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

assumes that students who understand what it means to be an accountable professional
will behave in ways that reflect behaviour bom of an internalisation of the NMC code of
professional conduct². But the idea that teaching the knowledge base of ethics will
result in more ethically oriented persons is unsustainable for, as Baier (1985) reminds
us, such teaching is as likely to encourage scepticism as morality. In nursing there is
evidence of a similar failure to connect teaching and learning of ethics with moral
behaviour. As Scott puts it:

.. .some nurse theorists have been misled in that they have confused the actual
process of moral development with theories about this process. This results in
the claim that, if Kohlberg’ s theory of moral development is used as a
framework in nursing education, it will lead to high levels of moral action by
student nurses and thus, as students qualify, to high quality moral behaviour
among practitioners.

(Scott 1995 p. 282) (original emphasis)

Thus one danger of the teaching of ethics as a discrete subject area is that it can have the
effect of intellectualising issues of moral consequence. The temptation to teach ethics in
ways that relate to ethical issues generated by the rise of science and the accompanying
technological advances also presents a danger. This approach might be described as a
‘big issues’ approach to ethics and features large in what has come to be known as
medical or bioethics. While interesting in themselves and for society generally, the big
issues of ethics are of less direct relevance to the everyday practice of the majority of
health care professionals than might be imagined. As such, teaching that emphasises
these types of ethical problems (issues related to biogenetics, abortion, euthanasia and
so on) tends to portray ethics as an abstract subject largely divorced from everyday
practice of nurses. And because these approaches tend to follow the ‘scientific’ view
that emotion should give way to reason, the teaching of ethics undertaken from these
perspectives cannot provide a proper foundation for moral education. Hence while the
teaching of ethics has much to contribute towards nursing students’ understanding of
professional and ethical obligations it does not, of itself, provide sufficient grounding
for the development of the kind of character traits that Everyman considers necessary
for nurse practitioners. In other words, teaching ethics (in the sense of a discrete
academic subject) cannot function as or replace a moral education designed to cultivate
those very particular virtues necessary for the ethical practice of nursing.

² One requirement of the NMC (2004a) is that students emerging from from pre-registration nursing
programmes as registered nurses will have internalised the NMC code of professional conduct.

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