physical reality inter alia of patients and nurses, Ofbuildings and medicines, of human
life, healing, and death and so on. Without these kinds of firmly held beliefs there
would be little point in the activity of nursing. The certainties we feel about such things
suggests that these are not the sorts of things that we should be open-minded about, for
if we entertained doubts about these things we would surely become lost in a haze of
perpetual uncertainty and cease to act altogether. These types of firmly held beliefs are
part of the practical limitations of open-mindedness.
The particular beliefs that nurses should not ordinarily be open-minded about that need
to be considered here are those that might be categorised as those belonging in the
moral domain. McLaughlin provides a forceful argument that there are some aspects of
the moral domain that are so basic and fundamental that it does not make sense (at least
in ordinary circumstances) to call them into question. He says:
The sorts of moral sensitivities, beliefs, judgements and commitments which
have been mentioned are basic or fundamental to the moral domain itself and to
call them into question, or to be disposed to do so, might be considered to
undermine the moral domain itself and to put the questioner outside that domain.
(McLaughlin 2003b p. 23)
The idea that nurses should be open-minded about such centrally important concerns
such as the need to demonstrate a caring attitude towards patients and about working
towards the relief of suffering seems inappropriate4. As does the idea that nursing has
nothing to do with enabling the flourishing of more-than-ordinarily vulnerable persons.
It does seem that to be open-minded about questions of this nature is antithetical to
nursing as a practice and questions of this sort do appear to be candidates for inclusion
in the things that nurses should not be open-minded about category.
Aiming for open-mindedness in the practice of nursing
Some of the difficulties involved in aiming for open-mindedness in general have been
discussed earlier in this chapter. The main difficulty is the Aristotelian problem of
hitting the mean and as Williams suggests there are a number of intellectual skills that
can be usefully brought to bear on the problem. The intellectual skills of analysis,
synthesis and evaluation will assist individuals to determine the legitimacy of evidence
and argument. In a practical activity such as nursing the importance of knowing which
evidence to attend to becomes ever more pressing precisely because the flourishing of
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