Part 1: A Call for Moral Clarity
Sally Thorne’s March 11 (2025) “We Were Made for These Times” editorial in Nursing Inquiry stimulated a lively discussion among nurse leaders about our ethical obligations (see for example, our Nursology.net March 21st post). Given the tumultuous challenges we are confronting every day now, the group was energized by Thorne’s sage counsel, “We are a force to be reckoned with when we work together toward what we know to be ethical and honorable.”
That moment—when a group of nurse leaders, nearly galvanized and ready to act, was halted by a refrain of “there are two sides to every story”—stuck with me. It wasn’t just a passing comment; it was a reminder of the powerful social dynamics that shape our responses to ethical crises. We are living through an era of profound political and moral division, one that demands not just philosophical debate but real, tangible action. As a nurse leader, I recognize that our profession is uniquely positioned within this struggle. Ethical knowing, as guided by Carper’s (1978) Fundamental Patterns of Knowing, requires us to engage with truth, not just perspective. And yet, we see time and again how the fear of being ‘too political’ or the instinct to remain neutral leads to a dangerous false equivalence—one that undermines our ethical responsibilities.
In a time when public health is under attack—when Medicaid could be stripped from those in need, reproductive rights are threatened, and families may again be torn apart at the border—those who create and disseminate knowledge about nursing and the health of those we care for—must take a stand. We are ethically obligated to reject false equivalencies and the insidious “both-sides” rhetoric that undermines truth-telling in how we develop and disseminate knowledge.
False equivalencies, a logical fallacy that suggests two opposing viewpoints are equally valid when one is demonstrably harmful, have no place in Nursing. They create the illusion of balance while elevating dangerous, unethical perspectives. This is not just an abstract concern—it is a direct threat to Nursing’s ethical foundation.
As Carper (1978) outlined in the Fundamental Patterns of Knowing in Nursing, ethical knowing is essential to our practice. It demands that we discern what is right, just, and true—not that we provide equal weight to perspectives that perpetuate harm. Marsha Fowler’s (2024) historical analysis of nursing ethics reminds us that nursing’s moral foundation is deeply tied to pragmatism—an orientation toward action that alleviates suffering, rather than an abstract debate detached from lived realities. The American Nurses Association’s (2025) Code of Ethics further cements our responsibility: we are called to advocate for human dignity, social justice, and evidence-based care.
Yet, we see some nursing leaders, journal editors, and nursing scholars occasionally falter in this duty, giving space to arguments that dilute ethical clarity for the sake of appearing “neutral.” As editor Sally Thorne (2025) writes in We Were Made for These Times, neutrality is often a form of complicity. Nurses are not passive observers; we are moral agents. To uphold Ethical Knowing in Nursing, we must actively reject false equivalencies and demand that our discourse reflects truth rather than mere perspective.
In the current climate, the time for polite deference is over. There is no “other side” to inaction in the face of harm. If Nursology is to remain an emancipatory, justice-driven discipline, we must refuse to elevate false debates at the expense of our ethical obligations.
This blog is the first of a series on false equivalencies. At least three more parts will elaborate on false equivalencies in Nursing:
- A Short Lesson in the Philosophy of Logic–How to Recognize False Equivalency
- Case Examples that have Faced Nurses Historically
- Beyond False Equivalencies: A call to Ethical Knowing in Nursing
This series is intended to evoke reaction and dialog! Join in the discussion by sharing your ideas in the comments below. Your comments will help shape the series on False Equivalencies in Nursing Ethics.
