Advertisement

Advertisement

Moral Courage: A Sociological Perspective

  • Culture and Society
  • Published: 26 February 2018
  • Volume 55 , pages 181–192, ( 2018 )

Cite this article

  • Eyal Press 1  

1585 Accesses

8 Citations

Explore all metrics

While many social scientists have written about obedience and conformity, few have analyzed the conduct of outliers and nonconformists who defy these forces by engaging in acts of moral courage. Among psychologists and philosophers, moral courage is often portrayed as an individualistic phenomenon that is immune to sociological analysis. This paper challenges this view, positing that social ties with like-minded coconspirators, an identification with ‘imagined others’ who espouse similar moral beliefs, and social interactions that awaken the conscience play a crucial role in facilitating these seemingly solitary acts. Drawing on two original case studies – a border guard who defied a restrictive immigration law on the eve of World War II, and a Serb who crossed the lines of ethnic division during the Balkan wars of the 1990s – the article illuminates the social dimensions of moral courage and contributes to the project of developing a social psychology of conscience.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price includes VAT (Russian Federation)

Instant access to the full article PDF.

Rent this article via DeepDyve

Institutional subscriptions

Similar content being viewed by others

case study moral courage with a family disruption

Talcott Parsons and the Sociology of Morality

Raquel Weiss & Jayme Gomes Neto

case study moral courage with a family disruption

Situated Moral Practice: Resisting Authority in Stanley Milgram’s “Obedience” Experiment

case study moral courage with a family disruption

Sociology as the Study of Morality

This account and the case study that follows both draw on a book published by the author in 2012.

Further Reading

American Civil Liberties Union. 2015. ACLU Edward Snowden Survey: Millennial Findings. Available at: https://www.aclu.org/snowden-poll-results

Anderson, B. 1983. Imagined Communities: Reflections on the Origins and Spread of Nationalism . Lonson: Verso.

Google Scholar  

Arendt, H. 1963. Eichmann in Jerusalem: A Report on The Banality of Evil . New York: Viking Press.

Arendt, H. 1972. Crises of the Republic: Lying in Politics; Civil Disobedience; On Violence; Thoughts on Politics and Revolution . New York: Harcourt Brace Jovanovich.

Bamford, J. 2013. August 15. They Know Much More Than You Think. New York Review of Books, 60 (13).

Baron, L. 1986. The Holocaust and Human Decency: A Review of Research on The Rescue of Jews in Nazi Occupied Europe. Humboldt Journal of Social Relations , 13 , 237–251.

Bauer, Y. 1978. The Holocaust in Historical Perspective . Seattle: University of Washington Press.

Bauman, Z. 1989. Modernity and The Holocaust . Ithaca, NY: Cornell University Press.

Bejski, M. 1989. The ‘Righteous Among the Nations’ and Their Part in the Rescue of Jews. In M. R. Marrus (Ed.), The Nazi Holocaust: Public Opinion and Relations to the Jews in Nazi Europe (pp. 430–453). Westport, CN: Meckler.

Brooks, D. 2013. June 10. The Solitary Leaker. New York Times.

Dindo, R. 1997. Gruninger’s Fall. Lea Produktion GmbH.

Drakulic, S. 1993. The Balkan Express: Fragments from the Other Side of War . New York: W.W. Norton & Co.

Durkheim, E. 1964. The Rules of Sociological Method . New York: The Free Press.

Earle, W. 1970. Some Paradoxes of Private Conscience as a Political Guide. Ethics, 80 (4), 306–312.

Article   Google Scholar  

Flyvbjerg, B. 2006. Five Misunderstandings about Case-Study Research. Qualitative Inquiry , 12 , 219–245.

Fogelman, E. 1994. Courage and Conscience . New York: Anchor Books.

Fromm, E. 1941. The Fear of Freedom . New York: Farrar & Rinehart.

Geras, Norman. 1995. “Richard Rorty and the Righteous Among the Nations.” Journal of Applied Philosophy 12: 151–173.

Glazer, P. M., & Glazer, M. P. 1989. The Whistleblowers: Exposing Corruption in Government and Industry . Basic Books.

Goodstein, L., & Yardley, J. 2015. September 20. Pope Francis Met with Kim Davis, Kentucky County Clerk, in Washington. New York Times .

Greenwald, G. 2014. No Place to Hide . New York: Metropolitan Books.

Gross, M. L. 1994. Jewish Rescueh in Holland and France during the second world war: Moral Cognition and Collective Action. Social Forces , 73 , 463–486.

Hallie, P. 1994. Lest Innocent Blood Be Shed: The Story of the Village of Le Chambon and How Goodness Happened There . New York: Harper Perennial.

Hamilton, V. L., & Kelman, H. 1989. Crimes of Obedience: Toward a Social Psychology of Authority and Responsibility . New Haven: Yale University Press.

Harding, L. 2014. The Snowden Files: The Inside Story of the World’s Most Wanted Man . New York: Vintage.

Hilberg, R. 1992. Perpetrator, Victims, Bystanders: The Jewish Catastrophe, 1933–1945 . New York: HarperCollins.

Hitlin, S. 2008. Moral Selves, Evil Selves: The Social Psychologic of Conscience . New York: Palgrave MacMillan.

Book   Google Scholar  

Hitlin, S., & Vaisey, S. 2013. The NEW Sociology of Morality. Annual Review of Sociology , 39 , 51–68.

