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)
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)
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)
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)
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.
This book presents an exploration of concepts central to health care practice. In exploring such concepts as Subjectivity, Life, Personhood, and Death in deep philosophical terms, the book aims to draw out the ethical demands that arise when we encounter these phenomena, and also the moral resources of health care workers for meeting those demands. The series Values in Bioethics makes available original philosophical books in all areas of bioethics, including medical and nursing ethics, health care ethics, research ethics, environmental (...) ethics, and global bioethics. (shrink)
Abstract According to the Deprivation Approach, the evil of death is to be explained by the fact that death deprives us of the goods we would have enjoyed if we had lived longer. But the Deprivation Approach confronts a problem first discussed by Lucretius. Late birth seems to deprive us of the goods we would have enjoyed if we had been born earlier. Yet no one is troubled by late birth. So it’s hard to see why we should be troubled (...) by its temporal mirror image, early death. In a 1986 paper, Anthony Brueckner and John Martin Fischer appealed to a version of Derek Parfit’s “Bias toward the Future”; they claimed that early death deprives us of future goods that we care about, while late birth deprives us of past goods that we don’t care about. In this paper I show that the Brueckner–Fischer principle is open to several possible interpretations, but that it does not solve the Lucretius problem no matter how we understand it. Content Type Journal Article Pages 1-9 DOI 10.1007/s11098-011-9766-6 Authors Fred Feldman, Department of Philosophy, University of Massachusetts at Amherst, Amherst, MA 01003, USA Journal Philosophical Studies Online ISSN 1573-0883 Print ISSN 0031-8116. (shrink)
The importance of public confidence in scientific findings and trust in scientists cannot be overstated. Thus, it becomes critical for the scientific community to focus on enhancing the strategies used to educate future scientists on ethical research behaviors. What we are lacking is knowledge on how faculty members shape and develop ethical research standards with their students. We are presenting the results of a survey with 3,500 research faculty members. We believe this is the first report on how faculty work (...) with and educate their PhD students on basic research standards. Specifically, we wanted to determine whether individual faculty members, who are advisors or mentors, differ in how they implemented components of responsible conduct of research (RCR) with their PhD students. Mentors were more likely than advisors or supervisors to report working with all of their PhDs, who graduated in the last 5 years, on the 17 recognized critical components of RCR training and research skill development. We also found about half of the faculty members believe RCR is an institutional responsibility versus a faculty responsibility. Less than a quarter have had opportunities to participate in faculty training to be a better mentor, advisor, or research teacher, and about one third of faculty did not or could not remember whether they had guidelines related to their responsibilities to PhD students. We discuss the implications of our findings and focus on ways that PhD research mentoring can be enhanced. (shrink)
Derek Parfit has recently defended the view that no one can ever deserve to suffer. Were this view correct, its implications for the thorny problem of the justification of punishment would be extraordinary: age-old debates between consequentialists and retributivists would simply vanish, as punishment would only—and simply—be justifiable along Benthamite utilitarian lines. I here suggest that Parfit’s view is linked to uncharacteristically weak arguments, and that it ought to be rejected.