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John Q by Nick Cassavetes: Psychological Analysis

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The 20th century saw revolutionary works on the development of morality, a topic highly explored till today by philosophers, anthropologists, psychologists and the likes. Morality, in general, differentiates right from wrong, good from bad (Edwards & Carlo, 2005). The study of moral development dates a long way back (Haidt, 2008; Edwards & Carlo, 2005). Renditions of theories on morality were subjected to constant scrutiny and revisions. Perhaps the most highly debated theory of moral development is Kohlberg’s (1966, as cited in Martin, Carlson, & Biskit, 2012; Haidt, 2008; Edwards & Carlo, 2005; Kohlberg & Hersh, 1977) stages of moral development. The longitudinal study involved the presentation of stories involving moral dilemmas, better known as Heinz dilemma (Martin et al., 2012; Santrock, 2011), to participants (boys between 10 and 17 years old). The moral conflict in Heinz dilemma is not unfamiliar to society today. Although hypothetical, the dilemma is not far from truth.

It may be familiar to all that at times decisions can be tough to make when faced with issues of moral and ethics. More often than not, the oxymoron of “rightfully wrong” presents itself in our decision making process. One movie, John Q, directed by Cassavetes (2002), aptly brings forth this moral dilemma. This essay shall, firstly, explore some of the major theories of moral development before Kohlberg’s work, namely Freud and Piaget. Followed by the evaluation of Kohlberg’s theory of moral development. Finally, alternative theories of morality and future directions shall be discussed. The evaluation of Kohlberg’s theory of moral development shall be analysed through the film, John Q. The movie depicts the moral dilemma of a man who held the emergency room of a privately-owned hospital hostage to save his dying son.

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Theories of Freud and Piaget

Prior to the proliferation of Kohlberg’s idea on morality, influential psychology theorist such as Sigmund Freud and Jean Piaget worked on the concept of morality (Turiel, 1998). One of the earliest exploration of morality was made by Freud when he detailed the concept of personality. Freud’s (cited in Martin et al., 2012) psychoanalytic structure on personality states that the id, ego and superego are different processes that regulate and manage our thoughts, feelings and actions. The id characterizes humans’ instinctual responses and operates on the principle of pleasure, the ego functions on the principle of reality and balances the desires of the id with the demands of the superego, the superego acts as the moral mechanism of the individual. Freud was focused on the concepts of conscience, the struggle for balance between the individual’s desires and the expectations of society (Turiel, 1998), and feelings of guilt and anxiety in the concept of moral development (Santrock, 2011).

Piaget (cited in Turiel, 1998) was more concerned with the knowledge and judgements of social relationships in morality. He believed that morality is embedded in a “system of rules, and the essence of all morality is to be sought for in the respect which the individual acquires for these rules” (Piaget & Gabain, 1965, p. 13). Furthermore, he believed that morality is influenced by emotional reactions and relationship with others (Turiel, 1998). Piaget (1932, as cited in Turiel, 1998) theorized that morality develops in two distinct stages: heteronomous morality and autonomous morality. The former stage occurs in children from about four to seven years of age, where rules and sense of justice are strictly adhered to, and are heavily influenced by their relationship with parents. Following that, children from seven to ten years old is in a stage of transition, showing some features of heteronomous morality and autonomous morality stages. The latter stage is exhibited by children from ten years of age and above, where the conception of man-made rules and laws, and the judgement of actions in relation to the intent and consequences, develops (Santrock, 2011; Turiel, 1998; Giammarco, 2015).

It can be observed that Freud and Piaget have contrasting views on morality (Turiel, 1998). Freud seems to allude morality to unconscious, innate psychological impulsions; whereas Piaget’s concept of autonomy – the conscious evaluation and “elaboration of norms” (Turiel, 1998, p. 474) – insinuates that morality is more than just a reaction to underlying psychological compulsions. Following Freud, Piaget and other theorists, the study of morality was heavily loaded on the system of societal control and psychoanalytic evaluations of individual’s interests and desires (Turiel, 1998). Subsequently, Kohlberg (1971) critiqued these dominant approach, and formulated his process of moral development (Kohlberg & Hersh, 1977).

Evaluating Kohlberg’s Stages of Development

Kohlberg extended Piaget’s two-stage moral development theory to a six-stage cognitive-developmental approach (Haidt, 2008). Like Piaget, Kohlberg based his theory on the domain of moral reasoning, and the stages are characterized as follow: Stages are organized thought systems, can only be in a state of chronological progress (never skip a stage), and are hierarchical in nature (Kohlberg & Hersh, 1977). The stages of development can be categorized as: Preconventional level, conventional level, and postconventional level. The first two stages of development falls under preconventional level of moral development, stages three and four in conventional level, and last two stages in postconventional level (Giammarco, 2015; Turiel, 1998; Kohlberg & Hersh, 1977).

