Nursing Philosophy最新文献

{"title":"Moral Distress and the Governance of Attention in Nursing: A Hanian Reading of the Structural Restriction of Moral Agency.","authors":"Juan Ignacio Rico Becerra, Aarón Muñoz Devesa","doi":"10.1111/nup.70100","DOIUrl":"10.1111/nup.70100","url":null,"abstract":"<p><p>Contemporary nursing is increasingly shaped by performance pressures, demands for traceability, and technological mediation. These developments do more than add tasks to everyday clinical work. They also shape what nurses can attend to, how they judge situations, and whether they are able to sustain the care they believe a patient needs. This article examines moral distress as a structural restriction of moral agency: nurses may recognise what a situation requires yet find themselves unable to act accordingly. Drawing on Byung-Chul Han's analyses of performance, psychopolitics, infocracy, and the palliative society, we develop a tetradic matrix that relates these contemporary logics to four goods of nursing care: attention, clinical judgement, alterity, and hope. In practice, these goods refer to sustained presence, prudent deliberation, recognition of the patient as a singular person, and hope understood as non-abandonment. Applied to the nursing metaparadigm, the matrix shows how clinical time, attention, documentation, and technological mediation can become places where moral agency is either supported or weakened. The article therefore argues for a shift in the ethical evaluation of nursing work: from a narrow focus on individual resilience towards the governance of attention and the institutional conditions that make responsible care possible.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70100"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wonderings on Agape and Eros: Relationship of Nursing Experience and Values to Liberal Humanism and Posthumanism.","authors":"Sarah K Valentine","doi":"10.1111/nup.70104","DOIUrl":"10.1111/nup.70104","url":null,"abstract":"<p><p>Nursing values include commitment to care for all and facilitation of healthy environments. The actualisation of these values, however, is often constrained by healthcare systems when overly influenced by neoliberal priorities for revenue generation. Assuming this context, the dynamics of two ontological nursing motives, loving service (agape) and creative agency (eros), are considered as they relate to nursing axiology, lived experience, and practice. Transversal analysis is engaged to further explore the implications that posthumanist philosophy may have for the relationship of eros-agape dynamics. Consequences for nursing practice and qualitative experience are considered. The analysis concludes in three propositions. The first, that in realigning loving service (agape) aspects of nursing with the nurse person's development of creativity and agency (eros), the nurse-person may be more satisfied in ego reward, and the actualisation of nursing values that hold commitment to all persons, facilitation of healthy environments, and actions of human caring, could be better supported. The second, that posthumanism, particularly the aspects of intersubjectivity and co-being, may transform the possibilities of eros and agape ontological motives in nursing to support greater emergence of connected multidirectional caring; so that the nurse-person is less alienated in providing care and, instead, is an active member of caring ecologies. The third, that in realigning loving service (agape) aspects of nursing with the nurse person's development of creativity and agency (eros), the nurse-person may be more satisfied in ego reward, and the actualisation of nursing values that hold commitment to all persons, facilitation of healthy environments, and actions of human caring, could be better supported.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70104"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking Back/Looking Forward.","authors":"Dillard-Wright Jess","doi":"10.1111/nup.70102","DOIUrl":"10.1111/nup.70102","url":null,"abstract":"","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70102"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Moral Agency in Technology-Mediated Care: Reclaiming Professional Responsibility in the Fifth Industrial Revolution.","authors":"Joseph Andrew Pepito, Ray Anne Labra-Pepito, Jason Arnold Pepito, Faustino Jerome Babate, Gil Platon Soriano, Judith Ismael, Sitti Shierwina Al-Jumayile","doi":"10.1111/nup.70098","DOIUrl":"10.1111/nup.70098","url":null,"abstract":"<p><p>Nursing practice is increasingly enacted within environments structured by intelligent technologies that filter perception, generate classifications and shape clinical priorities. While nurse scholars have begun to examine moral agency in the context of artificial intelligence, much of the broader ethical discourse on AI in healthcare continues to foreground governance, safety and institutional accountability, leaving the conditions under which nurses exercise professional moral responsibility comparatively under-theorized. This paper argues that technology-mediated care constitutes a moral environment that reshapes how responsibility is distributed, interpreted and enacted in clinical practice. Drawing on nursing ethics and socio-technical thought, it distinguishes between technical delegation and moral delegation, clarifying that while intelligent systems may inform action, they cannot assume moral answerability. Nursing moral agency is reconceptualized as relationally oriented moral perception, interpretive judgement and accountable action that remains fundamentally non-delegable, even under conditions of extensive mediation. Boundary-setting is advanced as a disciplined ethical practice through which nurses delineate the limits of technological authority and sustain professional responsibility. By articulating moral agency as both situated and irreducible, this analysis contributes a conceptual framework for understanding ethical responsibility in the Fifth Industrial Revolution and re-centres the nurse as the accountable moral subject within technology-mediated care.