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Table 1 Kohlberg’s stages of moral development

From: How the COVID-19 pandemic affects the moral reasoning of pediatric residents and the general population

Preconventional stage

Stage 1

Avoidance of punishment. The physical consequences of the act determine whether it is good or bad.

Stage 2

Instrumental exchange. Right actions are those that instrumentally satisfy one’s own needs. People are valued in terms of their usefulness.

Conventional stage

Stage 3

Interpersonal conformity. Right actions are those expected by society or peers, with the purpose of obtaining the approval of others.

Stage 4

Law and order. Right actions consist of doing the right thing, respecting authority and maintaining social order. Deviation from the rules can lead to social chaos.

Postconventional stage

Stage 5

Social contract. Behavior is guided by a sense of obligation to a social contract that protects people’s rights. Laws and obligations should be based on the rational calculation of global utility, “the greatest good for the greatest number”

Stage 6

Universal ethical principles. Right actions are defined in terms of universal moral principles (justice, fairness of human rights, and respect for the dignity of human beings as individuals).