In his attempt to explain and draw together disparate aspects of the tradition of the virtues MacIntyre develops a complex and specific concept that he terms a practice. By a practice he means to describe certain types of activities in which excellences can be pursued and that offer those engaged in a practice access to the goods internal to that practice.Sellman and Wainwright have both suggested that there are advantages to be had in understanding nursing as a practice in (...) this MacIntyrean sense. This paper suggests that nursing should be considered as a particular type of MacIntyrean practice, and I have used the term a professional practice to identify this species.This paper also considers some of the implications of such a perspective and suggests that one benefit of thinking of nursing as a professional practice is that it may offer a route by which the virtues necessary for nursing can be identified. (shrink)

Professional nursing -- Human vulnerability -- Practices and the practice of nursing -- Trust and trustworthiness -- Open-mindedness -- The place of the virtues in the education of nurses.

The virtues have been a neglected aspect of morality; only recently has reference been made to their place in professional ethics. Unfashionable as Florence Nightingale is, it is nonetheless worth noting that she was instrumental in continuing the Aristotelian tradition of being concerned with the moral character of persons. Nurses who came under Nightingale’s sphere of influence were expected to develop certain exemplary habits of behaviour. A corollary can be drawn with the current UK professional body: nurses are expected to (...) behave in certain ways and to display particular kinds of disposition. The difference lies in the fact that, while Nightingale was clear about the need for moral education, current emphasis is placed on ethical theory and ethical decision-making. (shrink)

The general expectation that patients should be willing to trust nurses is rarely explored or challenged despite claims of diminishing public trust in social and professional institutions. Everyday meanings of trust take account of circumstance and suggest that our understanding of what it means to trust is contextually bound. However, in the context of health care, to trust implies a particular understanding which becomes apparent when abuses of this trust are reported and acknowledged as scandals. The predominant assumption in the (...) literature that trust is something that occurs between equally competent adults cannot explain trust in nursing precisely because of the unequal power relationships between patients on the one hand and healthcare professionals on the other. Moreover, the tendency to conflate terms such as trust, reliance, confidence and so on suggests that confusion permeates discussions of trust in nursing. In this paper, I argue in support of Annette Baier’s requirement of good will (or lack of ill will) as the essential feature of trust, and outline how this account (i) enables us to make the necessary distinctions between trust on the one hand and ‘trust pretenders’ on the other; and (ii) lays the foundations for understanding trust in relationships, such as those between patients and nurses, where power differentials exist. (shrink)

The idea that nurses should be trustworthy seems to be accepted as generally unproblematic. However, being trustworthy as a nurse is complicated because of the diverse range of expectations from patients, relatives, colleagues, managers, peers, professional bodies and the institutions within which nursing takes place. Nurses are often faced with competing demands and an action perceived by some as trustworthy can be seen by others as untrustworthy. In this article some of the reasons for the importance of being trustworthy are (...) offered together with a preliminary discussion about how being a trustworthy nurse is far from straightforward. (shrink)

In this paper, Sherrill Grace, Findley’s biographer, will examine her biographical practices in the context of Findley’s own memoir, Inside Memory, and his interest in creating fictional auto/biographers and auto/biography in several of his major novels. His fictional auto/biographers often use the same categories of document that Findley himself used—journals, diaries, archives—and this reality produces some fascinating challenges for a Findley biographer, not least the difficulty of separating fact from fiction, or, as Mauberley says in Famous Last Words, truth (...) from lies. Like many writers, Findley kept journals all his life, and they are a key source of information for his biographer; however, his way of recording information and his creation of fictional journals means that a biographer must tread carefully. While not a theoretical study of auto/biography, in this paper Grace will offer insights into the traps that lie in waiting for a biographer, especially when dealing with a biographee who is as self-conscious an auto/biographer as Findley. (shrink)

