Nursing Ethics A Virtue-Based Approach

by Armstrong, Alan E.

• ISBN13: 9780230506886
• ISBN10: 0230506887
• Edition: 1st
• Format: Hardcover
• Copyright: 2007-05-15
• Publisher: Palgrave Macmillan

Summary

Reacting against the dominance of obligation-based moral theories in both general and nursing ethics, the author proposes a 'strong' (action-guiding) account of a virtue-based approach to moral decision-making within contemporary nursing practice. Merits and criticisms of obligation and virtue-based approaches to morality are identified and examined. One of the author's central premises is that the notions of moral goodness and badness carry more moral weight than the traditionally important notions of moral rightness and wrongness. Therefore, the author argues that in order to deliver morally good care, it is vital to consider the kind of nurse one is and this means examining one's moral character. This book will be rewarding reading for a wide range of readers including clinical nurses, nurse educators and nurse ethicists; indeed, anyone interested in morality and ethics and the work of nurses will find this book stimulating reading.

Author Biography

ALAN E. ARMSTRONG is Senior Lecturer in Nursing at the University of Central Lancashire.

Table of Contents

Preface and Acknowledgements	p. ix
Introduction	p. 1
Broad aim of the book	p. 1
Plan of the book	p. 1
Illness, Narratives and the Value of the Nurse-Patient Relationship	p. 4
Introduction	p. 4
Illness and narratives	p. 4
Hospitalization and patients' emotions	p. 6
A brief history of the nurse-patient relationship	p. 9
The nurse-patient relationship in contemporary nursing and the notion of empowerment	p. 10
Therapeutic nurse-patient relationships	p. 13
The role of the nurse	p. 16
Barker, Jackson and Stevenson on the essential feature of mental health nursing	p. 19
Defining a 'good' nurse	p. 22
Conclusions	p. 24
The Virtues in General Ethics	p. 26
Introduction	p. 26
On 'faring well'	p. 26
The virtues in the history of philosophy	p. 27
What is a virtue?	p. 28
Assumptions about virtues and goodness	p. 30
Virtues or vices?	p. 31
Is it possible to provide a complete list of virtues?	p. 31
What might determine important virtues?	p. 32
What is a virtue? Revisited	p. 34
Why should the virtues be valued?	p. 35
Advantages of the virtue-based approach to morality	p. 37
Problems with the virtues	p. 38
Conclusions	p. 39
A Critique of Obligation-Based Moral Theories in General Ethics	p. 40
Introduction	p. 40
Characterizing obligation-based moral theories	p. 40
Consequentialism	p. 41
Objections to act-consequentialism	p. 44
Problems with utilitarianism	p. 48
Merits of consequentialism	p. 57
Rule-consequentialism	p. 58
Consequentialism - conclusions	p. 59
Deontology	p. 60
Contemporary deontology	p. 60
Deontological constraints	p. 63
Intention and foresight in deontology	p. 65
Problems with deontology	p. 68
Deontology and intuitions: A response	p. 74
Deontology: Conclusions	p. 75
Conclusions	p. 75
The Origins, Development and Tenets of Virtue Ethics	p. 77
Introduction	p. 77
The origins and development of virtue ethics	p. 77
The central tenets of virtue ethics	p. 78
Virtue ethics: Nomenclature	p. 79
Supplementary virtue ethics	p. 79
Strong virtue ethics	p. 82
Aristotle's virtue ethics	p. 83
Objections to Aristotle's ethics	p. 88
Virtue ethics and moral character	p. 91
Conclusions	p. 94
Common Objections to Virtue Ethics	p. 95
Introduction	p. 95
Conclusions	p. 108
A Critical Account of Obligation-Based Moral Theories in Nursing Practice	p. 109
Introduction	p. 109
Why are obligation-based moral theories popular in nursing?	p. 109
Examples of the deontic approach to moral decision-making in the nursing literature	p. 110
Moral decision-making tools	p. 114
The four principles approach to biomedical ethics	p. 115
Criticisms of obligation-based moral theories in nursing	p. 120
Conclusions	p. 122
Virtue-Based Moral Decision-Making in Nursing Practice	p. 125
Introduction	p. 125
Judgement and moral wisdom	p. 126
The virtue-based helping relationship	p. 134
The virtue-based approach to moral decision-making in nursing practice	p. 141
Merits of the virtue-based approach to moral decision-making in nursing practice	p. 144
Criticisms of the virtue-based approach to moral decision-making in nursing practice	p. 148
Conclusions	p. 155
MacIntyre's Account of the Virtues	p. 157
Introduction	p. 157
Criticisms of MacIntyre's thesis	p. 167
Conclusions	p. 178
MacIntyre's Account of the Virtues and the Virtue-Based Approach to Moral Decision-Making in Nursing Practice	p. 180
Introduction	p. 180
Nursing practice, narratives and morality	p. 180
Nursing as a practice: Its internal goods and the virtues	p. 182
The virtue-based approach as a tradition of enquiry	p. 186
Conclusions	p. 186
Conclusions	p. 187
Introduction	p. 187
Criticisms of the virtue-based approach to moral decision-making in nursing practice	p. 191
Areas for further research and enquiry	p. 194
Merits of the virtue-based approach to moral decision-making in nursing practice	p. 195
Teaching the virtues	p. 197
Conclusions	p. 199
Notes	p. 201
Bibliography	p. 224
Index	p. 233
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