References
American Nurses Association. (2025). Code of ethics for nurses. American Nurses Publishing. https://codeofethics.ana.org/home
Carper, B.A. (1978) Fundamental Patterns of Knowing in Nursing. Advances in Nursing Science, 1, 13-24. http://dx.doi.org/10.1097/00012272-197810000-00004
Fowler, M. (2024). Nursing Ethics, 1880s to the Present: An Archaeology of Lost Wisdom and Identity (1st ed.). Routledge. https://doi.org/10.4324/9781003262107
Thorne S. (2025). We Were Made for These Times. Nursing inquiry, 32(2), e70010. https://doi.org/10.1111/nin.70010
About Christina Nyirati
Christina has been a member of the Nursology.net advisory team since our launch in 2018, and has recently joined as a blog contributor. She serves as an IRB member for the Pacific North West University of Health Sciences, and has taught nursing ethics in both undergraduate and graduate nursing education programs in Ohio and Washington State. Watch for her review of Marsha Fowler’s new book Nursing Ethics, 1880s to the Present: An Archeology of Lost Wisdom and Identity.
See more about Christina on the Nursology.net “People” page.
Thanks for being so clear, clarity is important!
Prof. Müller Staub (Maria), Thank you so much for your thoughtful comment—I’m grateful that the clarity in the post resonated with you! I’d love to deepen the conversation by hearing more about your own experiences in clinical practice, as well as your engagements with students, clinical sites, and fellow nurse scholars and clinicians, and in the development of your own research and scholarship. If you’re willing to share, specific examples of situations that required responses in challenging times such as we are facing now – would be particularly helpful in illustrating how we can all work toward clearer, more ethically sound in our responses in the current environment. Your insights will help us build on that clarity and further ground our responses.
Yes!!
I’m in!
I think many of our nursing organizations are rife with false equivalencies.
Dr. Nancy Carolyn Sharts-Hopko, Thank you for highlighting this critical issue—I wholeheartedly agree with your observation that false equivalencies pervade many of our nursing organizations. I’ve observed similar patterns, which often hinder the ethical clarity and moral courage necessary for our profession to thrive.
Your comment leads me to consider: how might we, as Nursologists—a community committed to Ethical Knowing in Nursing, our moral courage and disciplinary integrity—come together to support nurses in cultivating ethical action within their professional organizations? How may we move now to nurses who belong to these organizations, strategize effectively from within to promote ethical clarity and reject harmful false equivalencies? I’d love to hear your thoughts or practical ideas about how we take action through our emancipatory knowing lens to support nurses at all levels to speak up, be heard, and impact organizational systems to be faithful to our ethical ways of knowing.
Your insights would greatly enrich this conversation, and perhaps inspire a collective path toward greater ethical clarity. Your input may even provide inspiration for creating a theoretical model of courage for the praxis of Ethical Knowing in Nursing!
I would like to know more about where you see nurses “giving space to arguments that dilute ethical clarity for the sake of appearing ‘neutral’.” Oddly, I haven’t seen much in the nusing SmartBrief emails I get about expected federal policy changes. Is this silence what you are referring to when you suggest that some nurses feel we should appear neutral?
It is very clear to me, living in rural Washington State, that even “small” cuts to Medicaid and Medicare are very likely to lead to loss of healthcare options, closure of our Federally Qualified Health Centers and rural hospitals, and therefore increases in severe illness and death, including in pregnancy and childbirth (I have a master’s degree in midwifery). I’m not even including in this calculation the damage caused by reduced access to all kinds of reproductive healthcare that has already occurred nationally. What a mess I foresee! We need to be speaking up. I think people still trust nurses.
Thank you! I look forward to reading the rest of this series.
Thank you, Dr. Nyirati, for clearly expressing this lack of moral courage by many professional organizations and journals. The revised Code also states “Nurses have a role at every level of the democratic process…(which) include(s) activism and protest to facilitate engagement and social awareness and inspire legislative transformation in the interest of health and nursing’s professional goals”. The only organization I have seen doing this in response to the ongoing political turmoil and threats is National Nurses United.
