Christian Ethics and Nursing Practice. Richard B. Steele

Чтение книги онлайн.

      Our sixth clarification has to do with how we refer to “the nurse.” We acknowledge that the history of modern nursing has been heavily female-dominated, but the 2017 National Nursing Workforce Study (Smiley et al., 2018) reports a welcome, steady increase in the numbers of men in the nursing profession. Additionally, we acknowledge that there is now much dialogue about gender identity and the use of preferred pronouns, which may apply to some of our readers (Turner, 2014). In view of these facts, we generally speak of “nurses” in the plural. Wherever we must refer to “the nurse” in the singular, we alternate the usage of male and female pronouns, rather than constantly using awkward or ungrammatical constructions such as “he or she,” “s/he,” or “they” in a singular sense. We ask the reader to understand that such singular pronouns are intended to apply to every nurse, regardless of gender or sexual orientation.

      Two Cautionary Notes

      Here we must interject two cautions. First, we raise the possibility that Christian nurses might experience a conflict of conscience when reading the Code (ANA, 2015), which regards itself as the “nonnegotiable” (p. vii) ethical standard of the profession. We assume that the supreme moral authority for every Christian is the Bible and that one of the chief ways in which thoughtful Christians put their respect for the Bible’s moral authority into effect in their personal and professional lives is by using it to test the adequacy of any other proposed moral standard. As it happens, we see nothing in the Code that flatly contradicts the moral teachings of the Bible, such that Christian nurses would be obliged in conscience to disobey the former in order to remain faithful to the latter. Nevertheless, Christian nurses cannot accept the Code’s claim to be “nonnegotiable in any setting,” if that implies that its text is perfectly unambiguous throughout, that its implications for clinical practice are always self-evident, or that questions can never be raised about its adequacy and relevance to specific cases. Yet we presume that the ANA does not intend its members to regard the Code in such a “fundamentalist” fashion. For the Code itself has a long history of development, which reflects the changes that have taken place in health care and in American society generally over the past century (pp. xi–xiii; Fowler, 2015, pp. vii–ix). Nurses have been asking tough questions of their Code since they first had one, and we presume that the ANA intends them to keep doing so. In that case, the Code serves as an indispensable working norm for nursing practice, a norm that should not be violated by individual nurses in their daily work but that is always subject to constructive critique, and that can be revised as necessary through due process by the ANA. No Christian nurse should have trouble accepting that.

      Second, even if Christian nurses can accept the Code (ANA, 2015) as morally binding upon their character and conduct, given that the Code itself is always revisable and that—for Christian nurses, at least—its moral authority is always subordinate to that of the Bible, there remains another problem. The ethical texts of the Bible are not always self-evident in meaning, nor is the precise manner of their application in specific cases always clear. Thus, although the moral teachings of the Bible are certainly indispensable for Christian nurses in interpreting the Code, those teachings themselves require careful theological interpretation and ethical reflection. The method we use here for interpreting our chosen biblical passages is both theological and historical-critical. A few words about these two features of our method are in order.

      On the one hand, we read the Bible theologically, that is, as Christian Scripture. The church throughout the ages has regarded the Bible as God’s authoritative word for God’s faithful people, as a testimony to God’s sovereign love and redemptive power in (or “behind”) human affairs. We are not committed to any particular theory of how the human authors of the Bible derived or experienced divine “inspiration.” We do, however, affirm that the church, under the guidance of the Holy Spirit, has recognized the voice of God in (or, again, “behind”) the writings included within the Bible and regards these writings as uniquely “useful for teaching, rebuking, correcting and training in righteousness” (2 Tim 3:16). Furthermore, we are guided in our reading of the church’s sacred book by the church’s rule of faith, that is, the cluster of doctrines and religious practices deemed orthodox by the ancient ecumenical councils and held in common by the Roman Catholic Church, the Eastern Orthodox Church, and most mainline Protestant and Evangelical churches. On the other hand, we read the Bible historico-critically, that is, in light of contemporary research into the history and culture of ancient Mediterranean societies. To interpret a passage of Christian Scripture faithfully obliges us to consider the circumstances under which it was originally written and the needs, problems and worldview of the people for whom it was originally written, at least to the extent that these can be reconstructed through research into the histories, cultures, languages and literary conventions of the ancient Near East. In interpreting Scripture, we regard theological reflection and historical criticism as friendly yokefellows, not fierce adversaries, and virtually all the secondary sources we cite share that view.

      The strategy for reading Scripture that we have adopted here draws heavily upon two sources. The first is The Art of Reading Scripture, coedited by biblical scholars Ellen F. Davis and Richard B. Hays (2003). Particularly useful is the book’s programmatic essay, “Nine Theses on the Interpretation of Scripture” (pp. 1–8). Our second major resource is Reading the Bible in the Strange World of Medicine, by theologian and bioethicist Allen Verhey (2003), and particularly his programmatic essay, “The Bible and Bioethics: Some Problems and a Proposal” (pp. 32–67). It must be stressed, however, that our reading of the texts we have selected to represent the four strands of biblical moral discourse is sharply focused by an objective that is not envisaged by the essays in the Davis and Hays volume and is only indirectly related to the purpose of the work by Verhey. Our objective is to show how the complex picture of Christian discipleship displayed in the Bible compares with the ethical responsibilities of professional nurses prescribed by the Code (ANA, 2015).

      The Origins and Distinctiveness of this Book

      As noted above, we intend this book to be used as a text for nursing ethics courses at Christian colleges and universities, and that is indeed how it came into being in the first place. The authors are faculty members at Seattle Pacific University (SPU). SPU is a church-related institution; its faculty and staff are required to be professing, practicing Christians; its curriculum and campus life are regulated by an official Statement of Faith. Undergraduates are required to take at least two, and usually three, courses in theology and Bible, and all graduate professional programs include one course (or short modules distributed over several courses) in discipline-specific theological reflection. The course from which this book originally sprang, NUR 6301 Values, Faith and Ethics, satisfies this requirement for the Master of Science in Nursing and Doctor of Nursing Practice degrees. It has been co-taught annually by Steele, a moral theologian, and either Wild or Monroe, both professors of nursing, since 2014. As our curriculum requires, and as our own consciences dictate, we teach the course from an explicitly Christian standpoint, but we neither proselytize our students nor penalize those whose religious views differ from our own. The present book, which arose from the lectures and class discussions for that course, takes the same approach. We try to show how Christian moral and religious convictions match up with the current ethical standards of the nursing profession, as stated in the Code (ANA, 2015), and we seek to highlight the spiritual and professional advantages for Christian nurses, who conscientiously apply their faith to their practice. Yet we do not claim that Christians somehow make “better nurses” than non-Christians (cf. Doornbos, Groenhout, & Hotz, 2005, 1–8). We write from a faith perspective, just as we teach. Yet we have no hidden evangelistic agenda and we intend no censure of those whose religious views differ from our own.

      The origins of this book help to explain its distinctiveness. On the one hand, little if any attention is given to Christian Scripture in the standard textbooks of bioethics and nursing ethics, such as Beauchamp and Childress (2013), Jonsen, Siegler, and Winslade (2015), Grace (2018), or Fowler (2015). On the other hand, one finds few if any citations to the Code (ANA, 2015) in works that analyze medicine and nursing from a theological perspective, such as O’Brien (2018), Doornbos et al. (2005), Lysaught, Kotva, Lammers, and Verhey (2012), or Thobaben СКАЧАТЬ