Hoffman, M. 2011. Does Higher Income Make You More Altruistic? Evidence from the Holocaust. The Review of Economics and Statistics , 93 , 876–887.

Huneke, D. 1981-1982. A study of Christians who rescued Jews during the Nazi era. Humboldt Journal of Social Relations , 9 (1), 144–150.

Kennedy, J. F. 1955. Profiles in Courage . New York: Harper & Brothers.

Kidron, P. 2004. Refusenik: Israel’s Soldiers of Conscience . London: Zed Books.

Linn, R. 1996. Conscience at War: The Israeli Soldier as a Moral Critic . Albany: State University of New York Press.

London, P. 1970. The Rescuers: Motivational Hypotheses about Christians who Saved Jews from the Nazis. In J. Macaulay, & L. Berkowitz (Eds.), Altruism and Helping Behavior (pp. 241–250). New York: Academic Press.

Mayer, J. 2011. May 23. The Secret Sharer. New Yorker.

Mead, G. H. 1956. The Social Psychology of George Herbert Mead. In Anselm Strauss (Ed.). Chicago: University of Chicago Press.

Merton, R. K. 1968. Social Theory and Social Structure . New York: The Free Press.

Michnik, A. 1985. Letters from Prison and Other Essays . Berkeley: University of California Press.

Milgram, S. 1974. Obedience to Authority: An Experimental View . New York: Harper & Row Publishers.

Monroe, K. R. 2004. The Hand of Compassion: Portraits of Moral Choice during the Holocaust . Princeton, NJ: Princeton University Press.

Moorehead, C. 2014. Village of Secrets: Defying the Nazis in Vichy France . New York: Harper Collins.

Oliner, S. P., & Oliner, P. M. 1988. The Altruistic Personality: Rescuers of Jews in Nazi Europe . New York: The Free Press.

Osiel, M. 1997. Mass Atrocity Collective Memory and the Law . New Brunswick, NJ: Transaction Publishers.

Packer, G. 2014. May 22. The Errors of Edward Snowden and Glenn Greenwald. Prospect .

Paldiel, M. 2007. Diplomat Heroes of the Holocaust . Jersey City, NJ: KTAV Publishing House.

PEW Research Center. 2014. Obama’s NSA Speech Has Little Impact on Skeptical Public. Available at: http://www.people-press.org/2014/01/20/obamas-nsa-speech-has-little-impact-on-skeptical-public/

Poitras, L. 2014. “Citizenfour.” Participant Media.

Poitras, L., & Snowden, E. 2014. May 7. Edward Snowden and Laura Poitras Take on America’s Runaway Surveillance State. The Nation.

Sidgwick, H. 1913. The Methods of Ethics . London: MacMillan.

Sontag, S. 2007. At the Same Time: Essays and Speeches . New York: Farrar Straus Giroux.

Staub, E. 2003. Notes on Cultures of Violence, Cultures of Caring and Peace, and the Fulfillment of Basic Human Needs. Political Psychology , 24 , 1–21.

Swedberg, R. 1999. Civil Courage (‘Zivilcourage’): The Case of Knut Wicksell. Theory and Society , 28 , 501–528.

Taylor, C. 1989. Sources of the Self: The Making of the Modern Identity . Cambridge, Mass: Harvard University Press.

Tec, N. 1986. When Light Pierced the Darkness: Christian Rescue of Jews in Nazi-Occupied Poland . New York: Oxford University Press.

Thoreau, H D. 1849. Available at: http://www.constitution.org/civ/civildis.htm

Toobin, J. 2013. “Edward Snowden Is No Hero.” The New Yorker . https://www.newyorker.com/news/dailycomment/edward-snowden-is-no-hero .

Walzer, M. 1970. Obligations: Essays on Disobedience, War and Citizenship . Cambridge, Mass: Harvard University Press.

Zimbardo, P. 2007. The Lucifer Effect: How Good People Turn Evil . New York: Random House.

Download references

Author information

Authors and affiliations.

New York University, 295 Lafayette Street, New York, NY, USA

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Eyal Press .

Rights and permissions

Reprints and permissions

About this article

Press, E. Moral Courage: A Sociological Perspective. Soc 55 , 181–192 (2018). https://doi.org/10.1007/s12115-018-0231-4

Download citation

Published : 26 February 2018

Issue Date : April 2018

DOI : https://doi.org/10.1007/s12115-018-0231-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Moral courage
  • Disobedience
  • Nonconformity
  • Find a journal
  • Publish with us
  • Track your research

Moral courage in action: case studies

Affiliation.

  • 1 Drexel University, Philadelphia, PA, USA.
  • PMID: 17907703
  • Advance Directives / ethics
  • Aged, 80 and over
  • Attitude of Health Personnel*
  • Codes of Ethics
  • Ethical Analysis
  • Interprofessional Relations / ethics*
  • Moral Obligations
  • Nurse's Role* / psychology
  • Patient Advocacy / ethics*
  • Personal Autonomy
  • Problem Solving / ethics
  • Professional-Family Relations / ethics*
  • Social Behavior
  • français
  • español
  • português (Brasil)
  • Bahasa Indonesia
  •   Home
  • Philosophy collections
  • Philosophical Ethics

The Library

Moral courage in action: case studies, full record, online access, collections.

entitlement

Export search results

The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.

Moral courage in action: case studies.