Research on the intersection of race and gender suggests that, for African Americans, racial inequality is more salient than gender inequality. However, theoretical perspectives on the multiplicative effects of status positions and “outsider within” models suggest that minority group membership can be a catalyst for the development of feminist attitudes. This article examines three issues central to feminism: recognition and critique of gender inequality, egalitarian gender roles, and political activism for the rights of women. The authors found that support for (...) feminist ideology was common for both African American women and men, although the level of support varied depending on the issue and by gender. Factors predicting the endorsement of feminist ideology also varied depending on the issue and by gender. The authors found partial support for the race saliency hypothesis, but there was also evidence of the multiplicative effects of status positions on African Americans' feminist attitudes. (shrink)

In societies divided on ethnic and religious lines, problems of democracy are magnified – particularly where groups are mobilized into parties. With the principle of majority rule, minorities should be less willing to endorse democratic institutions where their parties persistently lose elections. While such problems should also hamper transitions to democracy, several diverse Eastern European states have formed democracies even under these conditions. In this book, Sherrill Stroschein argues that sustained protest and contention by ethnic Hungarians in Romania and (...) Slovakia brought concessions on policies that they could not achieve through the ballot box, in contrast to Transcarpathia, Ukraine. In Romania and Slovakia, contention during the 1990s made each group accustomed to each other's claims and aware of the degree to which each could push its own. Ethnic contention became a de facto deliberative process that fostered a moderation of group stances, allowing democratic consolidation to slowly and organically take root. (shrink)

The values of nursing arise from a concern with human flourishing. If the desire to become a nurse is a reflection of an aspiration to care for others in need then we should anticipate that those who choose to nurse have a tendency towards the values we would normally associate with a caring profession (care, compassion, perhaps altruism, and so on). However, these values require a secure base if they are not to succumb to the corrupting pressures of the increasingly (...) instrumental nature of the values of the institutions in which healthcare in general and nursing in particular takes place. One way of securing a base for withstanding the corrupting influences of the institution is to understand nursing as a practice in the sense in which Alasdair MacIntyre uses that term. In this brief paper I will outline ways in which the managerial imperative of meeting targets is both distorting practice and undermining nursing’s values. I conclude that understanding nursing as a MacIntyrean practice provides a refuge from what might otherwise be overwhelming pressures for nurses to adopt instrumental values to the detriment of professional caring values. (shrink)

This paper introduces the notion of open‐mindedness before proceeding to outline its value to the practical activity of nursing. An argument is constructed to point to the desirability of the development of a virtue of open‐mindedness in nurses in order to complement evidence‐based practice. Attention is drawn to two failures of open‐mindedness (the vices of closed‐mindedness and credulousness), which have the potential both to restrict autonomous practice and to cause harm.

The prevalent theories of metaphor in the literature, with very few exceptions, involve a conversion of either meaning or reference from the literal meaning or reference of the metaphor to either a corresponding simile or to a metaphorical meaning or reference. In this essay an altemative to the conversion view - i.e., a constancy theory - is offered that requires no such conversions. H.R Grice's notions of conversational maximes and implicatures provide a conceptual framework within which to account for metaphors (...) in a totally literal context. A selection procedure is suggested as the mechanism by which one can interpret metaphors and distinguish them from other figures of speech. (shrink)

Classical philosophical Daoism and ecofeminism converge on key points. Ecofeminism’s critique of Western dualistic metaphysics finds support in Daoism’s nondualistic, particularist, cosmological framework, which distinguishes pairs of complementary opposites within a process of dynamic transformation without committing itself to a binary, essentialist position as regards sex and gender. Daoism’s epistemological implications suggest a link to ecofeminism’s alignment with a situational and provisional model of knowledge. As a transformative philosophy, the cluster of concepts that give specificity to the Daoist notion of (...) transformation offers content and direction for the notion of transformation central to many ecofeminist philosophies. These affinities offer possibilities for developing the relevance of both philosophies to bear upon a theoretical understanding of how we can live in a respectful and sustainable relationship with our natural environment. (shrink)

