The concept of praxis, also known as the practical discourse in philosophy, has been expressed in different ways in different eras. However, the linkages from one era to another and from one paradigm to another are not well explicated in the nursing literature. Difficulties with translations of ‘praxis’ into ‘practice’ and the connotations of the word ‘practical’ in the English language and in nursing have influenced extrapolation of the linkages. More recently, further blurring of the linkages occurred from the popular (...) association of praxis within the emancipatory paradigm. Integral to the concept of praxis, since the time of Aristotle, is the notion of phronesis: a process of moral reasoning enacted to establish the ‘good’ of a particular situation, often referred to as practical wisdom. The purposes of this paper are twofold. Firstly to demonstrate a number of linkages and shifts in the evolution of praxis. This, I believe, will enhance understanding of the multiple expressions of praxis in contemporary nursing. Secondly, to promote and affirm the importance of praxiological knowledge development in the discipline. Furthermore, increased appreciation of the concept of praxis provides an important vehicle for the advancement of nursing as a moral endeavour and the nurse as moral agent. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

The aim of this essay is to test the claim that epistemologists—virtue epistemologists in particular—have much to learn from virtue ethics. The essay begins with an outline of virtue ethics itself. This section concludes that a pure form of virtue ethics is likely to be unattractive, so the virtue epistemologist should examine the "impure" views of real philosophers. Aristotle is usually held up as the paradigm virtue ethicist. His doctrine of the mean is described, and it is explained how that (...) doctrine can provide a framework for an account of epistemic virtue. The conclusion of the essay is that a virtue epistemology based on analogies with virtue ethics, though well worth developing and considering, will face several challenges in fulfilling the significant promises that have been made on its behalf. (shrink)

This paper is a discussion of the emotion of compassion or pity, and the corresponding virtue. It begins by placing the emotion of compassion in the moral conceptual landscape, and then moves to reject the currently dominant view, a version of Aristotelianism developed by Martha Nussbaum, in favour of a non-cognitive conception of compassion as a feeling. An alternative neo-Aristotelian account is then outlined. The relation of the virtue of compassion to other virtues is plotted, and some doubts sown about (...) its practical significance. (shrink)

Modern virtue ethics is commonly presented as an alternative to Kantian and utilitarian views—to ethics focused on action and obligations—and it invokes Aristotle as a predecessor. This paper argues that the Nichomachean Ethics does not represent virtue ethics thus conceived, because the discussion of the virtues of character there serves a quasi-Platonic psychology: it is an account of how to tame the unruly (non-rational) elements of the human soul so that they can be ruled by reason and the laws it (...) imposes. This is explicitly stated in Book X, where it is also affirmed that the question of which laws reason should impose is addressed in The Politics. The Ethics and Politics can therefore be seen as a unity—as Aristotle's version of Plato's Republic—and it is the failure to recognize this that explains Aristotle's misappropriation by the modern virtue ethicists. (shrink)

A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of (...) the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle’s practical approach to ethics are considered alongside Hursthouse’s analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach. (shrink)

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. (shrink)

A careful reading of Aristotle's Nicomachean Ethics focusing on his treatment of politics reveals a multifaceted discipline with political science, legislation, practice and ethics. These aspects of the discipline bear clear resemblance to the multiple conceptions of nursing. The potential that nursing is a multifaceted discipline, with nursing science as just one facet challenges the author's own conception of nursing as a practical science. Aristotle's discussion would seem to argue that nursing science is nursing, but nursing is more. Nursing is (...) also ethical practice, or art, and legislative for health. The multifaceted discipline of politics is united by the end, the common good, a just community that makes human happiness possible. Reasoning in this way, nursing is unified by its end, health of individuals and communities. Since nursing is not unique in having health as its end, this discussion ends with the question of where its uniqueness lies, i.e. within the activities or the personal presence of its practitioners. This discussion also contains some of the contemporary ethical and legislative challenges with which nursing is confronted. (shrink)

