title: Towards a strong virtue ethics for nursing practice.
abstract: 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.
authors.affiliation: Department of Nursing, University of Central Lancashire, Preston, Lancashire, UK. aearmstrong@uclan.ac.uk
authors.forename: Alan E
authors.initials: AE
authors.lastname: Armstrong
mesh_terms: D001294:Attitude to Health; D002605:Character; D004644:Emotions; D004645:Empathy; D026689:Ethical Analysis; D028663:Ethical Theory; D004993:Ethics, Nursing; D006808:Humanism; D006801:Humans; D019359:Knowledge; D009014:Morals; D024802:Nurse's Role; D009723:Nurse-Patient Relations / Q000941:ethics; D009742:Nursing Theory; D010344:Patient Advocacy; D010687:Philosophy, Nursing; D028662:Principle-Based Ethics; D012803:Sick Role; D012945:Social Values; D028722:Virtues