Background: Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. Objective: This article is an analysis (...) of the concept of moral courage in nursing. Design: Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis. Data sources: The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Results: Seven core attributes of moral courage were identified: 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. Discussion and conclusion: This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

A number of scholars have suggested that Milgram’s laboratory studies of obedience offer an incisive analysis of the behavior of the Holocaust perpetrators. The present paper rejects that position. The contrasts between the two events, at every level of analysis, are striking: In Milgram’s research, innocent peers were harmed in the context of science; in the Holocaust, rabidly hated, subhuman enemies were murdered in the context of ‘war’. With regard to underlying psychological mechanisms, the evidence questioning the relevance of Milgram’s (...) research is equally compelling: obedience pressures had little role in the Holocaust. Most of the Nazi perpetrators showed no remorse or moral distress over the murders and perhaps most critically, virtually all of the killers knew that they could choose not to participate in the killings. (shrink)

I explore tensions between the dynamics observed during a shadowing experience in a clinic and a hospital and theories of power and organizations. Commenting on what the tensions reveal about “power at work” (in the dual sense of how power works and power in the workplace), I suggest that some of the most gratifying experiences of workplace collaboration for healthcare professionals may occur as a result of their having successfully navigated complex coalitions of hierarchies, teams and webs rather than dutifully (...) adhering to any single organizational structure. (shrink)

More than 7% of all German physicians became members of the Nazi SS during World War II, compared with less than 1% of the general population. In so doing, these doctors willingly participated in genocide, something that should have been antithetical to the values of their chosen profession. The participation of physicians in torture and murder both before and after World War II is a disturbing legacy seldom discussed in medical school, and underrecognised in contemporary medicine. Is there something inherent (...) in being a physician that promotes a transition from healer to murderer? With this historical background in mind, the author, a medical student, defines and reflects upon moral vulnerabilities still endemic to contemporary medical culture. (shrink)

Many medical students are fearful of voicing their concerns about ethically troubling medical practice. Yet they must speak up if they are to meet their responsibilities to patients, colleagues, and the profession of medicine.