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Received: 30 July 2018    Revised: 2 December 2018    Accepted: 21 December 2018

DOI: 10.1111/nin.12281

F E AT U R E

A humanism for nursing?

Graham McCaffrey

Faculty of Nursing, University of Calgary,

Calgary, Alberta, Canada
Correspondence
Graham McCaffrey, Faculty of Nursing,
University of Calgary, Calgary, AB, Canada.
Email: gpmccaff@ucalgary.ca
Abstract
Humanism has appeared intermittently in the nursing literature as a concept that can
be used in understanding nursing. I return to the concept in response to noticing the
term appearing in the context of health humanities, where it is loosely associated
both with humanities and being humane. I review the usage and critiques of human-
ism in both nursing and medical literature and then re-­evaluate what the idea of hu-
manism might hold for nursing, trying to avoid the traps of an over-­determination of
the human subject, or dichotomizing nursing as art or science, technology or caring. I
draw on writings on humanism primarily from Emmanuel Levinas and Edward Said to
emphasize strands in humanism of obligation towards others and of critical discern-
ment within history and culture directed towards democratic practices. I discuss in
passing the strong association in the UK particularly between humanism and scient-
ism as a note of caution about the plurality of the term humanism. I conclude that
humanism is a tradition that does offer productive ways of thinking about nursing
with the proviso that it ought to be treated carefully as a problematic tradition and
not as a new essence for nursing.

KEYWORDS
humanism, liberal arts, nursing, philosophy

1 |  I NTRO D U C TI O N other, humaneness in clinical practice; implicitly in an association that

In this respect our townsfolk were like everybody else,
wrapped up in themselves; in other words they were
humanists; they disbelieved in pestilence.  (Camus,
1947/1960, p. 34)
Humanism encompasses a long and sprawling set of intellectual
traditions, values, and disciplines. As a term, it has appeared in nursing
and medical literature with a range of desired meanings, not surpris-
ingly since healthcare is given by and to humans, and we usually hope
with a degree of humane feeling towards others. In this paper, I offer
a reappraisal of humanism and its potential value as a way of think-
ing about nursing, drawing on perspectives from within the humanist
traditions. My exploration of humanism was prompted by noticing
the term used by both nursing and medical colleagues in contexts, re-
spectively, of nurse education and the medical humanities. Humanism
is used in association with the humanities on one side, and on the
justifies and reinforces each word in terms of the other. One further
extension of the etymological reinforcement is the personified iden-
tity of the humanist, as a caring, arts loving (caring because arts lov-
ing) practitioner. It is not that such practitioners do not exist, but the
assumption of a causal chain of association does not hold up against
a cautionary shadow figure such as Radovan Karadic, who was a psy-
chiatrist and poet, before ending up a convicted war criminal (BBC,
2016). Avoiding being too concrete, however, does not mean that
there is nothing there; Helen Small, a Professor of English writing in
her book The Value of the Humanities (2013), took the etymological
shuffle into account:
…to question the force of the etymological connection
between “human,” “humane,” “humanities,” and insist
upon the non-­transparency of human experience—its
historical contingency, its at least partial psychologi-
cal inscrutability, its linguistic conditioning—is not to
render the link invalid.  (p. 24)

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https://doi.org/10.1111/nin.12281
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My intention in this paper is to allow the looseness of the links to
make room for variant interpretations of humanism, from the point of
view of a nurse, and with the goal of providing an account of humanism
that can offer insights for the discipline of nursing. The first step will
be to look at what the disciplinary literatures of medicine and nurs-
ing have had to say about humanism, noting both the familial resem-
blances and contrasts between the two disciplines. I will then discuss
works by Emmanuel Levinas and Edward Said that invoke humanism
directly, followed by a consideration of contemporary secular human-
ism and its critics. I will offer a version of humanism for nursing out of
these discussions.
