The relationship between moral reasoning, ethical sensitivity, and empathy among nursing students: A cross-sectional study
Abstract
This cross-sectional study investigated interrelationships between moral reasoning, ethical sensitivity, and empathy among 200 Iranian nursing students using Rest’s Four Component Model. Participants demonstrated high moral sensitivity (88.9 ± 9.9) and moderate empathy (97.4 ± 10.7), but suboptimal moral reasoning (43.1 ± 4.6) despite progression across academic years. A significant positive correlation linked moral sensitivity and empathy (r = 0.329, p < 0.001), while moral reasoning showed no significant relationship with either sensitivity (r = −0.100) or empathy (r = −0.041). Notably, empathy declined with academic advancement (ρ = −0.32, p < 0.05), and dormitory residents scored higher in practical (rule-based) decision-making (p = 0.006). Findings reveal a critical disconnect: although students recognize ethical dilemmas (sensitivity) and demonstrate emotional engagement (empathy), they lack systematic frameworks for moral reasoning. This underscores curricular deficiencies in ethics education, necessitating integration of simulated dilemmas, empathy-centered reflection, and expert mentorship. Urgent reforms should bridge cognitive-affective gaps to prepare nurses for complex ethical challenges in clinical practice.
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