Nursing Philosophy最新文献

Artificial intelligence (AI) plays an increasingly significant role in nursing care. Many scholars have not only discussed the nature of AI and the effects of its application in nursing practice, but also raised the question of whether AI can replace the nurse in healthcare. In this paper, I aim to demonstrate that the nature of AI is fundamentally distinct from the nature of the nurse, and therefore, AI cannot replace the nurse in the care of the patient. I present my argument in two main parts. In the first, I refer to the scholastic principle agere sequitur esse and to the classical conception of the human being as developed by (neo)Thomists. This means that the argument is grounded in the thought of Thomas Aquinas and certain representatives of neo-Thomism. According to the strategy adopted in this paper, the human being is understood as a person who elicits from within themselves specific personal acts. In the second part, I emphasize that, in contrast to the nurse, AI lacks several essential components that appear to be crucial for meeting the personal needs of patients. I conclude that, according to (neo)Thomistic assumptions, AI can neither replace the nurse nor be considered an equal partner, because it is not endowed with the personal capacities and components that are essential for providing proper care to the patient. The (neo)Thomistic perspective allows one to regard AI solely as a therapeutic tool.

At the start of academic nursing in the United States, nurses philosophized. And they did it grandly. So grandly in fact that this entire period (beginning in the mid 1900s) has been called the era of grand nursing theory. Grand nursing theory attempted to express the conceptual side of nursing but struggled, not least in confusing philosophy with theory. Nevertheless, grand nursing theories are still actively promoted in nursing education, practice, and research, suggesting there is something to them that continues to resonate with nursing. This resonating something can be made more consistent when connected to the philosophy of Gilles Deleuze. For Deleuze philosophy is not a tracing of the actual in terms of theory. Rather, every actuality involves a 'shadowy and secret part,' which is its conceptuality, and which is the work of philosophy to construct. It is this conceptuality that speaks the shadowy part of an actuality, and which Deleuze calls an event. An analysis of a 2008 paper by grand nursing theorist Margaret Newman and colleagues demonstrates that they were trying to speak an event of nursing through creative gestures such as 'rhythmic fluctuations' and 'oscillating possibilities' and 'experiencing the infinite,' but were using outdated theory structures to formalize them, which made for distortions and denaturing effects. Reconsidering their creative gestures through a Deleuzian philosophy premised on movement and variation (rather than stasis and standardization) a concept of liquid perception is developed to express how nursing can be conceived as bearing witness to an event and counter-actualizing its emerging possibilities in the context of healthcare. It involves gaining a capacity to bear affects and thereby pass to different and more expansive thresholds of perception, which Deleuze defines as becoming subjected to an action, and affirms Newman and colleagues claim that 'relationship … emerge[s] as the central focus of the discipline.' Liquid perception expresses this relationality in terms of a practice of making actionable more and other things across more and other dimensions, thus expanding the very scope of what can become related, thus expanding the very potentiality of nursing. Importantly, liquid perception has nothing to do with putting forth a new grand theoretical truth of nursing. It constitutes a dynamic conceptualization that makes nursing visible without making prescriptions. Liquid perception is not a fact about nursing-it is a speaking of what remains shadowy and secret in nursing, which involves nursing's unique efficacy, and becoming worthy of its event.

Professional codes of ethics for nurses and midwives and the pedagogies they inform are often intellectualist; they assume implicitly that impartial practical reasoning selects the goal of moral deliberation as well as the means to its achievement. In this paper we argue that while the intellectual virtues and impartial moral deliberation are involved in moral decision-making in mature adults, the end is determined by a professional nurse's character, that is, by the influence of non-rational virtues. Such virtues include distinct nursing dispositions, excellences and regulative ideals which are triggered almost automatically in response to certain morally salient situations. Practical wisdom (phronesis) selects and guides the means to the aim and is ontologically interdependent with virtue and is guided by virtue. Although codes of ethics are useful, they often indicate that developers have misconstrued the nature of phronesis and its relationship to virtue. As such, many promote the development of technical expertise at the expense of holistic ethically sensitive person-centred care. Using insights from contemporary neo-Aristotelian interpretations we explicate these concepts and their relationship to show that the end of moral deliberation is non-negotiable. We argue that while person-centred care requires distinct technical competence and knowledge development it also includes an ineliminable emotional or affective component. Person centred patient care is most effective when practitioner thought and feeling operate as one. We use features of Irurita's typology of hands (soft, firm, hard and rough) to illustrate this claim. We conclude by briefly comparing virtue ethics with deontological and consequentialist moral theories and argue that truly ethical deontological and consequentialist responses also presuppose virtuous moral character.

