Critical Social Justice: The Moral Imperative for Critical Perspectives in Nursing

Elizabeth McGibbon; Sionnach Lukeman

doi:10.25071/2291-5796.21

Authors

Elizabeth McGibbon St. Francis Xavier University
Sionnach Lukeman St. Francis Xavier University

DOI:

https://doi.org/10.25071/2291-5796.21

Keywords:

Critical social justice, Critical perspectives in nursing, Moral bystanding, Nursing activism

Abstract

There is increasing urgency to enact critical perspectives in the profession of nursing, with a resurgence of the political, a deliberative focus on social change, and a growing uneasiness with remaining neutral in the face of such pressing need. This analysis starts with a brief overview of critical perspectives, underscoring nursing’s complex positioning at the interface of witnessing peoples’ suffering, and the structural change necessary to address its root causes. Although witnessing may imply watching, or even bystanding, here it refers to historical and cultural meanings of witnessing as standing alongside in solidarity and action throughout the struggle for justice—bearing witness as a moral and a political obligation. Moral bystanding is described as a foundational barrier to achieving the moral imperative of critical perspectives. We conclude with pathways for cultivating and enacting a critical gaze, and a call for moral courage to systematically integrate critical perspectives in nursing. Throughout the discussion, we draw upon the work of nurse ethicists to provide important links about enacting critical perspectives as part of the moral foundation of nursing. Our intention is not to provide an analysis of the moral contexts of nursing, but rather to situate critical perspectives within the moral territory of social change, synthesizing key ideas that have direct salience for critical social justice in nursing.

Keywords: critical perspectives in nursing, critical social justice in nursing, moral bystanding, social change

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Author Biographies

Elizabeth McGibbon, St. Francis Xavier University

Dr. Elizabeth McGibbon is a nationally recognized critical health scholar and nursing professor st STFX. Her teaching and research focus on embodied oppression, access to health care, health equity and public policy, and the political economy of health. She leads a national research project, Mapping Health Equity in Canadian Public Policy (SSHRC), and is co-researcher in a study aiming to diversify our dialogue and understanding of heart health of Manitoban First Nations People (CIHR, Lead: Annette Schultz). She is a founding member of the International Association for Qualitative Research and was one of three leads in the establishment of the National Collaborating Center, Determinants of Health (NCCDH). She published the first Canadian books to address anti-racism specifically in health care practice (McGibbon & Etowa, 2009) and oppression as a social determinant of health (Edited Volume, 2012). She is an invited author in five multiple edition Canadian books about critical social science applications, particularly in the health fields; and the first book to address complexity science applications in the criminal justice system (Pycroft & Bartollas, Eds., United Kingdom, 2014). Along with social justice colleagues, her awards include recognition from The Nova Scotia Human Rights Commission (anti-racism community action), and the Canadian Armed Forces (refugee humanitarian work).

Sionnach Lukeman, St. Francis Xavier University

Sionnach Lukeman, MScN, RN, is a PhD student in Nursing at the University of Victoria. She is also an Assistant Professor at St. Francis Xavier University’s Rankin School of Nursing. Her practice background before academia was public health leadership and content expertise in healthy development. Her research program involves: Public health services and systems, political economy of health, and the integration of social justice in nursing education curriculum.

References

Anderson, J. M. (2002). Toward a post-colonial feminist methodology in nursing research exploring the convergence of post-colonial and feminist scholarship. Nurse Researcher, 9, 720. DOI: https://doi.org/10.7748/nr2002.04.9.3.7.c6186

Au, W. (2019). A Marxist education: Learning to change the world. Chicago: Haymarket Books.

Berkman Klein Center for Internet & Society at Harvard University (2019). Critical race theory. Retrieved from: https://cyber.harvard.edu/research/bridge

Browne, A., Smye, V., & Varcoe, C. (2005). The relevance of postcolonial theoretical perspective to research in Aboriginal health. Canadian Journal of Nursing Research, 37, 1637.

