Ethics and the Good Nurse
eBook - ePub

Ethics and the Good Nurse

Character in the Professional Domain

  1. 104 pages
  2. English
  3. ePUB (mobile friendly)
  4. Available on iOS & Android
eBook - ePub

Ethics and the Good Nurse

Character in the Professional Domain

About this book

Ethics and the Good Nurse draws on internationally leading empirical research conducted by the Jubilee Centre for Character and Virtues and explores nursing as a virtuous profession through a close examination of nurses' character.

With the belief that virtues such as kindness, integrity, compassion and honesty are core to the nursing profession, this book draws on extended insights from the Jubilee Centre's Virtuous Practicing in Nursing study to understand the role of such virtues in the professional practice and education of nurses. This book brings together knowledge from academics, scholars and practitioners to address the influence of personal and professional character on nurses and nursing.

By including clear implications for policy, practice and research, Ethics and the Good Nurse serves as essential reading for a wide audience, including nurses, policy makers and nursing organisations and provides a timely and much-needed contribution to the field of nursing and character education.

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Information

Publisher
Routledge
Year
2021
eBook ISBN
9781000539806

1 The professions and character

DOI: 10.4324/9781003146308-2

Introduction

Whether inspired by a desire to justify an occupation’s status as a profession (e.g., teaching and social work) or by the need to re-assert precisely what lies at the heart of a long-standing profession in the wake of public concerns about standards (e.g., medicine and law), the related questions of what constitutes a profession and what constitutes professional practice have received a great deal of attention over recent years. A core concern within this literature on the professions has been to highlight and seek to understand the ethical basis of professions, whether generally or specifically. Professions are deemed inherently ethical occupations because, and more so than other occupations, they place high moral demands on the conduct of workers. Indeed, these ethical and moral demands – which include care, integrity, fairness and diligence – are often viewed as the defining feature of many professions, including nursing, medicine, law and teaching, reminding us that professions are ultimately concerned with human actions and interactions. As Oakley and Cocking (2001) remind us, the focus of professional work is typically the provision of goods – such as health, education and justice – that are fundamental to flourishing individuals and societies. In specific relation to healthcare, a number of authors cite the importance of virtues such as trust, compassion and kindness as being core to the profession (see, e.g., Tuckett, 2000; Armstrong, 2006, 2007; Brody and Doukas, 2014; Rhodes, 2020). Yet, and as various professional ā€˜scandals’ over the last 20 years have evidenced, every profession and professional faces ethical challenges and dilemmas as part of their work. Indeed, the very ethical nature of the professions entails that public mistrust and criticism results when conduct falls below the standards expected (Blond et al., 2015).
In order to examine the ethical nature of professions and the ethical dilemmas experienced by professionals, since its inception, the Jubilee Centre has undertaken a number of empirical studies examining character, virtues and the professions. Some of these studies have concentrated on the professions generally (Arthur et al., 2019), while others have focused on specific professions: law (Arthur et al., 2014), medical practice (Arthur, KristjƔnsson, Thomas et al., 2015), education (Arthur, KristjƔnsson, Cooke et al., 2015), business (KristjƔnsson, Arthur et al., 2017) and the British Army (Arthur et al., 2018). More recently, through the project Practical Wisdom and Professional Practice: Integration and Intervention, the Centre has built on this research to examine particular commonalities and differences across professions and professionals (Arthur and Earl, 2020).
The purpose of this chapter is to provide an initial survey of the existing literature on the professions. The first section considers briefly what constitutes a profession in general terms, before turning to the more specific ethical dimensions of professional activity. It does so in light of the now widespread trend towards managerialism, accountability and efficiency, which has been witnessed across professions in a number of countries over the last 30 years. In the second section, attention moves to consider the value of a virtue-based account of professional ethics. In this section, we draw on the Jubilee Centre’s neo-Aristotelian approach to virtues and character in order to argue that professional ethics not only involves but also transcends reliance on rules and duties, thereby requiring professionals to act with professional wisdom and judgement.

What constitutes a profession?

