moral courage essay

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What Stops People From Standing Up for What’s Right?

In 2015, Stanford graduate students Carl-Frederik Arndt and Peter Jonsson (both from Sweden) found Chanel Miller being sexually assaulted while unconscious. As soon as they got a sense that something was not right, the two prioritized the well-being of a stranger over their own safety and convenience. They approached and stopped the perpetrator and, when he tried to escape, held him down until the police arrived at the scene.

By saving Miller and stopping her perpetrator, Arndt and Jonsson showed moral courage .

Moral courage is needed when we see that our principles have been violated, social norms were transgressed, or the law was broken. If we act to stop these wrongdoings, despite the risk of backlash, we act morally courageous.

That can involve a range of behaviors. The Swedes acted morally courageous by helping a person in danger. As Miller wrote about the two in her 2019 book, Know My Name : “You’ve taught us that we all bear responsibility to speak up, wrestle down, make safe, give hope, take action. . . . We must protect the vulnerable and hold each other accountable. May the world be full of more Carls and Peters.”

In other realms, a student can be morally courageous by confronting bullies, speaking up against discriminating behavior, or reporting cheating. And an employee can act morally courageously by making corporate fraud public. The potential backlash to such acts could, for example, be physical attacks or social exclusion by peers. By standing up in defense of their moral principles despite risks, morally courageous individuals can become a protective force for individuals, a catalyst for social change, and an inspiration for others, thereby making a crucial contribution to the greater good.

Against this backdrop, we hope for a society where many people show moral courage. Instead, however, moral courage is relatively rare. We can probably all recall reports of violent fights, sexual harassment, or racist attacks in which no one intervened, or perhaps we have found ourselves in such situations and remained inactive.

Such personal experiences are backed up by research. Studies that assess morally courageous behavior find that only about 20% of participants who witness wrongdoings intervene against them. At the same time, many more people intend to intervene . What, then, stops them from putting their intentions into action? If we understand why moral courage is rare, we can better find effective ways to promote it. Here are two potential explanations for the rareness of moral courage.

Moral courage can break down at many points

Moral courage involves a complicated internal process—and that very complexity can foil morally courageous actions.

In a 2016 chapter , Anna Halmburger and her colleagues suggest that this process can be broken down into five stages, and at each stage, the process may be interrupted, leading to a lack of morally courageous behavior:

Witnesses need to notice an incident, and
they need to interpret it as wrongdoing.
Then, witnesses need to assume responsibility, and
they need to believe they possess effective intervention skills.
Ultimately, witnesses need to decide whether to intervene despite potential risks.

Let’s use an example of bullying at school to illustrate the model. Imagine you are a student witnessing classmates pushing another student into a corner. You might instantaneously think this treatment is hurtful and wrong for your classmate. Perhaps seeing someone treated in an unjust way also angers you—or you might see it as playful teasing among friends and find it funny.

If you interpret the treatment as wrong, you might feel responsible for stopping it—or you might think that other classmates or a teacher should handle it. If you assume responsibility, you need to know how to intervene, like calling a teacher or confronting the bullies—but maybe you are unsure how to proceed. Ultimately, you need to believe that intervening can make a difference, even if you fear backlash, like becoming the bullies’ next target. As this illustration shows, much can go wrong and hinder moral courage.

In a recent study , we investigated the process of moral courage in a so-called experience-sampling study. Participants reported wrongdoings they observed in their everyday lives over seven days via prompts on their mobile phones. For any wrongdoing reported, participants then answered questions that addressed the different stages of the model of moral courage. Our findings aligned with the model, showing that moral courage was more likely when participants felt responsible and efficacious but less likely when they perceived the situation as risky .

We also wanted to know whether some people are more prone to show moral courage than others due to their personality . We found that participants who generally tend to morally disengage —that is, to not take their own moral standards all too seriously at times—felt less responsibility and thus showed less moral courage. Conversely, participants who generally believe themselves to be well-equipped to deal with challenges felt more efficacious and thus showed more moral courage. Accordingly, aspects of our personality shape the process of moral courage.

Besides personality, situational factors can affect the different stages of moral courage. For example, often, we could lack essential information about a situation. This makes it difficult to confidently say whether someone’s actions are morally wrong. Also, if other people are present, we might be less likely to feel responsible for intervening. A lack of information and the presence of other people can thus be barriers to moral courage.

Taken together, it is essential to understand that moral courage is a complex process and how the process pans out is shaped, to some extent, by our personality and the situation.

It’s difficult to see the big picture

When we find ourselves in a situation that requires moral courage, it can sometimes be challenging to see its benefits for the greater good. This can be because some forms of moral courage do not feel exactly agreeable.

For instance, it often requires calling perpetrators out on their wrongdoings or even using physical force to stop them, and confronting others in such ways can feel unpleasant. Also, reporting others’ wrongdoings to authorities can feel wrong since it might be seen as tattling . This is especially the case if we know the perpetrator , when they are our friends, family, or colleagues.

Consider our example of moral courage in the context of bullying: Calling out classmates or reporting them to a teacher may be all the more difficult because we feel a sense of loyalty toward them. The need to be loyal to those we are close to can conflict with our goal to stand up for fairness or justice and can hold us back .

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When it comes to standing up to others’ wrongdoings, anger plays an important role—but that’s an emotion we may not readily associate with the greater good. We often think of anger as a negative emotion linked to aggression, but it turns out that it can also be a force for good. Anger is a common reaction to wrongdoings, and it provides us with a strong urge to make things right.

What does that mean for moral courage? In a recent study in which participants—seemingly casually—witnessed the embezzlement of research funds, their prime reaction was anger (rather than, for example, empathy), and the more anger they experienced, the more likely they were to show moral courage. In other words, it seems that anger can spark moral courage. But since anger has a rather bad reputation, we might be tempted to push it down, thereby extinguishing the spark.

Taken together, it is often challenging to show moral courage. But knowing all those things that make it difficult should not discourage us. Instead, we can use this knowledge to develop concrete ideas on how to promote moral courage.

How can we foster moral courage?

Every person can try to become more morally courageous. However, it does not have to be a solitary effort. Instead, institutions such as schools, companies, or social media platforms play a significant role. So, what are concrete recommendations to foster moral courage?

Establish and strengthen social and moral norms: With a solid understanding of what we consider right and wrong, it becomes easier to detect wrongdoings. Institutions can facilitate this process by identifying and modeling fundamental values. For example, norms and values expressed by teachers can be important points of reference for children and young adults.
Overcome uncertainty: If it is unclear whether someone’s behavior is wrong, witnesses should feel comfortable to inquire, for example, by asking other bystanders how they judge the situation or a potential victim whether they are all right.
Contextualize anger: In the face of wrongdoings, anger should not be suppressed since it can provide motivational fuel for intervention. Conversely, if someone expresses anger, it should not be diminished as irrational but considered a response to something unjust.
Provide and advertise reporting systems: By providing reporting systems, institutions relieve witnesses from the burden of selecting and evaluating individual means of intervention and reduce the need for direct confrontation.
Show social support: If witnesses directly confront a perpetrator, others should be motivated to support them to reduce risks.

We see that there are several ways to make moral courage less difficult, but they do require effort from individuals and institutions. Why is that effort worth it? Because if more individuals are willing and able to show moral courage, more wrongdoings would be addressed and rectified—and that could help us to become a more responsible and just society.

About the Author

Julia sasse.

Julia Sasse, Ph.D. , is professor for general psychology and media effects at the Applied University Ansbach and affiliated researcher at the Institute for Ethics in Artificial Intelligence at TUM.

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Essay About Courage: Top 5 Examples and 6 Prompts

Courage covers a range of topics and meanings. Here are examples and prompts to help you write your essay about courage.

Many believe bravery and courage mean the same thing and even use them interchangeably. However, though both describe heroic acts, they are not the same. Where bravery is the lack of fear, courage is taking action despite it.

Some argue that courage takes more strength because it means sharing your story even though you may be ridiculed, rejected, and misunderstood. It takes courage to admit when you’re hurt or feel lost, vulnerable, and need help.

If you’re having problems channeling and describing what courage is, here are examples that will assist you in connecting with this subject:

1. My Opinion About Courage by Gary Collins

2. moral courage by fernando wood, 3. courage by benjamin patrick, 4. the importance of courage by saloni, 5. essay on courage by manasi shewale, 1. what does courage mean to you, 2. your most courageous act, 3. a courageous hero, 4. things you are most afraid of, 5. what creates doubt, 6. a time when you failed to show courage and regretted it.

“And even then, she had no grudge against the world. She doesn’t think the world owes her. She never takes money or even grains that she hasn’t earned.”

In this essay, Collins shares his experience with courage through someone named Sunita. Sunita told Collins about her life and what made her who she is. Such as at a very young age, she fought to support herself because no one would have done that for her, and many other tales.

Her stories made Collins realize how lucky he is and how he should be grateful for the many opportunities that come his way without the need to suffer as she did. He also includes that Sunita lives on to inspire others with her courage.

Check out these essays about beliefs .

“Moral courage is standing up for values such as honesty, fairness, compassion, respect, and responsibility but just having these values are not enough we have to try to put them into practice, and we have to commit to moral principles as well…”

Moral courage is doing what’s right and following what your conscience dictates. Wood has three significant elements of moral courage: principle, endurance, and danger.

He explains moral courage through Geoge Norris, Nelson Mandela, and Malala Youssafzai. These people took risks even if their lives were in danger to follow their conscience and do the right things. Wood instills that moral courage is essential in making a critical move, especially when choosing the greater good.

“Courage is the only thing that gets us through the hard times, and the tempting opportunities. Courage is vital to the evolution of the human population. It is also an essential quality to becoming a successful person.”

Patrick discusses how courage helps a person succeed in life. He mentions that we all have courage, but some use it differently than others.

He gives an example of a girl who plays hockey, where the other members are all boys. They looked down on her because of her gender. But instead of giving up, she took it as a challenge and courageously showed them she could play at their level. She became friends with most of the team, but there was one boy who kept on bullying her. The boy misused his courage, but the girl used her courage to fight him off.

“Courage is mental and moral strength to venture, persevere, and withstand danger, fear, or difficulty. It is the firmness of mind and will in the face of danger or extreme difficulty.”