I defend the epistemic thesis that evaluations of people in terms of their moral character as good, bad, or intermediate are almost always epistemically unjustified. (1) Because most people are fragmented (they would behave deplorably in many and admirably in many other situations), one's prior probability that any given person is fragmented should be high. (2) Because one's information about specific people does not reliably distinguish those who are fragmented from those who are not, one's posterior probability that any given (...) person is fragmented should be close to one's prior—and thus should also be high. (3) Because being fragmented entails being indeterminate (neither good nor bad nor intermediate), one's posterior probability that any given person is indeterminate should also be high—and the epistemic thesis follows. (1) and (3) rely on previous work; here I support (2) by using a mathematical result together with empirical evidence from personality psychology. (shrink)

Aristotle has famously made the claim that having the right emotion at the right time is an essential part of moral virtue. Why might this be the case? I consider five possible relations between emotion and virtue and argue that an adequate answer to this question involves the epistemic status of emotion, that is, whether the perceptual awareness and hence the understanding of the object of emotion is like or unlike the perceptual awareness of an unemotional awareness of the same (...) object. If an emotional awareness does not have a unique character, then it is unlikely that emotions provide an understanding that is different from unemotional states of awareness: they are perhaps little more than “hot-blooded” instances of the same understanding. If, on the other hand, an emotional state involves a perceptual awareness that is unique to the emotion, then emotions are cognitively significant, providing an understanding of the object of the emotion that is absent in a similar but unemotional episode of awareness. I argue the latter and substantiate the claim that emotions are essential to moral virtue because they can be essential to a full understanding of the situations that they involve. In such cases, emotions are not merely a symptom of the possession of an adequate understanding, but are rather necessary for having an adequate understanding. (shrink)

Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an (...) emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics. (shrink)

This paper will examine a claim that nursing is united by its moral stance. The claim is that there are moral constraints on nurses' actions as people practising nursing and that they are in some way different from both what for now can be called standard morality and also different from the person's own moral views who also happens to be a nurse, hence the defining and unifying factor for nursing. I will begin by situating the claim within the broader (...) area about the need for a definition to state features that are essential to all and only members of its class. This will highlight the fact that there are two distinct types of definition used by authors seeking to find a unity for nursing. One type of definition has to do with goals or purposes given to nursing and the other with ends discovered as nursing. But even if there are ends waiting to be discovered a particular practical concern is how we can have knowledge of them. I will suggest that knowledge by intuition is plausible but that as things currently stand in moral epistemology it will not provide the unifying ground for nursing. Then I will argue that in the latter approach to definition a certain account of human nature has been advanced in order to provide features that are there to be discovered and so not dependent on human beings for the definition or classification. However, such an attempt to define nursing cannot do what is wanted. Rather than the account of human nature grounding morality and doing so for nursing, the account of human nature itself relies upon a prior account of morality. Because of this it loses its supposed ground of unity for the profession. Nursing is not united by its moral stance especially if this is understood in a strong sense as unique moral stance, but as things currently stand in moral epistemology this is not necessarily a bad thing for practitioners or patients. (shrink)

It has been claimed that there are certain acts that nurses as people practising nursing must never do because they are nurses and this is regardless of what the same agent should do; that certain actions are not part of proper nursing practice. The concept of an internal morality has been discussed in relation to medicine and has been used to ground the actions proper to medicine in a realist tradition. Although the concept of an internal morality of nursing is (...) not explicitly mentioned in the literature the underpinning ideas about the proper practice of nursing based on philosophical realism I argue equate with it and a discussion of the method of an internal morality can help to understand how arguments against euthanasia related to the profession of nursing are far from clear. Ultimately, although the idea of particular acts proper to nurses qua nurses is not clear, the concept of an internal morality can help to get practitioners to see how the profession is tightly linked to moral actions, even so the hard problems in bioethics such as the morality of euthanasia remain hard for all and the easy ones easy for all. (shrink)

1. Presumably the point of, say, inculcating a moral outlook lies in a concern with how people live. It may seem that the very idea of a moral outlook makes room for, and requires, the existence of moral theory, conceived as a discipline which seeks to formulate acceptable principles of conduct. It is then natural to think of ethics as a branch of philosophy related to moral theory, so conceived, rather as the philosophy of science is related to science. On (...) this view, the primary topic of ethics is the concept of right conduct, and the nature and justification of principles of behaviour. If there is a place for an interest in the concept of virtue, it is a secondary place. Virtue is a disposition to behave rightly; the nature of virtue is explained, as it were, from the outside in. (shrink)

