Seminar

 
SUBMITTED TO :- SUBMITTED BY:-
Dr. Renju Sussan Baby Khushboo
Associate Professor MSC Psychiatry Nursing 1st year
College of Nursing College of Nursing
AIIMS BBSR AIIMS BBSR
Lawrence Kohlberg
Lawrence Kohlberg

Birthplace: Bronxville, New York, United States

Born: October 25, 1927

Died: January 19, 1987

Nationality: American

Occupation: Psychologist, College Teacher

Moral development
Moral development is the process thought which children develop
proper attitudes and behaviours toward other people in society, based on
social and cultural norms, rules, and laws.
MORALS VALUES
Morals are more of a societal Values are a more individual view
view of right or wrong. of right or wrong.
Development of moral theory

Jean Piaget – cognitive

theory
 Kohlberg’s Stages of Moral Development
Moral development theory

level - 1 level - 2 level -3

(pre-conventional) (conventional) (post-conventional)

stage 1 - punishment and stage 3 - interpersonal stage 5- social contract

obedience orientation concordance orientation legalistic orientation

stage 2 - stage 6 - universal

instrumental stage 4- law and order ethical principle
relativist orientation orientation
orientation
Level 1: pre – conventional (Prominent from Ages 4 to 10 Years)

• Common in children.

• Reasoners in the pre-conventional level judge the morality of an action

by its direct consequences.

• Purely concerned with the self in an egocentric manner.

 Stage 1: Punishment and Obedience Orientation

• The individual is responsive to cultural guidelines of good or bad and right

or wrong, but primarily in terms of the known related consequences.
• Individuals focus on the direct consequences that their actions will have for
themselves.
• The individual at the first stage does not understand or care that other people
can have similar wishes and desires besides their own desires. Thus, the
person in this stage acts in an egoist manner.
 Stage 2: Instrumental Relativist Orientation
• Behaviors at the instrumental relativist orientation stage are guided by
egocentrism and concern for self.

• Intense desire to satisfy one’s own needs, but occasionally the needs of others
are considered.

• Decisions are based on personal benefits derived.

• Limited interest in the needs of others, but only to a point where it might
further one's own interests, such as you scratch my back, and I'll scratch yours.
Level II: Conventional Level (Prominent from Ages 10 to 13
Years and Into Adulthood)
• The individual has a motivation that is concerned with mutual relations
and expectations.
• The main motivation is to be accepted and socially approved by others
and, in this context, to fulfil the orders of those who are hierarchically
superior.
• Therefore, at this level, people define interpersonal relations through their
place in society.
 Stage 3: Interpersonal Concordance Orientation

• Guided by the expectations of others.

• Approval and acceptance within one’s societal group provide the incentive
to conform.
• Individuals are receptive of approval or disapproval from other people as
it reflects society's accordance with the perceived role.
 Stage 4- law and order orientation
• It is important to obey laws, dictums and social conventions because of their
importance in maintaining a functioning society.
• Moral reasoning in stage four is thus beyond the need for individual
approval exhibited in stage three; society must learn to transcend individual
needs.
• A central ideal or ideals often prescribe what is right and wrong, such as in
the case of fundamentalism.
.
 Level : 3 post conventional stage (can occur from
adolescence onward)
• Principled level.

• Realization that individuals are separate entities from society now becomes salient.

• One's own perspective should be viewed before the society’s, sometimes mistaken for
pre-conventional behaviors.

