This is lightly edited and referenced version of a presentation given at the 20th International Philosophy of Nursing conference in Quebec on 23rd August 2016. Philosophical texts are not given the same prominence in nurse education as their more valued younger sibling, primary research evidence, but they can influence practice through guidelines, codes and espoused values. John Stuart Mill’s harm principle, found in On Liberty, is not a universal law, and only a thoroughgoing libertarian would defend it as such, though (...) it, or its remnants, can be seen can be seen in policy documents. But its influence is weakening. Smoking bans in enclosed spaces were initially justified with other‐regarding considerations, but judgements from unsuccessful legal challenges from patients in UK psychiatric hospitals rely on preventing harm to the smoker, even when smoking outside, which does not harm others. In the wake of legislation, no‐smoking policies enacted by hospitals are becoming more aggressive, banning smoking both inside and outside, and extending the use of power gained through employment to prevent nurses assisting patients enjoy a lawful habit. Mill’s dictum has been subverted, and this speaks to the fundamental purpose of nursing. Should nurses collude and willingly exert their power for their version of the good of the patient? Or should they instead reaffirm values that support and facilitate life choices made by autonomous people? The paper supports the latter option, and this has wider application for nursing which can be illuminated, if not settled, by revisiting Mill and his famous dictum. (shrink)

Nurses play a key role in the provision of services in relation to sexuality in both primary and sexual and reproductive health‐care. Given the intersection of sexualities with a range of social injustices, this study reviews research on nursing practice concerning sexuality from an emancipatory/social justice perspective. A systematic review of English articles published in nursing journals appearing on the Web of Science database from 2009 to 2014 was conducted. Thirty‐eight articles met the inclusion criteria. Analysis consisted of a descriptive (...) phase (types and location of studies, aspects of sexualities focused on, target health users and aspects of nursing practice focused on) and a critical/emancipatory phase. In terms of practice, our analysis revealed that: barriers exist to the integration of issues relating to sexuality in nursing practice; the social location of nurses and their personal feelings regarding sexuality influence their practice; content that addresses gendered norms and media that assist in communication underpin some emancipatory practices. Few studies locate analyses of nursing practice within gendered, cultural and social norms; consider advocacy as part of the practice of nurses; or analyse the promotion of health user participation in health services and structures. The implications for emancipatory practice are drawn out. (shrink)

In this article, a poetical and performative narrative is shared to examine how the use of stories to critically self‐reflect on oppression facilitates an understanding of critical social theory in nursing education and impacts social justice. A fusion of prose with a poetical narrative is employed; the latter is reserved to capture the immediacy of personal, emotive, and embodied storied experiences. This deeply intimate and dialogical story begins with a pedagogical experiment created to facilitate nursing students' understanding of critical social (...) theory. Drawing upon Paulo Freire's work, the nursing teacher in a professional development course attempted to deconstruct power relations and cultivate an open and safe learning environment by sharing a poem that depicts her oppression. Students then anonymously wrote a word/statement about their oppression. The teacher created a composite poem from students' words and shared it with the class; it was a powerful moment that highlighted their shared humanity. As a way to further explore stories and consider how to preserve these words, a small group of students and the teacher formed the ‘the oppression group’. Towards the end, we conclude an unfinished story by realizing that the chains of oppression are loosening and humanity is surfacing. There is still a camouflaging of an authentic self. There are still stories to be told. The group is not yet certain if a social representation of an authentic self is possible and if all stories can be told. It has become apparent that the personal can play out in social justice as enacted in the classroom between teacher and students and provides an entry point into the development of the capacity to be social agents in nursing. The group simultaneously concludes the story with both an ending and a threshold of social justice. (shrink)

In this paper, we explore the concept of bearing witness in nursing practice. We examine the description of bearing witness in the nursing literature, particularly that offered by William Cody who suggests that bearing witness results in the limited moral obligation of “true presence.” We then turn to Lorraine Code's work on testimony, drawing parallels between the concepts of testimony and bearing witness. Code suggests that receiving testimony results in a responsibility to respond, and that this is an ethico‐political obligation. (...) We discuss these ideas in relation to a Canadian exemplar of witnessing the Truth and Reconciliation Commission of Canada's work to understand and address the historical injustices done to Indigenous peoples in Canada. Here, we focus on the Commission's definition of witnessing and highlight the experience of Shelagh Rogers who served as an honorary witness. As an outcome of our analysis, we suggest that bearing witness in nursing practice is most usefully conceptualized as both a moral and a political obligation. Implications for nursing practice are suggested, including first, the need to critically examine our own understandings of power and privilege in order to authentically bear witness and avoid being complicit in injustice, and second, the concomitant responsibility to take action to challenge injustice once we have borne witness to it. (shrink)

Paradigm debates have been featured in the nursing literature for over four decades. There are at least two opposing paradigms specific to nursing that have remained central in these debates. Advocates of the unitary perspective (or simultaneity paradigm) consider their theories to be more philosophically advanced and contemporary alternatives when compared to the older more traditional ideas characteristic of models they describe as originating from the totality paradigm. In the context of these debates, I focus on some theoretical positions embedded (...) in the unitary perspective, noting their limitations with respect to integrating the individual and social mandates of nursing; nurses are responsible not only for individual health‐related needs, but also for the health of the collective. I explore two hypotheses that may explain the powers of endurance of the unitary perspective. Paley, who outlines the origins of nurses' ‘slave morality’, inspires the first hypothesis. The second hypothesis speaks to the location of nursing knowledge development in the context of liberal ideology. In this work, I outline key conceptualizations of the unitary perspective in order to clearly illustrate the limitations of the unitary perspective for nurses' social mandate. Then, I explore how slave morality and liberal ideological assumptions might both work to sustain the unitary perspective. A paradigm for nursing must have utility in addressing both the health‐related needs of individuals, and for addressing the health of the collective. To this end, I advance suggestions in three areas: first, to transform nurses' slave morality to more honest and noble aspirations; second, to examine liberal ideological premises; and third, to end paradigm debate by resituating elements of the unitary perspective to the level of mid‐range theory, where it could be most effective for research and practice with specific populations. (shrink)