Jenkins Karen, Kinsella Elizabeth Anne, DeLuca Sandra
Health and Rehabilitation Science Graduate Program, Faculty of Health Sciences, Western University, London, Ontario, Canada.
School of Nursing, Fanshawe College, London, Ontario, Canada.
Nurs Philos. 2019 Jan;20(1):e12231. doi: 10.1111/nup.12231. Epub 2018 Nov 18.
The concept of phronesis is venerable and is experiencing a resurgence in contemporary discourses on professional life. Aristotle's notion of phronesis involves reasoning and action based on ethical ideals oriented towards the human good. For Aristotle, humans possess the desire to do what is best for human flourishing, and to do so according to the application of virtues. Within health care, the pervasiveness of economic agendas, technological approaches and managerialism create conditions in which human relationships and moral reasoning are becoming increasingly de-valued. This creates a tension for nurses, and nursing leaders, as the desire to do what is morally right is often in conflict with contextual demands. In this paper, Aristotle's writing on phronesis is examined with a focus on his classic conceptions of eudaimonia, the virtues, deliberation, judgement, and praxis. Building on Aristotle's work, a number of contemporary views are explored with a focus on what various conceptualizations offer for the discipline of nursing. These expanded conceptions of phronesis include attention to: embodiment in practice; open-mindedness including the capacity to stay curious and open to recognizing what we do not know; perceptiveness as a disposition towards insight and aesthetic understanding; and reflexivity as an ongoing process of interrogation and inquiry into ourselves and our actions. Drawing on these concepts, we discuss the affordances of phronesis as a morally informed guiding force to attend to modern-day challenges in nursing practice and nursing leadership.
实践智慧的概念历史悠久,且在当代关于职业生活的论述中正在复兴。亚里士多德的实践智慧概念涉及基于朝向人类福祉的伦理理想的推理和行动。对亚里士多德而言,人类有做对人类繁荣最有益之事的愿望,并通过美德的运用来实现这一愿望。在医疗保健领域,经济议程、技术方法和管理主义的盛行营造了一种氛围,在这种氛围中,人际关系和道德推理正日益受到贬低。这给护士和护理领导者带来了一种张力,因为做符合道德之事的愿望常常与实际情境的要求相冲突。在本文中,我们审视了亚里士多德关于实践智慧的著作,重点关注他对幸福、美德、慎思、判断和实践的经典概念。在亚里士多德著作的基础上,我们探讨了一些当代观点,重点关注各种概念化表述对护理学科的贡献。这些对实践智慧的扩展概念包括关注:实践中的体现;开放性思维,包括保持好奇心和对认识到我们所不知之事持开放态度的能力;洞察力,即一种朝向洞察力和审美理解的倾向;以及反思性,即对我们自身及我们的行动进行持续审问和探究的过程。借鉴这些概念,我们讨论了实践智慧作为一种有道德依据的指导力量,在应对护理实践和护理领导中的现代挑战方面所具有的作用。