  • MLA style: "Moral courage in action: case studies.." The Free Library . 2007 Jannetti Publications, Inc. 15 Apr. 2024 https://www.thefreelibrary.com/Moral+courage+in+action%3a+case+studies.-a0168333900
  • Chicago style: The Free Library . S.v. Moral courage in action: case studies.." Retrieved Apr 15 2024 from https://www.thefreelibrary.com/Moral+courage+in+action%3a+case+studies.-a0168333900
  • APA style: Moral courage in action: case studies.. (n.d.) >The Free Library. (2014). Retrieved Apr 15 2024 from https://www.thefreelibrary.com/Moral+courage+in+action%3a+case+studies.-a0168333900

Terms of use | Privacy policy | Copyright © 2024 Farlex, Inc. | Feedback | For webmasters |

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

  • Advanced Search
  • Journal List
  • ScientificWorldJournal
  • v.2022; 2022

Logo of tswj

A Study of How Moral Courage and Moral Sensitivity Correlate with Safe Care in Special Care Nursing

Fateme mohammadi.

1 Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran

Banafsheh Tehranineshat

2 Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

Afsaneh Ghasemi

3 Department of General Health, Fasa University of Medical Sciences, Fasa, Iran

Mostafa Bijani

4 Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran

Associated Data

The data supporting the findings of the present study are available from corresponding author upon request.

Nursing is a caring profession, and nurses who have moral sensitivity and moral courage presumably can provide safe and better care for patients. This study aims at investigating how moral courage and moral sensitivity correlate with safe care in special care nursing.

This study is a descriptive work of research. The participants consisted of 524 nurses who were in practice in the ICU (intensive care unit), CCU (C\coronary care unit), post-CCU (postcoronary care unit), and dialysis of four hospitals located in the south of Iran selected via census sampling. Data were collected from April to September 2020 using the moral sensitivity questionnaire (MSQ), professional moral courage questionnaire (PMCQ), and the assessment of safe nursing care questionnaire (ASNCQ). The collected data were analyzed using descriptive statistics, t -test, chi-square, multiple regression analysis, and Pearson's correlation coefficient in SPSS v. 22.

The mean ± SD of the nurses' age was 33.89 ± 6.91 years, and the mean ± SD of their work experience was 9.16 ± 4.67 years. The total mean score ± SD of the nurses' moral sensitivity was found to be 93.41 ± 2.68, the total mean score ± SD of their moral courage was found to be 96.38 ± 3.63, and the total mean score ± SD of their safe care scores was found to be 321.80 ± 9.76. The values of Pearson's correlation coefficients showed significant correlations between moral courage and safe care ( r  = 0.54, p < 0.001), moral sensitivity and safe care ( r  = 0.59, p < 0.001), and moral sensitivity and moral courage ( r  = 0.52, p < 0.001).

There is a positive correlation between moral sensitivity and moral courage. Both positively correlated with special care nursing. Accordingly, through effective planning, education, and giving their support, nurse administrators can promote the abovementioned ethical virtues in the nursing staff, thereby improving the quality of care.

1. Introduction

Nurses are among the most important members of healthcare teams whose beliefs and attitudes have a significant impact on the performance of healthcare teams and the quality of care provided by them [ 1 ]. Caring is the essence of nursing and the primary and exclusive purpose of the profession [ 2 , 3 ]. Nursing is defined as a caring profession with six main principles: compassion, trust, commitment, competence, communication, and courage [ 4 , 5 ]. One of the factors that play a major role in the provision of safe, systematic, and quality care is moral courage [ 6 ]. Caring for critically or terminally ill patients, performing invasive care procedures, having to cope with emerging deadly diseases, etc. make it necessary for care providers, including nurses, to possess moral courage [ 7 ]. Moral courage means taking action in accordance with ethical values in spite of hardships and hazards in the face of moral challenges and dilemmas. An individual with moral courage consciously and voluntarily makes decisions and takes actions, which are beneficial to others despite all the negative consequences for them [ 8 , 9 ].

Moral courage is a virtue that is essential for working conscientiously by all care providers, especially nurses. The increasing awareness of care receivers, changes in the healthcare needs of societies, social justice, and access to healthcare services have increased nurses' ethical distress, thus the need for these care providers to possess high levels of moral courage [ 10 ]. Due to the nature of their profession, nurses need to have the moral courage to provide safe, quality care, and avoid unethical behaviors [ 11 ]. Moral courage enables care providers to observe the ethical values and principles of their profession in such situations as maintaining patient privacy, breaking bad news, and caring for patients with infectious diseases [ 12 , 13 ].

To provide safe care, in addition to possessing moral courage, care providers require awareness of ethical principles and moral sensitivity [ 14 ]. As one of the main components of professional competence in nursing, moral sensitivity helps care providers have patience, peace, and a sense of responsibility [ 15 ]. Moral sensitivity is the foundation of ethics in nursing and paves the ground for providing effective and ethical care to patients [ 16 ]. Care providers who have moral sensitivity care for their patients with devotion, they are sensitive to the physical and psychological needs of their patients, and they actively try to find ways of meeting those needs in a safe manner [ 17 ]. According to Khodaveisi et al., there is a significant positive relationship between moral courage and moral sensitivity and between moral courage and safe nursing care in nurses caring for COVID-19 patients. In addition, there is a significant positive relationship between moral sensitivity and safe nursing care [ 18 ].