Many patients are subject to 'do not resuscitate' orders or are 'allowed to die'. The predominant moral position within health care seems to be that this is permissible, while voluntary euthanasia is not. This paper attempts to consider the logic of that position. It is not intended as a case for or against voluntary euthanasia; those cases are made elsewhere. Instead, this is an attempt to challenge implicit assumptions. It is the experience of many nurses that issues relating to matters (...) at the end of life are far from being resolved. This paper does not try to offer any practical solutions but aims at some clarification of the language used. This, it is hoped, will enable nurses to contribute to the debate. (shrink)

Few would argue with the idea that nursing research should be conducted ethically yet obtaining ethical approval is considered by many to have become unnecessarily burdensome. This brief article investigates the idea that there might be a relationship between the level of perceived burdensomeness of the research ethics application process on the one hand and the character of the nurse‐researcher on the other. Given that nurses are required to be other‐regarding, a nurse who undertakes research primarily for self‐regarding reasons would (...) seem to be acting in ways inconsistent with the aims of nursing as set out in nursing codes. It is suggested that the self‐regarding nurse‐researcher may find the ethics application process more burdensome than the other‐regarding nurse‐researcher who, it is further suggested, is engaged with nursing research as a practice in the technical sense in which that term has been developed by the philosopher Alasdair MacIntyre. (shrink)

Metaphor, I argue, is a type of expression that is used to communicate information beyond that communicated by its literal meaning. I argue that the literal meaning of metaphors are essential. I attempt to account for metaphor in such a way as to retain the literal meaning, while also accounting for what is called the "metaphorical meaning" of metaphors. Secondly, I am concerned with the mechanisms in virtue of which we are able to distinguish the metaphorical from the literal. ;Chapter (...) I is a discussion of the problems that I will consider in the dissertation. These include distinguishing metaphorical from literal expressions, Donald Davidson's learnability and scrutability criteria, the exclusionary criteria, conversion and constancy theories of metaphor, and truth-values of metaphors. ;Chapter II critically examines Aristotle's, Max Black's, and Monroe C. Beardsley's intensional conversion theories. Here I argue that conversion theories are inadequate and unnecessary to account for metaphorical attributions. ;Chapter III critically examines extensional conversion theories of metaphor including Nelson Goodman's version. I discuss the difficulties that arise in postulating such reference conversions. I argue that this type of conversion theory is also unsuccessful and unnecessary. ;Chapter IV is a critical examination of four types of emotive theory of metaphor, one of which is Max Rieser's. These theories maintain, and I deny, that metaphors have an "emotive meaning" in addition to or instead of their literal meaning. I consider the shortcomings and consequences of emotive views, and argue that the postulation of emotive meanings is also misguided and unnecessary. ;Chapter V offers an alternative to conversion theories. Here I argue for a theory requiring no meaning or reference conversions. My view involves H. P. Grice's notions of conversational maxims and implicatures. I conclude that metaphors retain their literal meaning, partly in virtue of which they generate implicatures. I also conclude that our recognition of, and ability to distinguish, metaphors from literal expressions involves the violations of conversational maxims. (shrink)

The following two letters were received in response to David Skidmore's article, 'Can nursing survive? A view through the keyhole', which was published in the December 1994 issue of Nursing Ethics.David Skidmore has been asked to reply; his comments follow. Both his and Janet Duberley's letters have been shortened with their consent.

The introduction of nurse‐led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call‐centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. (...) Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call‐centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional ‘hands‐on’ models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries. (shrink)

It is not unusual for the adjective ‘vulnerable’ to be applied to those in receipt of nursing practice without making clear what it is that persons thus described are actually vulnerable to. In this paper I argue that the way nursing has adopted the idea of vulnerability tends to imply that some people are in some way invulnerable. This is conceptually unsustainable and renders the idea of the vulnerable patient meaningless. The paper explores the meaning of vulnerability both in general (...) terms and in the context of nursing practice. It is argued that to be in receipt of nursing is to become, to a greater or lesser extent, more‐than‐ordinary vulnerable. Thus all patients are more‐than‐ordinarily vulnerable and this restricts their potential to flourish. Nurses are well placed to contribute to the flourishing of more‐than‐ordinarily vulnerable persons and my substantive claim is that this ‘protective’ function is indeed a legitimate and fundamental part of the role of nurses. (shrink)