看護における徳の倫理の意義

Virtue Ethics and Its Implications for Nursing

要旨

　徳の倫理と原則の倫理は，看護・医療の倫理における最も主要なアプローチである．原則の倫理は行為を，徳の倫理は行為者の性格や態度を吟味し，これらは互いに補いあって機能する．徳の倫理は，1970年代の原則の倫理台頭で衰退したが，最近の海外文献はその復興を示している．日本では，医学上の問題や原則の倫理が，看護倫理教育の中心であると報告されており，徳の倫理への関心は高くない．それは，専門職としての看護の発展を妨げていた，かつての徳の倫理への記憶が今に影響しているためかもしれない．本稿は，徳の倫理に新たな光を当て，看護におけるその重要性を述べる．著者らの研究知見を用いつつ，次の点を強調する：1)時代の求めとともに変容する看護師の徳・資質探求の重要性，2)看護実践の状況・文脈および看護師の語りは，徳の倫理の教材として有用であること，3)徳の倫理の看護師への文化的適合性，および4)看護倫理教育における対話の重要性．

Abstract

　Virtue ethics and principle-based ethics are two major approaches in nursing and healthcare ethics. These approaches complement each other by emphasizing different aspects of ethics. Principle-based ethics emphasizes action, and virtue ethics focuses on character and attitudes of the person who performs the action. Virtue ethics, almost pushed aside the dominance of principle-based ethics since the 1970 s, is regaining attention in the recent international literature. Whereas the nursing literature in Japan reports that virtue ethics is rarely included in the ethics course topics which center around medical issues and principle-based ethics. Perhaps this is because the memory of old virtues, that undermined nursing's professional development, still lingers in Japanese nursing. This article sheds a new light on virtue ethics and discusses its importance for nursing in Japan. The authors' research findings are used in the discussion to suggest the following：1)It is important to explore nursing's evolving virtues to meet the society's expectations of nurses, 2)Practice contexts and nurses' narratives are good materials for teaching and learning virtue ethics in class as well as in practice, 3)Culturally, virtue ethics fits with nurses better than principle based ethics, and 4)Dialogues is essential to the teaching of nursing ethics.