2 |  H U M A N I S M I N M E D I C A L A N D
N U R S I N G LITE R AT U R E
2.1 | Humanism and medicine
The Arnold P. Gold Foundation, which has a goal of promot-
ing humanism in medical students, states on its website that ‘The
humanistic healthcare professional demonstrates the following
attributes: Integrity, excellence, collaboration and compassion, al-
truism, respect and resilience, empathy, and service’ (Arnold P. Gold
Foundation, 2018, np). Buck, Holden, and Szauter (2017) in a syn-
thesis of studies looking at changes in humanism in medical students
over time found that the most commonly mentioned construct in
the literature was empathy, with others including integrity, compas-
sion, altruism, respect, service and commitment to excellence. This
list is very similar to the Gold Foundation attributes, which begs the
question of a feedback loop in the literature, reaffirming agreement
about what constitutes humanism for medical education. A previ-
ous review article by the same authors, looking at the assessment
of humanism, had an additional category of ‘Identity development
[that] refers to the transformative process of becoming a human-
istic physician’ (Buck, Holden, & Szauter, 2015, p. 15). They also
placed humanism as a component of professionalism for physicians.
Martimianakis et al. (2015) conducted a review of humanism in med-
ical education in relation to the hidden curriculum also noted ‘a con-
flation between professionalism and humanism’ (p. 5). They found
over 80 attributes associated with humanism, the most frequently
used being (in alphabetical order) ‘altruistic, caring, compassionate,
empathetic, professional, and respect’ (p. 9). The authors discussed
the claim that hidden curriculum, mostly meaning role modelling of
un-­humanist behaviours, is a threat to humanism but concluded less
starkly that there ought to be a balance between humanism and ‘the
realities of medicine’ (p. 11) in practice. They mentioned the medi-
cal humanities movement in passing, with its promotion of employ-
ing arts and humanities resources explicitly in medical education to
promote humanism, but observed that more often authors in their
review advocated for direct teaching of the humanism attributes, in
alignment with competencies categorized under professionalism and
communication.
In the medical humanities literature, humanism is understood
both as a matter of desired attributes and in relation to humanities
disciplines and works. In a recent textbook of medical humanities,
Cole, Carlin, and Carson (2015) gave a thoughtful introduction to
the conflation of humanities in medical education with a more amor-
phous idea of medical humanism. They noted that an increasing con-
cern with humanism in medicine, as a counter-­force to specialization
and use of technology, coincided with a suspicion of, and moving
away from the tradition of western humanism in the humanities
disciplines themselves. They located the origin of medical human-
ities firmly in ‘the pursuit of humanitas, that compassionate stance
toward others that ideally emerges from education in the liberal arts’
(p. 373). Kumagi (2008) described an approach to patient-­centred
medical education using narrative techniques, ‘aimed at fostering
humanism in medicine’ (p. 653). Bleakley (2015), in his recent book
about medical humanities, resisted the conflation of humanities and
humanism. He endorsed a belief that the humanities can help in the
formation of medical students as more discerning and sensitive doc-
tors, but was sceptical about the association of humanism with the
idea of a virtuous agent. Specifically, he was concerned that whereas
humanism in modern medicine is often associated with person-­
centredness, ‘person centredness readily aligns with narcissism’ (pp.
91–92) and asserted that ‘…one can be humane without subscribing
to modern humanism’ (p. 92). (A counterpart to this observation is
that one can be steeped in the humanities without being humane.)
2.2 | Humanism and nursing
In the nursing literature, by contrast, there is no equivalent frame-
work for humanism as a set of professional attributes that can and
should be taught to students. Playle (1995) dichotomized humanism
and positivism, arguing for ‘a more humanistic approach to nursing
care’ (p. 981) whereby ‘the subjective experience of the patient and
a more holistic, psychosocial approach are now seen as the basis for
more individualized care within a humanistic framework’ (p. 981).
The themes of anti-­positivism, holism and individualized care are
familiar tropes in nursing—the most unusual feature of Playle’s argu-
ment is bringing them together in relation to humanism. For Playle,
humanism was associated with the art, as opposed to the science, of
nursing which is another familiar trope. However, humanism remains
here a somewhat vague organizing principle, more clearly defined
rhetorically by what it is not (positivist, objective, natural science)
than by what it is. Nelson (1995) wrote about humanism in nursing by
way of a Foucauldian genealogy of the theme of self-­actualization in
modern nursing. She identified themes in the Christian roots of nurs-
ing, including an ethic of service and spiritual redemption, that were
taken up into modern nursing through Florence Nightingale and her
early training with religious orders. Nelson argued that these reli-
gious strands have been secularized into the humanism of late 20th-­
century nursing theory, and are apparent in expansive definitions
of health and nursing’s telos. ‘This humanist framework of holistic
nursing provides the rationale for the normative work of nurses as
facilitators of patient self-­development’ (p. 40). For Nelson, similarly
to Bleakley (2015), humanism in this sense places ‘supreme value…
upon the subjectivity of the patient, the reverence that attends their
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uniqueness, and the caring relationship’ (p. 40). Writing as she was in
the era of nursing grand theory, her account does help to make sense
of the quasi-­religiosity in the work of many nurse theorists. Although
nursing theories, as attempts at comprehensive systems, have largely
disappeared from the nursing scene, some of the elements Nelson
identified such as holism, and the mission of nurses to bring patients
along the path of self-­actualization are still very much present. In a
much more nuanced way than Playle (1995), Nelson critiqued what
she called ‘the colonization of the field’ (p. 41) by this brand of hu-
manism and argued that rather than an existential struggle between
art and science, nursing is better understood as ‘a set of practices or
technologies that do not stand in need of unification at a higher level
in the form of an all-­encompassing belief system or doctrine’ (p. 41).