One of the most important groups of nurses who provide care in critical or emergency situations where patients' lives are at serious risk is special care nurses [ 19 ]. Special care units sometimes have to provide care to patients whose conditions are critical. In this context, moral courage and moral sensitivity can ensure ethical decisions and safe care. Accordingly, this study investigates the correlation between moral courage and moral sensitivity on the one hand and safe care on the other in special care nursing.

2.1. Study Design and Setting

This study is a descriptive, cross-sectional work. The participants consisted of all the nurses who were in practice in the special care units (ICU, CCU, post-CCU, and dialysis) of four university hospitals located in the south of the province of Fars, Iran.

2.2. Population and Sample

Sampling lasted from April to September 2020 and was carried out according to the census sampling. Accordingly, 635 nurses in practice in special care units were invited to participate in the study; 524 of the participants completed and returned the questionnaires. Thus, the response rate was 82.51%. The inclusion criteria were being willing to participate and having at least one year's work experience. The subjects who failed to answer over half of the questions on the questionnaires and did not return the questionnaires were excluded.

2.3. Ethical Considerations

This study has been approved by the ethics committee of the Fasa University of Medical Sciences with the ethical code (IR.FUMS.REC.1399.098). All participants were informed of the objectives of the study and asked to sign the consent form. They were also assured that all their information would remain anonymous and confidential.

2.4. Data Collection

Data were collected using the following tools.

2.5. The Moral Sensitivity Questionnaire (MSQ)

Developed by Lutzen et al. in 1994, the moral sensitivity questionnaire consists of 25 items in 6 domains. Each item is scored on a 5-point Likert scale, ranging from “completely agree” (4 points) to “completely disagree” (0 points); the total score range is between 0 and 100. The 6 subscales of the questionnaire are as follows: (1) respect for patients' autonomy, (2) familiarity with the principles of communicating with patients, (3) professional knowledge, (4) experience of moral conflicts, (5) use of ethical concepts in ethical decision-making, and (6) honesty and benevolence [ 20 ]. A score between 0 and 50 indicates low moral sensitivity, a score between 51 and 75 indicates average moral sensitivity, and a score between 76 and 100 indicates high moral sensitivity. In Iran, the moral sensitivity questionnaire has been found to possess content and face validity. The reliability of the tool equals Cronbach's alpha of 0.83 [ 21 ].

2.6. The Professional Moral Courage Questionnaire (PMCQ)

The professional moral courage questionnaire was developed by Sekerka et al. in 2009. The scale consists of 15 items addressing 5 dimensions: moral agency (tendency to perform ethical acts and being prepared and able to face and cope with ethical issues) (3 items), multiple values (ability to combine one's own values with professional and organizational values and giving priority to professional values) (3 items), the endurance of threat (ability to identify threatening situations and to endure and overcome them) (3 items), going beyond compliance (willingness to perform ethical acts despite barriers and peripheral pressures at work) (3 items), and moral goals (setting personal goals based on respect, honesty, giving priority to patients, and accepted ethical values in the profession) (3 items). Each item is scored on a 7-point Likert scale, ranging from “never true” (1 point) to “always true” (7 points)—the total score range is between 15 and 105. A score between 15 and 50 indicates low professional moral courage, a score between 51 and 75 indicates average professional moral courage, and a score between 76 and 105 indicates high professional moral courage [ 22 ]. In Iran, Mahdaviseresht et al. verified the reliability of the scale with Cronbach's alpha of 0.81 [ 23 ].

2.7. The Assessment of Safe Nursing Care Questionnaire (ASNCQ)

Developed by Rashvand et al. in 2017, the assessment of safe nursing care questionnaire is a local instrument based on the healthcare system of Iran. The validity of the scale has been tested and verified by the faculty members of several medical schools. Cronbach's alpha of ASNCQ has been found to be 0.97, which demonstrates the high reliability of the scale. According to Rashvand et al., ASNCQ is a general scale that can be used for all subjects, free of inclusion criteria. The instrument consists of 32 items in 4 parts: part 1 addresses nursing skills (16 items), part 2 deals with the assessment of patients' psychological safety (4 items), part 3 deals with the assessment of patients' physical safety (7 items), and part 4 evaluates nurses' teamwork skills (5 items). All the items are scored on a 5-point Likert scale: never (1 point), seldom (2 points), sometimes (3 points), frequently (4 points), and always (5 points). The questionnaire also shows the loading of each item: the loading of items 14, 18, 19, 20, and 32 equals 1, the loading of items 2, 3, 4, 5, 7, 10, 11, 12, 13, 15, 16, 17, 21, 26, and 30 equals 2, the loading of items 1, 6, 8, 9, 23, 24, 25, 27, 29, and 31 equals 3, and the loading of items 22 and 28 equals 4. Thus, the respondent's score for each item is multiplied by the loading of that item and the resultant value is considered for evaluation. A score between 73 and 170 indicates poor performance, a score between 171 and 267 indicates average performance, and a score between 268 and 365 indicates satisfactory performance [ 24 ].

2.8. Data Analysis

The collected data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) in SPSS v. 22. The researchers used the chi-square test, independent t -test, and Pearson's correlation coefficients to study the relationship between moral courage, moral sensitivity, safe care, and demographic variables in special care nursing. The level of significance was set at P < 0.05. Next, the variables of demographics, moral courage, and moral sensitivity, which were found to correlate with safe care ( P < 0.05), were entered into multivariate linear regression with the backward technique.