Brian Sinclair Working Group (2015). Out of sight: Interim report of the Sinclair Working Group. Winnipeg: Brian Sinclair Working Group. Retrieved from: http://ignoredtodeathmanitoba.ca/index.php/2017/09/15/out-of-sight-interim-report-of-the-sinclair-working-group/

Buck-Mcfadyen, E., & Macdonnell, J. (2017). Contested practice: Political activism in nursing and implications for nursing education. International Journal of Nursing Education Scholarship, 14(1), 1–13. DOI: https://doi.org/10.1515/ijnes-2016-0026

Campbell, M. & Kim, E. (2018). The (missing) subjects of research on gender and global governance: Toward inquiry into the ruling relations of development. Business Ethics, 27(4), 350-360. DOI: https://doi.org/10.1111/beer.12189

Carnevale, F. (2013). Confronting moral distress in Nursing: recognizing nurses as moral agents. Revista Brasileira de Enfermagem, 66, 33-38. DOI: https://doi.org/10.1590/S0034-71672013000700004

de Vira, A. (2014). Critical theory and social justice. Brazil Political Science Review, 8(1), 109-126. DOI: https://doi.org/10.1590/1981-38212014000100005

Djkowich, M., Ceci, C. & Petrovskaya, O. (2019). Bearing witness in nursing practice: More than a moral obligation? Nursing Philosophy, 20, e12232. DOI: https://doi.org/10.1111/nup.12232

Doane, G.H. & Varcoe, C. (2014). How to nurse: Relational inquiry with individuals and families in shifting contexts. New York: Wolters Kluwer.

Duncan, S., Rodney, P.A., & Thorne, S. (2014). Forging a strong nursing future: insights from the Canadian context. Journal of Research in Nursing, 19(7-8), 621-633. DOI: https://doi.org/10.1177/1744987114559063

Ellen, M. & Shamian, J. (2011). How we move beyond a policy prescription to action. Healthcare Papers 11(1), 76-83. DOI: https://doi.org/10.12927/hcpap.2011.22257

Emejulu, A. (2008). Learning for democracy: Ten propositions and ten proposals. In Reclaiming purpose in community education: The Edinburgh Papers 2008. Edinburgh: University of Edinburg. Retrieved from: https://criticallychatting.files.wordpress.com/2008/11/theedinburghpapers-pdf.pdf

Falk-Rafael, A. (2005). Speaking truth to power: nursing's legacy and moral imperative. Advances in Nursing Science, 28(3), 212-223 DOI: https://doi.org/10.1097/00012272-200507000-00004

Freire, P. (1970, 1993). Pedagogy of the oppressed. London: Continuum International Publishing Group Inc.

Gaventa, J. (2006). Finding the spaces for change: A power analysis. Institute of Development Studies Bulletin, 37(6). Retrieved from: https://www.powercube.net/wpcontent/uploads/.../finding_spaces_for_change.pdf DOI: https://doi.org/10.1111/j.1759-5436.2006.tb00320.x

Gerlach, A.J., Browne, A. J., Sinha,V., & Elliott, D. (2017). Navigating structural violence with Indigenous families: The contested terrain of early childhood intervention and the child welfare system in Canada. The International Indigenous Policy Journal, 8(3). Retrieved from: https://ir.lib.uwo.ca/iipj/vol8/iss3/6 DOI: https://doi.org/10.18584/iipj.2017.8.3.6

Habermas, J. (1970). Toward a rational society: Student protest, science, politics. Boston: Beacon Press.

hooks, b. (1994). Teaching to transgress. Education as the practice of freedom. New York: Routledge.

Jacobson Consulting Inc. (2017). Trends in own illness- or disability-related absenteeism and overtime among publicly-employed Registered Nurses: Quick Facts 2017. Ottawa: Canadian Federation of Nurses Unions. Retrieved from http://www.nursesunions.ca/wp-content/uploads/2017/05/Quick_Facts_Absenteeism-and-Overtime-2017-Final.pdf

Lewis, S. (2010). So many voices, so little voice. Canadian Nurse, 106(8), 40.

Lorber, J. (1994). Paradoxes of gender. New Haven: Yale University Press.

McGibbon, E. (2017). The social determinants of health: Embodied oppression across the lifecourse. In Antony W. & Antony, J. (Eds.), Power and resistance: Critical thinking about Canadian social issues, 6th Edition (pp. 165-194). Halifax: Fernwood Publishing.