In the light of this reading of nursing, her analysis provides an illumi-
nating account of how we might understand the ‘humanist’ strand in
modern nursing identities, taking from it what has potential to pro-
vide good care without hypostasizing it as a moral diktat. Traynor
(2009) revisited the nursing literature in a critical review in which
he argued that for nursing, humanism has most often been defined
in opposition to ‘a dehumanizing alternative, often associated with
medicine’ (p. 1564) and in favour of holism, empathy and therapeutic
relationship. Traynor found this dualism excessive and limiting, since
it caricatures medicine as a kind of constellation of all that is techni-
cal, objective and unfeeling, in a way that interferes with or even
prevents discussion of the role of science and technology in nurs-
ing. In addition, over-­emphasis on the human subject tacitly excludes
antihumanist theories such as poststructuralism that disturb the
surface of ‘the individual human as continuous, integrated, autono-
mous and transparent to itself’ (p. 1564). Rolfe (2015) advocated for
Gadamerian hermeneutics to become the whole foundation of nurs-
ing education and research, in the name of humanism, but in doing
so recapitulated the dualist argument observed by Traynor (2009).
Létourneau, Cara, and Goudreau (2017) again reviewed the nursing
literature and rehearsed the history of humanism in the Renaissance
and Enlightenment. They highlighted the influence of Martin Buber’s
I-­Thou relationship and Carl Roger’s person-­centred psychology on
the idea of humanism-­as-­caring in nursing. They concluded that hu-
manism in nursing has two components, ‘therapeutic attunement
between self and others’ and ‘authenticity in one’s intentionality or
commitment to care for others’ (p. 37).
Despite the anti-­medical stance in some of the nursing literature,
there are similar arguments and counter-­arguments around human-
ism in the literature from both disciplines. Medico-­nursing humanism
appears primarily as a set of attitudes, centred on empathy and un-
derstanding for recipients of care, practised within therapeutic re-
lationships. Authors from both disciplines tend to define humanism
partly by what it is not, in a dichotomized opposition to technical, ob-
jectifying and distancing beliefs and practices. Points of divergence
are that in the medical literature, humanism is aligned with profes-
sionalism, and more often reproduced as a taxonomy of attributes
and practices, whereas in the nursing literature it is more likely to be
presented as existentially foundational to the discipline. There are
also dissenting voices, observing the dichotomy and suggesting that
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both medicine and nursing are more pluralistic in practice than can
be properly or usefully represented by a moralizing binary. Critics
also note the formation of an improbably coherent human subject
at the centre of this humanism, always available for self-­realization
through benign dialogue. Authors in the medical humanities litera-
ture, while tracing the line from humanities to humanism, also ex-
press a sensitivity to the limits and critiques of an uncomplicated,
person-­centred humanism.
Having outlined the predominant account of humanism in med-
icine and nursing, and some of its weaknesses, I will now turn to a
range of authors from philosophy and literary studies to work out an
interdisciplinary framework for a humanism that may be workable
for nursing (and possibly other health professions).
3 | PE R S PEC TI V E S O N H U M A N I S M
Humanism is such a variegated tradition that I have necessarily been
selective in the sources I have drawn upon for the present explora-
tion. I have drawn primarily on two authors, based on their discus-
sion of themes in humanism that are pertinent for nursing. Emmanual
Levinas (1906–95) was a French philosopher known for his radical
account of otherness that places us in a situation of obligation to-
wards others. Edward Said (1935–2003) was a Palestinian-­American
professor of literature and scholar of postcolonialism, known for his
historical analyses of classic works of literature. Both published col-
lections of essays (Levinas, 2003; Said, 2004) about humanism, re-­
evaluating and reclaiming it in the light of what they saw as attacks
from Heidegger, in the case of Levinas, and poststructuralism in the
case of Said.
