Abstract

No aspect of nursing practice exists that does not invite consideration of its moral dimensions, and numerous ethical theories and perspectives have been advanced as moral guides to practice. However, nursing has yet to consider the sociocultural factors contributing to the development of ethical knowledge for the discipline and profession, which in turn shapes those who use and those who are affected by this knowledge. Postmodern views about the nature of knowledge and reality offer the discipline an epistemological perspective that explicitly addresses the social construction of ethical theory development for nursing. Furthermore, postmodern philosophy provides assumptions and beliefs for the conceptualization of an alternative moral approach for nursing. This inquiry proposes that such an approach can be found within the patient-nurse relationship in the form of a relational narrative, an ethic cocreated by patient and nurse. ;The purpose of this philosophical inquiry is to further develop nurse philosopher Sally Gadow's original conception of the relational narrative as a moral approach for nursing, an ethic consistent with postmodern perspectives on the nature of knowledge and reality that addresses the particular moral challenges of nursing practice. Toward this purpose, the inquiry first explores from a postmodern perspective the proposition that all ethical theory in nursing is socially constructed. Nursing's predominant ethical approaches, principle-based bioethics and care-based ethics, are critically analyzed as examples. Second, the relational narrative is philosophically elaborated through further development of its foundations in relationship and narrative and through articulation of the ethic's value dimensions. These dimensions include shared intentionality focusing on the good, moral agency, critical agency, engagement, and care respect. Third, a selection from the literary genre of pathography is used to illustrate and further illuminate the relational narrative. The inquiry concludes with an examination of the relational narrative as a postmodern ethic for nursing, one that potentially overcomes the weaknesses of nursing's predominant moral approaches related to their social construction. Implications of the inquiry for nursing knowledge development, practice, and education are addressed