Abstract

This dissertation proposes and defends the thesis that there is a morality internal to the practice of nursing from which the moral obligations of nurses can be derived. Nursing practice is the starting point from which all analysis proceeds. The opening chapter describes characteristics of a moral profession, identifies the nonnegotiables of moral health care, clarifies what it is reasonable to expect from a clearly-articulated statement of the morality internal to the practice of nursing, critiques healthcare's changing face in light of threats to the public and nursing itself and explores the practical consequences of our failure to achieve, and to promulgate in a meaningful way, a consensus about the morality internal to the practice of nursing. With a case made for the significance of the project, the opening chapter concludes with a discussion of the project's methodology and the philosophy of nursing. ;The second chapter examines nursing's moral virtues and obligations in light of an ethic of professional caring comprised of six necessary and sufficient elements: affective, cognitive, volitional, motivational, imaginative, and expressive. The major difficulties associated with an ethic of professional caring are addressed: the difficulty conceptualizing caring and specifying related moral obligations, the increasing tendency to privatize caring and to view it as an optional service as the marketplace dominates the practice of healthcare, and the need to address care's "dark side." The concluding chapter defends the claim that the centrality of professional caring to nursing provides a basis for a theory of nursing ethics which properly grounds the moral obligations of professional nurses. The chapter does not argue that professional caring provides the grounding for a distinct theory of nursing ethics. The chapter concludes with a discussion of how nurses working within this moral orientation can influence clinical ethics as it is practiced today and of the challenges a care-based ethic poses to nursing practice, education, and research