3.1 | Levinas and humanism
Levinas’ humanism begins with the situatedness of human beings in
relation with others and his insistence on the face-­to-­face encounter
so that, ‘any philosophical translation of embodied concrete life must
consider the human subject as it is constituted through relations
with others’ (Bergo, 2011, Section 4.2). Cohen, in his introduction
to the English edition of a series of essays by Levinas on the theme
of humanism, contrasted Levinas’ insistence upon the particularity
of human being in relation to another human being with Heidegger,
‘whose “fundamental ontology” submerges human subjectivity in
the impersonal historical “truth of being”’ (2003, p. ix). Heidegger
(2008), in his Letter on Humanism, observed that different interpre-
tations of humanism stemmed from different interpretations of the
human, and that none of them for him were yet adequate. He used
the image of circling around as a critique of conventional thinking
about humanism: ‘Expelled from the truth of Being, man everywhere
circles around himself as the animal rationale’ (p. 245). Yet, in another
way, it is Heidegger who put humanism on hold, circling around the
question of Being before finding a way to commit to human beings.
Levinas’ profound emphasis on the ethical demand of the par-
ticular human other is more promising as a source for a humanism
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that speaks to nursing. The other, for Levinas as for nursing, is al-
ways situated in a concrete somewhere: ‘The Other gives itself in
the concrete of the totality to which it is immanent and that…our
cultural initiative—artistic, linguistic, or corporal gesture—expresses
and unveils’ (2003, p. 31). Although forms of cultural expression
here are thought of as primarily artistic, an occupation like nursing
is also a form of cultural expression in the sense of the historically
conditioned fabric of needs and activities organized at the level of
a society. Even before culturally mediated embodiment and enact-
ment, however, he argued that, ‘the epiphany of the Other bears its
own significance, independent of the signification received from the
world. The Other not only comes to us from a context but signifies
by itself, without that mediation’ (p. 31). Levinas argued that morality
is originary, and pre-­cultural:
Neither things nor the perceived world nor the sci-
entific world allow us to connect with the standards
of the absolute. Those are all cultural Works, bathed
in history. But moral standards are not embarked in
history and culture. They are not even islets poking
up in it, because they make all signification possible,
even cultural signification, and they make it possible
to judge Cultures.  (p. 38)
Ethics for Levinas was the ground of social being and obligation.
Although otherness might enjoin a moral response, it is empirically
obvious that the morality of any given response can run the all-­too-­
human gamut from radical hospitality to extermination. While Levinas’
ethics of the Other retrieved the human face from the impersonality of
Heidegger’s Dasein and placed the necessity of living with others at the
centre of human life, his philosophy brought with it an all-­encompassing
Ought which is difficult to reconcile with history, politics or everyday
life. Other Continental philosophers have expressed misgivings about
this dimension of Levinas’ thought. Ricoeur (1992) described Levinas’
radicality of the Other as ‘hyperbole of separation’ (p. 337) in which
‘no middle ground, no between, is secured to lessen the utter dissym-
metry between the Same and the Other’ (p. 338). Kearney, in his book
Strangers, Gods and Monsters (2003) identified that if, ‘the Other sur-
passes all our categories of interpretation and representation, we are
left with a problem—the problem of discernment’ (p. 67). Drawing back
from Levinas’ extreme of ‘self-­abjection’ (p. 71), Kearney argued for
the necessity of finding criteria of judgement in our openness to oth-
ers. Discernment is far closer, and more useful to, nursing practice in
which nurses constantly have to balance competing needs of multiple
patients, make judgements about potential threats from patients, and
evaluate the significance of patients’ own estimation of their needs.
When a nurse encounters a patient, it is only a localized occasion
of ‘the epiphany of the Other’ (Levinas, 2003, p. 31), one in which
secondary and contingent cultural conditions apply: the prerog-
atives and limits of the professional, the rights of the patient, the
legislated expectation that the professional holds requisite knowl-
edge and skills at their disposal, the patient who manifests as such
because of some or other need—be it illness or a question, but a need
that a nurse can reasonably be expected to meet to some degree.
