The Moral Orientations of Justice and Care among Young Physicians  

Oleh:

Self, Donnie J. ; Jecker, Nancy S ; Baldwin, DeWitt C

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Cambridge Quarterly of Healthcare Ethics (keterangan: ada di Proquest) vol. 12 no. 01 (2003), page 54.

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Perpustakaan FK Nomor Panggil: C01.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. 1 Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.2 There have been a number of studies in recent years describing the moral reasoning of medical students and healthcare professionals.3,4 Some of the studies have assessed educational interventions designed to increase moral reasoning, and some have compared various methodologies for teaching medical ethics.s,6 In contrast to the moral reasoning of medical students and healthcare professionals, there have been virtually no published reports on the moral orientation of medical students and healthcare professionals. The distinction between moral reasoning and moral orientation has been discussed elsewhere in a report on veterinarians7 but is briefly described as follows. As derived from the cognitive moral-development theory of Kohlberg, moral reasoning is the degree to which one employs the use of the principle of justice or relies on the concept of justice in resolving moral conflicts. Based on the pioneering work of Piaget and Dewey, Kohlberg devised a moral-development theory involving six stages of moral development.8,9 His work has gained wide attention and has been validated by multiple studies substantiating his stagetheory claims.lO These studies report evidence for the universality of moral reasoning across 26 Asian and Western cultures in both the Northern and Southern hemispheresy,12 Kohlberg's theory articulates a hierarchical sequence of moral reasoning, culminating with justice reasoning as the highest moral value.B In response to Kohlberg's theory, which regards justice as the moral ideal, Gilligan formulated a moral-development stage theory that holds care as the moral ideap4 In Kohlberg's model, what is morally right is defined by justice, fairness, and independent principle guidedness, whereas in Gilligan's model, moral rightness is interpreted to mean care, relatedness, and refraining from doing harn or violence. Lacking comparable empirical support for her stage theory, Gilligan later moved away from the concept of moral stages. Rather, she began to emphasize the concept of moral orientation or moral voice, for which she does have empirical evidence. IS Moral orientation refers to the framework in which a moral dilemma is perceived and described. Gilligan has identified two moral voices or orienta

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