Social Justice: a Nursing Imperative
Social justice requires mutual respect. In nursing, social justice is an embedded ethical value professed to currently and historically. In the long thread of the history of nursing, it has been understood and accepted that nurses take care of all persons who need care. And in the current Code of Ethics for Nurses, this is the first Provision.
A fundamental principle that underlies all nursing practice is respect for the inherent dignity, worth, unique attributes and human rights of all individuals the need for and right to health care is universal, transcending all individual difference.1
Respect is such a simple word. Human dignity and worth are concepts that call for respect. The very basic and challenging action respect requires is to accept without judgement any and all differences between and among people. It means suspending judgement. Pre judgments (prejudice) make that difficult. ‘Prejudice’ consists of thoughts and feelings, such as stereotypes, attitudes, and generalizations usually based on little or no experience and then are projected to everyone in that group. All humans have prejudice: we cannot avoid it (Pg. 19 white Fragility.) It is a way we make sense of other groups.
When prejudice leads to value-based judgements resulting in discrimination, mutual respect becomes impossible. So, what does respect really look like? It looks like non judgmental acceptance of another’s skin color, beliefs, values, customs and traditions, and all other differences regardless of how strange or odd they seem. It looks like acknowledging the individual uniqueness of every human being and respecting their humanness regardless of how it differs from our humanness.
In Values for a New Millennium, Robert Humphrey explains that mutual respect is based on Natural Law, which he defines as the fact that every human being has the same drive or need to preserve self, family, and species. This is an immutable truth, whether we are talking about a very complex community of highly educated people with extraordinary wealth or a very simple society without written language and with few physical resources or possessions. The drive or need to preserve self, family and species is the same. Humphrey believes that recognizing this fundamental equality of all humans is the justifiable foundation for mutual respect.3
Within the profession of nursing, social justice is embedded in the writings of our most powerful legacy leaders. The writing of Florence Nightingale, Lillian Wald, Margaret Sanger, and Annie Goodrich to name a few, unambiguously and consistently claim social justice as one of the primary characteristics of the Nursing profession.
Virginia Henderson’s definition of nursing left no doubt about the meaning of nursing care. With powerful, simple and strong language, Virginia Henderson’s definition of nursing thoroughly sets a firm foundation for universal respect for the human dignity of all people In the language of this definition, she also lays out the nature of the covenant between society and the nursing profession. By claiming ownership for dealing with human vulnerabilities……regardless of any and all differences. This definition of Henderson’s cements social justice as the bedrock of the nursing profession.
The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health, or recovery, or a peaceful death (or to a peaceful death) that the person would perform unaided if they had the necessary strength, will or knowledge. And to do this in such a way as to help the person him gain independence as rapidly as possible.2
Nursing meets humans when they are most vulnerable. As Mary Koloroutis notes:
As nurses we touch the naked body and the very soul of people in our care. This core truth demands great awareness, profound respect, and an unwavering commitment to hold each life placed in our hands with dignity and reverence. (I believe we have a moral imperative to protect and preserve human dignity and to never reduce a person to the status of object.)
Sometimes we don't know what we don’t know. In recent years, the term implicit (or unconscious) bias has been helping people with white skin understand how the reality of white privilege makes us complicit in the racial disparities that plague America. For many people with white skin, the idea of having ‘privilege’ is difficult to comprehend. Especially those on the lower rungs of the social status ladder. Even for people in the middle class coming to grips with the meaning of white privilege often may be too difficult to comprehend, let alone accept. The fact is that our society as a whole is based on an understanding that “white skin is better than brown/black skin.” It took me a long time and many discussions and reading to finally accept the truth about white privilege. About myself and about others. Respect is key to social justice. For civilization to live up to this truth, system racism needs to be understood and dismantled. The color of a person’s skin can no longer mean white skinned people are of higher value than people whose skin is another color. White color is not better than brown, black, yellow or red skins, no matter what we were taught. Mutual respect regardless of skin color is basic to social justice.
1. Code of Ethics’ for Nurses. Nursebooks.org, Page 1.
2. Henderson, Virginia. “The Nature of Nursing”. American Journal of Nursing 64 (1964):62-68
3. Humphrey, Robert. Values for a New Millennium. The Life Value Press, 1992.