Ethical codes are one strand in this contingency. For the instance
of the nurse–patient relationship, encounter with the Other is me-
diated through and through with the contingency of nurse as nurse
and patient as patient.
3.2 | Said and humanism
Edward Said (2004), in a series of lectures published towards the
end of his life, reevaluated and reasserted humanism at the begin-
ning of the 21st century based on his long, parallel careers as liter-
ary scholar and political activist. He wished to explore ‘the useable
scope of humanism as an ongoing practice and not as a possession…
what humanistic activity is about rather than a list of desirable at-
tributes in a humanist’ (Said, 2004, p. 6). His stated aim here already
avoids essentialisms of humanism as governing ideology or humanist
identity. His characterization of humanism as a practice lends itself
to thinking of humanism as a way of thinking that can be applied, and
aligns with the practising of practice professions.
Part of Said’s defence and restatement of humanism was in re-
sponse to antihumanist tendencies in structuralism and postmod-
ernism which, as noted above, have appeared as critical cautions in
the healthcare literature on humanism. He readily acknowledged
the finitude of human knowledge, and of human self-­k nowledge,
but rather than leading to an abandonment of humanism, he found
in it a prompt and an invitation towards new understanding, which
will always be unfinished: ‘…There is always something radically
incomplete, insufficient, provisional, disputable, and arguable
about humanistic knowledge…that…gives the whole idea of hu-
manism a tragic flaw that is constitutive to it and can never be
removed’ (p. 12). One of the implications here is the finitude of the
historical horizon, and Said placed the humanities plainly within
history ‘as made by human action’ (p. 10). In spite of his qualifi-
cations of human knowledge, he asserted that humanism remains
‘the achievement of form by human will and agency’ (p. 15). It is
not difficult to see his emphasis on history and agency, history by
which humans are made and re-­made, and which humans strive to
re-­make, as the common ground between his scholarly and politi-
cal commitments.
Whereas Said mounted a defence of humanism against postmod-
ern criticism on one side, he argued on another side against conser-
vative humanists who would enclose the canon of western literature.
He readily owned up to his own love of canonical authors but argued
that to eternalize them as great works only leads into a dead end of
stultifying nostalgia. Thus, humanism for Said required engagement
with the past in the light of the present, opening up traditions to
each other, and enabling questioning, criticism and discovery.
Humanism is not about withdrawal and exclusion.
Quite the reverse: its purpose is to make more things
available to critical scrutiny as the product of human
labour, human energies for emancipation and enlight-
enment, and, just as importantly, human misreadings
McCAFFREY
and misinterpretations of the collective past and pres-
ent.  (p. 22)
Said, as a literary scholar, primarily had literary texts in mind as
the products and the locus of humanistic practice, and yet he found
in humanism a dialectic of reception and resistance that lifts the eyes
of the reader from the page and into the world. Humanism is, he said
‘a worldly practice’ (p. 75) that provides ‘the means…of antinomian or
oppositional analysis between the space of words and their various or-
igins and deployments in physical and social place…on the ground of
daily life…’ (p. 83). I find in Said’s inclusivity a welcome for nursing in
humanism, and an opening of space for recognizing, valuing and prac-
tising in the relationship between arts and humanities and nursing.
3.3 | Humanism and atheism
In seeking what is available for nursing in the flux of humanism, it
is worth noticing that humanism in contemporary British usage is
almost a synonym for atheism. I want to make a brief detour into
what that mould of humanism, and its critics, can offer to my search.
The website of Humanists UK (formerly the British Humanist
Association) presents humanism as a mélange of atheism, rigid ad-
vocacy of scientific method as the only legitimate source of knowl-
edge (or at least knowledge worth taking seriously) and, with no
blush of contradiction, a series of non-­empirical moral injunctions
(Humanists UK, 2018). If you started out, as much of the medico-­
nursing literature on humanism does, looking for some relief from
technocratic medicine and came to humanism by this door, you
would find yourself right back at the hierarchy of evidence, with ran-
domized controlled trials at the summit, like Alice in her looking-­glass
world trying to reach the top of a hill and finding herself back where
she started (Carroll, 1893/1998). This brand of humanism has come
in for repeated criticism from British thinkers John Gray and Terry
Eagleton. Gray (2009) pointed out that humanist morality is derived
from Christian morality (p. 13) and argued that the anthropocentrism
of secular humanism, with its veneration of human reason, has cre-
ated a ‘species of scientism, in which fundamentalism and nihilism
are conjoined, which allies itself with a sentimental humanism to give
us the distinctive modernist worldview’ (p. 382). Gray went beyond
these objections to question the assumption of a universal humanity
implied in any conception of humanism. For Gray, there is no human-
ity as a whole, no believable narrative of human progress, there are
only human beings, in particular times and places, holding various
values, and pursuing various goals by various means. ‘The concep-
tion of humankind as a collective agent gradually achieving its goals
is not reached by observation. All that is empirically observable are
human beings muddling on with their conflicting goals and values’
(Gray, 2018).