Saloni’s essay shows two kinds of courage: physical and moral. People who depend on physical strength show physical courage. They can protect and help others. If a person is weak, they are not physically courageous.

On the other hand, one’s honesty connects to their moral courage. They are the ones with convictions and don’t support evil works. Even if you are a weak person, you can still be morally courageous. Unfortunately, this courage is rare nowadays because people are afraid of being attacked mentally and emotionally. To be morally courageous means to be a fighter to go against wrong-doings.

“It is very difficult to keep up your morals and therefore, gather up the necessary courage to fight against the wrong situations. Therefore, in today’s date, it is even rarer to find a person with the proper morals required to live a satisfactory life.”

Shewale shares little acts of courage in our everyday lives – such as a girl who loves to dance but is afraid of the stage or a person who’s readying themselves for a job interview. Courage is not only shown in grand scenes but in small acts that help us survive our daily lives.

The author further discusses events where courage helps in more controversial fields, such as injustices to farmers and students’ bullying.

If you want to upgrade your writing style, check out these top essay writing tips to level up your essay.

6 Prompts on Essay About Courage

After reading relevant examples in essays about courage, it’s now your turn to try your hand at creating one. Below are prompts that can guide you in your essay writing:

There is no one definition of courage. It differs from each individual, and its meaning is affected by our experiences and knowledge. In this prompt, share the word “courage” and discuss what courage means to you. When do you feel courageous, and why? Then, describe personal experiences of being courageous or stories of courageous people who inspire you.

Think about a time when you were courageous. Create an essay based on this event and describe in detail what happened. Convey your thoughts and feelings, and show why you were courageous.

Write an essay about a hero in your life. This could be a celebrity you admire, a relative or friend, or a teacher in school. Describe why this person is courageous, why you look up to them, and how they inspire you. Make sure to include fine details of their personality and how they act. This will make for an exciting and compelling essay.

The first step to being courageous is acknowledging you are afraid. Then, to get your fears out of the way, you need to identify what and why they exist. This prompt lets you connect with your readers who have the same worries.

For example, you can share that you’re afraid of rejection, being alone, etc. Then, discuss why and what you plan to do to overcome them. You can also write about how you plan to be courageous while still afraid.

Our greatest challenge to succeeding in something is doubting ourselves. When we doubt ourselves, we start to think of all the things that can go wrong. So we show our courage by being afraid of these negative consequences but still trying and hoping for a good result.

Share an experience when you still tried, even when you’re unsure. It doesn’t need to have the best ending. You only have to prove that it’s better to try and fail than fail without trying at all.

There will always be times when we desperately want to be more courageous but fail to do so due to various factors. Write about that experience, share your feelings, and what you’ll do if you have the chance to repeat that situation.

Do you want to write about another topic aside from courage? Check out this list of best writing topics for students !

Maria Caballero is a freelance writer who has been writing since high school. She believes that to be a writer doesn't only refer to excellent syntax and semantics but also knowing how to weave words together to communicate to any reader effectively.

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Essay On Is Moral Courage

Table of Contents

Short Essay On Is Moral Courage

Moral courage is the ability to stand up for one’s beliefs and values, even in the face of opposition or danger. It is the courage to do what is right, even when it is difficult or unpopular.

Moral courage is essential in a society as it helps to maintain ethical standards and prevent corruption and abuse of power. It is demonstrated in acts of integrity, honesty, and fairness, and it inspires others to do the same. People with moral courage are willing to speak out against injustice and to defend the rights of others, even at personal risk.

In today’s world, there are many challenges to maintaining moral courage. Society often rewards conformity and punishes dissent, and many individuals are afraid to speak out for fear of losing their jobs, reputation, or relationships. Additionally, the media often portrays moral courage as weakness, leading many people to believe that it is better to remain silent.

However, moral courage is a critical component of leadership, and leaders with moral courage are often the most successful and respected. They are able to make tough decisions and stand up for what is right, even when it is not popular. They inspire others to do the same, and they help to create a culture of integrity and accountability.

In conclusion, moral courage is a vital component of a healthy and thriving society. It requires individuals to be willing to stand up for their beliefs and values, even in the face of opposition or danger. It is essential for leaders to demonstrate moral courage in order to inspire others and create a culture of integrity and accountability. By fostering moral courage, we can create a better world for ourselves and for future generations.

Long Essay On Is Moral Courage

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Moral Courage: A Sociological Perspective

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

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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.

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When Right is Not Easy: Social Work and Moral Courage

December 3 rd 2009

Allan Barsky , JD, MSW, PhD is a Professor of Social Work at Florida Atlantic University and a member of the NASW National Ethics Committee. He is also the author of Ethics and Values in Social Work: An Integrated Approach for a Comprehensive Curriculum , which offers a series of learning modules that will ensure graduates receive a comprehensive ethics and values education. In the post below Barsky asks how we learn moral courage?

When social workers think of ethics, they often think of the NASW Code of Ethics. The Code of Ethics identifies a list of ethical principles and standards of behavior for professional social workers. It tells us to respect the dignity and worth of all people, to maintain client confidentiality, to promote client self-determination, to maintain high standards of professional competence, and to promote social justice. When ethical guidelines are clear and non-conflicting, they are generally easy to follow. But what happens when social workers know the right way to act – what is ethical – but acting in an ethical manner poses risks to the social worker? Consider a social worker who knows that the executive director is using agency funds for personal benefit, a worker who is aware that a clinical supervisor is acting in a discriminatory manner toward African Americans, or a worker who suspects that key donors to the agency have earned their money through illegal Ponzi schemes? Consider also a social worker who unintentionally breaches the Code of Ethics but is too ashamed to admit it. In such cases, the worker knows that the right thing to do is to confront the unethical behavior or wrongdoing. In practice, workers may do nothing for fear of reprisal. A worker’s fears may include:

• What if I raise the issue and my superiors get angry? • What if I can’t prove the wrongdoing and people accuse me of being insubordinate, traitorous, or disloyal? • Am I willing to risk scorn, humiliation, alienation, or even the loss of my job?

On the other hand, if the worker does not confront the wrongdoing, then the worker’s inaction perpetuates the problem.

Knowing what is right does not necessarily mean that workers will do what is right. Often, it takes significant moral courage to do the right thing. Moral courage refers the virtue of having the strength to do what is right in the face of opposition . Moral courage is required to put ethics into action under challenging circumstances ( Strom-Gottfried ).

So if moral courage is so important, where do we learn it? Certainly, some people learn moral courage from their families and from modeling key people in their formative years. Has anyone heard of a course in moral courage – in primary education, in college, or in any school of social work? I haven’t. If we expect social workers (and indeed all people) to act ethically, shouldn’t we equip them with the skills they need to put ethics into action? Shouldn’t social work education include the development of moral courage?

The question is not simply, “Should we provide education to foster moral courage?” but “What should moral courage education include?” What knowledge and information should we provide, and what types of learning experiences should be used to promote moral courage? How can we ensure that social workers not only know what is the right thing to do, but that they have the moral strength to put that knowledge into action? I welcome your responses.

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Featured Article: Moral Courage and Intelligent Disobedience

Home » Simons Center News » Featured Articles » Featured Article: Moral Courage and Intelligent Disobedience

Featured article:

Moral Courage and Intelligent Disobedience by Ted Thomas and Ira Chaleff

The military needs men and women who have courage–the physical courage to go into battle, to overcome fear in the face of bodily injury or death, mental pain, and lifelong disabilities. Militaries run on physical courage. Without it, they run from a fight and surrender. Many sources quote Aristotle as saying, “Courage is the first of human qualities because it is the quality which guarantees the others.” Courage is a primary virtue, as all other virtues require it.

There is another type of courage the military needs, but it is hard to measure or even define–moral courage. The following words of Robert F. Kennedy are as salient today as they were in June of 1966 when he spoke them in Cape Town, South Africa. “Few men are willing to brave the disapproval of their fellows, the censure of their colleagues, the wrath of their society. Moral courage is a rarer commodity than bravery in battle or great intelligence. Yet it is the one essential, vital quality of those who seek to change a world which yields most painfully to change.” Bravery in battle is needed, but so is the courage to stand up for what is right and against what is immoral, unethical, or illegal.

A critical application of moral courage is knowing when and how to disobey–which can be thought of as intelligent disobedience. This involves an ability to work within the system to maintain standards and uphold moral values. Organizational culture and operational pressures can sometimes cause the values of people to become blurred when the mission becomes more important than virtues. These can take us down the slippery slope of ends justifying means. Good people and good Soldiers can do bad things in these situations…

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Moral Courage and Intelligent Disobedience PDF

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Ted Thomas is Director of the Department of Command and Leadership in the U.S. Army Command and General Staff College at Fort Leavenworth, Kansas. Thomas graduated from the United States Military Academy and served in various command and staff positions before retiring. He received a master’s from the University of Illinois, and a Ph.D. from Missouri University of Science and Technology.

Ira Chaleff is president of Executive Coaching & Consulting Associates in Washington, DC. He is the author of The Courageous Follower, now in its third edition, and co-editor of The Art of Followership , part of the Warren Bennis Leadership Series. His latest book, Intelligent Disobedience: Doing Right When What You’re Told to Do Is Wrong , was named the best leadership book of 2015 by the University of San Diego.

Posted: April 11, 2017 by Simons Center

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Home — Essay Samples — Sociology — Society — Honesty: A Virtue of Integrity and Moral Courage

Honesty: a Virtue of Integrity and Moral Courage

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Defining honesty, the significance of honesty, challenges and benefits of practicing honesty.

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Defining Courage: the Essence and Impact of Bravery in Everyday Life

This essay about the multifaceted nature of courage examines how it manifests not only in grand heroic acts but also in everyday situations and personal challenges. It highlights courage’s role in overcoming fear and embracing vulnerability, showing up in acts of empathy, resilience, and selflessness. The piece emphasizes that courage fosters community and inspires others, acting as a beacon of hope and a catalyst for positive change in both individuals and societies.

How it works

Courage serves as a critical component of human life, threading through our experiences and defining moments with its dynamic presence. It propels us beyond our comfort zones, enabling us to face challenges and uncertainty with steadfastness and determination. This essay explores the essence of courage, not just in heroic acts but also in everyday resilience and actions.

