The vast majority of research in nursing ethics over the last decade indicates that nurses may not be fully prepared to ‘deliver the good’ for their patients, or to contribute appropriately in the wider current health care climate. When suitable research projects were evaluated for this article, one key question emerged: if nurses are educationally better prepared than ever before to exercise their ethical decision-making skills, why does research still indicate that the expected practice-based improvements remain elusive? Hence, a number (...) of ideas gleaned from recent research about the current nature of nursing ethics, and especially teaching nursing ethics to student nurses, are analysed and critiqued in this article, which concludes with a cluster of ideas and conclusions based on that analysis. It is hoped that such a review may serve as a catalyst for nurse educators to re-examine their teaching practices with a view to enhancing good nursing practice through educational means. (shrink)

The prevailing accounts of Aristotle's view of practical wisdom pay little attention to all the intellectual capacities discussed in Nicomachean Ethics Book 6. They also contrast the phronimos with the wicked, the continent or the incontinent, rather than with those who have 'natural virtue' (innate or habituated), and thereby they neglect the importance of experience, through which those capacities are acquired. When we consider them, we can see what sort of experience is needed and hence what sort aspirants to full (...) virtue should be trying to acquire. It turns out that much of the knowledge such experience yields is just plain worldly knowledge. But it is not to be despised on that account. The phronimos must meet a threshold of knowledge that he will, indeed, share with some of the wicked, but will have a superior version that goes beyond theirs. (shrink)

: Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this contribution is to develop a fundamental ethical view on nursing care considered as moral practice. Three main components are analyzed more deeply--i.e., the caring relationship, caring behavior as the integration of virtue and expert activity, and "good care" as the ultimate goal (...) of nursing practice. For the development of this philosophical-ethical interpretation of nursing, we have mainly drawn on the pioneering work of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. We will also show that the European philosophical background offers some original ideas for this endeavor. (shrink)

Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the ‘therapeutic’ or ‘helping’ nurse–patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories (...) and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics’ action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further. (shrink)

Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an (...) emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics. (shrink)

Care is widely thought to be a role virtue for health care professionals (HCPs). It is thought that in their professional capacity, HCPs should not only take care of their patients, but should also care for their patients. I argue against this thesis. First I show that the character trait of care causes serious problems both for caring HCPs and for cared-for patients. Then I show that benevolence plus caring action causes fewer and less serious problems. My surprising conclusion is (...) that care is a vice rather than a virtue for HCPs. In their professional capacity HCPs should not care for their patients. Instead HCPs should be benevolent and act in a caring manner toward their patients. Keywords: care, ethics, virtue CiteULike Connotea Del.icio.us What's this? (shrink)

Compassionate care: a moral dimension of nursingThis paper focuses on the concept of compassion and its meaning for nursing practice. Compassion is often considered to be an essential component of nursing care; however, it is difficult to identify what exactly comprises compassionate care. To begin with, there is a general discussion of the meaning of compassion and an examination of its common usage. An argument then is presented that compassion is more than just a natural response to suffering, rather that (...) it is a moral choice. The paper outlines the extent to which this concept has implications for nursing care, highlighting some of the obstacles that nurses need to overcome in order to maintain this essential moral value of the caring role. (shrink)

Champions of virtue ethics frequently appeal to moral perception: the notion that virtuous people can “see” what to do. According to a traditional account of virtue, the cultivation of proper feeling through imitation and habituation issues in a sensitivity to reasons to act. Thus, we learn to see what to do by coming to feel the demands of courage, kindness, and the like. But virtue ethics also claims superiority over other theories that adopt a perceptual moral epistemology, such as intuitionism (...) – which John McDowell criticizes for illicitly “borrow[ing] the epistemological credentials” of perception. In this paper, I suggest that the most promising way for virtue ethics to use perceptual metaphors innocuously is by adopting a skill model of virtue, on which the virtues are modeled on forms of practical know-how. Yet I contend that this model is double-edged for virtue ethics. The skill model belies some central ambitions and dogmas of the traditional view, especially its most idealized claims about virtue and the virtuous. While this may be a cost that its champions are unprepared to pay, I suggest that virtue ethics would do well to embrace a more realistic moral psychology and a correspondingly less sublime conception of virtue. (shrink)

We have seen important work on questions such as: whether there is a uniquely female approach to ethics, whether ethics should be par.

In recent years philosophers and bioethicists have given considerable attention to the concept of care. Thus we have seen important work on questions such as: whether there is a uniquely female approach to ethics, whether ethics should be partial or impartial, and whether care must be supplemented by justice. Despite this valuable and extensive work, however, some important distinctions have gone largely undiscussed. This paper tries to fill a gap left in our understanding of the concept of care itself by (...) distinguishing between compassion and two kinds of pity. While all three are kinds of caring, we should not give them similar moral evaluations. Consequently, the distinction between compassion and different kinds of pity gives us an important insight into the question of whether we can consider care a virtue for health care professionals. (shrink)