Eagleton (2009), in a critique of militant atheist humanism, which
he labelled as ‘liberal humanism’ (p. 168) made the case instead for
a ‘tragic humanism [which] shares liberal humanism’s vision of the
free flourishing of humanity; but it holds that this is possible only by
confronting the very worst’ (p. 168–9). Eagleton’s critique provides a
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version of humanism that holds on to humanity in its full scope; a hu-
manism that does not valorize a rationalist, beneficent ideal subject,
unencumbered by superstition. Instead, Eagleton invoked a human-
ism that has to think itself, and act, out of and with, in awareness of
and in spite of, the plenitude of human desires, values, powers and
purposes.
The detour into modern secular humanism and its critics stands
as a reminder that humanism is a manifold tradition, such that one
cannot assume someone else will mean the same thing as oneself by
the term; it may even be the opposite. However, it is through listen-
ing to the multivocal tradition that it becomes possible to start to
articulate a version of humanism for nursing.
4 | D I S CU S S I O N : H U M A N I S M A N D
NURSING
Humanism is used loosely among healthcare practitioners, and in
the disciplinary literature, to denote a well-­intentioned and person-­
centred approach to practice. As such, it is consistent with common
professional and ethical standards, but it does not reflect a deeper,
rigorous examination of the humanist tradition in relation to nursing.
In the discussion to this point, I have introduced a range of ideas
from humanist thinkers than can be applied to nursing. My goal is
not to establish another humanist identity, but to ask how human-
ism can inform a standpoint of understanding nursing. I am arguing
for a more parsimonious humanism, a humanism inflected with the
critiques of humanism without letting go of it altogether: Something
more like Edward Said’s humanism, or Eagleton’s ‘tragic humanism’
(Eagleton, 2009, p. 168).
To bring humanism to bear on nursing, it is necessary to establish
nursing as an activity that is both very specific and an expression of
basic human needs. Nursing is a discipline of relationship. Even if this
is a truism about any profession, it is true of nursing in an important
sense that there is a central, organizing relationship between nurse
and patient (here I use the word patient as a kind of archetype that
can stand for client, family, community or other person or group who
is contingently present in relation to a nurse). Since nurses neces-
sarily are in relation to non-­nurses, nursing always transcends itself.
Nursing in practice is always in communication with the wider world,
in conversation with the human other. Another condition of nursing
relationships is a characteristic of the patient which, archetypally,
could be labelled as woundedness (which, again, covers all kinds of
health needs from actual wounds to very light, metaphorical wounds
of lack of knowledge about health). Conditions of woundedness in
such are broad sense are not so rare and are even, according to the
first Buddhist noble truth, fundamentally human: ‘birth is suffering,
aging is suffering, illness is suffering, death is suffering; union with
what is displeasing is suffering; separation from what is pleasing is
suffering; not to get what one wants is suffering…’ (Bodhi, 2005,
p. 76). In the light of the idea that suffering is an inevitable part of
being human, nursing appears as a distinct activity because it is ori-
ented towards suffering, often in a visceral way. The crossing point
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between the locale of nursing and the world of the human is pre-
cisely here in practice based upon intentional turning towards the
human experience of suffering. Part of the work for humanism is to
maintain the open border and to facilitate traffic in both directions,
without narrowing humanism to virtuous self-­regard, or bringing
down the barrier of professional exclusivity.
4.1 | A humanism for nursing
One purpose of the discussion in this paper of debates among hu-
manist thinkers is to emphasize the range of ideas that are available
under the broad category of humanism. I have been deliberately se-
lective in concentrating on the works of thinkers that I argue con-
tribute important elements to humanism from a nursing standpoint.
