Philosophy: core concepts and historical perspectives

Nursing Philosophy

Comparative Analysis of Realist, Anti-Realist, Phenomenological, and Postmodernist Views on Nursing Philosophy

Looking into the extant philosophies regarding the study of nursing as a field of medical science, nurses, academicians, and researchers have a multitude of viewpoints to analyze nursing research data from. In this paper, the researcher looks into four viewpoints of nursing philosophy, identified as follows: realism, anti-realism, phenomenological, and postmodernist viewpoints.

The first viewpoint is the philosophy of realism. Scientifically, realism is defined as the "position that scientific theory construction aims to give us a literally true story of what the world is like, and that acceptance of a scientific theory involves the belief that it is true" (90). An important characteristic attached to the realist view is its belief in the infallibility of the scientific theory or experience. In realism, the individual seeks knowledge based on observable fact or information -- that is, knowledge-gaining through one's external environment. Facts derived from the realist viewpoint relies heavily on concrete examples or cases, as opposed to abstract imaginings or ideas that the mind has constructed or created. When applied in the field of nursing, both in theory and practice, the realist viewpoint is a dominant philosophy observed among practicing nurses. Realism is manifest in nursing when a nurse tries to assess a patient's vitals through his/her external environment, that is, observable data such as vital signs as symbolically represented and electronically shown in apparatuses attached to the patient's body. Another more controversial and prevalent example of realism as applied in the practice of nursing is the determination of life and death through apparatuses, which is often a debated case when discussing the issue of euthanasia. Can life be considered as such if the patient is no longer responding to human communication or interaction, but is still showing vital signs of life? For realists, a patient manifesting signs of "life" biologically is considered alive, despite his/her lack of ability to communicate or interact with another individual.

In direct opposition to the realist viewpoint is the anti-realist stance. Anti-realism posits that "the aim of science can well be served without giving such a literally true story, and acceptance of a theory may properly involve something less (or other) than belief that it is true" (90). Though it does not combine both concrete information and abstract ideas into nursing practice and theory, anti-realism takes into account that a theory can be explained through concrete examples and facts while retaining with it the characteristic that part of its explanation is derived from abstract imaginings or ideas of the theorist. Returning from the example presented earlier, realists would consider an individual as alive because s/he manifests signs of biological or physiological life. However, from the anti-realist point-of-view, such manifestations are not enough for an individual to consider the patient alive. One can posit that the absence of the patient's ability to communicate or interact is a manifestation of death, or the state of not being alive. That is, despite the biological signs of life shown in the apparatuses, anti-realists view the patient as dead because s/he is no longer able to perform one function that humans are distinctly known to be able to accomplish excellently: the ability to communicate and/or interact with others.

The phenomenologists, meanwhile, "centered their attention on the lived experience of those persons being smiled at and touched. Since human consciousness is the only object which may be studied, it was the essential experience of patients that mattered" (130). In this philosophy of nursing, experiential relations between the nurse and the patient is considered the most important learning that a medical practitioner can have. This viewpoint also debunks the belief that nurses should be professional and clinical in their manner and treatment of patients, wherein patients are considered as "subjects" and treatments are objectively developed -- with the aid medical science. A most prevalent example of the phenomenological viewpoint as practiced in nursing is the conflict between being professional and caring in one's treatment of a patient. Phenomenologists believe that caring for the patient is not an act of unprofessionalism, but rather, an act of compassion and service to the patient, as one might expect from a nurse as a medical practitioner.