narrow view of modem ethical theory) without recognising the potential this has to
undermine not only professional trust relationships but also the general level
background trust is to take a parochial view of health care practice. This is one of the
central points in Janet Jackson’s book long argument . .explain[ing] why we need to
adopt a very strict teaching repudiating the telling of lies ... in medical and nursing
practice” (Jackson 2001 p. ix). Thus Potter places the virtues and particularly the virtue
of trustworthiness at the heart of matters in health care ethics. In so doing,
trustworthiness becomes the focus for her analysis of the relationships between health
care professionals and those for whom they provide care. What she finds is that while
some harms are avoided by the application of mainstream modem moral theory
(narrowly conceived), other potential harms are neglected. And it is these other harms
that form part of the concerns of nurses who have found the practice of deception
uncomfortable, even when putative moral justification has been provided. My own
experience of facilitating discussions of ethical issues with qualified nurses reinforces
this as they express similar concerns when they find themselves capitulating to or
colluding with deceptions they find to be distressing. These concerns lend weight to
Potter’s claims about the failure of the modem application of moral theory; a failure to
account for the moral sensibilities of the actors involved. While the attempt to remove
emotion from ethics by concentrating on abstract reasoning can provide justification for
some otherwise morally objectionable practices, it rarely (if ever) provides sufficiently
consistent (or acceptable) logical conclusions at the extremes without some tortuous
form of convoluted argumentation or the application of some additional principle.
Attempts to pick out inconsistencies and counter argument are, after all, what fill the
pages ofbioethics texts and journals.
Nursing takes place within institutional contexts grounded in artificial and bureaucratic
constmctions; an environment in which it is possible, should one so choose, to divorce
one’s professional life from one’s personal life. In such an environment it becomes easy
to imagine that decisions made in the professional arena are unrelated to the social
world. This separation between the professional and the personal provides the
possibility for the Corroption of character of those who wish to engage with ethical
practice, especially in the face of established and dominant justificatory, but incomplete,
rationales for right actions. This is one of the reasons that Potter argues for the need for
5 a lie is justified in this context in terms of what Potter understands as mainstream moral theory.
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