schools of nursing to incorporation into higher education. This required a culture change
as nurse teachers who had previously been generalists (that is, taught whatever needed
teaching) found themselves required to teach to a specialism. Consequently, many nurse
teachers were forced to adopt or develop particular subject expertise in order to teach,
for example, anatomy and physiology, sociology, psychology, ethics and so on to
nurses. That many nurse teachers were ill prepared as subject specialist teachers in
ethics is witnessed by the development of courses aimed at just such nurse teachers1.
This lack of a tradition of formal ethics teaching in nursing education may help to
account for the continuing debates about the purpose(s) of teaching ethics to nurses (see,
for example, Scott 1995, Sellman 1996, Holt and Long 1999, NMC 2004a, Woods
2005, Woogara 2005).
Nevertheless, the teaching of ethics to nurses tends to take the form of the necessary
learning of a subject matter that can be applied to practice situations in just the same
way as, for example, the learning of physiology or psychology. As a result there is a
tendency to teach ethics theory in the form of, for example, principles, rights theory,
deontology or utilitarianism and this is certainly how health care ethics is presented in
many popular ethics textbooks (see, for example, Gillon 1985, Edwards 1996,
Thompson et al. 2000, Beauchamp and Childress 2001). And while some more than
others of these texts offer discussion of ethical matters they generally do so from a
position that might be described as attempts to work out what to do when certain types
of situations arise. Indeed, some (see, for example, Seedhouse 1998) provide models for
ethical decision-making. This reflects an emphasis of the ‘application of theory’
approach to professional education and assumes that the intellectualisation of matters
ethical will lead to reasoned moral action. While it is indeed appropriate to rehearse and
debate ethical positions on, for example, whether or not one should lie to patients, in
order to assist students to engage with a variety of theoretical perspectives, it is not clear
that the teaching of ethics in this modem sense as an academic subject can lead to
reasoned moral action. The teaching of ethics as a discrete subject (sometimes
conceived as the teaching of professional issues or as teaching for accountability)
ɪ There were isolated examples of ethics teaching to nurses before this: for example, Alistair Campbell (a
theologian) was delivering ethics lectures to nurses in Scotland in the 1970s. However, the point here is
that with the introduction of Project 2000 it was nurse teachers who found themselves having to deliver
the ethics component of the nursing curriculum. One course aimed specifically at nurse teachers teaching
ethics without any formal qualification in ethics was the MA in Teaching Health Care Ethics run at the
Institute ofEducation, University of London during the 1990s. Interestingly, there still seems to be a need
for such courses as evidenced by the recently introduced summer schools at the University of Surrey.
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