A total of 524 nurses participated in this study. The mean ± SD of the nurses' age was 33.89 ± 6.91 years, and the mean ± SD of their work experience was 9.16 ± 4.67 years. Table 1 shows the participants' demographic characteristics. The total mean score ± SD of the nurses' moral sensitivity was found to be 93.41 ± 2.68, the total mean score ± SD of their moral courage was found to be 96.38 ± 3.63, and the total mean score ± SD of their safe care scores was found to be 321.80 ± 9.76. Table 2 shows the participants' mean scores for each dimension of moral sensitivity and moral courage. The calculated Pearson's correlation coefficients showed significant and direct correlations between safe care on the one hand and the demographic variables of age ( r  = 0.45, p < 0.001), and work experience ( r  = 0.42, p < 0.001).

The demographic characteristics, moral sensitivity' scores, moral courage' scores, and safe care' scores based on the demographic characteristics.

Means and standard deviations of the participants' scores for the domains of moral sensitivity, moral courage, and safe care.

Moreover, the Pearson's correlation coefficients showed a significant and direct correlation between the participants' moral courage scores and safe care scores ( r  = 0.54, p < 0.001). There were also significant and direct correlations between the participants' moral sensitivity and safe care ( r  = 0.59, p < 0.001) and moral sensitivity and moral courage ( r  = 0.52, p < 0.001).

The results of the study showed that among the domains of moral sensitivity, use of ethical concepts and familiarity with interpersonal communication skills had a small and negative correlation with safe care ( r  = −0.17, p < 0.008 and r  = −0.27, p < 0.001, respectively). Among the domains of moral courage, moral goals and going beyond compliance had a negative and small correlations correlate with safe care ( r  = -0.24, p < 0.002 and r  = −0.27, p < 0.001, respectively).

The results of multiple regression analysis showed that, overall, the variables of demographic characteristics, moral sensitivity, and moral courage explained 60% of the variance of the total safe care scores ( Table 3 ).

Predictors of safe care in special care nursing.

4. Discussion

This study was conducted to investigate the correlation between moral sensitivity and moral courage on the one hand and safe nursing care on the other. The results of the study showed that moral sensitivity and moral courage significantly correlated with safe care. In addition, there was a significant correlation between moral sensitivity and moral courage.

In the study of Kleemola et al., the nurses state that the situations in which moral courage is required are centered on safe care. Such situations are often related to having a verbal communication, engaging with patients, and engaging with managers and doctors. The participants also state that moral courage-based care is characterized by showing respect for patients, alleviating their pain, treating patients equally, and maintaining patients' dignity [ 25 ]. According to Gallagher, promotion of moral courage can improve the quality of healthcare [ 26 ]. Nurses who possess moral courage are always present at their patients' side, view their patients as human beings with various needs, empathize with their patients, and care about their interactions with their patients [ 27 , 28 ]. Thus, by showing moral courage when defending patients' rights, nurses can have a direct impact on patients' safety [ 29 ].

The findings of the present study showed the moral courage status of the nurses to be satisfactory. The participants' highest mean scores were for the following dimensions of moral courage (in descending order): moral goals, tolerating the threat, and moral agency. Only the dimension of moral goals was found to significantly correlate with safe care. The dimension of moral goals is associated with the use of goal-setting strategies toward benefiting others, giving priority to others' needs over one's own needs, and following ethical values and principles in practice [ 30 ].

Endurance of threat is related to the ability to cope with the reactions of one's colleagues and the significance of maintaining one's professional and personal status [ 31 ]. Moral agency is connected with having a sense of responsibility and managing difficult situations. This appears to be an important dimension as nurses with greater moral agency provide better care to patients because they are better capable of managing and resolving moral conflicts in complex ethical situations [ 32 ]. It seems that the application of goal-setting strategies by the special care nurses in the present study has been more significant in their observance of ethical principles toward providing safe care.

Another finding of the present study is a significant correlation between moral sensitivity and safe care: the higher the nurses' moral sensitivity, the safer the nature of care they give. Similarly, Mohammadi et al. reported that nurses who possess enough moral sensitivity could create an atmosphere in which patients not only have their rights respected but also feel safe in these conditions, and the goals of healthcare can be accomplished [ 33 ]. Amiri et al. do not report a significant correlation between moral sensitivity and safe care, but they report a significant inverse correlation between “experience of ethical conflicts”—one of the domains of moral sensitivity—and quality of care. It appears that nurses who practice ethical decision-making are faced with a conflict between their personal and ethical values and, therefore, suffer from ethical tension. If this tension is not coped with properly, it can lead to nurses' distancing themselves from their patients and feeling indifferent to ethical care [ 34 ]. Stressing the significance of moral sensitivity in their study, Razzani et al. state that in order for ethical principles and rules to be observed in healthcare environments, caregivers need to be aware of and sensitive to these principles—only then can care be provided effectively [ 35 ]. According to the study of Escolar-Chua, there is a significant positive correlation between nursing students' moral sensitivity and ethical tension: the students who had experienced ethically distressing situations had an understanding of other caregivers' performance and the ethical factors that affected patients' conditions. In conclusion, the nursing profession is inherently sensitive to other people's needs [ 36 ].