Courage transcends mere fearlessness; it involves acknowledging fear and choosing to act despite it. It’s the courage of a single parent balancing work and family, their tenacity shining through daily struggles to provide and care for their children.

It’s not the size of the act but the heart behind it that defines true courage.

Courage also emerges in quieter forms—like the introvert who steps up to voice their thoughts or the person who opens up about personal challenges to a friend. These acts of bravery, though subtle, are profound demonstrations of courage in personal authenticity and vulnerability.

Acts of kindness and empathy also embody courage. Consider healthcare workers facing long hours under stressful conditions, volunteers dedicating time to causes close to their hearts, or someone intervening in a difficult situation to help a stranger. Such actions underscore the altruistic nature of courage, highlighting its role in fostering community and solidarity.

However, courage isn’t without its adversaries. Doubt, fear, and uncertainty can dim its light, making the journey fraught with internal conflicts. Yet, recognizing these feelings as part of the human experience is in itself an act of bravery. Courage doesn’t require invulnerability but rather the acceptance of our vulnerabilities.

The influence of courage is far-reaching, inspiring others and generating a ripple effect of resilience and positivity. Like a pebble tossed into a pond, a single courageous act can lead to waves of change, encouraging others to act bravely and compassionately.

In conclusion, courage is a beacon of hope amid adversity, a force available to everyone, regardless of circumstance. It encourages us to confront life’s challenges and to grow from them, proving that courage is indeed a vital thread in the fabric of human existence.

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ADL Student Essay Contest: A Tribute to Moral Courage: Standing Up Against Injustice

January 29, 2024

A Tribute to Moral Courage: Standing Up Against Injustice Student Essay Contest

2024 ESSAY CONTEST IS BACK!!

Submissions due March 29, 2024

ADL’s A Tribute to Moral Courage: Standing Up Against Injustice student essay contest inspires educators, students and families/caregivers to research moral courage to find the very best in humanity! We all need the motivation to remember those ordinary people who take extraordinary actions for the good of others because it inspires us to find those characteristics within ourselves.

SHARE THIS ESSAY CONTEST with your students, your children or grandkids in your life, your youth groups and sports teams to encourage and build student leaders! There are remarkable examples throughout history and in more contemporary times of those fighting for a cause that creates justice, builds empathy and promotes compassion for all of us.

This essay contest uses the history of the Holocaust to educate students about the ramifications of present-day stereotyping, prejudice, racism and antisemitism. The Holocaust provides a context for exploring the dangers of remaining indifferent and silent in the face of the oppression of others. In addition, this essay contest invites the writer to learn about moral courage and the personal and societal benefits that may be realized by standing up to injustice.

This essay contest uses the history of the Holocaust as a backdrop to encourage students in 7-12 grade to recognize those individuals and groups who took a strong stand on a specific issue based on their personal beliefs or convictions, regardless of the danger or threat to their safety. Not only will students write about how that person’s moral courage has an impact on the world, but also, most importantly, how those actions have influenced their own lives . Past essay winners wrote about Bob Marley, Cesar Chavez, Imani McGee-Stafford, Marsha P. Johnson and Irena Sendler.

Student writers must be Colorado, New Mexico or Wyoming students in grades 7-12. Monetary awards will be granted to the top three winners in two divisions:

Division I: 7th-9th grade
Division II: 10th-12th grade

Contest Rules & Submission Guidelines:

For full essay contest details, click here: 2024 Essay Contest FULL Rules & Guidelines

Download forms here: Essay Application Form & Essay Reflection Sheet

Submissions can be submitted two ways – Submissions due March 29, 2024!!

Snail mail – Instructions are above in the full rules and guidelines . Use these links for the essay application form & reflection sheet .
Electronically – Submit all information on the following link and be prepared to complete the application form & reflection sheet online. NOTE – a strong suggestion is to have answers to the application form & reflection sheet prepared on a separate document, which will allow for an easy cut and paste to the form. Submit your essay here : https://form.jotform.com/240283992873165

2024 Essay Winners will be recognized on the evening of May 8, 2024, at 5:30 pm MT at ADL’s 2024 Governor’s Holocaust Remembrance Program . Stay Tuned for Registration for this event!

The A Tribute to Moral Courage student essay contest is made possible by an anonymous donor who believes that anti-bias education and building communities is essential for our youth, families and educators.

Read, learn and get inspired work by our past winners .

Follow the links below:

2022 Student Winners

2021 Student Winners

Doing the right thing: Pathways to moral courage

Patient advocacy requires nurses to support and protect their patients. Nurses often find themselves in ethically questionable situations that conflict with their personal and professional morals. Sometimes, speaking out for the patient requires them to demonstrate moral courage—for instance, in the face of conflicting loyalties, in highly charged conflict situations, or when the patient’s rights are being violated. This article provides an overview of moral courage, defines important terms, examines barriers to moral courage, discusses strategies for developing moral courage, reviews peer support and organizational cultures that support moral courage, and discusses whistle-blowing.

Defining key terms

Moral courage is the willingness to stand up for and act according to one’s ethical beliefs when moral principles are threatened, regardless of the perceived or actual risks (such as stress, anxiety, isolation from colleagues, or threats to employment). Moral distress occurs when nurses feel powerless to act after witnessing improper behavior, if organizational constraints make doing the right thing difficult or impossible. Ultimately, these situations challenge one’s sense of virtue , which involves acting in accordance with one’s moral and ethical principles. Moral courage is a virtue and needs to be developed (as does emotional intelligence) to determine when action is required. Thus, moral courage is linked to virtue ethics , which emphasizes the role of character rather than doing one’s duty to bring about good consequences. Virtue ethics appreciates that conflicts occur and that more than just moral wisdom is needed to ensure a moral outcome.

Case scenario: Susan’s dilemma

The following scenario illustrates the moral distress a nurse may experience when her patient advocacy meets resistance or her moral courage is challenged. It also describes effective management strategies to help nurses resolve these problems. Julie, age 45, works in a telemetry unit at a university medical center. A registered nurse (RN) for 20 years, she is now a charge nurse on the 7 A.M.-to-7 P.M. shift. She has an in-depth understanding of the goings-on at her hospital and is highly respected by her peers. This weekend, Julie is busy as usual when Dr. Shoen, an attending physician, tells her she’s unhappy with Susan, a staff nurse. According to Dr. Shoen, Susan seems to question everything Dr. Shoen does for Mr. Yarrow, her agitated semicomatose patient. Susan, in the meantime, speaks to Brenda, a new nurse graduate, about Mr. Yarrow’s apparent need for more sedation. She says she hesitates to ask Dr. Shoen for a sedative order because of her experiences with retaliation in similar circumstances. Brenda, who has studied moral courage at nursing school, finds it disheartening that an experienced nurse like Susan seems to lack the courage to speak her mind about a patient’s care because she fears negative consequences. She recognizes that Susan’s concern over her patient needs to be elevated, and finds Julie to tell her Susan might need help. After Brenda speaks with Julie, Julie enters Mr. Yarrow’s room, assesses him, speaks with Susan and Brenda, and validates their concerns about his care. With Brenda present, Julie talks with Susan about options for speaking up for what she believes is in the patient’s best interest. Julie presents the option of using objective data—namely, the SBAR (Situation-Background-Assessment-Recommendation) technique—to help resolve the situation. She role-plays with Susan how to approach team members when she has a concern about patient care, and suggests she use the technique with Dr. Shoen. Taking Julie’s advice, Susan speaks to Dr. Shoen. An hour later, she tells Julie, “It’s always been hard for me to step forward and say something when I know a patient should be getting better care. But the technique you showed me helped me present the facts to Dr. Shoen in a professional way without making her feel threatened. Now she understands the need for medication, and the patient is comfortable.” Later, Brenda tells Julie she’s grateful she had the opportunity to witness moral courage in action.

Barriers to showing moral courage

All healthcare organizations and professionals have a responsibility to uphold high ethical standards. But not all situations in which nurses advocate for patients turn out the way Susan’s did. Sometimes nurses face obstacles when advocating for patients, and some nurses may try to circumvent morally courageous behavior. Ethics experts have identified several barriers to morally courageous behavior:

organizational culture, which sets the stage for how individuals respond to unethical behavior. In an organizational culture that eschews the interdisciplinary dialogue crucial to resolving unethical behavior or that disregards unethical actions, staff may shy away from morally courageous behavior. Also, some nurses may be willing to compromise their personal and professional standards if their organization tolerates unethical situations, preferring to avoid the risks of displaying moral courage. What’s more, some nurses may grow more reluctant to face the difficult challenge of confronting unethical behaviors.
lack of concern by colleagues who don’t have the moral courage to take action
groupthink, in which individuals collectively decide to look the other way when unethical behaviors occur, with subsequent loss of independent thinking
preference for redefining unethical actions as acceptable. For example, a nurse observes, but pretends not to see, two nurses repeatedly documenting narcotic wastage by cosigning each other’s name.

CODE: An aid to demonstrating moral courage

Remembering what actions to take when you face a moral dilemma can be emotionally and cognitively difficult. Vicki Lachman, a coauthor of this article, developed the mnemonic CODE to help nurses recall the steps to take. (See CODE: The key to taking action in a dilemma by clicking the PDF icon above.)

The first step is to critically evaluate the situation to determine whether moral courage is needed to address it. Morally courageous people know how to use affective and objective information to determine whether a situation warrants further exploration.

O: Obligations to honor

The “O” in CODE stands for the nurse’s ethical obligation, as outlined in the Code of Ethics for Nurses from the American Nurses Association (ANA). When caught in a moral dilemma, you should self-impose a purposeful time-out for reflection to help determine what moral values and ethical principles are at risk or are being compromised. Suppose, for example, that Wendy, RN, interprets Dr. Colton’s avoidance of a dying patient’s family as a lack of compassion. During a time-out, she comes to see that by avoiding delivering bad news to the family, Dr. Colton is dishonoring the patient’s autonomy. She decides to approach the situation from an ethical stance and avoid a judgmental communication. She considers: What’s the right thing to do? What principles need to be expressed and defended in this situation?