At the preconventional level, the child makes moral judgements based on rules of society and labels of good and bad, however, these labels are interpreted in terms of physical consequences of behaviours and shunning from punishment (Kohlberg & Hersh, 1977; Giammarco, 2015). This is similar to Piaget’s stage of heteronomous morality wherein there is strict adherence to rules. The child in the conventional level is loyal to the family, group or nation and seeks to actively maintain positive relationship and foster a sense of belonging (Kohlberg & Hersh, 1977). This level of moral development is in conjunction with Piaget’s idea of interdependency and positive relationships. At the postconventional level, the individual applies moral values in the absence of authority figures (unlike the previous levels) and has a greater awareness of general moral principles (Kohlberg & Hersh, 1977; Giammarco, 2015). This is in line with Piaget’s autonomous morality stage, where individuals understand the “bigger picture”. The respective stages of each level of moral development shall be illustrated with examples from the film, John Q.

Kohlberg’s theory in relation to John Q

The film, John Q, is a prime example of Kohlberg’s dilemma. Similar to the Heinz dilemma created by Kohlberg, the film depicts tough moral decisions the protagonist, John Q, had to make in order to grant his dying son a heart transplant. The first stage of moral development is characterized by the avoidance of punishment and obedience, the second stage is marked by the advancement of one’s self interest (Kohlberg & Hersh, 1977). The character, Mitch, portrays the first two stages of moral development. Mitch’s main concern, throughout the film, was to stay out of trouble and only thought about what he wanted as a personal reward; and whether he implicated others or not was of no concern to him.

The third stage is depicted by the conformity to society’s standards of good behaviour, and the maintenance of agreeableness in interpersonal relationships (Kohlberg & Hersh, 1977). This aspect of the stage is portrayed by John Q’s son in the scene where he offered to give his savings of the week to the family, signifying that he is a “good boy” and concerned about harmonious relationship. Moving on, the fourth stage is signified by the maintenance of law and order (Kohlberg & Hersh, 1977). The scenes of John Q saving up money, going to his insurance policy makers, looking for financial aid prior to his resort of using force portrayed his conformity to law and order, which constitutes “good” behaviour.

Following the fourth stage, the fifth stage is marked by the evaluation of rules and laws in relation to personal values and general moral principles (Giammarco, 2015; Kohlberg & Hersh, 1977). Clearly, laws are not blindly adhered to in this stage, and the understanding that laws can be changed are developed (Kohlberg & Hersh, 1977). Finally, the sixth stage focuses on the universal application of equality, human rights and respect (Giammarco, 2015; Kohlberg & Hersh, 1977). This is evident throughout the later part of the film where John used an unloaded gun to take hostages in the emergency room, even though he knew that he had violated the law and that there will be punishments meted out to him, to save his son.

The examples above illustrated the various stages of the moral development of Kohlberg’s theory. While the film is fictitious, it presents to the audience the applicability of Kohlberg’s theory in today’s context. The events in the film may well happen in real life, albeit perhaps not to such a large extent. Although Kohlberg’s theory have been prominent in explaining moral development since early 20th century, it is not without limitations and critique.

Review of Kohlberg’s Theory

The cognitive developmental approach of Kohlberg has been supported and criticized by many. One of the debate on his theory alludes to Kohlberg’s emphasis on the role of reason (Arnold, 2000). Kohlberg had been criticised for ignoring other factors which are related to moral functioning such as emotion (Gibbs, 1991). Blasi (cited in Arnold, 2000) further criticised Kohlberg’s lack of convincing evidence for the role of reason in relation to moral behaviour. Perhaps the most denouncing criticism on the role of reason of Kohlberg’s theory is the perception of the moral person the emphasis on reason had created – one that is apathetic, indifferent and detached, far from the truth of everyday life (Boyd, 1989, as cited in Arnold, 2000).

Another criticism of Kohlberg’s theory is in his methodology. Critics argue that Kohlberg’s study of moral reasoning is too abstract, artificial and not a true reflection of real-life situations, hence not as emotionally engaging (Arnold, 2000; Gilligan, 1982; Giammarco, 2015, Krebs & Denton, 2005). Kohlberg’s using of the Moral Judgement Interview scoring system (Colby & Kohlberg, 1987) had been a continual debate due to the low reliability and validity of the test (Arnold, 2000).

