{"title":"Nursing in Capitalist Healthcare: The Ethical Dichotomy Between the Vocation of Nursing and the Healthcare-Industrial Complex.","authors":"Norman Jigs Quiñones","doi":"10.1111/nup.70094","DOIUrl":null,"url":null,"abstract":"<p><p>Nursing is a profession grounded in a vocation of caring, altruism and moral responsibility. However, contemporary nursing practice occurs largely within a healthcare system structured by neoliberal, productivity-driven imperatives-commonly described as the healthcare-industrial complex. As market-oriented logics continue to shape healthcare delivery and access to care, tensions emerge between the moral foundations of nursing and the economic rationalities that govern healthcare institutions. This paper presents a philosophical analysis of the bioethical contradictions that nurses experience in practising within the healthcare-industrial complex. Drawing on bioethical principles, nursing ethics and critical social theory, the analysis examines how neoliberal healthcare structures create moral distress, ethical dissonance and constrained moral agency among nurses. This paper argues that nurses' ethical struggle is not a failure of professional integrity but a predictable outcome of structural forces that compel participation in systems that are misaligned with nursing's moral commitments. By elucidating these dynamics, this analysis offers a conceptual framework for understanding nurse moral distress and identifies pathways for ethical agency, resistance and professional advocacy within contemporary healthcare.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70094"},"PeriodicalIF":2.0000,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290111/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing Philosophy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nup.70094","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
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Abstract
Nursing is a profession grounded in a vocation of caring, altruism and moral responsibility. However, contemporary nursing practice occurs largely within a healthcare system structured by neoliberal, productivity-driven imperatives-commonly described as the healthcare-industrial complex. As market-oriented logics continue to shape healthcare delivery and access to care, tensions emerge between the moral foundations of nursing and the economic rationalities that govern healthcare institutions. This paper presents a philosophical analysis of the bioethical contradictions that nurses experience in practising within the healthcare-industrial complex. Drawing on bioethical principles, nursing ethics and critical social theory, the analysis examines how neoliberal healthcare structures create moral distress, ethical dissonance and constrained moral agency among nurses. This paper argues that nurses' ethical struggle is not a failure of professional integrity but a predictable outcome of structural forces that compel participation in systems that are misaligned with nursing's moral commitments. By elucidating these dynamics, this analysis offers a conceptual framework for understanding nurse moral distress and identifies pathways for ethical agency, resistance and professional advocacy within contemporary healthcare.
期刊介绍：
Nursing Philosophy provides a forum for discussion of philosophical issues in nursing. These focus on questions relating to the nature of nursing and to the phenomena of key relevance to it. For example, any understanding of what nursing is presupposes some conception of just what nurses are trying to do when they nurse. But what are the ends of nursing? Are they to promote health, prevent disease, promote well-being, enhance autonomy, relieve suffering, or some combination of these? How are these ends are to be met? What kind of knowledge is needed in order to nurse? Practical, theoretical, aesthetic, moral, political, ''intuitive'' or some other?
Papers that explore other aspects of philosophical enquiry and analysis of relevance to nursing (and any other healthcare or social care activity) are also welcome and might include, but not be limited to, critical discussions of the work of nurse theorists who have advanced philosophical claims (e.g., Benner, Benner and Wrubel, Carper, Schrok, Watson, Parse and so on) as well as critical engagement with philosophers (e.g., Heidegger, Husserl, Kuhn, Polanyi, Taylor, MacIntyre and so on) whose work informs health care in general and nursing in particular.
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