Towards a strong virtue ethics for nursing practice

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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 wellestablished 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 virtuebased 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 contextdependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to
develop this account yet further
Original languageEnglish
Pages (from-to)110-124
Number of pages15
JournalNursing Philosophy
Issue number3
Publication statusPublished - 2006

Bibliographical note

This frequently cited paper summarises my 2004 PhD thesis.


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