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70098"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Using AI to Relating Through AI: A Postphenomenological and Reflexive Inquiry Into Nursing Education in Developing Country Contexts.","authors":"Gideon Dzando","doi":"10.1111/nup.70090","DOIUrl":"10.1111/nup.70090","url":null,"abstract":"<p><p>Artificial intelligence (AI) technologies are increasingly integrated into nursing education often framed as neutral tools that enhance learning efficiency, consistency, and clinical decision-making. However, this instrumental framing obscures how AI may fundamentally reshape nursing students' perception, ethical orientation, and professional formation, particularly in developing country contexts. Nursing training in developing countries is often characterised by infrastructural constraint and epistemic inequality compared to developed countries. This paper offers a conceptual-theoretical analysis of AI in nursing education with a focus on how it mediates the ways nursing students come to see, interpret, and relate to patients and clinical knowledge. Drawing on postphenomenology and a reflexive decolonial stance, the paper conceptualises AI as a mediating force. The analysis is structured around four modes of technological mediation (embodiment, hermeneutic, alterity, and background relations) to examine how AI reshapes embodied clinical practice, interpretive frameworks, pedagogical authority, and the hidden curriculum of nursing education in developing country settings. Reflexive attention to moments of critical friction reveals tensions between the standardised logic embedded in AI systems and the situated, relational realities of nursing education. The paper argues that AI mediates not only what nursing students know, but how they learn to attend, judge, and assume ethical responsibility. By foregrounding mediation and epistemic justice, it calls for more reflexive, context-sensitive approaches to integrating AI in global nursing education.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70090"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Camp, Seriousness and Professional Comportment in Nursing.","authors":"Daniel Joseph E Berdida","doi":"10.1111/nup.70091","DOIUrl":"10.1111/nup.70091","url":null,"abstract":"<p><p>Professional comportment is widely treated in nursing education and practice as a necessary marker of trustworthiness, maturity and professional identity. Yet comportment is rarely examined as more than a neutral code of appropriate conduct. In this paper, I argue that professional comportment functions as a discipline of seriousness through which nursing regulates credibility, embodiment and belonging. Comportment does not simply guide what nurses should do; it also shapes how nurses should look, sound, feel, and appear in order to be recognised as legitimate. In this sense, it operates as an aesthetic and affective norm as much as an ethical one. Drawing on Camp as a philosophical method, I show that nursing's ideal of seriousness depends on disavowed forms of performance, composure, restraint and respectability. I argue that seriousness is not merely a personal virtue but a socially conferred style of legitimacy that unevenly rewards some forms of embodiment while marking others as excessive, immature or unprofessional. Camp is valuable here not because it rejects care, but because it exposes the artifice of seriousness and creates critical distance from norms that present themselves as natural. Through this lens, professional comportment can be understood as a site where gendered, racialized, classed and heteronormative expectations are reproduced under the language of professionalism. As an illustrative case, I consider nursing memes and online self-stylization as minor but revealing sites where professional seriousness is publicly negotiated. These cultural forms do not simply resist professional norms; they can also reproduce the exclusions they appear to unsettle. I conclude by proposing a plural ethics of professional presence, one that distinguishes ethical obligation from respectability, preserves accountability and care, and loosens the hold of singular, assimilative models of seriousness.