This is Part 1 in an series of postings we’ll be doing on the role of critical thinking in Nursing Ethics, here on the Nursing Ethics Blog.
Let’s start with a definition. Critical thinking can be defined as “the systematic evaluation or formulation of beliefs, or statements, by rational standards.”*
In terms of nursing ethics, that definition has several crucial elements.
The first has to do with the word “systematic.” Thinking critically about ethical standards in nursing is “systematic” in that it has to do with the application of distinct procedures and methods. At times, that might involve the use of very technical tools, such as the tools of formal logic, to assess the validity of arguments. In other cases, it will involve looking for well-known patterns of good or bad reasoning, including for example the many fallacies to which human reason is sometimes subject. In other cases, being systematic will simply mean looking carefully at the various parts of an argument (its premises and conclusions) and at how the argument is structured, in order better to assess its strengths and weaknesses. Thinking critically about nursing ethics means doing something more than having an opinion. It implies a careful, systematic approach.
Here’s an example. Imagine a fellow nurse, one administering a clinical trial, says to you, “If someone is my patient, then I owe that person a duty of care. Right? And according to the relevant regulations, I owe the participants in this clinical trial a duty of care, so they must therefore count as my patients!” That’s an ethically significant conclusion. But is the argument leading to it a good one?
At some level, that argument may sound plausible, and to many nurses, the conclusion will be an attractive one. But someone skilled in critical thinking might recognize that that argument has the following form:
If P, then Q.
Arguments of that form are pretty common (so common, in fact, that they’ve been given a technical name, “affirming the consequent”) and they are always, always faulty. The premises of an argument with that structure simply cannot support that conclusion. But good critical thinkers will also recognize that the failure of this argument doesn’t automatically spell doom for that argument’s conclusion: it just means that someone needs to try again.
The second implication of the definition of critical thinking offered above has to do with what it says about about “evaluation” and “formulation” of beliefs. This implies that critical thinking is to be applied to evaluating existing beliefs as well as to the process of building new ones. In terms of nursing ethics, then, critical thinking can be used in two ways. First, it can be used as part of reflective practice, as part of evaluating our own current beliefs about what constitutes ethical or unethical nursing practice. Second, it can be used in formulating new ethical standards, for example when a new code of ethics or is being devised.
The third implication has to do with the words “rational standards.” Those words imply that particular views about nursing ethics (or bioethics or professional ethics, more generally) ought to be judged by how well they are supported by good reasons. That is, a commitment to thinking critically about nursing ethics means only adopting points of view that you have good reasons to adopt, and committing to values you have good reasons to be committed to, rather than adhering to stale, unexamined beliefs or doing things a particular way “because that’s the way we’ve always done it.”
As this series progresses, we’ll look at different elements of critical thinking, and how some of the specific skills of critical thinking can be applied to thinking about nursing ethics.
*Lewis Vaughn and Chris MacDonald, The Power of Critical Thinking, 2nd Canadian Edition, Oxford University Press, 2010.