The nursing profession has long cared for and sought to heal the sick. The nurse today functions within healthcare teams inside hospital systems or in outpatient settings. Throughout the nursing profession, ethics has been important. The Nightingale Pledge was the ethical standard for the ideal nurse adapted from the Hippocratic Oath and named after Florence Nightingale. It held the nurse responsible to God, forbid harming the patient, and commissioned nurses to promote the health of patients and assist physicians in this endeavor. The profession advanced in 1965 to create nurse practitioners to address the needs of access to healthcare. Nurse practitioners are nurses with advanced graduate-level training to examine, diagnose, treat, and prescribe in order to help and heal patients. The nurse practitioner role was originally created for nurses to assist physicians to see more patients independently. Unfortunately, nurse practitioners do not have any ethical framework or oath that shapes their practice. Only one proposal of a nurse practitioner code of ethics has been attempted. There are no oaths for nurse practitioners to serve as an ethical framework for nurse practitioners. Like the Nightingale Pledge that was fashioned from the Hippocratic Oath, nurse practitioners ought to practice from the moral framework of Hippocratism. Moreover, medicine and nursing were both influenced greatly by early Christianity, and Christian nurse practitioners ought to practice Christian Hippocratism. In order to base the virtuous nurse practitioner’s practice in an ethical framework, an Oath for Nurse Practitioners is proposed.
Category Archives: Early Access
Hippocratic Resistance: Conscientious Medicine and Strategic Ethics
Abstract
Conscientious medicine enjoys a long history, with roots reaching back to the Hippocratic Oath. Conscientious objection (CO) as a particular manifestation of such practice carries broader implications for healthcare and society. While patients have the right to decline treatments, they are free to do so for a variety of reasons, even against medical advice (AMA). Healthcare professionals (HCPs), on the other hand, are viewed differently. When it comes to morally questionable interventions, they may be asked to put aside their own convictions out of a sense of obligation or duty. Critics claim that conscientious objection that delays or limits interventions can cause harm. Supporters of conscientious objection argue that there is a growing list of interventions that raise larger questions about the definition of harm and the very nature of humanity. Not only is objection justified in such cases, but it may also be essential to the honest practice of pluralistic medicine. This essay argues that conscientious objection is a defending characteristic of medical ethics as part of the healing identity, with strong historical roots. In addition to safety and policy, conscientious practice acts as an ethical line of defense that has protective qualities for society. Current literature on this topic speaks to the clinical challenges involved with balancing objection and access. This essay uses historical examples going back to Hippocrates to illustrate how respecting individual conscience is strategic for the collective endeavor of medical ethics.
Keywords: Autonomy, Authority, Nonmaleficence, Conscientious, Conscience, Medical Ethics, Integrity, Hippocrates
Book Review: David VanDrunen, “Natural Law: A Short Companion”
Natural law as a guide to ethics has gotten a bad name in some Protestant circles on the grounds that it is a “Roman Catholic” doctrine that insufficiently appreciates the effects of the Fall on human reason and will. David VanDrunen—professor at Westminster Seminary California, ordained minister in the Orthodox Presbyterian Church, with a law degree and a PhD in Christian Ethics—begs to differ. This introduction to his work on natural law lays out its Scriptural basis. It deserves a place on the shelf of any Christian interested in ethics.
A Higher Calling: Bioethical and Christian Perspectives on Medical Drone Delivery in Developing Nations
This review discusses the emerging technology of medical drone delivery and the associated logistical, bioethical, and Christian worldview considerations. Utilization of drones for delivering medical supplies, though a groundbreaking advancement enhancing medical accessibility and timeliness, raises significant bioethical concerns rooted in principles like beneficence, non-maleficence, autonomy, justice, and explicability. These concerns entail ensuring equitable distribution of medical resources for public benefit while safeguarding patient privacy and data integrity. It is imperative for companies to adhere to regulatory frameworks and transparently communicate about this emerging technology. Addressing these challenges necessitates stakeholder collaboration, involving manufacturers, healthcare providers, regulatory authorities, and communities. From a Christian worldview, key principles encompass the sanctity of life, justice and equity, responsible stewardship of resources, and community welfare. The bioethical implementation of medical delivery drones depends on finding a balance, leveraging technological progress for societal good, and mitigating risks through conscientious, accountable practices. By embracing this approach, the healthcare sector can effectively leverage drone technology to enhance patient care and public health outcomes while upholding the intrinsic values of healthcare, such as compassion, empathy, and human connection.
Emerging Technology and Public Health Ethics
Emerging technology used in public health surveillance has increased tremendously in the past decade and especially during the COVID-19 pandemic. Technologies such as surveillance video monitoring, facial recognition software, and artificial intelligence are used with increasing frequency in the name of preventing or containing diseases. These same technologies have been used by governments for uses other than public health surveillance in so-called “function creep.” Such uses can infringe upon individual autonomy and personal privacy. Ethical analysis during the COVID pandemic typically followed utilitarian analytical frameworks. This presentation uses a virtue ethics analysis of surveillance technologies emphasizing honesty, responsibility, and compassion. Utilitarian ethical analysis leads governmental actions to seek actions and use technologies that protect the most people, but do not necessarily benefit minority groups. Virtue ethics presents a firmer ground to protect the health of the community while safeguarding minority rights through its focus on the moral development and character formation of the public health professional, the individual, and the community. Lastly, a Christian reflection on such issues is examined. Ethical analysis of public health surveillance technologies must precede use of such technologies. A virtue ethics approach can assist in such analysis, supporting the health of the community while protecting the rights of the vulnerable.
Ethics of Virtual Reality at the End of Life
Clinically, virtual reality (VR) applications can be used to control pain and to treat psychological disorders. Christians should be attentive to issues of embodiment and excarnation when approaching this technology. At the end of life, VR can help mend one’s relationship to one’s body and promote relationships of care and love between persons. Negatively, VR can be depersonalizing if it alienates a patient from the flesh world. However, VR can help a patient towards a good death as a pain relief adjunct when used within a caring community.
Remembering the Life and Legacy of Robert D. Orr (1941–2021)
For this issue of Ethics & Medicine, we offer a collection of essays and reflections on the life and legacy of Robert D. Orr, MD, CM (1941–2021).
Book Review: Dennis L. Durst, “The Perils of Human Exceptionalism”
Theologian Dennis Durst’s The Perils of Human Exceptionalism is a historical theological anthropology on the intellectual history of the 19th century that impacted human exceptionalism.
Robert Orr’s Legacy of Theologically Rich Clinical Ethics Leadership
Dr. Robert D. Orr was a committed Christian, good friend, and exemplary physician. His medical prowess and wisdom were perhaps most powerfully evidenced in his book Medical Ethics and the Faith Factor: A Handbook for Clergy and Health-Care Professionals. That book was the third project developed for The Center for Bioethics & Human Dignity’s (CBHD’s) second book series with Eerdmans, Critical Issues in Bioethics. His volume brilliantly demonstrates how the work of earlier books in the series produced by Biola’s Scott Rae and Harvard’s Arthur Dyck cash out in the everyday practice of medicine. It is a wonderful discussion of a great array of real-life case studies, filled with the insight that comes from a lifetime of faithful caring for patients in the service of God.
Robert Orr, MD: Educator
I probably first encountered Dr. Bob Orr in Toronto—close to 40 years ago. We were both attending a conference—sponsored by the Christian Medical & Dental Associations (CMDA)—that was intended to be an introduction to faith-based medical ethics and would drum up interest for this relatively unheralded discipline.