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



is true that there are some very specific examples of discipline specific applications of
the findings of science it is not clear that any one example of what is termed an applied
science is a science as such. The difference between an activity that claims to be an
applied science and one that merely makes instrumental use of scientific knowledge is
unclear which makes any claim that nursing is an applied science difficult to evaluate.
Edwards takes the view that:

If in saying nursing is an applied science it is meant that the findings of science
are instigated
in a scientific manner ... then perhaps nursing is an applied
science such as civil engineering.. .But a crucial difference remains. Nursing
actions are answerable to subjective considerations in a way in which applied
sciences are not. The fact of whether or not a bridge is a good bridge can be
determined by objective criteria... The question of whether or not a pattern of
nursing interventions is a good one cannot be determined wholly by objective
criteria.

(Edwards 2001 p. 140) (original emphasis).

If nursing is an applied science (understood in the sense of making use of the findings
of science) then presumably the practice of nursing is to be based on scientific evidence.
And if science is taken to be descriptive activity then this will not only affect the types
of evidence that are accepted as legitimate but will also determine the types of questions
asked. Opponents of nursing as a science suggest that this is already happening and
point to the dominance of certain sorts of evidence which has the effect of restricting the
types of questions that can be answered to those that suit quantitative approaches to
enquiry. What this approach fails to consider, it is claimed, is the human dimension of
nursing activity.

There is a place for quantitative enquiry particularly in the technical aspects of nursing
but even where evidence from quantitative enquiry is useful it does not of itself
necessarily provide a sufficient basis for practice decisions. When caring for a patient
with a wound it is indeed necessary to draw upon the best available scientific evidence
but the quantitative evidence that wound type x is best treated using product type z
should not be the only evidence a nurse uses to make a final choice of dressing. Apart
from the fact that the nurse may need to choose between different commercial versions
of a product type z (versions that may have only subtle and therapeutically insignificant
differences) there will be individual differences of any given patient of which the nurse
must take account. Add to this the personal preferences of both patient and nurse
together with the nurse’s experiences of using different products then it becomes
apparent that the choice of dressing rests on more than just the best available scientific

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