The findings of the present study showed the moral sensitivity mean score of the nurses to be satisfactory. Among the domains of moral sensitivity, honesty and benevolence, use of ethical concepts, and familiarity with interpersonal communication skills were the areas where the participants scored the highest. The results also showed that the dimensions of use of ethical concepts and familiarity with interpersonal communication skills significantly correlated with safe care. In most studies conducted in other countries, the nurses' highest mean scores are for the use of ethical concepts [ 37 , 38 ]. In the study of McDonald et al., the interactions between nurses and patients are often influenced by the dominant work culture that is the outcome of the relationships between nurses, their colleagues, the authorities, patients, and the organization [ 39 ]. According to a study in Iran, compliance with ethical principles in clinical decision-making is not satisfactory and nurses are not capable of employing their ethical knowledge in real settings [ 40 ]. In the present study, however, the moral sensitivity scores of the nurses were satisfactory and honesty and benevolence were considered to be important. The culture of supporting nurses in the special care units in the present study caused the nurses to promote ethical practice and interpersonal communication. According to the study of Amiri et al., the moral sensitivity mean score of nurses in internal wards is considerably high [ 41 ]. The findings of the study of Ohnishi et al. show that nurses in the psychiatrist units of hospitals in Finland and Japan have high levels of moral sensitivity [ 42 ].

On the other hand, a few studies report nurses' moral sensitivity to be average or below average [ 40 – 43 ]. This discrepancy can be attributed to cultural and organizational differences and, more importantly, to differences between diseases and care units. Patients' physical and psychological conditions can influence nurses' moral sensitivity—the nurses who are in practice in special care and psychiatric units report higher levels of moral sensitivity than the nurses in other units [ 44 ]. The findings of the present study also show a statistically significant correlation between moral courage and moral sensitivity. Likewise, Watkins et al. report a significant positive correlation between moral courage and moral sensitivity [ 45 ]. This means that an increase in nurses' moral sensitivity correlates with an increase in their moral courage. In the study of Hannah et al., moral courage is reported to significantly correlate with ethical behaviors [ 46 ].

In addition, it seems that moral sensitivity can cause ethical distress and if nurses possess moral courage, acting ethically will reduce their ethical distress. All these factors are indirectly inter-related [ 47 , 48 ].

The findings of the present study show a positive relationship between special care nurses' work experience and age on the one hand and moral courage and moral sensitivity on the other, which is consistent with the study of Ebadi et al. This relationship can be attributed to more experienced nurses' better familiarity with organizational conditions, higher professional and moral competence, and adoption of courageous behaviors displayed by their colleagues in clinical environments [ 49 ]. Similarly, the results of the study by Khodavesi et al. show that age and work experience positively correlate with moral sensitivity, moral courage, and safe nursing care in COVID-19-specific hospital departments. However, Khodavesi et al. did not find the relationship between age on the one hand and moral sensitivity and moral courage on the other to be significant, which is inconsistent with the findings of the present study [ 18 ].

Hanifi et al. report a significant relationship between moral courage and gender in nursing students [ 50 ]. Similarly, a few other studies claim that gender influences individuals' level of awareness regarding ethics and current norms: men are more likely to display courageous behaviors, while women tend to behave more humbly and conservatively [ 23 – 51 ].

According to the findings of the present study, safe care significantly correlates with age, gender, education, work experience, and the unit where nurses work. A safe healthcare system relies on measures that ensure nursing interventions are free from error and any unwanted consequences. In the study of Kim, the results show a significant relationship between nurses' education, age, professional experience, experience of safety accidents, and job satisfaction on the one hand and safe care activities on the other [ 52 ].

Similarly, Mwachofi et al. reported a significant correlation between nurses' perception of safe care and their age: older nurses are less familiar with safe care [ 53 ]. Kalantari et al. did not find the relationship between nurses' place of work, gender, type of employment, work shifts, and participation in workshops on the one hand and their professional performance on the other to be statistically significant [ 54 ]. However, the study of Beeman titled “The Educational Needs and Management of Military Nurses,” shows a significant correlation between nurses' providing safe care and their age and work experience [ 55 ]. The majority of the nurses who participated in the present study were young and, since education on codes of ethics in patient care has been added to the nursing curriculum in recent years, the young and less experienced nurses seemed to have a better understanding of moral sensitivity and moral courage in providing care to patients. In addition, nurses with higher education have a better understanding of moral sensitivity and moral courage in providing safe care.

The results of the study showed that the most powerful predictor of safe care was the unit where the nurses worked. The second best predictor of safe care was nursing skills. Special care units are among the most sensitive hospital environments where nurses play a significant role. However, the available literature does not provide much information about clinical measures intended to increase the safety of patients in special care units [ 56 ]. The study of Jin and Yi recommends that healthcare personnel should be given continuous education and that their critical thinking and teamwork skills need to be improved in order for safe care to happen [ 57 ]. According to another study, life-threatening situations and lack of quick access to a doctor can increase the rate of error if nurses' knowledge and skills are inadequate [ 58 ]. Thus, the development of nurses' knowledge and skills will enhance patients' safety and the quality of care provided to patients in special care units. The novelty of the subject of the present study made it difficult to discuss the findings of the study in comparison with other studies.

4.1. Limitations

One of the limitations of the present study is that the questionnaires were completed on a self-report basis and the respondents' answers to the items may not have been accurate. In addition, the present study exclusively addressed nurses. It is suggested that future studies evaluate other members of healthcare teams, including doctors. It is also suggested that a similar study be carried out in other countries.