African philosophical thoughts suggest that personhood is founded on and can be understood as emerging from the community. Thus, the community is essential to understanding personhood. In other words, we cannot know the person, without first knowing the community. This assertion brings to the fore a potentially novel pattern of knowing which has received limited attention in the discipline of nursing: communal knowing. This paper presents the authors preliminary thoughts on communal knowing as a novel pattern of knowing from the African philosophical perspective. Communal knowing, an epistemology deeply rooted in African philosophical traditions prioritizes interdependence, collective wisdom, and harmony over individualism. This approach to generating and transmitting knowledge is context-dependent and arises from dynamic social interactions, shared experiences, and the guidance of elders, ancestors, and community leaders. The primary aim of communal knowing is the restoration and preservation of social, spiritual, and environmental equilibrium-where healing is understood not as an isolated biological event but as the re-establishment of balance within the collective. Knowledge in this system is embedded in cultural symbols, oral traditions-such as proverbs, storytelling, poetry, and rituals-and expressive forms like Adinkra and Samai symbols, which encode values like unity, humility, resilience, and mutual support. These mediums serve as vehicles for moral education, critical reflection, and the reinforcement of virtues essential for communal well-being. The community itself acts as an educational institution, where learning is continuous, relational, and hierarchically structured-integrating the living with ancestral wisdom. This epistemology challenges Western individualistic models by framing knowledge as a process rather than a possession, inseparable from culture, spirituality, and relational contexts.

Nursing ethics has long drawn on established frameworks such as principlism, care ethics, and relational approaches to guide practice. While these models provide valuable direction, they often overlook how the intentional structure of action shapes ethical meaning in clinical encounters. This article argues that Anscombe's philosophy, particularly her work on intention and action, offers the conceptual tools to enrich nursing ethics by grounding moral significance in action-guiding reasoning. Although her work has not been widely applied to nursing, it offers substantial potential to enhance ethical decision-making, patient-centered care, and holistic support. Drawing on her seminal text, Intention (1957), this paper examines Anscombe's concepts of intention, motives, and the distinction between intentional and non-intentional actions, as well as intentional omissions. These ideas provide a foundation for understanding intention as action-guiding reasoning rather than an internal mental state, an approach that deepens ethical reflection and promotes more intentional, virtuous nursing care. The paper also addresses Anscombe's rejection of the fact/value dichotomy, a distinction famously articulated by Hume (2022/1739), who argued that moral values cannot be derived from observable facts alone. Instead, Anscombe maintains that ethical meaning is embedded in the description of intentional action, a view that, when extended to nursing, offers a fresh perspective for clinical decision-making. Through applications to ethical dilemmas, communication, and holistic care, it Anscombe's philosophical perspective can enrich nursing and foster morally meaningful, intention-based practice that upholds both patient autonomy and professional integrity. This paper is organized into key sections addressing motives and action, intentional omissions, the fact/value distinction, clinical decision-making, communication, and holistic support.

Person-centred care dominates today's sociopolitical landscape, influencing the approach and conduct of healthcare institutions, organisations and practices. It seeks to elevate and transcend former biomedical models by centralising a person's needs, preferences and values in the care process. Positioned as the 'gold standard' approach, person-centred care has become a central attribute in shaping professional identities and public discourse, influencing the ethos, attitudes and behaviours of healthcare professionals. Despite its dogmatic prominence in policy and professional discourse, there are entrenched bureaucratic structures, organisational barriers and conflicting agendas that impede professional efforts to uphold patient agency and autonomy; this has resulted in inconsistencies in its understanding and implementation. Furthermore, the framework itself fails to empower healthcare professionals to challenge practice when it is felt that person-centred principles are compromised, rendering it little more than a rhetorical device used to promote self-interest, enhance professional status and power. Given this fallacy, this critique contends that person-centred care is effectively 'dead'; its demise regrettably orchestrated at the hands of those entrusted to deliver it. In line with a Derridean deconstructive approach, we also provocatively question whether the very concept was ever 'alive' to begin with and whose interest it ultimately served. While its demise may signal time for a paradigmatic shift, it also presents an opportunity to reimagine healthcare practice in a manner that aligns with a more authentic approach. Inspired by Nietzsche's concept of the Übermensch ('Over-man'), we propose a vision of the 'Über-professional', whose 'Will to Power' transcends institutional constraints and conventional practices. By embracing authenticity, the Über-professional model offers both opportunity and 'permission' for adoptees to recognise and resist practices when these conflict with the provision of care. It therefore empowers them to ensure that all voices are heard, preferences are respected and the interests of patients are fully represented in all care decisions.

