Virtue Ethics, Caring, and Nursing

Article excerpt

Virtue ethics is proposed as an alternative method for evaluating nursing practice. Unlike deontological and utilitarian ethical theories, which center on the action and outcome of moral behavior, respectively, virtue ethics focuses on the nature of the agent as the determining factor in analyzing ethical conduct. A historical development of virtue ethics traces its religious roots, its fall from favor by moral philosophers, and the renewed interest in the field.

Caring is identified as the central virtue for nursing. Three perspectives on the virtue of caring are presented: virtue as an attribute; virtue as individual actions reflective of the agent's nature; and virtue as meeting the obligations of role. The implications of each for nursing practice are explored.

If nursing is to be considered virtuous, caring must be demonstrated through the care given by nurses. This is a professional commitment toward which nurses must work collectively.

Ethical theories provide the framework for choosing, justifying, and judging action. They develop guides for behavior and use the terminology of oughts and shoulds. In nursing, two types of ethical theories are used to evaluate practice. One emphasizes action itself as the critical element in choosing and evaluating moral conduct and is called deontological or principled ethics. The other focuses on outcome of the action and is called utilitarian or consequentialist.

For example, if a nurse wished to decide what to do in response to the request of a family to conceal a terminal diagnosis from a patient, the nurse could use a deontological approach and consider principles such as autonomy, beneficence (doing good), and nonmaleficence (do no harm) as guides for conduct. The nurse could also take a more utilitarian perspective and consider whether telling the truth or deceiving the patient would achieve the best outcome for the greatest number of people concerned. Although these two ethical perspectives are quite different, in practice most people use a combination of deontological and utilitarian reasons in determining and justifying a course of action.

This article discusses a third form of ethical theory that could be helpful in evaluating moral conduct in nursing - virtue ethics. Instead of focusing on either the action or the outcome as the determining factor in the moral scheme, virtue ethics examines the moral agent.

Moral conduct requires more than an action and an outcome; it requires an agent or actor. Virtue ethics focuses on this third aspect of ethical behavior, the nature or being of the agent: " . . . the sort of person who is doing the act has a significant impact on how we regard the act morally" (Becker, 1975, p. 119). It reflects one root of the word ethics, ethos, which in Greek means custom or character, and emphasizes the quality or virtue of the moral agent.

Three perspectives on virtue ethics are presented: virtue as a personal attribute, virtue as actions reflective of the agent's personal nature, and virtue as actions that meet the agent's role obligations. Caring is identified as a basic nursing virtue and used to exemplify how virtue ethics can be applied to nursing practice.

HISTORICAL OVERVIEW OF VIRTUE ETHICS

Inquiry into the character of the agent was once prevalent in philosophical and religious argumentation about ethical behavior. It lost respectibility, however, with the rise of egalitarianism and empiricism in the nineteenth century. This loss of regard for virtue ethics may have been based on the fact that the judging of human character was often prejudiced by, if not motivated to support, bigotry and class distinction. The educated upper class wished to believe themselves innately more virtuous and therefore deserving of their place in society. In addition, pseudoscientific efforts to quantify the differences in human character led to charges of quackery and the eventual abandonment of the study of virtue by the scientific establishment. …