This paper makes the case for a pluralist, contextualist view of nursing ethics. In defending this view, I briefly outline and reject two current perspectives of nursing ethics – the Traditional View and the Theory View. Proponents of the Traditional View cast nursing ethics as a subcategory of health care ethics and argue that nurses, like other health professionals, must draw insight from ethical frameworks such as deontology, utilitarianism or principlism in order to negotiate the ethical challenges they meet with in the course of their work. I argue that the Traditional View is problematic because it (a) fails to sufficiently acknowledge the unique nature of nursing practice and (b) applies standard ethical frameworks, such as principlism, to moral problems that tend to alienate or undermine nursing ethical concerns.
Alternatively, the Theory View aims to build an independent and comprehensive theory of nursing ethics. Such a theory is usually grounded in a particular nursing philosophical approach, or, it appeals to an ethical framework, such as virtue ethics, care ethics or feminist ethics, that is seen as particularly compatible with nursing interests. I argue that the Theory View is also found wanting because it (a) fails to sufficiently acknowledge the heterogeneous nature of nursing practices (b) over-emphasises the differences and undervalues the similarities between nurses and other health professionals and (c) assumes that one ethical framework can be meaningfully applied across diverse moral problems and contexts.
My alternative, is to argue that nursing ethics inquiry should take a pluralist and critical stance toward available ethical frameworks and the negotiation of the ethical realm. On this view, the search for moral consensus or a unique ethical framework for nursing is replaced by the task of working strategically with multiple frameworks in order to expand the moral agency of nurses and empower them to positively engage with moral uncertainty as an inevitable feature of living a moral life. I conclude by indicating some of the implications that this has for the teaching of nursing ethics.