evidence (and it should be emphasised here that there is no controversy about the
compelling nature of this evidence) is a failure of open-mindedness. As Aristotle
reminds us in the Nichomachean Ethics (1953 edn) a virtue is a disposition to act. When
I claim that open-mindedness is a virtue I am claiming something more than just the
forming or revising of beliefs; I am claiming that the open-minded nurse is one who is
disposed to act in a manner consistent with those beliefs. So it is not that I am claiming
nurses should only revise their beliefs but that they should also act in a way that is
consistent with their beliefs, particularly where a failure to do so may put themselves or
others at risk of harm. And if one of the legitimate aims of nursing is human flourishing
as suggested throughout this thesis then a failure to protect patients from an avoidable
risk of harm is a failure in professional practice.
So while (because of the weight of evidence against lifting in general) an open-minded
nurse is committed to a firm view about the undesirability of lifting adult patients this
does not mean that she or he will never resort to lifting even when she or he knows that
the potential for harm from lifting exists. It may be that in an emergency such as a fire, a
nurse may believe it necessary to lift if the equipment cannot be set up in time3. For a
nurse (while still recognizing manual handling is normally appropriate) to lift in this
sort of case is to demonstrate open- rather than closed-mindedness about lifting. That is
to say that while the nurse may have a suitably firm view that lifting is generally
inappropriate, that firm view can remain open to revision in a particular situation where
in her or his opinion complying with the general injunction not to lift may have more
harmful consequences than lifting. Of course, decisions of this nature cannot be mere
arbitrary decisions rather they require the application of what I have termed professional
phronesis.
This example of the general inappropriateness of lifting is in sharp contrast to the
wholesale adoption of advocacy as a legitimate part of the role of the nurse during the
1980s and 1990s with very little critical debate, and certainly without a generally
accepted definition of the term. Seedhouse (2000) has reviewed the ways in which
advocacy has been interpreted by nursing scholars and finds disagreement and variation
together with a lack of any clear analysis of the concept as it relates to practising nurses.
This I take to be a different sort of failure of open-mindedness; a tendency to form a
belief on the basis of insufficient evidence and/or argument, that is, credulousness. It is
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