No one should deny that the freedom to strike is recognised as a democratic and fundamental human right of all employees, irrespective of whether they are private or public employees.

It is a universal right that is enshrined within international law and the constitutions of over 90 nations.

However, if nurses choose to go on strike, there are always those who regard such actions, although legal, as unethical, arguing that such an act could endanger human life and welfare. Within the nursing profession, this problematic dichotomy of major values has always caused a great deal of unease and often anguish.

That is, nurses are probably some of the very last people who wish to go on strike because nurses are acutely aware that although observing the law may be important, ethical practice is, and always has been, the central hallmark of their profession.

What then of the current plan of nurses to strike in New Zealand?  For me, it boils down to two major ethical positions, at first apparently at odds with each other, but in the final analysis, not necessarily incompatible or even irreconcilable.

The first position is generally supported by utilitarian ethics, the major objective argument being that it is eventually for the greater good and for the benefit of the greatest number of people that nurses should be able to strike. If successful, the effect would be that employers would take heed of the plight of their employees (e.g. shortages of staff, insufficient renumeration, difficult working conditions, lack of adequate support, etc.) and make significant changes.

This would lead to a stable and reliable nursing workforce, who, when finally paid wages and given decent working conditions that befits their crucial position and responsibilities in society, would not leave the profession, would remain dedicated to their tasks, and would undoubtably offer significant (health-related) benefits to the whole of society.

The second ethical position is that of an ethic of care, where it is not so much the greater good for the greatest number that matters, but the nature of the good acts themselves, and the ways that they might be maintained in the care of every individual. This position, in contrast to the rather impersonal and broad arguments within a utilitarian approach, directly affects the subjective heart of nursing itself.

That is, nurses realise only too well that their relationships with society are predominantly concerned with meeting the health care needs of each individual within that society, and therefore it is not a question of the greatest good for the greatest number but the greatest and most appropriate amount of possible care for every person in need that is at stake. During a nursing strike, this is all but guaranteed because nurses only strike after a considerable length of time has been given to employers to prepare, provisions have been made to ensure no one comes to any significant harm because of the strike, and the public are well informed about the reasons for the strike, including the longer-term benefits that it might bring.

Hence, as all nurses undoubtably consider before striking, there may be a way to enact one’s human right to strike for not just one’s colleagues within the profession but for the good of the whole of society; and at the same time to ensure that no harm will come to any individual within the health system.

Essentially, and perhaps as a reflection of the ‘pragmatic ethics’ that nurses have been forced to adopt over decades of national and localised neglect of their needs and those of their profession, if there is to be a strike, then nurses will seek to achieve both collective and the individual levels of professional and personal responsiveness, i.e. they will take industrial action for the greater good, but at the same time they will ensure the ongoing care of every individual.

Let no one say that a nurse in this country, whether striking or not, does not know the meaning of personal and professional sacrifice.

Author: Martin Woods is a senior lecturer at Victoria University of Wellington’s Graduate School of Nursing, Midwifery & Health. He has a special interest in nursing ethicsand is the New Zealand representative for Ethics and Human Rights for the International Council of Nursesand has contributed to New Zealand’s Codes of Ethics for Nurses and other national Codes of Ethics.

 

 

 

 

 

 

1 COMMENT

  1. your author states that Nurses “will take industrial action for the greater good, but at the same time they will ensure the ongoing care of every individual”. this statement is unachievable in that the weeks building up to the designated strike dates countless nursing and administrative staff hours were deferred to “preparing for the Strike” these people failed to attend other planned meetings across the country and locally. These diversions indirectly subtracted from patient care on a day to day basis, the level and impact of these processes would be difficult to measure. However what would be measurable is the number of patients who had surgery cancelled as a result of the nurses strike. These people were informed that there surgery was to be rescheduled, most with no alternative date for their procedures. It would be interesting to know how many of these cancelled patients, over the two week potential strike period were admitted acutely with urgent conditions, that would not have emerged if they had had the operative intervention when first planned. The far reaching affects from two weeks of surgery reduction to acute only or day only cases can have far reaching affects, this is the consequence where the effects to the patient group as a whole could not be accurately measured and the individual promise of ongoing care is not able to be achieved. The cost to these patients who are suffering on waiting lists across the country have to accept that nurses are striking for their good, but this is a hard pill to swallow for some.

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