Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

In recent years, there have been growing calls for nurses to have a formal advanced practice role as nurse ethicists in hospital contexts. Initially proposed in the cultural context of the USA where nurse ethicists have long been recognised, the idea is being advocated in other judications outside of the USA such as the UK, Australia and elsewhere. Such calls are not without controversy, however. Underpinning this controversy are ongoing debates about the theoretical, methodological and political dimensions of clinical ethics (...) support services generally, and more recently where nurses might ‘fit’ within such a service. In considering whether nurse ethicists ought to have a place in clinical ethics support services, a number of questions arise such as: Is such a role warranted? If so, what credentials should nurses assuming the title of ‘nurse ethicist’ be required to have? What standards of practice ought nurse ethicists be required to uphold? What is the ultimate role and function of nurse ethicists in hospital contexts? And in what contexts might a nurse ethicist be most useful? In this essay, brief attention will be given to addressing these questions. It will be concluded that, as a minimum, nurses wishing to assume an advanced nursing practice role as a nurse ethicist must have substantive grounding in the foundational knowledge of the disciplines of both moral philosophy and nursing ethics. They must also not lose sight of the ultimate goal of nursing ethics, notably, to promote and advance ethical nursing practice and the provision of ‘good’ nursing care. (shrink)

JOHNSTONE M‐J. Nursing Inquiry 2012; 19: 107–115 [Epub ahead of print]Academic freedom and the obligation to ensure morally responsible scholarship in nursingAcademic freedom is generally regarded as being of critical importance to the development, improved understanding, and dissemination of new knowledge in a field. Although of obvious importance to the discipline of nursing, the nature, extent and value of academic freedom and the controversies surrounding it have rarely been considered in the nursing literature. It is a key aim of this (...) paper to redress this oversight by providing a brief examination of: (i) the principle of academic freedom; (ii) the distinction between academic freedom, freedom of speech, and the academic freedom to publish; (iii) the problem of ideological judgments being dressed up as scientific or discipline judgments to supports ‘bad’ conclusions; and (iv) the standards that might otherwise be appealed to for determining whether maverick manuscripts supporting morally abhorrent conclusions should be accepted for publication. It is suggested that the tenets of academic freedom require robust international debate, with due attention being given to such issues as the development of an international declaration on academic freedom to publish in nursing, how to ensure a robust rebuttal system in nursing journals to counter specious scholarship, and how to better promote the letters pages of nursing journals as a venue for facilitating debate on controversial issues. (shrink)

Volume 1. Developing theoretical foundations for nursing ethics -- volume 2. Nursing ethics pedagogy and praxis -- volume 3. Politics and future directions on nursing ethics.