4.2. Implications for Clinical Practice

Moral courage contributes to nurses' moral sensitivity in their clinical practice. As nurses who possess high levels of moral courage and sensitivity take better care of patients, nursing managers are recommended to take steps to educate nurses about ethical codes and moral sensitivity and help them develop moral courage so that they can provide safe nursing care.

5. Conclusion

There is a positive correlation between moral sensitivity and moral courage. Both are positively correlated with special care nursing. Accordingly, through effective planning, education, and giving their support, nursing managers are recommended to pay special attention to moral sensitivity and moral courage as qualities that can improve the quality of care and ensure safe care.

Acknowledgments

The authors would like to appreciate Fasa University of Medical Sciences & Clinical Research Development Unit of Fasa Valiasr Hospital for financially supporting this research.

Data Availability

Conflicts of interest.

The authors declare that they have no conflicts of interest.

Homeworkgain

Homeworkgain

The ethical principles that are violated in the case study?

Topic: ethical case study, nsg 3007 foundations of professional nursing.

Ethical/Legal Case Study

Several case studies that are relevant to the practice of a medical-surgical nurse will be explored. Each student is assigned to a case study and prepare a PowerPoint presentation to discuss: 1. The ethical issues presented in the case study. 2. The ethical principles that are violated in the case study? 3. The ethical and moral obligation of the nurse? 4. The suggested solutions for the case study?

Case Study # 2- Moral Courage with a Family Disruption

The 79-year-old patient in the Host family has COPD and mild dementia, and currently is hospitalized because of diagnosis of cerebrovascular accident (CVA). The CVA has left her with partial paralysis of the left side and inability to speak. The family expects the nurses to do everything for the patient, even though the patient is able and willing to do a number of basic care functions. The crisis occurs when the son comes to the nurses’ station, screaming at the unit secretary about the staff’s incompetence and demanding to see the nursing supervisor. The charge nurse is in the nurses’ station and is able to address the hostile situation. What actions should the charge nurse take ?

1. The ethical issues presented in the case study. 2. The ethical principles that are violated in the case study? 3. The ethical and moral obligation of the nurse? 4. The suggested solutions for the case study?

Image preview for “the ethical principles that are violated in the case study?”

The ethical principles that are violated in the case study

Click the purchase button to get full answer.

Related downloads.

  • Explain a strategy to mitigate each of these threats.
  • Explain how the leader’s decision impacted the results of the Challenger’s mission.
  • I chose a career to write about which is an RN (registered nurse).

IMAGES

  1. Moral Courage in Family Disruption by Kimberly Dyches on Prezi

    case study moral courage with a family disruption

  2. PPT

    case study moral courage with a family disruption

  3. Solved Case Study: Moral Courage with a Family Disruption

    case study moral courage with a family disruption

  4. Solved Case Study: Moral Courage with a Family Disruption

    case study moral courage with a family disruption

  5. 27 Examples of Morals & Ethics (A to Z List) (2024)

    case study moral courage with a family disruption

  6. PPT

    case study moral courage with a family disruption

VIDEO

  1. "रामदेव" बदजुबानी और विवादों के गुरु !!|case study|Moral teacher|Saturday -9:30- P.M-live-47|

  2. B. N. Rau|डॉ. अम्बेडकर से संविधान निर्माण का श्रेय छीनने का ब्राह्मणवादी षड्यंत्र |case study|

  3. Judging Others

  4. Separating families: Experiences of separation and support

  5. Can THIS Atrocity of Alexander the Great Be Justified

  6. Sam Altman on Sora Release Date 📅 #business #news

COMMENTS

  1. PDF Ethics, Law, and Policy

    Moral Courage with a Family Disruption Tom has been a clinical nurse on the unit for 3 years and tonight is charge nurse for a fully occupied 30-bed unit. Even though two staff members called in sick, the ... second case study will center on the management of a disruptive family. Case three will emphasize the ongoing

  2. Moral Courage in Action: Case Studies

    The first case study focuses on the need for moral courage in the dying patient, where the right action is supporting the patient's expressed wishes. The second case study will center on the management of a disruptive family. Case three will emphasize the ongoing ethical issues of incivility/bullying toward new nurses.

  3. Disentangling the Link Between Disrupted Families and Delinquency

    disrupted families and delinquency. Contrary to trauma theories, the cause of the family disruption mattered: disruptions caused by disharmony were associated with higher delinquency rates than disruptions caused by death. However, Bowlby's (1951) theory was supported by the fact that the loss.

  4. Family Disruption and Social, Emotional and Behavioral ...

    The association between family disruption and child socio-emotional and behavioral development is a relatively well-examined but as yet unresolved issue, and the conclusions of previous research have been ambiguous. Further, some studies have indicated that associations may depend on other risk factors, yet the question of heterogeneity has been relatively little discussed. The purpose of this ...

  5. Exploring the Relationships Among Moral Distress, Moral Courage, and

    Moral courage in practice: Implications for patient safety. Journal of Nursing Regulation, 6(2), 10-16 10.1016/S2155-8256(15)30381-1 > Crossref Google Scholar; Escolar-Chua R.L. (2016). Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students.