Dr. Robichaux, thank you for this thoughtful comment. You highlight a crucial point—the ANA Code of Ethics calls on nurses to be active participants in democracy, advocating for policies that uphold health, justice, and human dignity. This is not an optional stance; it is an ethical mandate. National Nurses United has indeed been at the forefront of activism, demonstrating the kind of moral courage that our profession requires. Their work reminds us that silence in the face of injustice is complicity. However, this should not fall on one organization alone. Every nursing body—whether state associations, academic institutions, or journal editorial boards—must embrace its ethical duty to speak truth to power. Professional nursing organizations, from the American Nurses Association and State affiliated associations, to the American Academy of Nursing, American Association of Colleges of Nursing, and others have a duty to respond—not merely as professional bodies, but as the stewards of a public trust. If we claim to uphold health and justice, we cannot be silent when policies strip people of access to care, erode protections for the most vulnerable, or deny the reality of public health crises.
Dear Dr. Nyirati,
Having read your response to Dr. Sharts-Hopko, I believe cultivating the ability to engage in ethical action or moral agency should begin in our education institutions. We all know that ethics education, for the most part, has been marginalized across the curricula, if it is present at all. Consequently, many nurses and nurse leaders do not recognize their ethical responsibilities and/or lack the knowledge or skills to speak up, intervene etc. They often believe that a passing understanding of the Code is sufficient. As a past member of the ANA Ethics Advisory Board and the Ethics Education Subcommittee, we were invited to submit ethics content for the Essentials revision. As you can see from examining the document, the ethics content is marginal. Our detailed submission was ignored except for some inclusion in the toolbox.
Well done!
Thank you for your clarity and for focusing our attention on the moral obligations we all share. The pressure to respect “both sides” of an issue is considerable and is frequently the means by which any productive dialogue is quelled. The call for truth rather than perspective begs the question, “Who’s truth?” Clearly mere facts alone are not compelling enough to break through to people who hold different values than the one’s we, as nurses, aspire to live by. As they are interpreted by a different frame of reference. So I ask, what is truth? And to go beyond that question, perhaps the challenge is to ask what values are given priority in our deliberation with those who hold different perspectives about human dignity, health and well-being. How does that shape policy and the health of a nation?
Dr. M. Patrice McCarthy, thank you for raising this critical question. “Whose truth?” is not just a philosophical question but a matter of real-world consequences—especially as nurses engage in ethical knowing. In nursing, truth is not simply a matter of perspective. Our ethical foundation, as articulated by Carper (1978), reminds us that ethical knowing does not stand alone—it is intertwined with empirical, personal, and aesthetic knowing. In other words, nursing’s truth is rooted in evidence, in lived human experience, and in the moral imperative to alleviate suffering.
Ethical knowing is not just an abstract system of analysis or a detached debate over philosophical questions—it is inseparable from our personal encounters with suffering, our empirical understanding of harm, and our aesthetic appreciation of human experience. This means that truth in nursing is not only about what we believe—it is about what we do.
When political leaders shape policies based on what they claim to be their truth, we as nurses must examine whether those truths uphold or violate our fundamental theoretical assumptions about what we claim as nurses to believe about human dignity, health, and well-being; and our obligation to act to preserve human health and well-being. We have seen this before. We saw it when political figures denied the reality of the AIDS crisis of the 1980s , when they justified the Tuskegee Syphilis Study in 1932, and when they sought, in the second half of the 20th century, to dismantle public health systems under the guise of economic freedom.
Dr. Sally Thorne admonishes us: Silence is complicity. We cannot afford to say, “That’s just their truth.” When we debunk false equivalencies, we can acknowledge diverse perspectives without abdicating our responsibility. We must engage, challenge, and intervene—not only through professional statements but through political advocacy, public testimony, and direct action.
Thank you Dr. Nyirati for this commentary – Yes we must speak truth to power – and instill ethical accountability into ourselves and the next generation of nursing. Too many rely on deferred responsibility and denial. I need to see nurses walk the talk before I can safely and authentically stand proud of nursing. We must use our agency to serve the common good even when so many do not see with a lens of justice.
As a retired scientist and educator I find the topic of false equivalences is both timely and important. The distinction between giving someone or a group an opportunity to provide their analysis or opinions is important. But it equally important that we do not consider a treatise on why the earth is flat to be something that should be included in the earth sciences curriculum.
I am passing this article on to one of my friends who is active in the nursing profession.
We are glad you found us! Thank you for this comment!