While definitions of what constitutes a profession abound, certain features seem to be generally, if not universally, accepted (see, e.g., Carr, 1999). These are that:
  • a profession is a paid occupation;
  • a profession requires formal qualifications, a high level of education and a prolonged period of training/induction;
  • a professional possesses high level theoretical and practical expertise in a given discipline;
  • a profession provides a public service;
  • a profession is, and professionals are, held in high esteem within society;
  • a professional acts with integrity, care, honesty and trust, exhibiting a level of professional autonomy and judgement;
  • professional ethics is guided by a code of conduct specific to that profession.
The Australian Council of Professions,1 which captures each of these features, define a ā€˜Profession’ as follows:
a disciplined group of individuals who adhere to ethical standards and who hold themselves out as, and are accepted by the public as possessing special knowledge and skills in a widely recognised body of learning derived from research, education and training at a high level, and who are prepared to apply this knowledge and exercise these skills in the interest of others. It is inherent in the definition of a Profession that a code of ethics governs the activities of each Profession. Such codes require behaviour and practice beyond the personal moral obligations of an individual. They define and demand high standards of behaviour in respect to the services provided to the public and in dealing with professional colleagues. Further, these codes are enforced by the Profession and are acknowledged and accepted by the community.
In the United Kingdom, various professions make clear the centrality of the ā€˜ethical’ to the nature of the profession. For example, in its Code of Ethics,2 the British Association of Social Workers asserts that:
Ethical awareness is fundamental to the professional practice of social workers. Their ability and commitment to act ethically is an essential aspect of the quality of the service offered to those who engage with social workers. Respect for human rights and a commitment to promoting social justice are at the core of social work practice throughout the world.
The Law Society of England and Wales3 makes clear that:
The commitment to behaving ethically is at the heart of what it means to be a solicitor.
Ethics is based on the principles of:
  • serving the interests of consumers of legal services
  • acting in the interests of justice acting with integrity and honesty according to widely recognised moral principles
Ethics will help you respond in the right way to any moral dilemmas you might face at work.
Many more codes of conduct from other professions that similarly locate ethical conduct as fundamental to the profession could be cited. However, despite these reasonably well-established and understood definitions, how best the ethical should be formulated conceptually and can be implemented practically, remains both disputed and challenging.
Clearly, ideas about what constitutes the ā€˜good’ professional transcend simply technical abilities and encompass notions of judgement, wisdom and care. However, further questions remain about the extent to which particular cultures, discourses and practices can put pressure on how professionals, particularly those working in the public sector, can act with (or indeed without) ethics and integrity (see, e.g., Furlong et al., 2017). Indeed, various studies evidence the impact (whether positive or negative) of workplace conditions on professionals’ ability to exhibit ethical conduct (see, e.g., Oakley and Cocking, 2001; RPS, 2011; Worth and Van Den Brande, 2019).
Discussions about the meaning and nature of ethical professional conduct and the effect of cultures, discourses and workplace practices typically concentrate around two particular considerations. The first is the impact, widely cited and critiqued in the current literature on ethics and the professions, of the increased forms of managerialism and instrumentalism that have roundly been identified as detracting from the ethical and societal role of professionals. According to critics, the turn to managerialism across and within the professions has led not to a renewed form of professionalism but to a processes of de- and re-professionalisation through which the goals of general accountability (to service-users and to government) and efficiency have actively worked against professional autonomy and judgement (Carr, 2011; Holbeche and Springett, 2004; George, 2017). The second consideration is the extent to which professions, such as health, teaching and social work, have come under increased public scrutiny and accountability in the wake of various ā€˜scandals’ (Seijts et al., 2017). Over the last 25 years in England, for example, high profile cases including the murder of Stephen Lawrence and resulting Stephen Lawrence Inquiry (known commonly as the Macpherson Report), the murder of Victoria ClimbiĆ©, the death of Peter Connelly (also known as Baby P), the Mid Staffordshire hospital crisis and the Rotherham Child Sexual Exploitation scandal have all raised serious questions about what were significant failures in professionals’ ethical judgement and conduct.
In the context of managerialism, accountability, efficiency, public scrutiny and increased workplace pressures, professions and professionals need to (re)envisage the ethical nature of their work. This (re)envisaging by necessity includes paying attention to what a profession aspires to be, what constitutes professional practice – whether generally or specifically for that profession – and how external factors shape the standing and work of professions today. In the next section, we start to examine these questions through a focus on a virtue-based approach to professional ethics. In doing so, we introduce key work in the field, particularly that makes reference to the concept of professional phronesis.

A virtue-based approach to professional ethics

The last few decades have witnessed a groundswell of interest in virtue-based approaches to professional ethics. Though not the only variant of a virtue-ethical approach, the majority of this interest has drawn on Aristotelian roots, and this concerted interest in Aristotelian/neo-Aristotelian virtue has been applied across a range of professional contexts, including accountancy (e.g., West, 2017), medicine (e.g., Pellegrino and Thomasma, 1993), nursing (e.g., Armstrong, 2006, 2007), social work (e.g., Adams, 2009), and youth work (e.g., Bessant, 2009). ...

Table of contents

  1. Cover
  2. Half Title Page
  3. Series Page
  4. Title Page
  5. Copyright Page
  6. Contents
  7. Acknowledgements
  8. Introduction
  9. 1 The professions and character
  10. 2 Virtues and the ethical nurse
  11. 3 Nurses and nursing: motivations, personal character strengths and ideal character strengths
  12. 4 Nurses, ethical dilemmas and the ethical education of nurses
  13. Conclusions, recommendations and further research
  14. References
  15. Index

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