  6. Moral Courage: A Sociological Perspective

    The article will conclude by weighing in on the longstanding methodological debate about the value of individual case studies in the social sciences, arguing that the study of moral courage underscores the value of this approach. As mentioned, the search for universal patterns in the study of moral courage is likely to be an exercise in futility.

  7. Moral courage in action: case studies

    Moral courage in action: case studies. Moral courage in action: case studies Medsurg Nurs. 2007 Aug;16(4):275-7. Author Vicki D Lachman 1 Affiliation 1 Drexel University, Philadelphia, PA, USA. PMID: 17907703 No abstract available ... Professional-Family Relations / ethics*

  8. Perceptions of important outcomes of moral case deliberations: a

    In addition, moral courage in nursing is also strongly associated with the professional role such as personal risks, commitment and true presence . It would be interesting to explore more deeply the meaning of moral courage in MCDs, and to study whether moral courage can be further developed through participation in MCDs.

  9. Moral courage in action: case studies

    In nursing practice, moral courage is needed due to many factors, such as increasing medicalization and focusing on technology or costs of care, which sometimes leave ethics to the side (Clarke ...

  10. Moral Courage in Action: Case Studies

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download.

  11. Ethical case study .pdf

    Enhanced Document Preview: Case Study: Moral Courage with a Family Disruption Student: Tom has been a clinical nurse on the unit for 3 years and tonight is charge nurse for a fully occupied 30-bed unit. Even though two staff members called in sick, the supervisor was able to pull an RN and a nurse's aid from another unit.

  12. Moral Courage in Family Disruption by Kimberly Dyches on Prezi

    Moral Courage in Family Disruptions Patient Advocate's Perspective Ethical and Moral Principles Patient's Perspective The patient advocate will find a way to communicate with the patient and a way for the patient to communicate with the family. This will hopefully relieve some. Get started for FREE Continue.

  13. Solved Case Study: Moral Courage with a Family Disruption

    Question: Case Study: Moral Courage with a Family Disruption Step 5: Apply the ethical theory to this case scenario and clearly explain the rationale for using this theory type your text here Tom has been a clinical nurse on the unit for 3 years and tonight is charge nurse for a fully occupied 30-bed unit. Even though two staff members called ...

  14. Case Study: Moral Courage

    Case Study: Moral Courage. Case study. Course. Med Surg (NURS 340) 91 Documents. Students shared 91 documents in this course. University Texas Lutheran University. ... then the intervention of the meeting worked. If the family feels more comfortable aftering talking with case management about the care of the their family member, then the ...

  15. Family Vulnerability, Disruption, and Chaos Predict Parent and Child

    The family disruption pathways revealed positive, statistically significant associations, indicating that families experiencing greater decreases in cohesion occurring between pre-COVID-19 assessments and those during COVID-19 were more likely to report lower parent (β = .21) and child (β = .24) HPB adherence. Higher family chaos during COVID ...

  16. PDF Integration Into Practice

    Moral Courage with a Family Disruption Tom has been a clinical nurse on the unit for 3 years and tonight is charge nurse for a fully occupied 30-bed unit. Even though two staff members called in sick, the supervisor was able to pull a RN and a nurse's aide from another unit. In shift report, Tom had heard again in detail about the Host family.

  17. Moral courage in action: case studies.

    The first case study focuses on the need for moral courage in the dying patient, where the right action is supporting the patient's expressed wishes. The second case study will center on the management of a disruptive family. Case three will emphasize the ongoing ethical issues of incivility/bullying toward new nurses.

  18. A Study of How Moral Courage and Moral Sensitivity Correlate with Safe

    The findings of the present study showed the moral courage status of the nurses to be satisfactory. The participants' highest mean scores were for the following dimensions of moral courage (in descending order): moral goals, tolerating the threat, and moral agency. Only the dimension of moral goals was found to significantly correlate with safe ...

  19. Moral Courage

    View on the below mentioned paragraph applying the ANA Code of Ethics for the scenario Moral Courage with a Family Disruption: Tom has been a clinical nurse on the unit for 3 years and tonight is Q&A Ethical Considerations-Case Studies #1 Dying Patient Mr. T. is an 82-year-old widower who has been a patient on your unit several times over the ...

  20. Solved Case Study: Moral Courage with a Family Disruption

    Question: Case Study: Moral Courage with a Family Disruption Step 2: Identify cross relationships among the ethical issues type your text here Tom has been a clinical nurse on the unit for 3 years and tonight is charge nurse for a fully occupied 30-bed unit. Even though two staff members called in sick, the supervisor was able to pull a RN and ...

  21. 334-Case Study .docx

    Moral courage in action: Case studies. Medsurg Nursing, 16 (4), 275-277. ... View on the below mentioned paragraph applying the ANA Code of Ethics for the scenario Moral Courage with a Family Disruption: Tom has been a clinical nurse on the unit for 3 years and tonight is. Q&A.

  22. Solved Apply the ethical theory to this case scenario

    Case Study: Moral Courage with a Family Disruption Step 5: Apply the ethical theory to this case scenario and clearly explain the rationale for using this theory type your text here Tom has been a clinical nurse on the unit for 3 years and tonight is charge nurse for a fully occupied 30-bed unit. Even though two staff members called in sick ...

  23. The ethical principles that are violated in the case study?

    Case Study # 2- Moral Courage with a Family Disruption The 79-year-old patient in the Host family has COPD and mild dementia, and currently is hospitalized because of diagnosis of cerebrovascular accident (CVA).