Philosophical Perspectives on Trustworthiness and Open-mindedness as Professional Virtues for the Practice of Nursing: Implications for he Moral Education of Nurses



much of value to think about if we wish to cultivate a disposition of trustworthiness, if
we wish, that is, to cultivate the virtue of trustworthiness.

Potter’s critique of modern moral theory

Potter characterises modem ethical theory as unsympathetic to matters of character and
certainly there is anecdotal evidence to support this assertion at least within medical and
bioethics. There is no doubt that the principle based approach OfBeauchamp and
Childress (2001) has come to dominate both the practice and the literature of medical
and bioethics and some commentators argue that this does indeed give prominence to
abstract reasoning. This seems to have led to a dominance of what might be termed a
justification-oriented ethics where the emphasis Ofjustification on the basis of abstract
principles marginalises other more individual patient-oriented approaches. Indeed, this
aspect of Potter’s attack on modem moral theory can be read as part of a larger feminist
critique of principlism. In this respect actions based on what Potter terms mainstream
modem moral theory (and she really means, I think, medicine’s interpretation of
principlism as abstract rather than person-situated) do seem to leave the effects of such
actions on individuals to one side when decisions are being made.

In reframing questions Ofjustification from the perspective of what she understands as
mainstream modem ethical theory to that of character virtues Potter addresses one of the
very real tensions in health care practice: the tension practitioners experience when
faced with real life dilemmas for which putative theoretical ‘right actions’ may well
satisfy the requirements of rational argument but yet leave the practitioner finding the
solution both unconvincing and unsatisfactory. In her example of telling a justified lie5
to save a life, she reminds us that we remain in danger of harming both ourselves as
moral agents (we become untmstworthy, even if only on the one occasion) as well as
those to whom we have lied (potentially affecting their future willingness-to-trust). Her
claim is that modem moral theory as understood by doctors and administrators takes a
short-term and narrow-minded view of the consequences of a justified lie, neglecting
other morally significant effects of lying on both the perpetrator and the recipient of the
lie. For Potter the most pernicious other morally significant effect is the effect on
trusting relationships, both in specific cases and in general. Ifhealth care professionals
accept betrayals of patients’ trust as inevitable then claims to ethical practice ring
somewhat hollow. Treating betrayals of tmst as routine (on grounds provided by a

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