Moral intensity and ethical sensitivity in pre-service therapeutic sciences clinicians: a vignette-level analysis of ethical principle recognition and ethical sensitivity skills

Ethical sensitivity is a foundational component of moral functioning, enabling individuals to recognise ethically salient aspects of situations. In healthcare education, this capacity is critical for ethical practice. While ethics education often emphasises ethical principle knowledge, less is known about how contextual features of moral situations-such as moral intensity-relate to different components of ethical sensitivity. This retrospective cross-sectional study examined vignette-level associations between moral intensity and ethical sensitivity using previously collected data from 120 final-year pre-service clinicians across the therapeutic sciences. Twelve clinical vignettes from the Measuring Instrument for Ethical Sensitivity in the Therapeutic Sciences (MIEST) were independently rated for moral intensity using Jones's six-dimension framework. Moral intensity scores ranged from 20 to 28 (possible range 6-30). Moral intensity was not associated with ethical principle recognition or overall ethical sensitivity scores. However, a strong positive vignette-level correlation was observed between moral intensity and ethical sensitivity skill identification (r = 0.81, p = 0.001). These findings provide preliminary empirical support for ethical sensitivity as a multidimensional construct and suggest that contextual features of moral situations may differentially engage perceptual-affective components of ethical sensitivity.