Tuesday, March 27, 2012

Lawrence Kholberg and Stages of Moral Reasoning

Lawrence Kohlberg's Stages of Moral Development was derived from the work of Swiss Psychologist, Jean Piaget.  Piaget claimed that moral development coincided with the development of schema and stages of reasoning in other regards.
Moral reasoning (cognitively, socially and emotionally influenced, the basis of ethical behaivour was divided into six stages:
Preconventional level (morality is due to external controls)
Stage 1 - Punishment and Obedience; child`s limitted thinking bases moral decisions upon fear or self interest.
Stage 2 - Relativistic orientation; child moves from fear of punishment to concern for fairness, rewards obtained
               by bartering
Conventional level of morality (morality as rules for society`s order)
Stage 3 - Social approval
Stage 4 - Maintains laws of system; teen and adult move from preoccupation with what is ``fair`for individuals      
               to factor in conformity to society`s needs; social conscience
Postconventional principled level (morality as value defined)
Stage 5 - Society`s good paramount
Stage 6 - Universal ethics; focus on justice, fairness; recognition of other`s moral standards

Carol Gilligan asserted that male and female moral development diverged. She agreed with Kolhberg`s developmental until age 7-11 when she felt Ethic of caring in girls - Girl`s goals focuses upon compassion, relationships and responsibilities, not better but different from boys. She felt the Ethics of Justice in boys dominated with Boy`s goal bing rationally committing to moral ideals of justice.

An integrated approach to moral development saw five stages of conceptualization<
1) morality of restraint
2) morality of mastery
3) morality of virtuous striving
4) idealization
5) individual responsibility

The philosophical assumptions underlying were that his stages fit `moral reasoning`and not `moral conclusions`.  He insisted that the form and structure of moral arguments is independent of the content. In psychiatry this commonly described as `process``
Kohlberg`s theory centered on the notion that justice is the essential characteristic of moral reasoning.
He further considered that moral judgements could be evaluated logically.
According to Kohlberg one did not `skip`developmental stages but rather movd to higher level of moral reasoning by increasing competence.

In 1979, the Defining Issues Test, based on Kholberg,  was created by James Rest.  In 1999 it was revisd as the DIT-2.

I first studied these stages in the mid 80s during my psychiatry residency.   Later  in preparation for my Master of Divinity I would review this material.  I believe Gilligan`s work has not stood the test of time as well as Kohlberg`s.  Goldberg`s book Emotional Intelligence added to their understanding .I found them all to be useful and applicable to understanding clinical moral dilemnas my patients faced and helpful for my patients to see them as such.  

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