D: Danger management

The “D” in CODE stands for danger: What do you need to do to manage your fear of being morally courageous? This step requires the use of cognitive approaches for emotional control and risk-aversion management. During this step, explore possible actions and consider adverse consequences associated with those actions. To avoid becoming overwhelmed when deciding how to act, focus on one or two critical values. In Wendy’s case, she focused on the values of autonomy and nonmaleficence. The cognitive reframing method helps a person learn to stop negative thought processes that interfere with effective analysis of a situation. By replacing negative thoughts with positive self-talk, you can focus on viewing the situation clearly. Equally important, strive to avoid stumbling blocks that might impede moral courage, such as apprehension or overreflection; these responses might make you “reason” yourself out of the risk of taking morally courageous action. If Wendy uses positive self-talk (“I can approach Dr. Colton and support the family by discussing with him how to deliver the bad news”), she’s more likely to take morally courageous action than she would if she used negative self-talk (“He’ll never listen to me”). Self-soothing is another way to promote risk taking. Risk-avoidant nurses tend to overvalue uncertainties and undervalue the chance of reaching a desired outcome. Risk-preference nurses do the opposite. To self-soothe, use deep-breathing and other techniques that reduce physiologic arousal of fear.

E: Expression

The “E” in CODE denotes expression and action through assertiveness and negotiation skills. Knowing one’s obligations and demonstrating specific behaviors can enable you to move past your fear and serve as an effective patient advocate, as Susan did in our case scenario. To avoid blocks to exercising moral courage, nurses need to develop moral courage through education and practice, and to use the tools they learn in making everyday decisions. This helps them develop morally courageous behaviors even before an ethical dilemma occurs. The negative assertion technique is one example of a tool that nurses can use. If Dr. Colton responds defensively when Wendy approaches him (“The family has been hostile to me since I started treating the patient”), she should first state which part of his response she agrees with, and then tell him which part she disagrees with. So she might say, “You’re right. The family has been hostile to you in the past. But we still have the ethical obligation to keep communicating about their mother’s deteriorating condition.”

Organizational cultures that support moral courage

In an organization whose culture supports moral courage, communication is open at all levels, policies and procedures support ethical practice, and leaders practice staff empowerment. Empowerment creates a positive work environment through such structures as professional practice models and shared governance, as well as participation in ethics committees. Leaders must ensure these structures are used to make individual and organizational accountability expected behaviors. In organizations that advocate accountability, managers must have the moral courage to generate crucial conversations with all healthcare team members. A crucial conversation is a discussion between two or more people where the stakes are high, opinions vary, and emotions run strong. For example, Julie, the charge nurse in our case scenario, role-modeled the needed communication to resolve Susan’s conflict with Dr. Shoen, demonstrating the crucial conversation Susan needed to initiate with Dr. Shoen to make Mr. Yarrow more comfortable.

Peer support

Nurses can increase their effectiveness as change agents by using peer support when they need to exercise moral courage for patient advocacy. Interventions to protect patient safety and improve the quality of care and health outcomes are enhanced when morally courageous nurses elicit peer support for advocacy endeavors. This helps combat the groupthink effect of putting direct pressure on dissenters not to oppose the group’s views. Peer support helps leaders understand that more than one staff member supports morally courageous action. Even when other colleagues may disagree with a courageous nurse who speaks up for a cause, nurses should be expected to support their peers’ right to address tough issues and problematic clinical situations. In our case scenario, Brenda sought peer support from Julie in handling the conflict and offered Susan her unsolicited support. Suppose, for example, a nurse is asked to get a signed consent form from a patient who’s about to undergo a nonurgent but essential operation (such as open reduction or internal fixation of the femur). But based on her assessment, the nurse determines the patient is cognitively impaired (which is an acute change) and has no family members who could care for her postoperatively. She calls the surgeon and expresses reluctance to get consent in this circumstance; the surgeon becomes angry and tells her to “get the consent anyway.” The operating-room nurse also is bothered by this interruption in the schedule, but chooses to support her peer’s courage in advocating for her patient. This additional peer support helps reassure the courageous nurse to continue to “do the right thing” despite clear opposition. In this way, peer support for nurses’ efforts to exhibit moral courage can improve the effectiveness of individual attempts. Nursing environments that foster peer support are highly desirable.

When is whistle-blowing necessary?

If a healthcare organization fails to put in place the necessary mechanisms for internal resolution of patient safety and quality concerns, whistle-blowing may be necessary for patient advocacy. Demonstrating moral courage means taking personal and professional risks; every nurse should understand this. But nurses also need to recognize their responsibility to uphold the ethical principles that guide nurses’ professional behavior, as outlined in the ANA Code of Ethics. Nursing’s Social Policy Statement from ANA provides additional direction on how nurses should conduct themselves in an ethical and responsible manner toward those they care for. Nurses have a responsibility to report unsafe, unethical, or illegal behaviors to individuals within an organization who are in a position to stop these behaviors. In Susan’s case, she was able to obtain the help she needed from a manager (Julie) to address her patient’s pain management with Dr. Schoen. However, in situations where internal resources have been exhausted (as when complaints to a compliance hotline and senior administrators go unheeded), whistleblowing becomes a nurse’s ethical obligation. When the organization fails to address unethical conduct, the nurse must go outside the organization for help. Susan collected all the facts and used her internal resources effectively. However, if Dr. Schoen had continued to resist and discount her opinions and the hospital had refused to address the potentially ineffective pain management, Susan would have been obligated to complain to the medical board and possibly consider resigning and seeking employment elsewhere. Nurses must play a pivotal role in promoting ethical environments—those where they and their colleagues believe they can be morally courageous and come forward with their concerns. In ethical workplaces with protection policies and a clear means for addressing concerns, where colleagues support whistleblowers, staff members who otherwise might be reluctant to be morally courageous feel more empowered to speak up.

Recommendations for practice, education, research, and policy

Nurses need to identify scenarios where they should demonstrate moral courage. Depending on the individual nurse’s role, these may include clinical, education, research, or policy scenarios. (See Wanted: More research on moral courage by clicking the PDF icon above.) To develop moral sensitivity, nurses must take the time to reflect not only on their personal and professional values but on their moral obligations. They need to become more “present” in the situation to better understand their own perspective and their patients’ situations. Administrators must create and support a culture that fosters moral courage—one with clear policies on conscientious objection, acknowledging and addressing a staff members’ moral distress, and encouraging peer support for the courageous nurse. Furthermore, bedside nurses and nursing administrators should use ethical decision-making practices to resolve value-based conflicts that lead to moral distress. (See Conscientious objection by clicking the PDF icon above.)

Education on moral courage

All healthcare professionals should be educated in demonstrating moral courage in the face of ethical challenges. Although much has been written on nursing intuitiveness, knowing how to demonstrate moral courage and create an organizational culture that fosters empowerment may not be so intuitive. For this reason, educational strategies should be used both in nursing care settings and academia. Nurses must learn the language of ethics, moral reasoning, and moral courage—and how to approach the moral dilemmas they may encounter. Role-playing is one strategy for learning new behaviors in difficult situations. This technique places nurses in dialogue pairs where they play out a scenario they’re given—for instance, a difficult but necessary conversation about maintaining standards rather than cutting corners, or how to approach senior personnel or physicians when concerned about a patient’s plan of care. This can make nurses better equipped to demonstrate moral courage when difficult situations arise. In both the workplace and academia, strategies exist to help nurses gain knowledge about ethics—for instance, discussion of a case and application of Code of Ethics provisions to the case; also, use of simulation with a standardized patient experiencing a violation of privacy or autonomy. Nursing educational curricula include ethics in both baccalaureate and graduate programs. Many schools have in-depth courses that give students time to learn the language of ethics and ethical reasoning, which helps in day-to-day practice. Nurses who think they lack the tools to handle difficult situations in daily practice can tap into webinars, nursing literature, and other continuing-education offerings. Also, most hospitals have ethics committees that offer consultation and can be called on to provide education. Workshops can be given on specific ethical subjects or case presentations. Nurse managers should play a role in requesting or promoting ethics educational opportunities in the workplace. (See Online resources on moral courage by clicking the PDF icon above.)

Policies related to moral courage

Healthcare organizations need to create policies that support nurses in demonstrating moral courage without fear of reprisal. Policy is imperative to enhancing healthcare workers’ ability to respond appropriately to unethical behaviors. All nurses should become staunch advocates of creating and implementing such policies. Leaders must recognize the importance of moral courage.

Support moral courage

The dynamic changes in health care over the past few decades have created increasingly complex moral and ethical dilemmas, some of which call on nurses to demonstrate moral courage. Addressing such dilemmas and acting appropriately are never easy. But nurses are accountable for providing the best possible patient care. Advocating for a patient’s best interest can pose challenges and risks, but nurses must resolve to uphold their ethical obligations. The increasing number of publications on moral courage underscores the need for an ongoing conversation among nurses in all roles and across all settings to commit to working toward creating environments that value and support moral courage.

Selected references

American Association of Critical-Care Nurses. Ethics in Acute & Critical Care Nursing. 2012. www.aacn.org:88/wd/practice/content/ethicmainpage.pcms?menu=practice. Accessed March 27, 2012.

American Nurses Association. Code of Ethics for Nurses with Interpretive Statements. Author: Silver Spring, Maryland; 2001.

American Nurses Association. Code of Ethics for Nurses with Interpretive Statements . Author: Silver Spring, Maryland; 2001. http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html Accessed March 27. 2012.

Catlin AJ, Armig C, Volet D, et al. Conscientious objection: a possible nursing response to care at the end of life which is harmful, causes suffering, or torture. Neonatal Netw. 2008;27(2):101-8.

Institute for Healthcare Improvement. SBAR technique for communication: A situational briefing model. 2011. www.ihi.org/knowledge/Pages/Tools/SBARTechniqueforCommunicationASituationalBriefingM odel.aspx. Accessed March 27, 2012.

Hodkinson K. How should a nurse approach truth-telling? A virtue ethics perspective. Nurs Philos. 2008 Oct;9(4):248-56.

Iseminger K, Levitt F, Kirk L. Healing during existential moments: the “art” of nursing presence. Nurs Clin North Am. 2009 Dec:44(4):447-59.

Lachman VD, ed. Applied Ethics in Nursing. New York, NY: Springer; 2006.

Lachman VD. Ethical Challenges in Healthcare: Developing Your Moral Compass. New York, NY: Springer; 2009.

Lachman VD. Moral courage: a virtue in need of development? Medsurg Nurs. 2007 Apr;16(2):131-3.

