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At least 19 recordsLinked to original sources
PubMed2005

Practising virtue: a challenge to the view that a virtue centred approach to ethics lacks practical content.

A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle's practical approach to ethics are considered alongside Hursthouse's analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach.

Ethical Theory↗
PubMed2000

The virtues in their place: virtue ethics in medicine.

We are currently in the midst of a revival of interest in the virtues. A number of contemporary moral philosophers have defended a virtue-based approach to ethics. But does this renewal of interest in the virtues have much to contribute to medical ethics and medical practice? This paper critically discusses this question. It considers and rejects a number of important arguments that purport to establish the significance of the virtues for medical practice. Against these arguments, the paper seeks to show that while the virtues have a genuine role to play in medical ethics, it is a limited role, one that is subordinate to the role that other moral concepts such as rules and principles play.

Complicity↗
PubMed2006

Towards a strong virtue ethics for nursing practice.

Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse-patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.

Attitude to Health↗
PubMed2002

The virtues of evidence.

Evidence-based medicine has been defined as the conscientious and judicious use of current best evidence in making clinical decisions. This paper will attempt to explicate the terms "conscientious" and "judicious" within the evidence-based medicine definition. It will be argued that "conscientious" and "judicious" represent virtue terms derived from virtue ethics and virtue epistemology. The identification of explicit virtue components in the definition and therefore conception of evidence-based medicine presents an important starting point in the connection between virtue theories and medicine itself. In addition, a unification of virtue theories and evidence-based medicine will illustrate the need for future research in order to combine the fields of virtue-based approaches and clinical practice.

Canada↗
PubMed2005

Practical virtue ethics: healthcare whistleblowing and portable digital technology.

Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development.

Attitude of Health Personnel↗
PubMed2000

An inquiry into moral virtues, especially compassion, in psychiatric nurses: findings from a Delphi study.

A three-round Delphi study was conducted to gather data on ethical reasoning among psychiatric nurses (N = 26 in round one (R1), decreasing to N = 14 in the final round (R3)). Transcripts of questionnaires were carefully read and compared. Responses were manually sorted into categories, themes and patterns of interest. Eight debates emerged from the data. This article discusses two in detail: the nature of moral virtues and the meaning of compassion in psychiatric nursing. A sympathetic overview of virtue ethics is also provided. The nurses' responses included a lot of virtue terms, such as, 'honest', 'fair', and 'care". However, 'nurses' moral virtues' was ranked low in importance as a notion invoked in ethical decision making in the round-one ranking exercise. Only half of the sample believed that the moral character of a psychiatric nurse is important in ethical decision-making. Further, most of the round-one sample thought the virtues could not be acquired. Compassion was identified as crucial to psychiatric nursing and the nurse-client relationship, though, as expected, many diverse meanings were attributed to this notion. While the Delphi method proved adequate for our purposes, problems with regard to accurately understanding the respondents' intended meanings highlighted a major weakness of this technique, in common with other methods relying on questionnaires. Further inquiry is needed regarding the role of moral virtues and virtue ethics in both psychiatric nursing and nurse education.

Delphi Technique↗
PubMed1996

Virtue in emergency medicine. SAEM Ethics Committee.

At a time in which the integrity of the medical profession is perceptibly challenged, emergency physicians (EPs) have an opportunity to reaffirm their commitment to both their patients and their practice through acceptance of a virtue-based ethic. The virtue-based ethic transcends legalistic rule following and the blind application of principles. Instead, virtue honors the humanity of patients and the high standards of the profession. Recognizing historical roots that are relevant to the modern context, this article describes 10 core virtues important for EPs. In addition to the long-recognized virtues of prudence, courage, temperance, and justice, 6 additional virtues are offered: unconditional positive regard, charity, compassion, trustworthiness, vigilance, and agility. These virtues might serve as ideals to which all EPs can strive. Through these, the honor of the profession will be maintained, the trust of patients will be preserved, and the integrity of the specialty will be promoted.

Altruism↗
PubMed2006

Facilitating the development of moral insight in practice: teaching ethics and teaching virtue.

Abstract The teaching of ethics is discussed within the context of insights gleaned from ancient Greek ethics, particularly Aristotle and Plato and their conceptions of virtue (arete, meaning excellence). The virtues of excellence of character (moral virtue) and excellence of intelligence (intellectual virtue), particularly practical wisdom and theoretical wisdom, are considered. In Aristotelian ethics, a distinction is drawn between these intellectual virtues: experience and maturity is needed for practical wisdom, but not for theoretical wisdom. In addition to this, excellence of character is acquired through habitual practice, not instruction. This suggests that there is a need to teach more than theoretical ethics and that the ethics teacher must also facilitate the acquisition of practical wisdom and excellence of character. This distinction highlights a need for various educational approaches in cultivating these excellences which are required for a moral life. It also raises the question: is it possible to teach practical wisdom and excellence of character? It is suggested that virtue, conceived of as a type of knowledge, or skill, can be taught, and people can, with appropriate experience, habitual practice, and good role models, develop excellence of character and become moral experts. These students are the next generation of exemplars and they will educate others by example and sustain the practice of nursing. They need an education which includes theoretical ethics and the nurturing of practical wisdom and excellence of character. For this purpose, a humanities approach is suggested.

