The majority of research on the moral development of
nurses is in line with Kohlberg’s theory. However, Gilligan noted that care and justice perspectives coexist in
moral conflict, and during the growth process, each complements each other and
promotes moral development and maturation. Chally, referring to Gilligan’s
theory, which has the perspective of relationship-focused care, argued that the
moral development of nurses should be considered from both care and justice
perspectives. In this paper, we analyzed publications that used Gilligan
protocol to conduct research on moral
conflicts experienced by nurses. Given the importance of care and
justice perspectives in moral reasoning, Gilligan’s theory, which incorporates both perspectives, is useful for analyzing
moral reasoning in nurses. Our analysis suggests that attachment and
connections based on relationships with patients and self-care are essential
elements of care, and self-care is important in moral decision making. The
inequality between nurse and physician roles was an issue raised with the
justice perspective. Since nurses’ roles are strongly influenced by their affection
toward and connections with their patients, it is important not to
overemphasize either perspective.
Cite this paper
Tsunematsu, K. and Asai, A. (2014) Analysis of “care” and “justice” involved in moral reasoning of nurse based on the Gilligan theory: A literature review using the Gilligan’s protocol. Open Journal of Nursing
, 101-109. doi: 10.4236/ojn.2014.42014
 Gilligan, C. (1982) In a different voice. Harvard University Press, Harvard.
 Kuhse, H. (1997) Caring: Nurses, women and ethics. Blackwell Publishers Ltd., London.
 Noddings, N. (1984) Caring. University of California Press Ltd., Berkeley.
 Chally, P.S. (1990) Moral and ethical development research in nursing education. National League for Nursing, 15-2339, 33-47.
 Goethals, S., Gastmans, C. and de Casterlé, B.D. (2010). Nurses’ ethical reasoning and behavior: A literature review. International Journal of Nursing Studies, 47, 635-650. http://dx.doi.org/10.1016/j.ijnurstu.2009.12.010
 Chally, P.S. (1990) Theory derivation in moral development. Nursing & Health Care, 11, 302-306.
 Casterlé, B.D., Roelens, A. and Gastmans, C. (1998) An adjusted version of Kohlberg’s moral theory: Discussion of its validity for research in nursing ethics. Journal of Advanced Nursing, 27, 829-835.http://dx.doi.org/10.1046/j.1365-2648.1998.00597.x
 Millette, B.E. (1993) Client advocacy and the moral orientation of nurses. Western Journal of Nursing Research, 15, 607-618. http://dx.doi.org/10.1177/019394599301500507
 Millette, B.E. (1994) Using Gilligan’s framework to analyze nurses’ stories of moral choices. Western Journal of Nursing Research, 6, 660-674.http://dx.doi.org/10.1177/019394599401600605
 Chally, P.S. (1992) Moral decision making in neonatal intensive care. Journal Obstetric Gynecologic Neonatal Nursing, 21, 475-482.http://dx.doi.org/10.1111/j.1552-6909.1992.tb01768.x
 Chally, P.S. (1995) Nursing research: Moral decision making by nurses in intensive care. Plastic Surgical Nursing, 15, 120-124.
 Mayeroff, M. (1971) On caring. Harper Perennial, New York.
 Anne, B.E. (2007) Men at work: Male nurses hit the road. Modern Medicine, 1 April 1971, 1-5.http://healthcaretraveler.modernmedicine.com/healthcare-traveler/news/modernmedicine/modern-medicine-feature -articles/men-work-male-nurses-hit-ro
 Japanese Nursing Association Publishing Company (2012) Statistical data on nursing service in Japan.http://www.nurse.or.jp/home/publication/toukei/pdf/toukei05.pdf
 Casterlé, B.D., Izumi, S., Godfrey, N.S. and Denhaerynck, D. (2008) Nurses’ responses to ethical dilemmas in nursing practice: Meta-analysis. Journal of Advanced Nursing, 63, 540-549. http://dx.doi.org/10.1111/j.1365-2648.2008.04702.x
 Susan, L. (2003) The experience of being an older staff nurse. Western Journal of Nursing Research, 25, 45-56.http://dx.doi.org/10.1177/0193945902238835
 Pinch, W.J. and Mary, E.P. (1997) Moral orientation of elderly persons: Considering ethical dilemmas in health care. Nursing Ethics, 4, 380-393.