• This stage corresponds to a universal set of moral principles that all people must follow,
according to Kohlberg, and moral superiority is characterized as reaching this stage.
 Stage 5: Social Contract Legalistic Orientation

• Individuals developed a system of values and principles that determine for

them what is right or wrong.
• 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.
Stage 6: Universal Ethical Principle Orientation
• Behavior at stage 6 is directed by internalized principles of honour,
justice, and respect for human dignity.
• They are not the concrete rules established by society.
• The allegiance to these ethical principles is so strong that the individual
will stand by them even knowing that negative consequences will result.
 Further stages
• Moral stage regression.
• Postulates the existence of sub-stages wherein the emerging stage has
not yet been adequately integrated into the personality.
• A stage 4½ or 4+, which is a transition from stage four to stage five,
sharing characteristics of both. Individual has become disaffected with
the arbitrary nature of law and order reasoning.
• Seen in students entering college.
Further stage (cont.)
Seventh stage may exist (Transcendental Morality or Morality of
Cosmic Orientation)

- religion with moral reasoning.

Further stage (cont.)
• Stage 0
The good is what I like and want (0-2yrs). Infants and young toddlers
are egocentric, liking or loving that which helps them and disliking or
hating that which hurts them.
 FORMAL ELEMENTS

stages
View of Persons Social perspective
6 Sees how human fallibility and frailty are Mutual respect as a universal
impacted by communication principle
5 Recognize that contracts will allow
persons to increase welfare of both Contractual perspective

4 Able to see abstract normative systems Social systems perspective

3 Recognize good and bad intentions Social relationships perspective

Sees that – other have goals and preferences,
2 Instrumental egoism
- Either conform to or deviate from norms
Only confined to self & norms are
1 recognised Blind egoism
 Theoretical assumptions (philosophy)
Kohlberg's theory is not value-neutral. This includes for instance a view
of human nature, and a certain understanding of the form and content of
moral reasoning. Finally, it takes a view of the social and mental
processes involved in moral reasoning.
 Theoretical assumptions (cont.)

The picture of human nature which Kohlberg begins with is the view that
humans are inherently communicative and capable of reason, and they
possess a desire to understand others and the world around them.
Theoretical assumptions (cont.)

Kohlberg's theory revolves around the notion that justice is the

essential feature of moral reasoning. Despite being a justice-centered
theory of morality, considered it to be compatible with plausible
formulations of deontology and eudaimonia.
Theoretical assumptions (cont.)

Kohlberg's theory understands values as a critical component of the

right. Whatever the right is, for Kohlberg, it must be universally valid
across societies (a position known as " moral universalism"): there can
be no relativism. Moreover, morals are not natural features of the
world; they are prescriptive. Nevertheless, moral judgments can be
evaluated in logical terms of true and falsity.
Theoretical assumptions (cont.)

A person who progresses to a higher stage of moral reasoning cannot

skip stages(4).
Critics
Androcentric
Critics (cont.)
• Other psychologists have questioned the assumption that moral action
is primarily reached by formal reasoning.
• Kohlberg’s basic work largely ignores both social experience and the
more emotional sides of experience, such as empathy, love and
feelings of belonging(5).
 Critics (cont.)
Cultural Bias

Many critics have determined that Kohlberg’s Theory is highly western

culture based. Many believe that Kohlberg’s theory does not support the
beliefs and cultural values that other societies may hold in high regard.
Relevance of Moral Development Theory to Nursing Practice

• Psychiatric nurses must be able to assess the level of moral development of their clients in
order to be able to help them in their effort to advance in their progression toward a higher
level of developmental maturity.
Relevance (cont.)
• Kohlberg’s theory provides a framework for examining how nurses
make ethical decisions and, more specifically, whether they are able to
permanently and critically reflect on their practice in terms of ethical
principles.

• The ethics of nursing are derived from the moral development theory.
Heinz dilemma

