A comparison of approaches to virtue for nursing ethics

As in many other fields of practical ethics, virtue ethics is increasingly of interest within nursing ethics. Nevertheless, the virtue ethics literature in nursing ethics remains relatively small and underdeveloped. This article aims to categorize which broad theoretical approaches to virtue have been taken, to undertake some initial comparative assessment of their relative merits given the peculiar ethical dilemmas facing nurse practitioners, and to highlight the problem areas for virtue ethics in the nursing context. We find the most common approaches fall into care approaches grounded in sentimentalist or feminist ethics, eudaimonist approaches grounded in neo-Aristotelianism, and those grounded in MacIntyre’s practice theory. Our initial assessment is that the eudaimonist approach fares best in terms of merit and relative to criticisms of virtue ethics. But an outstanding issue concerns the motivational psychology of virtuous nursing and whether virtue ethical accounts of right action are self-effacing, i.e. justify an act on grounds that cannot function as the agent’s reason for doing it if she is to act well. One of us, Newham, believes that a virtue consequentialist approach is the best response to these issues. Some form of pluralistic theory, such as Christine Swanton’s, may be needed to explain the many competing values and goods involved in ethical nursing.