Laschinger HK, Finegan J, Wilk P. Context matters: the impact of unit leadership and empowerment on nurses’ organizational commitment. J Nurs Adm. 2009 May;39(5):228-35.

Murray JS. Before blowing the whistle, learn to protect yourself. Am Nurs Today. 2007;2(3):40-2.

Murray JS. Moral courage in healthcare: acting ethically even in the presence of risk. OJIN. 2010;15(3):Manuscript 2.

Murray JS. The Paul Revere Freedom to Warn Act: legislation to protect federal whistleblowers from retaliation. Am J Nurs. 2008 Mar;108(3):38-9. doi:10.1097/01.NAJ.0000312253.48872.56.

Patterson K, Grenny J, McMillan R, Switzler A. Crucial Conversations: Tools for Talking When Stakes are High. 2nd ed. New York, NY: McGraw-Hill; 2011.

A clinical professor who teaches ethics, Vicki D. Lachman is also a track coordinator for the Innovation and Intra/Entrepreneurship program in advanced practice nursing at Drexel University in Philadelphia, Pennsylvania. John S. Murray is the director of nursing research, Surgical Programs/Emergency Department, at Children’s Hospital Boston in Boston, Massachusetts. Karen Iseminger is director of ethics at St. Vincent Health in Indianapolis, Indiana. Kathryn M. Ganske is director and associate professor of the Division of Nursing at Shenandoah University in Winchester, Virginia.

20 Comments .

Advocating for our patients is the right thing to do, regardless of whether the doctors or organizations agree with what the nurse is doing is the right thing or not. All nurses have an obligation to do the right thing for the patient’s best interest. In reality, the truth is the nurse will be taking a chance of losing her job to advocate for the patient and the nurse have to do the right thing and take that chance.

I have contacted the ethics board on more than occasion. I have zero qualms about doing it again if necessary.

When an organization doesn’t support moral courage for its employees, I wonder whose interests do the management and the organization behind it serve? All nurses should comply with the Code of Ethics for nurses. On the other hand, the nursing management should have a strong leadership and organizational culture of behavior to promote patients’ rights and safety. Additionally, nurses should work with all possible nursing committees available to advance quality improvement and justice.

“preference for redefining unethical actions as acceptable. For example, a nurse observes, but pretends not to see, two nurses repeatedly documenting narcotic wastage by cosigning each other’s name.”

I taught an Ethics course for a decade, please inform us, as to what ethical principle is being violated here.

IT should be every nurses duty to practice moral courage in their place of work. Too many things go un-noticed due to fear of loosing your job. To often many nurse do not advocate for their patients due to the environment they are in and the bosses they work for. Hopefully we will all learn that fear does not fix anything. Great read.

Moral courage is something that should be part of any organization orientation processes.. and also yearly continuing education. In efforts of continued understanding across the board for a positive culture in a healthcare organization. good read

Moral courage should be taught not only in school but also integrated into the orientation process of younger, novice nurses so they will have the voice and ability to speak up when faced with an ethical dilemma in their young practice.

Why no mention of the biggest challenge on the horizon for nurses: mandatory vaccination?

Because this article was posted in 2012

Whose moral courage this should be? Not nurses only.

Moral courage should be demonstated by anyone not only nursing. The said part of demontrating moral courage is that person is likely to be terminated.

An excelent article and learning experience, which I plan to share with my students. One comment; on pages 26-27, the nurse “…is asked to get a signed consent form from a patient…she expresses reluctance…the surgeon becomes angry and tells her to ‘get the consent anyway'” Physicians are responsible for obtaining informed consent. Nurse may witness the consent, but should never be sent into the room to get an informed consent from the patient.

That is exactly right.

I recently was given DON position over a group of nurses who had not had a DON in years. I knew on day one I was going to have problems. I uncovered so many nursing practices that were unethical. Six weeks later the nurses banded together, met with the owner and demanded he let me go or they all would walk out. Unfortunately, he chose the easy route and let me go. I know I was sent there to warn him of the unethical illegal practices of his nurses. Now up to him to fix it.

On a positive note, in my workplace I have been able to lead by example and be the patient advocate. By meeting these challenges the surgeons have realized that the tides have changed and now my fellow nurses are doing the same (: It took one nurse willing to stand up to each doctor every time there was a real issue and hold my ground explaining respectfully and professionally why whatever was happening was wrong and immoral to finally change the course of things. They are listening now!

I have personally experienced the “back lash” for speaking up about issues directly related to moral/ethical/legal issues involving patient related issues and those we as non-managerial nurses are actually “forced” to submit to by those in the position to effectively end our employment. This has happened more than once to me personally. I am now in a position that I can not find employment because the same people we are supposed to report to are the ones forcing these issues.

Great article! Too bad so many people don’t support one another. Most of the people I work with are too afraid of losing their jobs to speak up, even if it will benefit the patient or the culture of the workplace.

In response to comment dated July 24, 2012. I would love to hear your stories that you have collected. I am doing some research with EBP/Retaining Nurses. Thankyou

In the correctional environment nurses are faced with issues of moral courage both related to patient care, saftey, and nursing practice. At this point you may have completed your collection of information on this subject.

I’m collecting stories such as these, of people who have exercised moral courage in the medical field and have faced backlash as a result. Please let me know if you are interested in participating.

Comments are closed.

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EssayBanyan.com – Collections of Essay for Students of all Class in English

Essay on Is Moral Courage Important than Physical Courage

We all have heard about these lines in the advertisements that “Dar ke aage jeet hai”. Have you ever thought that what is the thing that brings victory after the fear? It is the courage that fosters us for getting victory over our fears. Without being courageous we cannot avail that victory. In the advertisement, the role of courage is compared to the soft drink. In real life, it is the physical and moral courage that makes us successful.

Short and Long Essay on Is Moral Courage Important than Physical Courage in English

Short and long essay provided below will help you in understanding courage, the importance of physical and moral courage. This will enable you to make out the difference between moral and physical courage. I hope that these essays might be beneficial for students and readers.

10 Lines Essay on Is Moral Courage Important than Physical Courage (100-120 Words)

1) We all know that moral courage is more important than physical courage.

2) Physical courage has only limited application.

3) Mental courage is more powerful and impactful than physical courage.

4) Mental courage can help you to fight even if you are having a bad physique.

5) People with great mental power can achieve moral courage easily.

6) Moral courage makes you stronger from the inside.

7) Moral courage helps you to make decisions wisely.

8) People with moral courage are respected everywhere.

9) Great fights and wars can be won through moral courage.

10) Moral courage gives us the power to distinguish between right and wrong.

Short Essay – 250 Words

Introduction

Courage is defined as the power in us to overcome any kind of fear. It inculcates in us the ability to stand for something that is right and oppose wrong deeds. Physical and moral courage are the two types of courage that are possessed by human beings. Both types of courage are important and have their own significance.

Moral Courage is scarcely used

Physical courage means that courage that is represented by the body. It is the power of the people who have great physical strength. They try to defend themselves by using their physical strength. The use of physical courage is not good every time. It results in war, bloodshed, and destruction. Moral courage is mainly the strength of people who have wider thinking capability. This is the virtue of wise people who live their life according to their own principles and values.

Moral courage instills power in us to oppose any wrong deed. We have observed that people mostly apply physical courage to tackle difficult situations in life. It is because this seems easy to make others fearful by our physical power. The use of moral courage by people is very rare in the world. People are easily involved in fights and taking revenge rather than thinking of solutions to any of the problems by using moral courage.

Physical strength loses when the body is weakened

Physical courage is developed by strengthening our body while mental courage is attained by exercising our mental capability. Physical courage declines after the body strength are weakened in old age while this is not applicable to moral courage. Moral courage never declines and remains with us till death.

Moral courage is therefore regarded as more important than physical courage. The use of moral courage can only ensure the peaceful living of human beings on the planet.

How Moral Courage is Important than Physical Courage – Long Essay

The word ‘courage’ is about doing anything bravely. Courage is an important virtue that is required by us to tackle different situations in our life either it is physical or moral courage. It totally depends upon us that what we have to apply at that time. It is the potential of doing something rather than boasting. There are very few people in this world who opt to show this virtue.

What is Courage?

There is a word called fear. I hope that every one of us experiences this at different times in their life. The power to overcome this fear is called courage. Courage is an ability that instills in us to do something that is difficult for us but is right. It is the quality of brave people as everyone does not have the power to show this quality.

It is an attribute that develops willingness in us to do something to protect our interest. Courage is the power that prevents us from doing those things that pleases someone and provides us discomfort. It is a quality of facing any distressing situation in life. It is a virtue that brings us into action and stands for anything wrong. We can say that it is the potential to stand for the right thing and prevent the happening of anything wrong.

Physical Courage v/s Moral Courage

Have you ever felt the difference between physical and moral courage? Yes, these are the two different types of courage.

Physical Courage – Physical courage as the name itself implies that it is related to physical strength. This type of courage depends upon strengthening of the body that is possible by strenuous exercises. It is courage that is represented by a strong body. It can be attained by everyone by becoming them strong physically. The sportsperson, wrestlers, boxers, soldiers, etc. are the examples of possessing this type of courage.

Physical courage is required at different times to fight from the difficult situations of life. The wars by the people in history for getting their rights are a great example of using physical strength. This strength has its limited application as it does not work well in every situation in our life.

Moral Courage – Moral courage is the virtue of the people who have great mental strength. It is the quality that is irrespective of body strength and can be possed by anyone who has great mental power. There are very few people who have strong moral courage. They are a source of inspiration and respected by everyone in society. The people abiding the moral values and some principles in life show the moral courage in them to speak for protecting their moral values from being violated. It is an act of thinking wisely about the consequences before acting.

We have seen people following their leaders or higher authority in different sectors even if they are wrong. They are ready to accept anything that is said by the boss. It may because of the fear of losing a job or reputation. Moral courage is most required at that time to face the situation by overcoming our fear. It is then we are respected by others because of our courageous behavior. Moral courage requires great power to support the right thing and stand against the wrong irrespective of the consequences.

Physical v/s Moral courage – Physical courage cannot be applied every time in our life. Moral courage is required most of the time to tackle the problems. But it is sad to state that moral courage is lacking in our society and everybody needs revenge. Suppose there is a war declared between two countries. One is having a sufficient number of soldiers to fight the war while the other is devoid of the number of soldiers. The only way to get out of this problem is to apply moral courage and find out the solution to get rid of the idea of war. The physical courage in this situation will only lead to destruction and pain.