• A dilemma that Kohlberg used in his original research was the

druggist's dilemma: Heinz Steals the Drug In Europe.
 Heinz dilemma
• A woman was near death from a special kind of cancer. There was one
drug that the doctors thought might save her.
• It was a form of radium that a druggist in the same town had recently
discovered.
• The drug was expensive to make, but the druggist was charging ten
times what the drug cost him to produce.
• He paid $200 for the radium and charged $2,000 for a small dose of the
drug.
Heinz dilemma (CONT.)
• The sick woman's husband, Heinz, went to everyone he knew to
borrow the money, but he could only get together about $ 1,000 which
is half of what it cost.
• He told the druggist that his wife was dying and asked him to sell it
cheaper or let him pay later. But the druggist said: "No, I discovered
the drug and I'm going to make money from it." So Heinz got
desperate and broke into the man's store to steal the drug-for his wife.
 Stage 1 (obedience)
• Heinz should not steal the medicine because he will consequently be put in prison which means
you are really terrible.
• or
• He should steal the medicine because it only worth 200 dollars, Heinz had offered to pay for it
and was not stealing anything else besides.

Stage 2 (self-interest)
• Heinz should steal the medicine because he will be much happier if he saves his wife, even if he
will have to serve a prison sentence.
• Or
• Heinz should not steal the medicine because prison is a awful place, and he would probably
languish over a jail cell more than his wife's death.
 Stage 3 (conformity)
• Heinz should steal the medicine because his wife expects it; he wants to be a good husband.
• Or
• Heinz should not steal the drug because stealing is bad and he is not a criminal; he tried to do
everything he could without breaking the law, you cannot blame him.

Stage 4 (self-interest)
• Heinz should not steal the medicine because the law prohibits stealing making it illegal.
• Or
• Heinz should steal the drug for his wife but also take the prescribed punishment for the crime
as well as paying the druggist what he is owed. Criminals cannot just run around without
regard to the law; actions have consequences.
 Stage 5 (human rights)
• Heinz should steal the medicine because everyone has a right to choose life,
regardless of the law.
• Or
• Heinz should not steal the medicine because the scientist has a right to fair
compensation. Even if his wife is sick it does not make his actions right.
Stage 6 (universal human ethics)
• Heinz should steal the medicine, because saving a human life is a more
fundamental value than the property rights of another person.
• Or
• Heinz should not steal the medicine, because others may need the medicine just
as badly, and their lives are equally significant
 Reference
Journals :
1. Sex Differences in the Development of Moral Reasoning: A Critical Review on JSTOR [Internet]. [cited 2021 Apr 17]. Available from:
https://www.jstor.org/stable/1130121?seq=1

2. Stages of Moral Development - Lawrence Kohlberg - Educational Technology [Internet]. [cited 2021 Apr 17]. Available from:
https://educationaltechnology.net/stages-of-moral-development-lawrence-kohlberg/

3. Kohlberg-Lesson.pdf [Internet]. [cited 2021 Apr 17]. Available from:

http://blogs.butler.edu/katherinelinportfolio/files/2013/06/Kohlberg-Lesson.pdf

4. Moral Reasoning of Education Students: The Effects of Direct Instruction in Moral Development Theory and Participation in Moral
Dilemma Discussion | Request PDF [Internet]. [cited 2021 Apr 17]. Available from:
https://www.researchgate.net/publication/242491627_Moral_Reasoning_of_Education_Students_The_Effects_of_Direct_Instruction_in_
Moral_Development_Theory_and_Participation_in_Moral_Dilemma_Discussion

5. Kohlberg’s Theory of Moral Development and Its Relevance to Education: Scandinavian Journal of Educational Research: Vol 23, No
2 [Internet]. [cited 2021 Apr 17]. Available from: https://www.tandfonline.com/doi/abs/10.1080/0031383790230202?journalCode=csje20

6. Moral Development | Lifespan Development [Internet]. [cited 2021 Apr 17]. Available from:
https://courses.lumenlearning.com/wm-lifespandevelopment/chapter/kohlbergs-stages-of-moral-development/
 Reference (cont.)
BOOKS :

1. Mary C. Townsend 8th edition mental health psychiatric nursing page no. 28-32.

2.Psychology by Pearson 5th edition K. Ciccarelli page no. 324- 356.

3. Marlow’s Textbook of Paediatric nursing , Dorothy R. Marlow 6th edition page no. 111-113.