=The%20ethics%20of%20nursing%20are,strict%20
ethics%20required%20of%20them.&text=This%20means%20this%20level%
20of,yet%20accepted%20society's%20conventional%20morality.