1. Chinn, Peggy L. RN, PhD, FAAN

Article Content

This is the fourth issue of Advances in Nursing Science (ANS 24:2) to focus on ethics. The first such issue was the third issue of volume 1, published in April 1979. At that early stage in the journal's history, we had not yet reached the point of publishing only unsolicited manuscripts; about half of the articles were unsolicited. That early issue topic was planned in part because the subject of ethics was a major concern among nurse scholars and practitioners alike, and it remains so today. Interestingly, some of the issues remain as timely today as they were in 1979. Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain. Without doubt, the depth and complexity with which issues are approached today have changed dramatically with the impressive growth of well-prepared nurse scholars who have developed sophisticated philosophic understandings and skills, and who have debated fundamental issues related to nursing and ethics.


ANS contributed significantly to the important ethical debates in nursing, starting with an article by Beverly J. McElmurry and Roland R. Yarling entitled "The Moral Foundation of Nursing," which was published in ANS 8:2 (January 1986, pp 63-73). This article prompted an impressive sequence of papers coming from many different ethical and philosophic perspectives, many of which were published in issues of ANS that were not specifically focused on nursing ethics and in other journals as well. McElmurry and Yarling responded to several of these papers in a guest editorial in ANS 11:3 (April 1989, pp xi-xii) and outlined their view of the various positions that other scholars assumed relative to their original work. Rightfully, there has been no single conclusion to this debate. Rather, the debate opened understandings to a number of different perspectives and positions that can be assumed concerning nursing, ethics, and nursing's ethical and moral foundations. Nurse scholars now understand that in pursuing ethical inquiry or in forming ethical arguments it is essential to be clear about one's ethical foundation, building the argument logically from that point forward. The debate opened possibilities and built a disciplinary understanding of the foundational choices that can be assumed.


In September 1996, ANS 19:1 focused on nursing ethics and reflected a growing maturity in that the articles focused increasingly on phenomena of the discipline that are clearly situated in the nurse-patient interaction, such as caring, compliance, transmission of HIV, and life-support decisions. At this point, the issues concerning what nursing is and the sources from which we draw our ethical reasoning assumed a more foundational position. In this current issue of ANS (24:2), the articles reflect a growing awareness and consciousness of our relationships with other disciplines, cultures, or environments-globalization, social justice and economics, and environments other than the traditional venues for delivery of care.


In my view, in this time of crisis for nursing and health care, the ethical issues that guide our practice and our scholarship are key to how we survive as a discipline and whether or not we thrive. It is imperative for all nurse scholars to be well versed in the ethical foundations of the discipline, to know where we stand, and to be ready and willing to act on our convictions. It also is imperative for nurse scholars with expertise in ethics and philosophy to remain visible and to bring their best thinking and analysis to the serious issues that we face in nursing and health care. I believe that the authors whose work appears in this issue of ANS contribute in significant ways, and their work will inspire those who follow in their footsteps.


-Peggy L. Chinn, RN, PhD, FAAN