1. Perron, Amaelie
  2. Rudge, Trudy
  3. Blais, Anne-Marie
  4. Holmes, Dave

Article Content


To the Editor:


We wish we could say that we are surprised by Dr Speraw's letter; however, it is not the case. Dr Speraw's letter does not address the actual content of our paper but focuses exclusively on our reference to the Homeland Security Nursing (HSN) programme, which she coordinates. She does not discuss the ontological and epistemological issues that we identify in her paper on a theory of homeland security. Although she does describe topics taught in the HSN programme and the research conducted within it, she does not refer to the partnerships established with military personnel and agencies in order to carry out some of these activities. Curiously, her letter focuses exclusively on disaster preparedness but silences entirely the overarching premise of the need for homeland security as the guiding philosophy of the programme. The tone of her letter and the accusations against the political and ethical dimensions of our article confirm that the title was chosen wisely.


The objective of our paper1 was to discuss the various ways in which military speech and ideology can make its way into nursing idiom and education. We believe we have done this successfully by raising the ontological, epistemological, and ethical concerns that result from this process. Neither we are sure which portion of our paper constitutes a personal attack on Dr Speraw, nor can we identify volatile or incendiary language in our argument. The issue we raise may be contentious and we do not expect consensus around this issue. This, however, should not serve as an argument to avoid or dismiss the issue altogether. At the risk of offending Dr Speraw, other than citing the article Dr Speraw cowrote with her colleague, our paper is not about her or the HSN programme. The programme is used as one example of many techniques and strategies through and by which military agencies have made their way into civilian spheres, including the universities and their research traditions. As shown in our paper, this trend has been observed in most academic disciplines and we highlight the fact that nursing constitutes a fertile space for such an incursion.


There is no need for personal attacks when one engages in a philosophical debate about current trends in nursing, whether these trends concern the evidence-based movement, the postmodern turn in nursing, practice development, or the influence of pharmaceutical industries. All the tools needed to engage in such debates are readily available to those who pursue a philosophical analysis. Philosophy allows us to take a step back and reflect on what it is that we do as nurses and to what purpose. Importantly, it also teaches us the various ways in which ideology operates and creates effects in everyday life.


Certainly, nurses, wherever and by whomever, will continue to be trained as "nurses". But one can legitimately wonder what kind of nurse is being educated and for what purpose. What is meant by "nurse"? The ontological answer we seek here goes beyond the usual rhetoric of "responding to today's needs". This statement has become quite empty on the simple basis that different interests and agendas spawn different needs, and a consensus around what might constitute "today's needs" is difficult to come by. Nurses trained in a programme that is explicitly geared toward the preservation of national security will respond to a specific set of interests that powerfully dictate "today's needs."Although the ideology of terrorism is a matter of focus in the HSN programme, we respectfully doubt that the very concept of "homeland security",which in many respects has functioned as a powerful (totalitarist) ideology since September 112 - 4 is awarded the same critical examination. Other than the matter of finances, which certainly restrict one's disposition to question certain things (the University of Tennessee received significant funding from the Department of Homeland Security to develop its homeland security programmes and research centers5-7) one must account for the very way ideologies function.


Arendt8(p469) defines ideologies as such:


An ideology is quite literally what its name indicates: it is the logic of an idea. ([horizontal ellipsis]) Ideologies pretend to know the mysteries of the whole historical process-the secrets of the past, the intricacies of the present, the uncertainties of the future-because of the logic inherent in their respective ideas.


Ideologies operate through a narrow mental framework that makes possible a shared (re)interpretation of particular events. They do not "have the truth as [their] purpose but [aim] at the fulfillment of the idea."9(p124). They function because they carry their own powerful internal logic, often backed up by moral discourses. Their logic operates to create conformity (of thought and conduct) as well as lack of questioning. Ideologies work because they deploy through (usually well-intended) agents who do not realize that they are a part of them. In producing consensus and homogeneous thought, they also exclude other ways of thinking, doing and being. Ideologies breed intolerance for differing opinions, all the while appearing neutral, apolitical, and benevolent. Ideologies supplant reflection and opinion8; they position themselves above reason-and critique. Since September 11, 2001, in the name of "homeland security"or the "War on Terror," there has been a massive surrendering of reasoning and decision making to the forces in power (largely military) which, by situating matters of national security above all else2,4 have achieved massive restructuring of civilian (including professional) structures, institutions, and responsibilities.3,4 This (self-)abdication is key to the success of ideology,8 whereby personal agencies are blurred and individual aspirations dissipate into one communal, self-confirmed, conviction, leading to a collective experience largely typified by fear and suspicion and the cultivation of "warfare personality."9(p126)