Attitude of Health Personnel↗
PubMed1995

Toward a virtue-based normative ethics for the health professions.

Virtue is the most perdurable concept in the history of ethics, which is understandable given the ineradicability of the moral agent in the events of the moral life. Historically, virtue enjoyed normative force as long as the philosophical anthropology and the metaphysics of the good that grounded virtue were viable. That grounding has eroded in both general and medical ethics. If virtue is to be restored to a normative status, its philosophical underpinnings must be reconstructed. Such reconstruction seems unlikely in general ethics, where the possibility of agreement on the good for humans is remote. However, it is a realistic possibility in the professional ethics fo the health professions where agreement on the telos of the healing relationship is more likely to arise. Nevertheless, virtue-based ethics must be related conceptually and normatively to other ethical theories in a comprehensive moral philosophy of the health professions. If he really does think there is no distinction between virtue and vice, why, sir, when he leaves our house, let us count our spoons. Samuel Johnson

Ethical Theory↗
PubMed1992

Caring, virtue theory, and a foundation for nursing ethics.

The purpose of this paper is to critically examine the use of a framework of virtue theory as a foundation for a nursing ethic embodied in the caring ideal. The first section summarizes the problems identified with traditional moral theory as a foundation for a nursing ethic based on the caring ideal. From these problems, adequacy conditions that a foundation must meet are identified. In section two, the basic ideas of virtue theory are sketched and an account of how virtue theory can be used as a foundation for a nursing ethic based on the caring ideal is discussed. Finally, virtue theory as a foundation for a nursing ethic à la caring is assessed against the adequacy conditions delineated in section one. The conclusion of this paper is that virtue theory does not offer a viable alternative to duty-based theories. While virtue theory provides promise in meeting the identified adequacy conditions, serious secondary issues arise that can not be immediately nor easily resolved.

Caregivers↗
PubMed1984

Courage: a neglected virtue in the patient-physician relationship.

The contribution that the virtues can make to the moral life in general and to the moral community constituted in the patient-physician relationship more specifically is gaining increased scholarly attention. This paper explores the meaning and relevance of the virtue of courage for patients and physicians. Courage is presented as a virtue for physicians in addition to the excellences of competence and compassion and a virtue for patients in addition to the excellences of compliance and gratitude. In agreement with Alasdair MacIntyre, courage is held to be necessary, at times, to our expression of care and concern for one another. The patient-physician relationship is shown to be a context in which care and concern is expressed, a context in which courage can be a relevant virtue. Certain conditions are listed as necessary to courage: freedom, fear, risk, uncertainty, an endangered good and a morally worthy end. Equivalents to these necessary conditions are discussed and held to be potentially present in patient-physician encounters. Physicians are pictured as a 'sustaining presence' who have duties toward patients of 'encouragement' that can be fulfilled in ways relative to the requirements of each circumstance. Patients are held to have a duty to learn about the nature of human existence and to develop the character necessary to its negotiation. Patients and physicians can be agents of courage who come together in a context of care and concern where certain goods are preserved even, at times, in the midst of loss. Thus, courage is presented as a relevant and important moral virtue for the patient-physician relationship in which those qualities that define who we are as a moral community are expressed and sustained.

Moral Obligations↗
PubMed1998

Is caring a virtue?

The significance of the question 'Is caring a virtue?' lies in the fact that both the ethics of virtue and the ethics of care have been proposed as alternatives to what may be termed 'bioethics'. The ethics of care has been of particular interest to nursing theorists, especially those who want to say that there is a body of distinctively nursing ethical theory which is different from bioethics. In answering the main question there are three supplementary aims: first, to explore the relationship between virtue ethics and the ethics of care, it is suggested that caring is not a virtue, but that the virtues involve caring correctly; second, to give a broad outline of what is meant by an ethics of virtue, including what it means to care correctly; and third, to examine implications of the theory for nursing.

Education, Nursing↗
PubMed1999

Virtue, personality, and social relations: self-control as the moral muscle.