How Moral Courage is Important than Physical Courage?

Physical and moral courage are two types of courage possed by human beings. It depends upon the situation that which type of courage has to be used. Moral courage is not the virtue that can be possed by all. It is the quality of people who abide by some values and principles in their life.

There are very less people in our society with moral courage. It is the power that helps us to speak us for anything wrong with us and of course every one of us does not have this courage. It is the virtue of people who does not have greed for the wealth of powerful position in life. The main thing they care is of doing the right thing in life. They are the great souls with a great potential to forgive instead of taking revenge. One can take the help of physical courage to get a high position in life but would not be able to attain the same and respect for longer duration without applying moral courage.

The great examples of people with moral courage are Swami Vivekananda, Mahatma Gandhi, Mother Teresa, Nelson Mandela, etc. It was because of the moral courage that Mahatma Gandhi was able to make India free from British rule. He fought bravely against them without the use of any weapon by presenting great moral courage. In this way, he also became a great exemplar for the people of the whole world. It is not that we remember Gandhiji because of his body or beauty. We remember him because of the great ideas and principles of his life. He always stood courageously for making his principles never go down. The potential of showing moral courage has the power of changing the world. Even the application of physical courage requires the use of moral courage before acting. Thus moral courage is considered more important than physical courage.

Moral courage makes us stronger and enriches us with the ability to stand for anything that harms us. Physical courage is easy to attain and there are many people that are having physical courage but at the same time, moral courage is also necessary to distinguish between right and wrong. We must try to develop the power of moral courage that will surely help in ending injustice and wrong and grant us a better world.

FAQs: Frequently Asked Questions

Ans. It is a potential to withstand fear and difficulties.

Ans. Lion is an animal that represents deathless courage and strength .

Ans. The ability to do something that is full of risk or doing anything for the first time is an example of courage.

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Moral Courage

Nursing continues to be the most trusted of professions (Norman, 2016, cited in DeSimone 2019). As a profession, nursing cannot separate itself from moral/ethical intent and behavior. Nursing educators therefore have a huge responsibility for building a strong moral and ethical foundation upon which future nurses will build their practice.

Moral courage is the ability to stand up for and practice that which one considers ethical, moral behavior when faced with a dilemma, even if it means going against countervailing pressure to do otherwise. Those with moral courage resolve to “do the right thing” even if it puts them at personal risk of losing employment, isolation from peers and other negative consequences. One should stand up for what is right even if it means standing alone (Murray, 2010). According to former Senator from Maine Margaret Chase Smith: The right way is not always the popular and easy way. Standing for right when it is unpopular is a true test of moral character.

One should not confuse moral courage with moral arrogance or moral certitude. Individual, social, and cultural values may differ, so it is important to have open, respectful communication (Murray, 2010) While the values of honesty, integrity, fairness, compassion and respect seem to be universal, different cultures might prioritize them differently.

Nurses need moral courage to assure quality care and safety of patients, to interact with other healthcare professionals and to advocate for consistent universal care with healthcare and community organizations (Pajakoski, 2021). Moral courage is needed to deal with unethical, unsafe or discriminatory practices (Murray, 2010).

To clarify the elements of moral courage, Numminen et al. (2016) analyzed literature and arrived at these attributes: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment (Numminen et al., 2016)

(Adapted from Kidder, 2005 )

He further makes us aware of impediments to exercising moral courage:

Lachman (2010) has written extensively about the virtue of moral courage. To bolster the teaching and ability to act with moral courage, she suggests the following using the acronym CODE:

C ourage to be moral requires:
O bligations to honor (What is the right thing to do?)
D anger management (What do I need to handle my fear?)
E xpression and action (What action do I need to take to maintain my integrity?)

She discusses strategies for overcoming risk-aversion and fear in order to speak out and “do what’s right.”

Reflections:

Questions and exercises to consider with classmates and/or colleagues:

Courage means overcoming fear - fear of failure, fear of ostracism, fear of being wrong. Identify which aspects of clinical care cause you most fear. What do you do to overcome that fear?
What do you fear most in interpersonal interaction? How do you overcome that fear in order to manage difficult discussions?
Could we say the staff who opposed the openness and kind of care being given on 5B were exhibiting moral courage?

Helpful Resources

Learn How to Cultivate Moral Courage Blog post by Senior Policy Advisor Liz Stokes for Healthy Nurse Healthy Nation

Six Ways to Find Your Courage During Challenging Times

“We teach who we are,” says educational philosopher Parker Palmer.

Early in my teaching career, I participated in a series of retreats led by the Center for Courage and Renewal, inspired by Palmer’s book The Courage to Teach . Palmer reminds us that our sense of self plays out in our work every day—and living with courage and integrity means finding balance and alignment between our inner and outer selves. In other words, our identities, values, and beliefs inform the selves we bring to others.

But how do we find the courage to stand up for our coworkers, students, neighbors, family and friends, and ourselves amid exhausting and unprecedented challenges? The truth is, I’m not particularly thrilled with the person I’ve been bringing to work lately. On some mornings, I’m simply looking for the courage to get out of bed.

If you are like me, there are days when you feel emotionally weary, inept, and cynical—all characteristics of burnout . However, I’m finding that the science of courage offers a psychological lifeline, helping us to clarify what really matters so that we can find a steadier, values-based resolve—and even inspire it in others. I dove into the courage research with teachers in mind, but these tips are for everyone.

Fortunately, courage comes in many forms. Although definitions range, researchers tend to agree that it features three primary components: a risk, an intention, and a goal that may benefit others. In a classic example, a student defends a peer who is being verbally assaulted by a bully, by interrupting the bully and telling them to stop. This purposeful act may come at a cost—perhaps socially or physically.

But courage doesn’t have to look dramatic or fearless. We express it in both bold and quiet ways. In fact, “ general courage ,” the confident or seemingly brazen actions perceived by others, differs from “ personal courage ,” those actions that are courageous in the minds of the actors themselves. It all depends on how you view the challenge in front of you and the fears associated with performing a particular behavior. In other words, these days, some of us may need significant “personal courage” to get out of bed and face the day on behalf of those students we value and care about.

Why is just showing up courageous? Daily stressors can pile up, leading to emotional exhaustion, a sense of detachment from your work, and the feeling that you simply aren’t as capable as you thought you were—and if you don’t feel capable, you may not feel particularly confident. Yet courage is also associated with other positive character strengths , like persistence and integrity.

The good news is that there are many ways to tap into our capacity for courage, whether we are adults or students. Here are six.

1. See yourself as courageous

First, if we describe ourselves as “courageous,” we are more likely to act courageously . In other words, if I tell myself that I’m a courageous person as I park in the school parking lot and walk into my school, it may actually give me a psychological boost and inspire me to meet the day with greater self-assurance.

Alternatively, we can take time to note and label all the courageous actions we have already taken in our lives. For example, when you consider how your childhood struggles inform your current relationships with coworkers or students, or how you made it through college as a single mom, or how you’ve learned to cope with a chronic health issue, you may be more likely to experience positive emotions while reconnecting with personal values and beliefs that can inspire future courageous behaviors.

Consider conducting an inventory of past actions with your students or colleagues so that you can identify and celebrate individual acts of courage together. Then, discuss how those actions influence who you are now and who you want to be.

2. Get comfortable with “mistakes”

We can recognize and celebrate courage with others, but it can also be a very internal, day-to-day experience. One of the most common ways we practice courage at work is in our pursuit of learning and personal growth. Research tells us that fear of failure can negatively correlate with courage, but what if it’s OK to make mistakes—and they are even welcomed learning tools?

Studies indicate that students may benefit from making mistakes (and correcting them) rather than avoiding them at all costs. And when researchers reviewed 38 studies of resilience in response to failure, errors, or mistakes, they found that more resilient individuals had lower levels of perfectionism and a more positive way of explaining past events: “I haven’t solved this long division problem yet, but I’ll try another strategy next.”

Another way to address fear of failure is through a simple practice you can share with your students or colleagues called “ Crumpled Reminder ,” where you write about a recent mistake you made, crumple up a paper representing your feelings about that mistake, and then discuss the ways mistakes strengthen brain activity and help us to learn and grow.

Crumpled Reminder

Write down a recent mistake and your feelings about it, and then crumple up the paper. Then reflect on how your mistakes help you learn.

Rather than fearing looming “failures,” seeing daily missteps as opportunities for learning frees all of us to appreciate learning for what it is—a process rather than a performance.

3. Keep trying

Courage at work also requires perseverance. As our fears lessen, we are more likely to persist in learning—to keep trying despite the obstacles ahead of us. And perseverance (or persistence), as a character strength, can also be modeled, observed, and developed. In fact, when adults model persistence in working toward a goal, infants as young as 15 months tend to mimic that behavior.

As teachers, we have a lot of power to influence our students’ efforts by sharing our own vulnerabilities while we read a challenging text, our own self-conscious emotions as we outline a timed essay, our stops and starts while solving a word problem, and our commitment to keep going.

And research suggests that teachers’ growth mindsets, or belief that intelligence grows and changes with effort, can be linked to the development of students’ growth mindsets. This more positive, flexible mindset can improve students’ performance at school, boost their well-being and social competence , and even promote kind, helpful, and prosocial actions. All these benefits may bolster our capacity for courageous actions, too.

4. Look for the heroes

Of course, if we are feeling apathetic, anxious, or fearful about stepping up and doing that next best thing at school or in life, it can be helpful to draw inspiration from others—whether near or far, real or fictional.

According to research , the individuals we admire may represent some aspect of our ideal selves as they demonstrate moral courage through difficult times and a desire to do good in the world. They can also inspire us to live more meaningful lives. Studies suggest that seeing images of heroes may move us to sense greater meaning in our lives—and even increase our drive to help others.

Basic social cognitive theory tells us that we are motivated through “vicarious experiences”—as we witness others’ actions. In fact, when adults observe courageous behaviors in their workplaces , like a teacher standing up for a group of students or a colleague advocating for an important policy, they are more likely to see the potential for organizational change and feel inspired to act courageously themselves.

