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

tempting to think that it might be case that nurses are able to quickly make up their
minds on the basis of the available evidence (after all nurses are often required to make
clinical decisions rapidly) but this would be to mistake credulousness for open-
mindedness. Advocacy was adopted as one of the 'big ideas' of its time and it has
become part of the received wisdom of nursing.

Limits to open-mindedness in nursing practice

All that has been said so far about the importance of open-mindedness for nursing
practice has been said in recognition that one legitimate end of nursing practice is
human flourishing, in particular the flourishing of more-than-ordinarily vulnerable
persons. And because some beliefs and actions are inconsistent with human flourishing
this puts some additional legitimate limits on open-mindedness for nursing practice. On
this account any nursing actions that interfere with human flourishing are actions that
nurses should not perform. For example, the routine killing of patients is prohibited not
only because it is against the law and contrary to the standards of the profession but
also, and perhaps more importantly, because it is inconsistent with the general concept
of human flourishing.

As outlined earlier a general disposition towards open-mindedness brings with it some
difficulties for everybody. The everyday experience of those working in health care is
such that it brings nurses and other health care workers closer to the margins of the
limitations of open-mindedness in very practical ways. Nurses are often confronted with
situations that challenge ordinary everyday assumptions about issues taken as largely
unproblematic by the general populace. This generates something of a problem as there
would seem to be a greater tension for nurses between the idea of a general disposition
towards open-mindedness on the one hand and the challenges to those things which we
should not ordinarily be open-minded about on the other. This is to say that there are
some things about which is it especially important nurses should hold firm beliefs for
the absence of such beliefs would, except, perhaps, in some extreme and exceptional
circumstances, be unprofessional and contrary to human flourishing. Some of the things
nurses should not ordinarily be open-minded about are considered below.

In common with human activity in general, working as a nurse presupposes a set of
firmly held beliefs in the existence of a physical and knowable world. It presupposes the

³Iam grateful to William Hare for suggesting this example as a possibility.

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