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70091"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"10.1111/nup.70094","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":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Just Human Things That You Do': Experiments Towards an Abolitionist Ethic of Care Among Healthcare Workers Caring for Pregnant Patients in Immigration Custody.","authors":"Amanda Heffernan","doi":"10.1111/nup.70095","DOIUrl":"https://doi.org/10.1111/nup.70095","url":null,"abstract":"<p><p>This study draws on data from a study about the experiences of pregnant people in United States immigration detention from 2017 to 2022. While the original research questions focused on the impact of US immigration enforcement on pregnant migrants, interviews with healthcare workers offered unexpected insights into their own responses to the moral distress they felt when caring for pregnant women in immigration custody. Their responses were varied, from distressed observation to humanitarian mitigation to circumscribed advocacy to active resistance; for a few labour and delivery nurses, this resistance entailed significant professional risk-taking on behalf of their patients. Healthcare workers navigated the power dynamics of healthcare institutions which mandate compliance with law enforcement and their own fears, misgivings and conditioning as they attempted to blunt and subvert the violence and reproductive oppression of the carceral state's immigration enforcement regime. Drawing on recent literature on abolition nursing, medicine and midwifery, and in the context of Donna Haraway's philosophical contributions, this article will explore how healthcare workers engaged in a constellation of practices towards a situated, feminist abolitionist ethic of care.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70095"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Generativity of Variability for Evidence-Based Practice.","authors":"Miriam Bender","doi":"10.1111/nup.70096","DOIUrl":"10.1111/nup.70096","url":null,"abstract":"<p><p>The evidence-based practice (EBP) paradigm has become a dominant approach to clinical care, organizing healthcare around the production, synthesis, and implementation of evidence. Yet despite sustained efforts to standardize practice in terms of evidence, variability in care delivery, outcomes, and decision-making persists. Nursing scholarship has critically examined EBP as a dominant epistemological orientation to practice, often identifying variability as that which troubles the evidentiary aspiration to standardize, generalize, and govern practice. Building on this work, I take variability as a starting point for examining how healthcare is configured as an evidentiary domain in the first place. Drawing on Michel Callon's concepts of framing and overflowing, EBP is approached as an ongoing effort to make clinical practice sufficiently calculable, comparable, and actionable. The analysis shows how variability appears not simply as what exceeds or opposes evidence, but as that which is directly operative in the processes through which evidentiary arrangements are developed, enacted, and transformed. In this way, evidence and practice emerge not as pre-existing domains requiring reconciliation, but as ongoing accomplishments produced through processes of framing and overflowing. What then becomes visible is the continual formation of healthcare, where evidentiary arrangements, clinical practices, problems, and possibilities are continually encountered, enacted, and made consequential, inviting inquiry into the ways nursing participates in these processes.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70096"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epistemic Injustice in Nursing Knowledge Production: A Three-Pillar Framework for Recognition, Redistribution, and Representation.","authors":"Ibrahim Aqtam","doi":"10.1111/nup.70101","DOIUrl":"10.1111/nup.70101","url":null,"abstract":"<p><p>Western-centric knowledge paradigms in nursing perpetuate epistemic injustice by systematically excluding racialized, Indigenous, and Global South ways of knowing from legitimate nursing discourse. Despite growing critical scholarship on this problem, no widely cited framework has yet translated foundational theories of epistemic injustice and social justice into a discipline-specific, operational governance tool for nursing institutions. This discursive paper examines how Western-centric knowledge paradigms in nursing contribute to epistemic injustice and develops an operational framework for epistemic justice in nursing education, research, and practice. A critical interpretive synthesis of literature from nursing philosophy, decolonial studies, critical pedagogy, and global health ethics was conducted using theoretical sampling across CINAHL, PubMed, Scopus, and Web of Science (1990-2025). The single-author interpretive synthesis was appropriate for theory generation, with saturation understood as the point at which additional texts did not introduce new framework-relevant constructs, rather than implying comprehensive coverage of the field. The paper develops three concrete outputs: a three-pillar framework for epistemic justice comprising Recognition, Redistribution, and Representation; measurable operational indicators for each pillar including citation equity indices, syllabus diversity audits, and leadership representation metrics; and a six-question decision audit tool designed to support institutional self-assessment of epistemic justice. The framework is explicitly positioned as an initial synthesis intended to support future collaborative development with Global South, Indigenous, and racialized nursing scholars. Achieving epistemic justice demands structural change to what counts as legitimate nursing knowledge. The paper further argues that decolonizing nursing knowledge requires not merely diversifying existing frameworks but interrogating the colonial foundations upon which dominant nursing epistemologies have historically rested. No patient or public involvement occurred in the design or writing of this discursive article.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70101"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}