A philosophy of nursing practice: An application of the Thomistic-Aristotelian concept of nature to the science of nursing

摘要

Accounts of nursing that focus exclusively on behaviors and interactions remain on the level of phenomena and are caught in the problem of enumerative induction. This study goes beneath behavior to focus on human nature. With human nature as its foundation, nursing can be seen as a practical science that seeks causal knowledge for the sake of practice. It employs the resolutive mode of speculative science to discover theoretical principles, and uses the compositive mode of practical science, along with prudence, to apply principles in patient care.;The thesis begins with an analysis of selected nursing frameworks. The Aristotelian concept of human nature is then introduced as the determinate principle of human existence and human action. It is explicated through the life-powers model of William A. Wallace. Specific powers characterize natures of various kinds. Intellect and will are powers most distinctive of human nature, but human nature integrates and includes virtually within itself all the lower powers; animal, plant, and inorganic. The proper functioning of these powers is necessary for health.;An Aristotelian understanding of nature and science thus provides new insights into the practical science of nursing. Nursing concepts are rooted in the extramental world through Wallace's typology of concepts. Due to the interpersonal nature of practice, a typology of behavioral concepts is introduced. Causal analysis is exemplified by demonstrations from decubiti research. This supports standards of intervention.;Activities that increase knowledge and choice promote the unique human end. These are the highest nursing activities. Activities that maintain life take place at the level of the nutritive and sensitive powers. On this view activities of physical care for the ill are vital nursing functions that in many cases have higher priority than education, even though education is the highest level of intervention. The nursing framework and transaction theory of Imogene King facilitate the integration of nature and science into nursing practice.;The thesis concludes with the speculative problem of the presence of the intellectual soul at the beginning of human life. It considers immediate and delayed hominization in the Thomistic tradition and offers an intermediate position at DNA activation.