Our students can benefit from models of courage, too. In the “ Who Are Your Heroes? ” lesson from Giraffe Heroes Project , students listen to and present hero stories, while exploring the risks and benefits of courageous acts. Stories like these can communicate shared values , make us more empathic , and may encourage us to help others .

5. Clarify your values

You may recognize heroism or courage in others, but sometimes struggle to see it in yourself. If so, it may be helpful to ask yourself a few key questions:

What do I value in myself?
What do I “stand for”?
What is important to me?
What are some of my successes and accomplishments?

When researchers measured teachers’ responses to prompts like these, they found that teachers’ anxiety immediately decreased—and they experienced more positive emotions over time when compared to a control group. Teachers’ values drive their goals and behaviors at school, while supporting their well-being and a sense of self-efficacy at work. If we feel clear and capable, we may also feel more courageous.

Philosophers consider courage to be a foundational virtue because it guides us to act on behalf of other virtues or values. In fact, our convictions, values, sense of integrity, honor, and loyalty can all influence our courageous actions. When we experience a threat to our moral code, we are likely to act in a way that upholds our beliefs and values. And the more powerful the belief , the more likely you will not be influenced or swayed by those around you.

You and your students can clarify your values and explore your character strengths through a range of simple practices for both adults and students , like Discovering Your Strengths and Talents , Eight Inner Strengths for Leaders , and Reminders that Encourage Moral Character Strengths .

6. Become part of a social force for courage

Finally, we can act on our values in community. After more than a year of isolation from each other—and the prospect of ongoing public health, environmental, and sociocultural crises—we are finding courage again in groups.

More Education Resources

Visit Greater Good in Education for more information, tips, and practices to support teacher and student well-being. To dive deeper into the research behind these practices and strategies, register for one of our online courses for educators .

Teachers and students are participating in social and emotional communities of practice, circles of courage , and other “ circles ” practices to nurture a sense of belonging, find emotional support, and engage in collective action. Studies indicate that social groups like these promote interdependence, social identity, and cohesion and influence courageous behavior, too.

And one of the most empowering things we can do for our students right now is to support them in being courageous community problem solvers, too.

Tribes Learning Communities curricula focus on active learning and community building among adults and students to reduce violence and increase kindness. For example, in their lesson “ Put Down the Put-Downs ,” students consider how hurtful name-calling really feels and brainstorm ways to end the problem in their classrooms and school. In this case, perspective taking and empathic responses can lead to more courageous and impassioned student action, cultivating a positive school and classroom climates where everyone is honored and valued .

Further, in the lesson “ It’s Up to Us to Stick Our Necks Out ,” students share stories about everyday heroes drawn from a free story bank , and then learn to “Be the Story” by selecting, planning, and enacting a service learning project to address a community challenge (such as homelessness, clean air or water, or a need for increased literacy). As we act on our values together, we may feel a greater sense of agency in a world that feels topsy-turvy right now.

During those dark, winter mornings when you really don’t want to crawl out of bed and face the day, remember that courage can also be a very private, personal act. There will always be risks and challenges to face, but what really matters most—in your gut? Is it love, learning, curiosity, compassion, hope? How do these values inform who you are and how you show up in the world?

These are the key questions that can help us to frame our truest intentions—even on our most difficult days.

New Course! Courage in Education

Face Challenges with Strength, Determination, and Hope

About the Author

Amy L. Eva, Ph.D. , is the associate education director at the Greater Good Science Center. As an educational psychologist and teacher educator with over 25 years in classrooms, she currently writes, presents, and leads online courses focused on student and educator well-being, mindfulness, and courage. Her new book, Surviving Teacher Burnout: A Weekly Guide To Build Resilience, Deal with Emotional Exhaustion, and Stay Inspired in the Classroom, features 52 simple, low-lift strategies for enhancing educators’ social and emotional well-being.

How to Transform Stress into Courage and Connection

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Courage Under Fire

2024 Winning Essay by Ruby McIntee

2024 Winning Essay by Ruby McIntee (pdf) List of 2024 Winners, Finalists, Semifinalists, Honorable Mentions

Ruby McIntee, an 18 year-old young woman with long brown hair parted down the middle is in a gray school uniform with a white shirt and striped tie. There are two stacks of books in front of her and shelves of books behind her.

Vito Anthony Marcantonio: The Idea Lives On

By Ruby McIntee High School of Dundee Dundee, Scotland

Woodlawn Cemetery is over 400 acres of non-denominational burial ground in the Bronx, New York. Hidden away, in the vast expanse of final resting places, is one grave that was not meant to be there. The headstone reads “Vito Marcantonio”. The man died in 1954, suddenly, aged only 51. He died with a rosary in his pocket (Day). Presumably, he should have been buried at St. Raymond’s, the Bronx’s only Catholic cemetery. But his body is not there. Cardinal Spellman denied him last rites ( Times , “THRONGS AT BIER OF MARCANTONIO”). What kind of heresy could Marcantonio have committed to be censured in death? Was he an arsonist? A mob boss? A murderer?

No.

Marcantonio was a seven-time US Representative, uncompromising in his commitment to liberty (“Vito Marcantonio Papers: 1935-1953”). The Cardinal’s vindictive act intended to distance the church from Marcantonio, to bury not only the man but his politics. To cloister Marcantonio’s relentless progressive lobbying away from the public eye, to shroud his words to history. But within dusty congressional records, Marcantonio's spirit still shines. Particularly, his opposition to H.R. 5852.

Proposed by Mundt and Nixon, the ‘Subversive Activities Control Act of 1948’ (H.R. 5852) was a measure to combat the dissemination of communism. Originating from the Un-American Activities Committee, the act required all communists to register with the Attorney General. It denied passports and non-elective federal jobs to communists, giving the Attorney General power to designate organisations “communist fronts” (Congress, House of Representatives,6104). The bill capitalised on American public hysteria during the second Red Scare. The fear of communism was visceral, the world had just witnessed Mao’s rise to power.

However, H.R 5852 didn’t just attack the left: it undermined The Constitution and its guaranteed freedoms. It didn’t just attack communists either: the legislation critically failed to define the term ‘communist’ (Hill). Left to interpretation, almost anyone could be silenced for political dissent (Thompson 83).

Vito Marcantonio would point this out in his opposition. He declared, “this anti-communist attack reaches out and destroys the rights of all those who disagree with the views of those who are today seemingly in power” (Congress, House of Representatives 5842). He argued against the “violence to the constitutional guarantee of due process” and compared it to legislation instituted by Mussolini and Hitler (Congress, House of Representatives 5842). Rising above hysteria, Marcantonio would get to the heart of H.R. 5852; “The question before the House,” he said, “is whether or not we shall have the courage to defend the democratic traditions of our Nation and the democratic foundations on which our Government is based, despite the hysteria which is mounting every day to the accompaniment of the fast beating of war drums” (Congress, House of Representatives 5842).

The democratic principles Marcantonio references within his speech are seen in his voting record. He advocated anti-lynching measures and abolition of the poll tax. From the start to the end of Marcantonio’s career, he would stand by his fundamental moral principles: democracy and equality (Meyer).

On the 19th of May 1948, the Subversive Activities Control Act passed in a landslide victory (Congress, House of Representatives 6150). Marcantonio would be labelled a “NATIONAL SCANDAL AND INTERNATIONAL DANGER”, becoming a pariah in the anti-communist fervour (“Letter No. 57” 3). He was secretly pursued by the very government that he faithfully served for most of his life. The FBI tracked his every move, as revealed in an FOIA request that produced a 25-part, 933-page file (Federal Bureau of Investigation). Marcantonio was shunned by all his colleagues, regardless of party affiliation. Association with Marcantonio’s voting record became political suicide. Congress passed bipartisan legislation preventing political party cross-filing, designed specifically to bar him from running in his own district (Champion 45).

On the 3rd of January 1951, the majority would succeed in damming the representative’s political prospects. Marcantonio would lose his seat. He died suddenly, three years later (Serby).

In his pocket was a rosary.

This display of faith did not matter to the Catholic Church. What mattered was Marcantonio’s politics. A belief in fundamental freedoms had already cost the Representative his career, and Cardinal Spellman would ensure Marcantonio paid a price even in death. For adhering to his principles Marcantonio lost his final resting place.

In his last speech to Congress, Marcantonio explained the politically damning but morally correct decisions he made: “I have stood by the fundamental principle which I have always advocated. I have not trimmed. I have not retreated. I do not apologise, and I am not compromising” (qtd in Simon). These words would be echoed years later, by John F. Kennedy. Kennedy claimed that courageous leaders would always do their duty “in spite of... consequences... obstacles... and pressures -- and that is the basis of all human morality” (Kennedy, Profiles 225).

In his opposition to the Subversive Activities Control Act, Vito Marcantonio fought in the public interest against the will of a tyrannical majority. His arguments that began on the house floor continued in the Nations courts. Aptheker v. Secretary of State, Albertson v. Subversive Activities Control Board, United States v. Robel: case after case of lower and Supreme Court rulings declared the Act unconstitutional, until it was repealed by Nixon himself in 1971, seventeen years after Marcantonio died (Izumi).

The courage of Marcantonio’s public opposition to the Mundt-Nixon bill, and his defense of free speech would define his life and death. He would not receive last rites and the American people would largely not remember his name. Yet, Marcantonio's legacy is very much alive. It lives on in the politicians who championed his causes posthumously, in ratifications and amendments, in repetition of rhetoric and case law, and in the new generation of politicians who stand for equality and against tyranny. Vito Anthony Marcantonio's body may lie in Woodlawn cemetery, but his political legacy continues. As J.F. Kennedy said, “A man may die, nations may rise and fall, but an idea lives on” (Kennedy, “Remarks”).

Works Cited

Champion, Thomas. Vito Marcantonio . Rutgers University Library, 1972, jrul.libraries.rutgers.edu/index.php/jrul/article/download/1532/2971. Accessed 11 Jan. 2024.

Congress, House of Representatives. “The Congressional Record.” United States Government Publishing Office , May 1948, pp. 6104–50. www.govinfo.gov/content/pkg/GPO-CRECB-1948-pt5/pdf/GPO-CRECB-1948-pt5-6-2.pdf . Accessed 15 May 2024.

