While the ethic of care has generally been regarded as an appropriate attitude for nurses, it has not received equal attention as a mode of ethical problem solving. The primary nursing model is exp...

The aim of this study was to investigate relationships between care and justice reasoning, dispositional empathy variables and meta‐ethical thinking among 128 students from a university of applied sciences. The measures were Skoe’s Ethic of Care Interview, the Defining Issues Test, Davis’s Interpersonal Reactivity Index and Meta‐Ethical Questionnaire. The results showed that levels of care reasoning were positively related to the post‐conventional schema and negatively related to the personal interest schema in justice reasoning. Age, meta‐ethical thinking, the post‐conventional schema and (...) perspective taking predicted care reasoning. Sympathy was positively related to both modes of moral reasoning among men and predicted their care reasoning. The results point out common elements for care and justice reasoning, underscore the importance of perspective taking for moral reasoning and indicate that the relationship between affective‐based empathy and moral reasoning is gender‐specific and far more complex than previous theories suggest. (shrink)

Dilemma discussions have been proven to be one of the most effective methods to enhance students’ moral reasoning in ethics education. Dilemma discussions are increasingly arranged online, but research on the topic has remained sparse, especially in the context of continuing professional education. The aim of the present paper was to develop a method of dilemma discussions for professional ethics. The method was based on asynchronous discussions in small groups. Health and social care students raised work-related dilemmas from their experiences (...) and discussed them in terms of professional values, ethical guidelines and theories. Participants in this quasi-experimental study were 87 first-term graduate students at a Finnish university of applied sciences. Health and social care students in two consecutive ethics courses constituted two experiment groups, whereas health and social care students and business students in other programmes served as control groups. Students filled in a Defining Issues Test (DIT2) at the beginning of their studies and three months apart. Statically significant increase in moral reasoning was evidenced for experiment group 2, when discussion groups were purportedly composed to maximise differences in initial levels of moral reasoning. Findings suggest that online dilemma discussions can advance students’ moral reasoning development, especially when students’ exposure to higher-level arguments is ensured through complementary means, such as instructions, examples and plenary discussions. Online real-life dilemma discussions may also serve other important goals of ethics education, especially acquiring ethical concepts, and they can promote other components of ethical decision making: ethical sensitivity and motivation, and acquisition of implementation skills. (shrink)

Background: The ethics of care and justice represent two modes of moral reasoning that nurses use in solving real-life ethical dilemmas. Research aim: The present study investigated what types of dilemmas nurses encounter in everyday work and to what extent they use care versus justice reasoning to solve them. Research design: The study used a cross-sectional survey design. Participants reported a real-life ethical dilemma and its resolution through an online survey. Open-ended data were analysed with an adjusted taxonomy of real-life (...) moral dilemmas and moral orientations. Quantified data were analysed with statistical methods (χ2-test, analysis of variance). Participants and research context: Participants were 334 registered nurses and 177 practical nurses from four health and social care organisations in Finland. Ethical considerations: The study was approved by the Research Ethics Committee of Finnish Institute for Health and Welfare. Findings: Nurses reported six types of ethical dilemmas. Nurses used more care reasoning on the needs of others and conflicting demands dilemmas than on applying rules, social pressure and reacting to transgression dilemmas. Applying rules and needs of others dilemmas were the most common types of ethical dilemmas in both occupations. Practical nurses reported more non-ethical dilemmas than registered nurses did. Discussion: Ethical dilemmas of nurses are diverse, and the use of care and justice reasoning is differentiated according to the type of dilemma. Care reasoning dominates nurses’ ethical decision-making when responding to the needs of patients. Nurses use justice reasoning when they apply regimens, rules and procedures. In everyday ethics, care and justice reasoning complement each other. Conclusions: Highly regulated healthcare environments prefer rule-oriented justice reasoning that may supersede care reasoning in addressing patients’ situations. Focus on technical-professional expertise may further hamper nurses’ ethical decision-making. Nursing education and management should encourage nurses to use ethical concepts and values in their work. (shrink)