Morality is a set of rules that enable people to live together in harmony, and virtue involves internalizing those rules. Insofar as virtue depends on overcoming selfish or antisocial impulses for the sake of what is best for the group or collective, self-control can be said to be the master virtue. We analyze vice, sin, and virtue from the perspective of self-control theory. Recent research findings indicate that self-control involves expenditure of some limited resource and suggest the analogy of a moral muscle as an appropriate way to conceptualize virtue in personality. Guilt fosters virtuous self-control by elevating inter-personal obligations over personal, selfish interests. Several features of modern Western society make virtue and self-control especially difficult to achieve.

Adaptation, Psychological↗
PubMed2002

Living well through chronic illness: the relevance of virtue theory to patients with chronic osteoarthritis.

OBJECTIVE: Virtues and vices possessed by patients may affect their quality of life and how well they cope with disease. The objective of this study is to assess the relevance of the concept of virtue and vice to patients with chronic arthritis. METHODS: Aristotle's theory of virtue and vice was used to construct a guide for in-depth interviews, carried out with 5 patients with chronic osteoarthritis. Interviews were tape recorded, transcribed, and analyzed (using Interpretative Phenomenological Analysis) for information on personal qualities or intellectual approaches that participants thought necessary to thrive in the face of chronic disease. RESULTS: Five main themes emerged: strength, prudence, gratitude, self-worth, and insight into flourishing. The data on each of these is compared with Aristotle's definitions of virtues and vices. CONCLUSIONS: Aristotle's virtue theory can be applied to the narratives of these patients with chronic osteoarthritis, and may help in understanding their coping strategies and quality of life.

Adaptation, Psychological↗
PubMed2006

The virtue of multiculturalism: personal transformation, character, and openness to the other.

The social, intellectual, and moral movement known as multiculturalism has been enormously influential in psychology. Its ability to reshape psychology has been due to its ethical force, which derives from the attractiveness of its aims of inclusion, social justice, and mutual respect. The cultivation of cultural competence, presented as a developmental process of acquiring self-awareness, cultural knowledge, and skills, is an important emphasis in the multicultural literature. The authors place the cultural competence literature in dialogue with virtue ethics (a contemporary ethical theory derived from Aristotle) to develop a rich and illuminating way for psychologists to understand and embody the personal self-examination, commitment, and transformation required for learning and practicing in a culturally competent manner. According to virtue ethics, multiculturalism can be seen as the pursuit of worthwhile goals that require personal strengths or virtues, knowledge, consistent actions, proper motivation, and practical wisdom. The authors term the virtue of multiculturalism openness to the other and conclude by describing how attention to cultural matters also transforms virtue ethics in important and necessary ways.

Awareness↗
PubMed1998

The ethics of care: a feminist virtue ethics of care for healthcare practitioners.

In this paper I seek to distinguish a feminist virtue ethics of care from (1) justice ethics, (2) narrative ethics, (3) care ethics and (4) virtue ethics. I also connect this contemporary discussion of what makes a virtue ethics of care feminist to eighteenth and nineteenth century debates about male, female, and human virtue. In conclude that by focusing on issues related to gender--primarily those related to the systems, structures, and ideologies that create and sustain patterns of male domination and female subordination--we can begin to appreciate that true care and bona-fide virtue can flourish only in societies that treat all persons with equal respect and consideration.

Empathy↗
PubMed1988

Virtue and the practice of modern medicine.

Robert Veatch has claimed that virtue theory is not only irrelevant but potentially dangerous in medical ethics. I argue that virtue is a far more prominent factor in contemporary medical practice than Veatch admits. Even if 'stranger medicine' is taken as the norm, proper conduct on the part of physicians depends on certain character traits in order to be maintained consistently over a long period of time and in situations which run counter to the physician's own interests. Right conduct, which Veatch argues is the central moral issue in the physician-patient relationship, is intertwined with certain virtues. Moreover, the virtue of integrity and the concept of a unified life-narrative are especially useful in analyzing an important factor missing in modern medicine. And since medicine relies necessarily on some concept of human flourishing I argue that virtue theory can play a central role in helping to determine the goals of medical practice.

Beneficence↗
PubMed2003

The virtues (and vices) of the four principles.

Despite tendencies to compete for a prime place in moral theory, neither virtue ethics nor the four principles approach should claim to be superior to, or logically prior to, the other. Together they provide a more adequate account of the moral life than either can offer on its own. The virtues of principlism are clarity, simplicity and (to some extent) universality. These are well illustrated by Ranaan Gillon's masterly analysis of the cases he has provided. But the vices of this approach are the converse of its virtues: neglect of emotional and personal factors, oversimplification of the issues, and excessive claims to universality. Virtue ethics offers a complementary approach, providing insights into moral character, offering a blend of reason and emotion, and paying attention to the context of decisions. The cases provided can be more adequately understood if we combine the approaches. Both should foster the virtues of humility and magnanimity.

Adult↗