McGibbon, E., Bailey, A., & Lukeman, S. (2019). Violence and health: A structural perspective. In J. Etowa & C. van Dalen- Smith (Eds.), Canadian Community Health Nursing (pp. 503-520). Toronto: Pearson.

McGibbon, E. & Lukeman, S. (2019). Political economy perspectives and the moral imperative for justice activism in nursing. Paper accepted for presentation. Atlantic Region Canadian Schools of Nursing, June, 2019.

McGibbon, E. & Hallstrom, L. (2012). Oppression and the political economy of health inequities In E. McGibbon (Ed.), Oppression: A social determinant of health (pp. 167-185). Halifax: Fernwood Publishing.

Navarro, V. (2019). Why the white working-class mortality and morbidity is increasing in the United States: The importance of the political context International Journal of Health Services, 49(2), 197-203. DOI: https://doi.org/10.1177/0020731419832236

Navarro, V. (2002). The political economy of social inequalities: Consequences for health and quality of life. New York: Baywood Publishing.

Numminen, O., Repo, H., & Leino-Kilpi, H. (2017). Moral courage in nursing: A concept analysis. Nursing Ethics, 4(8), 878-891. DOI: https://doi.org/10.1177/0969733016634155

Pace News Ltd. (2019). The political compass. Retrieved from: https://www.politicalcompass.org/

Peter, E. (2011). Fostering social justice: The possibility of a socially connected model of moral agency. The Canadian Journal of Nursing Research, 43(2), 11-7.

Rankin, J. (2017). Conducting analysis in institutional ethnography: Guidance and cautions. International Journal of Qualitative Methods, 16(1), 1-11. DOI: https://doi.org/10.1177/1609406917734472

Rodney, P., Brown, A., & Liashenko, J. (2004). Moral agency: Relational connections and trust. In J. Storch, P. Rodney & R. Starzomski, (Eds.), Towards a moral horizon: Nursing ethics for leadership and practice (pp. 154-171). Toronto: Pearson Canada.

Rodney, P. & Street, A. (2004). The moral climate of nursing practice: Inquiry and action. In J. Storch, P. Rodney, & R. Starzomski, (Eds.), Towards a moral horizon: Nursing ethics for leadership and practice (pp. 209-224). Toronto: Pearson Canada.

Ryan, J. & Rottman, C. (2007). Educational leadership and policy approaches to critical social justice. Journal of Educational Administration and Foundations, 18(1–2), 9–23.

Smith, D. (1990). Texts, facts, and femininity: Exploring the relations of ruling. London: Routledge.

Smith, D. (1987). The everyday world as problematic: A feminist sociology. Boston: Northeastern University Press.

Stevens, P. (1992). Applying critical theories to nursing in communities. Public Health Nursing, 9(1), 2-9. DOI: https://doi.org/10.1111/j.1525-1446.1992.tb00065.x

Storch, J. (2004). Nursing ethics: Developing a moral terrain. In J. Storch, P. Rodney & R. Starzomski, (Eds.), Towards a moral horizon: Nursing ethics for leadership and practice. (pp. 1-16). Toronto: Pearson Canada.

Thompson, I., Melia, K., Boyd, K., & Horsburgh, D. (2006). Nursing ethics. London: Churchill Livingston.

Tutu, D. (2009). The secrets of a peacemaker. The Guardian, Saturday, May 23, 2009.

Van Dijk, T.A. (2001). Critical discourse analysis. In D. Tannen, D. Schiffrin & H. Hamilton (Eds.), Handbook of Discourse Analysis (pp. 357–71). Oxford: Blackwell.

van Wijlen, J. (2017). Healing the healer: A caring science approach to moral distress in new graduate nurses. International Journal for Human Caring, 21(1), 15-19. DOI: https://doi.org/10.20467/1091-5710-21.1.15

Zbogar, V. (2014). Brian Sinclair's death was a homicide: But call it whatever you want, just address the discrimination. Winnipeg Free Press Print Edition, June 16, 2014, A9.