Eulogy for a Friend

From Nursing Ethics, 1880s to the Present (p. 396-397)
Used by permission 2024 © Marsha Fowler
Chapter 11 Notes

This concluding chapter is a series of personal narratives by friends whom I have known from the early days of bioethics. Andy’s narrative was to be the last pages in my book. He was working on his narrative but was having some health challenges (as he called them). I suggested that he set it aside and focus on his health, but he emailed back immediately and said, emphatically, “no,” that working on it was helpful and he would have it to me within the week. Typical Andy. Shortly thereafter, I received word that he had died. I was undone.

Andy was a dear friend of over 40 years, more a friend than colleague, but that as well. We seemed to start projects together but somehow mostly did not manage to finish them, providing an ongoing excuse to work together to not finish them again. And again. It was always more fun to cavort together, hither and thither, through the recesses of the mind, recalling that there was a poem or editorial cartoon about that, whatever “that” was. Andy was an unparalleled and acute intellectual provocateur. We spent no small amount of time in elasticizing and reimagining ethics, like toying with pre-Lockean political theory as it might interact with notions of informed consent, or not. In the mid‑1980s we had collected 2,500 nurses’ first‑hand cases of clinical ethics, got started on typologizing them, and then decided that going to a museum would be more fun, or going for Chinese food, than writing a tiny program to transpose two letters in a word-processing document, and then speculating whether a dog, his black dog, would circle its bed in the opposite direction in the Southern Hemisphere—you know, the truly momentous and profound philosophical questions that had to be addressed. Somehow, we never finished the typology of the cases, but we finished the Chinese takeout, though we never came to philosophical truth about the dog circles. Notwithstanding, we accomplished some engaging mental work and collaboration. He was generous that way. He was also good fun and a good person.

Andy was an ardent supporter of nursing, which put him outside the mainstream of philosophers in bioethics, and at cross-purposes or odds with some. But he was his own person. While Andy is credited with distinguishing between moral uncertainty, moral dilemma, and moral distress, there are some ways in which that was the least of his contributions to nursing, and to focus there terribly understates his contributions and who he was as a person. Andy was a kind, supportive, and exceedingly generous colleague to all, and patient and affable with both those who did not know enough, or should have known better. He could be gently stern. He was a person of good humor and great warmth. I deeply miss Andy and in some ways his death is a marker of the passing of the generation of those of us early‑into‑the‑field, to the next generation of scholars and practitioners of ethics in nursing whom we hope will greatly exceed our own accomplishments. Even though his vignette for my book was unfinished, I close these remarks and this book with his own heartfelt words:

Nursing is the morally central health profession. Philosophies of nursing, not medicine, should determine the image of health care and its future directions. In its anxiety to control the institutions and technology of health care, medicine has allowed the central values of health care—health and compassion—to fall to the hands of nurses. Nurses thus supply the real inspiration and hope for progress in health care, and among health professionals, represent the least equivocal commitment to their clientele.³³