Dr Speraw adamantly insists that the HSN programme was not overtaken by the military and that it trains nurses in disaster preparedness. Unfortunately, this argument misses the mark because in today's post 9/11 context, disaster planning and management neither can be spoken about outside of the military idiom, nor can disaster-prepared nurses practice outside of militarized contexts of care, as though military matters do not concern them. Disaster (natural or man-made) enjoys a strong (constructed) interreliance with issues of national security, an ideological space where the military holds a dominant position. Homeland security and disaster management speech are powerful because they are laden with assumptions about civilian responsibility and duty, portrayed as patriotic, natural, and hence can be used unproblematically. As stated in our paper, we are not suggesting that nurses should not intervene when and where disaster strikes. Instead, we are highlighting the way powerful (ideological) discourses shape nursing work but also the way they further perpetuate themselves by and through nursing work. Nurses can become effective mediators of particular ideologies because of their privileged relationship with populations, but also because their work is typically viewed as benevolent and grounded in commonly held moral obligations. The multiplication of education and research endeavors (including, but not limited to, the HSN programme) further legitimizes militarized ideological discourses making them that much more difficult to challenge.


Despite their stellar track record of "doing good," nurses are not exempt from the risk of perpetrating acts that are not in accordance with nursing philosophy, even though their intentions are honest (see for instance nurses' involvement in capital punishment).10 In our paper, we provide several scenarios regarding the way this may occur. What we highlight is that nurses are ideally positioned to carry out actions that are not of their doing and that fulfil an agenda that is not theirs, whether they may (inadvertently or not) promote a particular policy, product or procedure, or follow questionable policies about restraints, confinement, or access to personal health information. We assert this political discussion, although difficult for many, is highly ethical and it falls within the scope of nursing academic work-toward an "ethics of discomfort,"11(p121) we might say.




1. Perron A, Rudge T, Blais AM, Holmes D. The politics of nursing knowledge and education: critical pedagogy in the face of the militarisation of nursing in the war on terror. Adv Nurs Sci. 2010;33(3):184-195. [Context Link]


2. Beresford AD. Homeland security as an American ideology: implications for U.S. Policy and action. J Homeland Secur Emerg Manag. 2004;1(3): Article 301. [Context Link]


3. Doumani B. Academic Freedom after September 11. New York: Zone Books; 2006. [Context Link]


4. Giroux HA. The University in Chains: Confronting the Military-Industrial-Academic Complex. Boulder, CO: Paradigm Publisher; 2007. [Context Link]


5. . Press Releases: UT Receives $7 Million in Federal Grants, 2004. Accessed October 28, 2010. [Context Link]


6. . Press Releases: UT to Receive $5 Million in Homeland Security Grants, 2005. Accessed October 28, 2010. [Context Link]


7. . Press Releases: DHS Announces $30 Million in Competitive Grants to Strengthen Preparedness Training, 2010. release0779.shtm. Accessed October 28, 2010. [Context Link]


8. Arendt H. The Origins of Totalitarianism. New York, NY: Harcourt Brace Jovanovich; 1966. [Context Link]


9. Allen W. Hannah Arendt and the ideological structure of totalitarianism. Man and World. 1993;26(2):115-129. [Context Link]


10. Holmes D, Federman C. Killing for the state: the darkest side of American Nursing. Nurs Inq. 2003;10(1):2-10. [Context Link]


11. Foucault M. The Politics of Truth. Los Angeles, CA: Semiotext(e); 2007. [Context Link]