Congress, House of Representatives. “The Congressional Record.” United States Government Publishing Office , May 1948, p. 5842. www.govinfo.gov/content/pkg/GPO-CRECB-1948-pt5/pdf/GPO-CRECB- 1948-pt5-3-2.pdf . Accessed 15 May 2024.

Day, Dorothy. Death in August – Vito Marcantonio – Catholic Worker Movement . 1 Sept. 1954, catholicworker.org/674-html. Accessed 12 Jan. 2024.

Hill, Warren P. “A Critique of Recent Ohio Anti- Subversive Legislation.” Ohio State Law Journal , vol. 14, 1953. CORE , core.ac.uk/download/pdf/159573883.pdf. Accessed 12 Jan. 2024.

Izumi, Masumi. “PROHIBITING ‘AMERICAN CONCENTRATION CAMPS.’” Pacific Historical Review , 2005, pp. 165–94. online.ucpress.edu/phr/article-abstract/74/2/165/80035/PROHIBITING-AMERICAN- CONCENTRATION-CAMPS?redirectedFrom=fulltext. Accessed 11 Jan. 2024.

Kennedy, John F. Profiles in Courage . New York, Harper Perennial, 2006.

Kennedy, John F. “Remarks for USIA Transmitter Opening, Greenville, North Carolina, 1963.” . 8 February 1963. Papers of John F. Kennedy. Presidential Papers. President’s Office Files. Box 42, Folder 38. John F. Kennedy Presidential Library and Museum, Boston, Massachusetts. https://www.jfklibrary.org/asset-viewer/archives/jfkpof-042-038#?image_identifier=JFKPOF-042-038-p0002 . Accessed 15 May 2024.

“Letter No. 57.” Counterattack: Facts to Combat Communism , 25 June 1948, pp. 3–4. https://library.bloomu.edu/Archives/SC/RadicalNewsletters/Counterattack/19480625.pdf Accessed 15 May 2024.

Meyer, Gerald. “Vito Marcantonio: American Radical. ” Marcantonio Defender of Human Rights http://vitomarcantonio.com/gerald-meyer-articles/vito-marcantonio-american-radical/ Accessed 15 May. 2024.

Serby, Benjamin. “New York’s Last Socialist Congressperson.” Jacobin , 20 Dec. 2018, jacobin.com/2018/12/vito-marcantonio-socialist-congress-puerto-rico-civil-rights. Accessed 11 Jan. 2024.

Simon, John J. “Rebel in the House: The Life and Times of Vito Marcantonio.” Monthly Review , 30 June 2014, monthlyreview.org/2006/03/01/rebel-in-the-house-the-life- and-times-of-vito-marcantonio. Accessed 12 Jan. 2024.

“Vito Marcantonio”. FBI file for Vito Marcantonio. File Number; 100- 28216, 2000, The FBI: Federal Bureau of Investigation, US Department of Justice, vault.fbi.gov/Vito%20Marcantonio. Accessed 12 Jan. 2024.

Thompson, Roger J. “Legislation From the Past Speaks to Us Today: The Mundt- Nixon Bill.” Law And Society Review USBC , 2002, pp.81-83. HeinOnline , heinonline.org/HOL/LandingPage?handle=hein.journals/lawso1&div=16&id=&page=. Accessed 12 Jan. 2024.

Times, New York. “THRONGS AT BIER OF MARCANTONIO; Catholic Church Refuses Him Religious Service -- Funeral Is Set for Tomorrow.” The New York Times , 11 Aug. 1954, www.nytimes.com/1954/08/11/archives/throngs-at-bier-of-marcantonio-catholic- church-refuses-him.html . Accessed 10 Jan. 2024.

U.S. National Park Service. Woodlawn Cemetery: Frederick Law Olmsted National Historic Site . www.nps.gov/places/woodlawn-cemetery.htm. Accessed 12 Jan. 2024.

“Vito Marcantonio Papers: 1935-1953.” Manuscripts and Archives Division, the New York Public Library , archives.nypl.org/mss/1871. Accessed 12 Jan. 2024.

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Guest Essay

In Medicine, the Morally Unthinkable Too Easily Comes to Seem Normal

A photograph of two forceps, placed handle to tip against each other.

By Carl Elliott

Dr. Elliott teaches medical ethics at the University of Minnesota. He is the author of the forthcoming book “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,” from which this essay is adapted.

Here is the way I remember it: The year is 1985, and a few medical students are gathered around an operating table where an anesthetized woman has been prepared for surgery. The attending physician, a gynecologist, asks the group: “Has everyone felt a cervix? Here’s your chance.” One after another, we take turns inserting two gloved fingers into the unconscious woman’s vagina.

Had the woman consented to a pelvic exam? Did she understand that when the lights went dim she would be treated like a clinical practice dummy, her genitalia palpated by a succession of untrained hands? I don’t know. Like most medical students, I just did as I was told.

Last month the Department of Health and Human Services issued new guidance requiring written informed consent for pelvic exams and other intimate procedures performed under anesthesia. Much of the force behind the new requirement came from distressed medical students who saw these pelvic exams as wrong and summoned the courage to speak out.

Whether the guidance will actually change clinical practice I don’t know. Medical traditions are notoriously difficult to uproot, and academic medicine does not easily tolerate ethical dissent. I doubt the medical profession can be trusted to reform itself.

What is it that leads a rare individual to say no to practices that are deceptive, exploitative or harmful when everyone else thinks they are fine? For a long time I assumed that saying no was mainly an issue of moral courage. The relevant question was: If you are a witness to wrongdoing, will you be brave enough to speak out?

But then I started talking to insiders who had blown the whistle on abusive medical research. Soon I realized that I had overlooked the importance of moral perception. Before you decide to speak out about wrongdoing, you have to recognize it for what it is.

This is not as simple as it seems. Part of what makes medical training so unsettling is how often you are thrust into situations in which you don’t really know how to behave. Nothing in your life up to that point has prepared you to dissect a cadaver, perform a rectal exam or deliver a baby. Never before have you seen a psychotic patient involuntarily sedated and strapped to a bed or a brain-dead body wheeled out of a hospital room to have its organs harvested for transplantation. Your initial reaction is often a combination of revulsion, anxiety and self-consciousness.

To embark on a career in medicine is like moving to a foreign country where you do not understand the customs, rituals, manners or language. Your main concern on arrival is how to fit in and avoid causing offense. This is true even if the local customs seem backward or cruel. What’s more, this particular country has an authoritarian government and a rigid status hierarchy where dissent is not just discouraged but also punished. Living happily in this country requires convincing yourself that whatever discomfort you feel comes from your own ignorance and lack of experience. Over time, you learn how to assimilate. You may even come to laugh at how naïve you were when you first arrived.

A rare few people hang onto that discomfort and learn from it. When Michael Wilkins and William Bronston started working at the Willowbrook State School in Staten Island as young doctors in the early 1970s, they found thousands of mentally disabled children condemned to the most horrific conditions imaginable: naked children rocking and moaning on concrete floors in puddles of their own urine; an overpowering stench of illness and filth; a research unit where children were deliberately infected with hepatitis A and B.

“It was truly an American concentration camp,” Dr. Bronston told me. Yet when he and Dr. Wilkins tried to enlist Willowbrook doctors and nurses to reform the institution, they were met with indifference or hostility. It seemed as if no one else on the medical staff could see what they saw. It was only when Dr. Wilkins went to a reporter and showed the world what was happening behind the Willowbrook walls that anything began to change.

When I asked Dr. Bronston how it was possible for doctors and nurses to work at Willowbrook without seeing it as a crime scene, he told me it began with the way the institution was structured and organized. “Medically secured, medically managed, doctor-validated,” he said. Medical professionals just accommodated themselves to the status quo. “You get with the program because that’s what you’re being hired to do,” he said.

One of the great mysteries of human behavior is how institutions create social worlds where unthinkable practices come to seem normal. This is as true of academic medical centers as it is of prisons and military units. When we are told about a horrific medical research scandal, we assume that we would see it just as the whistle-blower Peter Buxtun saw the Tuskegee syphilis study : an abuse so shocking that only a sociopath could fail to perceive it.

Yet it rarely happens this way. It took Mr. Buxtun seven years to convince others to see the abuses for what they were. It has taken other whistle-blowers even longer. Even when the outside world condemns a practice, medical institutions typically insist that the outsiders don’t really understand.

According to Irving Janis, a Yale psychologist who popularized the notion of groupthink, the forces of social conformity are especially powerful in organizations that are driven by a deep sense of moral purpose. If the aims of the organization are righteous, its members feel, it is wrong to put barriers in the way.

This observation helps explain why academic medicine not only defends researchers accused of wrongdoing but also sometimes rewards them. Many of the researchers responsible for the most notorious abuses in recent medical history — the Tuskegee syphilis study, the Willowbrook hepatitis studies, the Cincinnati radiation studies , the Holmesburg prison studies — were celebrated with professional accolades even after the abuses were first called out.

The culture of medicine is notoriously resistant to change. During the 1970s, it was thought that the solution to medical misconduct was formal education in ethics. Major academic medical centers began establishing bioethics centers and programs throughout the 1980s and ’90s, and today virtually every medical school in the country requires ethics training.

Yet it is debatable whether that training has had any effect. Many of the most egregious ethical abuses in recent decades have taken place in medical centers with prominent bioethics programs, such as the University of Pennsylvania , Duke University , Columbia University and Johns Hopkins University , as well as my own institution, the University of Minnesota .

One could be forgiven for concluding that the only way the culture of medicine will change is if changes are forced on it from the outside — by oversight bodies, legislators or litigators. For example, many states have responded to the controversy over pelvic exams by passing laws banning the practice unless the patient has explicitly given consent.

You may find it hard to understand how pelvic exams on unconscious women without their consent could seem like anything but a terrible invasion. Yet a central aim of medical training is to transform your sensibility. You are taught to steel yourself against your natural emotional reactions to death and disfigurement; to set aside your customary views about privacy and shame; to see the human body as a thing to be examined, tested and studied.

One danger of this transformation is that you will see your colleagues and superiors do horrible things and be afraid to speak up. But the more subtle danger is that you will no longer see what they are doing as horrible. You will just think: This is the way it is done.

Carl Elliott ( @FearLoathingBTX ) teaches medical ethics at the University of Minnesota. He is the author of the forthcoming book “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,” from which this essay is adapted.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

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O: Obligations to honor

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