ABSTRACT
Advances in technology and the growing complexity of the health-care delivery system present nurses with recurrent situations that pose ethical problems. Breakthroughs such as organ transplantation occur in medical treatment; epidemics such as AIDS and teenage pregnancy continue; exposures to clients who lack access to health care arouse troubling concerns about justice; and pressures for cost containment require difficult decisions regarding allocation of resources. The wrenching ethical decisions brought about by these trends add to the ethical issues nurses historically have faced in their day-to-day care of patients. Since the founding of modern nursing by Florence Nightingale in the mid-1800s, nurses have been instructed to undergird their practice with strong moral values. To help overcome the Sairey Gamp image of the venal, drunken women who “nursed” the sick, as described by Charles Dickens in Martin Chzuzzlewit (Cook, 1913), Nightingale carefully selected Protestant deaconesses, Catholic sisters, and a few “ladies” to take with her to the Crimean War zone. Having been well educated in classical studies, she believed that intelligence, education, and strength of character were essential ingredients for the professional practice of nursing (Barritt, 1973). These characteristics remain critical for nursing practice today.