‘Applied ethics’, as that expression is now used, is a single rubric for a large range of different theoretical and practical activities. Such rubrics function partly as a protective device both within the academic community and outside it; a name of this kind suggests not just a discipline, but a particular type of discipline. In the case of ‘applied ethics’ the suggestive power of the name derives from a particular conception of the relationship of ethics to what goes on under (...) the rubric of ‘applied ethics’. Not everyone who conducts activities under that rubric owes allegiance to this conception and there are doubtless some who would repudiate it as strongly as I do. But it is that dominant conception from which most work in this area derives or aspires to derive its philosophical legitimacy. What is that conception? (shrink)

From the book To my mind the most striking development in ethical theory since the 1970s has been an attempt to reactivate the Platonic-Aristotelian ethical ...

Trustful interaction serves the interests of those involved. Thus, one could reason that trust itself may be analyzed as part of rational, goaloriented action. In contrast, common sense tells us that trust is an emotion and is, therefore, independent of rational deliberation to some extent. I will argue that we are right in trusting our common sense. My argument is conceptual in nature, referring to the common distinction between trust and pure reliance. An emotional attitude may be understood as some (...) general pattern in the way the world or some part of the world is perceived by an individual. Trust may be characterized by such a pattern. I shall focus on two central features of a trusting attitude. First, trust involves a participant attitude (Strawson) toward the person being trusted. Second, a situation of trust is perceived by a trusting person as one in which shared values or norms motivate both his own actions as well as those of the person being trusted. As an emotional attitude, trust is, to some extent, independent of objective information. It determines what a trusting person will believe and how various outcomes are evaluated. Hence, trust is quite different from rational belief and the problem with trust is not adequately met in minimizing risk by supplying extensive information or some mechanism of sanctioning. Trust is an attitude that enables us to cope with risk in a certain way. If we want to promote trustful interaction, we must form our institutions in ways that allow individuals to experience their interest and values as shared and, thus, to develop a trusting attitude. (shrink)

In this work, the author has fashioned out of the logical and linguistic theses of his earlier books a full-scale but readily intelligible account of moral argument.

This paper defends an account of compassion and argues for the centrality of compassion to the proper practice of medicine. The argument proceeds by showing that failures of compassion can lead to poor medical treatment and disastrous outcomes. Several case studies are discussed, exemplifying the difference between compassionate and noncompassionate responses to patients seeking help. Arguments are offered in support of approaching reports of persistent pain with a trusting attitude, rather than distrust or skepticism. The article concludes by suggesting educational (...) improvements to encourage compassion. (shrink)

In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)

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. (shrink)

Virtue ethics is perhaps the most important development within late twentieth-century moral philosophy. Rosalind Hursthouse, who has made notable contributions to this development, here presents a full exposition and defense of her neo-Aristotelian version of virtue ethics. She shows how virtue ethics can provide guidance for action, illuminate moral dilemmas, and bring out the moral significance of the emotions.

The sort of ethical theory derived from Aristotle, variously described as virtue ethics, virtue-based ethics, or neo-Aristotelianism, is becoming better known, and is now quite widely recognized as at least a possible rival to deontological and utilitarian theories. With recognition has come criticism, of varying quality. In this article I shall discuss nine separate criticisms that I have frequently encountered, most of which seem to me to betray an inadequate grasp either of the structure of virtue theory or of what (...) would be involved in thinking about a real moral issue in its terms. In the first half I aim particularly to secure an understanding that will reveal that many of these criticisms are simply misplaced, and to articulate what I take to be the major criticism of virtue theory. I reject this criticism, but do not claim that it is necessarily misplaced. In the second half I aim to deepen that understanding and highlight the issues raised by the criticisms by illustrating what the theory looks like when it is applied to a particular issue, in this case, abortion. (shrink)

The purpose of this paper is to introduce a two level account of moral thinking that, unlike other accounts, does justice to three very plausible propositions that seem to form an inconsistent triad: (1) People can be morally virtuous without the aid of philosophy. (2) Morally virtuous people non-accidentally act for good reasons, and work out what it is that they ought to do on the basis of considering such reasons. (3) Philosophers engaged in the project of normative ethics are (...) not wasting their time when they search after highly general moral principles which could not be discovered or be justifiably accepted through non-philosophical thinking, and which specify the good reasons that virtuous people act on, as well as provide a criterion or criteria for determining what it is that people ought to do. (shrink)