So we might say that while training is a necessary component of nursing education,
especially for the development of particular skills and in order to act ‘automatically’ in
certain sorts of situations, that training not only has limited application in terms of being
a nurse (for health care assistants are often trained in this sense but do not as a result
become nurses) but also must be undertaken with due regard for the moral implications
of the actions for which individuals are being trained. Nurses may not be in a position to
refuse to resuscitate a patient (for decisions about whether or not to resuscitate are not
normally within a nurse’s sphere of authority) but they can, and arguably should,
become involved in discussions in which decisions about patients’ resuscitation status
are made. Just because a nurse is trained and skilled in resuscitation does not mean that
she or he should begin a resuscitation attempt on a patient for whom such an attempt is
inappropriate. However, a nurse is obligated to begin a resuscitation attempt on all
patients who suffer a cardiac arrest unless a ‘do not attempt resuscitation’ (DNAR)
status has been agreed. Although a nurse could cite moral grounds for refusing to
resuscitate a patient without a DNAR order this would be to earn institutional, legal, and
professional censure and very likely result in dismissal and possibly the loss of nurse
registration. Given that a nurse is expected to know these things and while it might
seem to be a moral act to refuse to take an active part in an inappropriate resuscitation
attempt, under normal circumstances the more moral act would be to pre-empt
inappropriate resuscitation attempts by arguing for a DNAR order. Task or response
training then may well be appropriate for some aspects of the role of a nurse but such
training is not without moral significance.
Training then has moral implications but it is not moral training as such. Moral training
implies being trained to act in particular ways that others believe to be morally correct
behaviour, and for other people’s ends. A distinction between training and education is
made here and hinges on the idea of human moral agency. It is possible to train a dog to
perform certain tricks or to train a parrot to say certain words but in so acting (so far as
we know) neither the dog nor the parrot are engaging with moral agency. So we might
train our paratrooper and our nurse to do certain things but even in so doing we accept
that neither will do these things without retaining their capacity for moral agency.
Towards an understanding of moral education for nurses
So we can say that moral education is different from moral training because in moral
education we aim to assist individuals to recognise and develop their moral agency. If
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