In assembling a version of humanism for nursing, I start with
Levinas’ phenomenological formation in the face of the other, and
the urgency of obligation in the face of the other. It stops short, with
Kearney and Ricoeur, of self-­abjection in unconfined obligation. It
must incorporate the formative pressures of being a nurse, of facing
the other equipped with socially sanctioned knowledge, skills, priv-
ileges, constraints and the contingent obligations of a profession.
Nursing is a practice of judgement in the face of the other; of dis-
cerning, discriminating, differentiating, prioritizing, to do as well as
possible, under the circumstances, for each of those multiple others
who keep on presenting themselves. There is no absolute, constitu-
tive moral commandment behind nursing, or if there is, it can only be
perceived through unending, fragmented instances of suffering and
need, brought forward by individuals, each with their own ranking
of their own suffering, in the face of which the nurse chooses. If in
this situation the nurse is as likely to murmur Sartre’s ‘l’enfer c’est
les autres’ (Sartre 1964/2018) as to experience Levinasian ecstasy
of self-­abnegation, that does not mean that she is not contingently
oriented in a certain ethical direction by virtue of being a nurse.
Nursing practices on an ethical tilt. By ‘ethical tilt,’ I have two ideas
in mind. First, professions including nursing have their own ethical
codes, systems of ‘oughts’ directed towards certain ways of behav-
ing and speaking in preference to others. Canadian nurses, for ex-
ample, according to the Canadian Nurses Association (CNA) Code of
Ethics (2017), have a responsibility to ‘engage in compassionate care
through their speech and body language and through their efforts to
understand and care about others’ health-­care needs’ (p. 8). Patients
have no reciprocal responsibility beyond ordinary social norms; the
professional relationship is not in this respect a level playing field.
Second, the ethical tilt keeps the nurse off balance, beckoning her
or him onward in the direction of the patient’s woundedness. It is
one inducement to responsiveness towards the other. Humanism of
woundedness also leans towards Eagleton’s ‘tragic humanism’ (2009,
p. 168). Nursing is a practice of self-­exposure, of turning towards
brokenness, vulnerability, disease, trauma, disease and death in the
hope of amelioration, healing, and comfort yet without any neces-
sary faith in ultimate progress. Where Eagleton’s term is helpful too
is in warning against the assumption of a mantle of humanist virtue
outside of the human. Nurses are also conditioned by suffering.
Edward Said’s practice of humanism brings to nursing a scep-
ticism, criticality and awareness of the world of human affairs out
of which our institutions and professions emerge; institutions and
profession that at the same time hold, limit and enable our prac-
tices to manifest in the world. The affirmative and celebratory as-
pect of Said’s humanism is his conviction of the value of the living
traditions of the humanities (for him, literature pre-­e minently) that
can not only withstand, but transcend criticality and in its light,
reflexively afford us the greatest possible field of opportunity for
self-­understanding. Literary and artistic works hold a breadth of
vision about human others, and by practising attention to them,
we can at the same time practice bringing ourselves into dialogue
with otherness. Humanism as a practice encompasses sensory
practices of attention, of looking, listening, touching and speak-
ing. Through Said’s insight into humanism as a practice, it can lead
to sharpening of perception and discernment, greater appreciation
of the plasticity and power of language, and a widening of our ca-
pacity to entertain plurality. These in turn are practices common
to Said’s literary humanism and to nursing.
5 | CO N C LU S I O N
Humanism is a rich and variegated tradition that has appeared in-
termittently in nursing theoretical literature, and continues to have
appeal for at least some healthcare practitioners. In this paper, I have
proposed a reappraisal of humanism form a nursing standpoint by
drawing on philosophers and literary critics, primarily Levinas and
Said, whose ideas have relevance for nursing. I have argued that
their relevance lies in their attention, respectively, to the situation of
obligation towards others, and in practices of critical discernment.
Nursing is constituted by a multiplicity of activities that take place
in complex social environments. A version of humanism that empha-
sizes the central role of relationships in nursing practices, and the
need for critical, reflective awareness renews the significance of hu-
manism for nursing.
ORCID
Graham McCaffrey  https://orcid.org/0000-0002-5702-4818
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How to cite this article: McCaffrey G. A humanism for
nursing? Nurs Inq. 2019;e12281. https://doi.org/10.1111/
nin.12281