Care-based ethical reasoning among first-year nursing and social services students

This paper is a report of a study conducted to describe nursing and social services students' ethical reasoning at the start of their studies.

Gilligan argued that there are two modes of moral reasoning - the ethic of justice, focusing on individuals' rights, and the ethic of care, focusing on responsibilities in relationships. Recent research has established the ethic of care as a developmental phenomenon. It has been widely argued that the ethic of care is crucial for nursing, but there has been little international research in this area.

Participants were first-year nursing and social services students in Finland (N =112). Their care-based moral reasoning was measured using the Ethic of Care Interview, and their ethical reasoning on an abortion-related dilemma was analysed by content analysis. Expressed ethical codes and principles were calculated according to levels. The data were collected over a 5-month period in 2007-2008.

Students' level of care reasoning was varied. Their current level of care reasoning was reflected in their responses to the ethical dilemma. Ethical reasoning at each level and its specific premises constituted a distinct entity. Use of the principle of self-determination was positively related to levels of care development. Care-based moral reasoning constitutes the bedrock for ethical reasoning among these novice students.

Educators should be sensitive to the variation in students' current developmental levels in care reasoning. Reflective discussion on real-life ethical conflicts should be an explicit part of education and clinical practice in caring professions.