The most well-known criticism of Kohlberg’s theory comes from Gilligan (1982). She proposed that Kohlberg’s theory of moral development is sex-biased. Kohlberg’s studies seemed to suggest that men are higher developed morally than women, as men seemed to adhere to universal ethical principles while women based judgements on the effects on others. Thus, in general, men reached stage five of Kohlberg’s developmental model whereas women at stage three (Gilligan, 1982; Martin et al. 2012). It appeared that men based their judgement more on abstract ideas while women on care and concern for relationships (Martin et al., 2012).

On the flipside, studies which support Kohlberg’s stage of moral development found the existence of distinct stages of moral development, and universality of the first four stages across cultures. Dawson (2002) found empirical evidence to support Kohlberg’s claim of distinct stages, more specifically between stages three and four, which had not been revealed previously. Moreover, results suggest that moral development is highly related to educational attainment and age. This likely shows the existence of stages as educational attainment and age progresses chronologically. More recently, Gibbs, Basinger, Grime and Snarey (2007) found that there is a universality effect across culture on “basic moral judgement development, moral values, and related social perspective-taking processes” (p. 491). This shows that there is a universal ethical consideration when faced with moral issues.

Since its inception, Kohlberg’s theory of moral development had assisted us to reach a deeper understanding of morality and its development. Kohlberg’s approach, while not free of shortcomings, had set direction for numerous research. Several other theories have emerged as a result of continuous debate over Kohlberg’s theory. The following section shall discuss some of these theories.

Evaluating Alternative Theories to Moral Development

One main theme in the current research of morality emphasizes on redefining moral domains (Arnold, 2000). Most prominently, the distinction of morality from other domains of social experiences (Turiel, 1983). Moral domain theorists typically categorizes judgements of social experiences as moral (principles of morality), conventional (pertaining to social regulations) and personal (autonomy and individuality) domains (Turiel, 1998; Lourenco, 2014). In contrast to Kohlberg’s stage theory, domain theory propose that the three domains develop in parallel, not chronologically (Turiel, 1983). Critics, however, suggest that the domain theory is not developmental, more similar to Piaget’s and Kohlberg’s theory than its proponents suppose (presumed to be in contrast to Piaget and Kohlberg), and empirically and theoretically inconsistent (Lourenco, 2014).

Another theory of moral development focuses on the moral self instead of moral reasoning, as was set out by Kohlberg (Frimer & Walker, 2008). Blasi (cited in Frimer & Walker, 2008) suggested that the moral personality may affect moral judgements, and that the self-identity might have huge influence on moral behaviours – commonly known as judgement-action gap (Frimer & Walker, 2008; Monin & Jordan, 2009). Recent findings by Yang, Stoeber and Wang (2015) suggested that moral perfectionism is a personality factor that can possibly explain the individual difference in moral values, virtues and judgements. This is consistent with Blasi (cited in Arnold, 2002; Frimer & Walker, 2008) that personality is a key factor in determining moral behaviours. Frimer and Walker (2008), however, also noted the problem of inconsistent empirical findings of moral behaviour, and the inflated scores on virtues or traits which are deemed to be positive.

In all, the domain and moral-self theories have their flaws, like any other theory; but they still suggest alternative approaches to moral development, providing researchers with more perspectives on the issue of moral development. Perhaps with more advanced research methodologies, these theories can prove to be an insightful theory in morality.


To conclude, this essay started off exploring theories of Freud and Piaget, which were the predominant theories before Kohlberg proposed his theory of moral development. The essay then continued to evaluate Kohlberg’s stages of development, an extension of Piaget’s two-stage theory. Kohlberg’s theory was analysed through the film John Q, and scenes from the film were used to illustrate the six stages of moral development. Literatures were then reviewed to compare and contrast several studies that support or critique Kohlberg’s theory. Finally, the essay introduced the domain and moral-self theories which provide alternative perspectives on the study of moral development.

At present, the review of various literatures on past predominant moral developmental theories suggests room for further exploration, and sets the stage for modern research on morality. Given the fast-changing world we live in, perceptions of morality now may well differ from the past, and continues to be dynamic. Perhaps while the sense of “right” and “wrong”, “good” and “bad” alters in relation to the changing trends of society, more pragmatic approaches should be utilized to work on our understanding of moral development (Krebs & Denton, 2005). While we set a new way forward, let us appreciate the strong foundation past theories have built. It is worthwhile for future research to consider the limitations of these theories and seek to expand on the existing frameworks of moral development in hopes to achieve a holistic understanding of moral development.


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