While social justice is widely upheld as a foundational value and responsibility within nursing, this concept remains poorly articulated and lacking in a clear and cohesive definition. In particular, prior conceptualizations of social justice within nursing have been critiqued as lacking a strong theoretical foundation and being insufficiently critical in orientation. Resultantly, guidance for nurses in engaging in social justice action is scant, and ultimately, the profession is challenged in truly taking up social justice as a central aim. As such, this critical interpretive synthesis aims to explore and synthesize how social justice is conceptualized within the nursing literature, and apply critical theoretical approaches to re-conceptualize social justice to guide nursing theory, research, and practice. To comprehensively review the literature on social justice (and the related concept of equity) in nursing, CINAHL and Medline (Ovid) databases were searched using nursing, social justice, and equity keywords. Following title/abstract and full text screening of 1428 references, N = 216 were retained for analysis, utilizing critical interpretive synthesis approaches through a critical social theory lens. Through a critical thematic analysis of the nursing literature, this review identifies that concepts of social justice and equity were often conflated in the nursing literature, and that dominant conceptualizations advance notions of social justice as distributive justice and as fairness. Engaging with these dominant conceptualizations through a critical lens illustrates that a re-conceptualization of social justice is necessary to establish conceptual clarity and more meaningfully support nurses in engaging with social justice through theory and practice. As such, this review presents the following re-conceptualized definition of social justice: As a guiding principle for nursing, social justice is a process of recognizing and remediating inequities at individual and structural levels towards a state of equity.

The interplay between personhood and community anchors philosophical enquiry into the essence of identity and selfhood, interrogating how societal frameworks both shape and are shaped by individuals. Despite advancements in these philosophical discourses, the notions of personhood and community remain underexplored in the African philosophical worldviews. As a starting point, this paper sought to remedy the underrepresentation of African philosophical views on personhood and community in global philosophical discourse. Rooted in the works of John Mbiti, Ifeanyi Menkiti, Kwame Gyekye and Kwasi Wiredu, African philosophical traditions emphasise that personhood is cultivated through ethical engagement, social participation and adherence to cultural norms. Mbiti posits that personhood is not inherent at birth, requiring rites of passage and active integration into communal life for its realisation, encapsulated in his axiom, 'I am because we are'. Menkiti extends this, framing personhood as an 'ontological progression' towards moral maturity, where communal norms and responsibilities shape one's identity. Gyekye, while acknowledging an inherent baseline of personhood, argues it is augmented through communal practices, critiquing exclusionary views that deny moral status to children. Wiredu introduces a dialectical model, where personhood is socially conferred through language, ethics and reciprocity, yet remains vulnerable to loss through moral failure, necessitating communal restoration. Collectively, these thinkers reject Cartesian dualism, advocating an approach that highlights interconnectedness and relational autonomy, holism, dynamism, communal identity, ethical mediation and communal healing practices. Divergences emerge between Mbiti and Menkiti's emphasis on earned personhood and Gyekye and Wiredu's recognition of inherent moral worth, reflecting nuanced debates within African communitarianism. These perspectives carry profound implications for healthcare, urging a shift from biomedical individualism to practices honouring cultural, spiritual and communal dimensions. In an era of global diversity, these thoughts offer a transformative framework for holistic, dignified healthcare, where healing transcends physical treatment.

In this paper I summarize a talk I was invited to give by the International Philosophy of Nursing Society (IPONS) as the Steven Edwards Memorial Lecture at the 2024 international nursing philosophy conference in association with IPONS. This occurred in the absolutely sublime setting of the restored outdoor Dodona Theatre, home to the ancient Greek oracle Dodona, mentioned in both the Iliad and the Odyssey, and which lies a few miles outside Ioannina, Greece, which was the site of the conference. In this magical setting I described a long tradition of rich diversity in terms of how nursing has engaged philosophy to produce, refine, and critique ideas, concepts, and arguments relevant to nursing. I then interrogated some of these relations and wondered about some future potentials for nursing and philosophy.

The evolution of nursing in Albania offers a unique philosophical skylight into its transformation. Albanian nurses are rethinking nursing, bolstered by global nursing philosophy within an Albanian philosophical and cultural context. The meaning of nursing emerges from a journey of discovery that leverages a philosophical lens to harmonise global nursing philosophy with Albanian culture. Nursing philosophical discourse in Albania is proposing solutions to address challenges posed by the country's significant healthcare transitions. Albanian nurse leaders have created a fruitful dialogue between global nursing philosophical concepts and the rediscovery of Albania's cultural principles amidst their efforts to redefine nursing. Through its newly developed 'BESA, kerING, pivetel' philosophy, Albanian nursing enriches the country's healthcare system, imbuing it with humanised, ethical, and culturally meaningful care.