ANS Ethics Collection – Entry 2
↘️ Available for free download
August 18- September 18, 2026
This article appeared in the third issue of ANS, six months after Carper’s well-known classic work introducing her philosophic analysis of early nursing literature revealing four fundamental patterns of knowing in nursing (Carper, 1978). These articles were based in part on her dissertation research at Teacher’s College, Columbia University (Carper, 1975). In “The Ethics of Caring” Carper focused on the dangers of specialization and of science and technology as dehumanizing forces in the growing healthcare system. Carper was well-positioned to address these issues; she was a nurse anesthetist and had worked in this role throughout her doctoral studies at Teacher’s College.
Carper noted that all healthcare providers have a commitment to provide humane care, but that the ability to do so was not sufficiently assured for all healthcare providers. The organization of healthcare by teams composed of many people who focus on various specialties, as well as the growing reliance on technology, pose serious threats to humane care. The central importance of caring, for nursing, provides a normative standard that shapes nursing’s focus. Carper stated:
Caring is the antithesis of possessing, manipulating or dominating. Caring is a process that requires devotion and trust. In any actual instance of caring there must be someone or something specific that is cared for. Caring cannot occur by sheer habit; nor can it occur in the abstract. (p. 14).
Carper maintained that caring is a commitment to a therapeutic use of self in relationship with another human being. She stated:
“It requires what may be referred to as the sacrifice of form; the awareness that abstract and generalized categories describing common group behaviors and traits can never encompass or express the uniqueness of the individual. The perception of a patient as a person goes beyond categorical recognition.” (p. 15).
Carper admonished those who claim to care for those who enter the healthcare system, to heed Myra Levine’s perspective: “the wholeness which is part of our awareness of ourselves is shared best with others when no act diminishes another person, and no moment of indifference leaves him with less of himself.” (Levine, p, 849). This, for Carper, is at the heart of the ethics of caring.
Next we will focus on the two articles by Roland Yarling and Beverly McElmurry published in 1983 and 1986. They posit that nurses are not free to exercise their moral duty to the patient because of constraints placed on them by institutions that demand loyalty to the institution over the needs of the patient.
Sources
Carper, B. A. (1975). Fundamental patterns of knowing in nursing [Doctoral dissertation, Teachers College, Columbia University]
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13–23. https://doi.org/10.1097/00012272-197810000-00004
Carper, B. (1979). The Ethics of Caring. ANS. Advances in Nursing Science, 1(3), 11–19. https://journals.lww.com/advancesinnursingscience/citation/1979/04000/the_ethics_of_caring.4.aspx
Levine, M. E. (1977). Nursing ethics and the ethical nurse. The American Journal of Nursing, 77(5), 845. https://doi.org/10.2307/3461709
Yarling, R. R., & McElmurry, B. J. (1983). Rethinking the nurse’s role in “do not resuscitate” orders: a clinical policy proposal in nursing ethics: a clinical policy proposal in nursing ethics. ANS. Advances in Nursing Science, 5(4), 1–12. https://doi.org/10.1097/00012272-198307000-00004
Yarling, R. R., & McElmurry, B. J. (1986). The moral foundation of nursing. ANS. Advances in Nursing Science, 8(2), 63–73. https://doi.org/10.1097/00012272-198601000-00010