Virtue in client centred care : a philosophical investigation of virtue and nursing in Canadian healthcare
Bibliographic record
Abstract
Part of the mandate of the Canadian Nursing Association is to develop and maintain a 'code of ethics'. Provincial professional nursing associations have largely based their own ethical frameworks on this code. However, as Mitchell and Benner have argued, ethical codes fail to capture some essential elements of the ethical life of nurses. This signals a need for a more accurate and experience based ethical framework for nurses. One such attempt is a document published by the Registered Nurses Association of Ontario entitled 'Client Centred Care' that presents an ethical framework that relies on a nurses' practical wisdom and that emphasizes individual experiences of ethical situations based on close relationships with patients. Some traditional ethical frameworks in the philosophical field have come under attack by Neo-Aristotelian Virtue Ethicists for the same reasons. These philosophers, including Wiggins, Maclntyre, Hursthouse, Zagzebski, and MacDowell, have supplemented unsatisfactory, traditional ethical frameworks with one that emphasizes perception of salience, practical wisdom, and practice. Because they are similar in their approaches to ethical life, and in their criticisms of traditional ethical frameworks, 'Client Centred Care' lends itself well to the vocabulary and conceptual structure of Virtue Ethics. However, for all its merits, 'Client Centred Care' does not provide us with the rigor of a serious ethical text, leaving terms inadequately defined and many questions unanswered. This work is an effort to clarify the ethical claims of this text through the lens of Virtue Ethics. In doing so, I will expose some of the deficiencies of this ethical framework for nurses and propose a curative solution by examining the work of Narrative Ethicists such as Martha Nussbaum.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.053 | 0.071 |
| Scholarly communication | 0.012 | 0.006 |
| Open science | 0.004 | 0.007 |
| Research integrity | 0.006 | 0.007 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".