Limitations and alternatives: ethical practice theory in nursing

Area of Science:

• Nursing Ethics
• Moral Decision-Making
• Theoretical Frameworks

Background:

• Selecting a theoretical framework prematurely can limit research findings in nursing.
• Kohlberg's theory, often used for nursing ethics, may not align with nurses' experiences.
• Kohlberg's ethic of justice contrasts with Gilligan's findings on women's ethic of care.

Purpose of the Study:

• To explore the limitations of prematurely applying theoretical frameworks in nursing theory building.
• To propose an alternative approach for developing nursing ethical practice theories.
• To highlight the importance of aligning theoretical frameworks with the lived experiences of nurses.

Main Methods:

• Critically analyzes the premature application of Kohlberg's theory in nursing ethics.
• Compares Kohlberg's ethic of justice with Gilligan's ethic of care.
• Suggests an inductive approach: describing nurses' moral decision-making before framework selection.

Main Results:

• Premature framework selection can lead to findings that do not reflect nursing reality.
• Kohlberg's justice-based framework may not fully capture the ethical decision-making of nurses, particularly women.
• An ethic of care, as suggested by Gilligan, may be more relevant to nursing practice.

Conclusions:

• Theoretical frameworks should be chosen after, not before, understanding the phenomenon of interest.
• An inductive approach, starting with empirical data from nurses, is recommended for theory development.
• This ensures that nursing theories are grounded in the actual experiences and moral reasoning of nurses.