Nortvedt P
University of Oslo, Blindern, Norway.
Sch Inq Nurs Pract. 2001 Spring;15(1):25-43; discussion 45-8.
This article argues that there is an important connection between ethical sensitivity and clinical competency in nursing. This is more than a defense for ethical attitudes and virtues in clinical practice, however. I will show in what way ethical sensitivity is important not only to moral judgment, but to professional clinical knowledge and judgment as well. Drawing on central insights from continental philosophy, Husserl, Heidegger, Levinas and Foucault, as well as classical virtue theory, the article elucidates the inseparability of ethical sensitivity and clinical knowledge in nursing. Ethical sensitivity has bearing upon clinical knowledge and awareness in two important ways. First, what we consider relevant clinical knowledge and therapeutic measures frequently encounter the realities of clinical conditions, realities which embody certain moral qualities and appeal to moral values. In clinical nursing, it is important to understand how this encounter between professional knowledge and moral values informs clinical action, making it morally as well as professionally proper. Second, sensitivity to vulnerability qualifies clinical knowledge in the way that it alerts clinical sensitivity altogether. Perception of morally salient features informs the nurse about significant changes in the patient's pathological condition. The ability to be touched morally by the patient's condition, his or her vulnerability or vitality and positive experience is epistemologically and prognostically significant.
本文认为,护理中的伦理敏感性与临床能力之间存在重要联系。然而,这不仅仅是对临床实践中伦理态度和美德的一种辩护。我将展示伦理敏感性不仅对道德判断,而且对专业临床知识和判断都具有重要意义的方式。借鉴大陆哲学、胡塞尔、海德格尔、列维纳斯和福柯的核心见解,以及古典美德理论,本文阐明了护理中伦理敏感性与临床知识的不可分割性。伦理敏感性在两个重要方面影响着临床知识和意识。首先,我们所认为的相关临床知识和治疗措施常常会遇到临床状况的现实,这些现实体现了某些道德品质并诉诸道德价值观。在临床护理中,理解专业知识与道德价值观之间的这种相遇如何为临床行动提供信息,使临床行动在道德和专业上都恰当,这很重要。其次,对脆弱性的敏感性以完全提醒临床敏感性的方式限定临床知识。对道德显著特征的感知会让护士了解患者病理状况的重大变化。被患者的状况、其脆弱性或活力以及积极体验在道德上触动的能力在认识论和预后方面都具有重要意义。