Aspects of Moral Knowledge in Nursing

By Sarvimäki, Anneli Rn, PhD | Scholarly Inquiry for Nursing Practice, January 1, 1995 | Go to article overview

Aspects of Moral Knowledge in Nursing


Sarvimäki, Anneli Rn, PhD, Scholarly Inquiry for Nursing Practice


The purpose of the article is to identify and clarify different aspects of moral knowledge in nursing and to discuss the relevance of these aspects to nursing practice, nursing ethics, and education. Moral action knowledge, theoretical-ethical, personal, and situational moral knowledge are identified as different aspects of moral knowledge in nursing. Moral integration refers to the coordination of the four aspects. Some controversies in contemporary nursing ethics are discussed in the light of the proposed notion of moral knowledge. The ethics of caring is discussed as a form of personal and situational moral knowledge. The notion of moral integration requires knowledge of abstract principles as well as virtue and caring as the foundation of nursing ethics.

The concept of nursing knowledge has been much discussed during the past years. Different types of knowledge, e.g., practical knowledge, tacit knowledge, theoretical knowledge, experiential knowledge and personal knowledge, have been recognized and investigated (Benner, 1984; Jacobs-Kramer & Chirm, 1988; Mitchell &Cody, 1992; O'Brien &Pearson, 1993; Packard &Polifroni, 1992; Schultz&Meleis, 1988; Smith, 1992). Nursing ethics, on the other hand, has usually not been connected with the concept of nursing knowledge. One exception is Carper (1978), who views ethics as the moral component of nursing knowledge. According to Carper "Knowledge of morality goes beyond simply knowing the norms or ethical codes of the discipline. It includes all voluntary actions that are deliberate and subject to the judgment of right and wrong-including judgments of moral value in relation to motives, intentions and traits of character." Bishop and Scudder (1990) refer to nursing ethics as clinical ethics and excellent practice which exceed mere application of principles. Referring to Tymieniecka (1983), they describe nursing ethics as a moral sense embedded in clinical practice. Thus, they view moral knowledge in nursing as primarily practical.

These descriptions imply that moral or ethical knowledge is a complex area of knowledge involving, for instance, principles, action, and traits of character. It is important to explicate the nature and aspects of moral knowledge in nursing. A clearer conception of moral nursing knowledge can open up new perspectives on theoretical conflicts in nursing ethics and bring new elements into the discussion of how ethics and morality can be learned and taught in nurse education.

The point made in this article is that moral knowledge, just as knowledge in general, is not only one type of knowledge but can be organized and expressed in many ways. The purpose is to identify and clarify different aspects of moral knowledge in nursing and to discuss the relevance of^these aspects to nursing practice, to the contemporary discussion in nursing ethics and to nursing education.

MORAL KNOWLEDGE

Moral knowledge can be described as knowing and implementing the integration of moral values and principles. Aspects of moral knowledge that will be recognized are theoretical knowledge, action knowledge, personal knowledge, and situational knowledge (Sarvimaki, 1991,1994a, 1994b). These aspects are chosen in order to correspond to forms or types that are common in the literature on nursing knowledge, but they do not necessarily exhaust the whole concept of moral knowledge in nursing.

Theoretical-Ethical Knowledge

In nursing epistemology as well as in philosophy, theoretical knowledge is usually identified as one type of knowledge. It is usually characterized as a conception of something, as conceptual and prepositional 'knowing that' (Hintikka, 1974; Ryle, 1976; Sarvimaki, 1988). As an aspect of moral knowledge, theoretical knowledge stands for an intellectual conception of what is good and right. It is organized into concepts and propositions that are formulated into judgments, rules, principles, and theories. …

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