St. Thomas University Spheres of Moral Agency Discussion Module 6 Discussion No unread replies.No replies. Good Citizenship Review Figure 16-1 Moral Ag

St. Thomas University Spheres of Moral Agency Discussion Module 6 Discussion

No unread replies.No replies.

Good Citizenship

Review Figure 16-1 Moral Agency on page 405 of Purtilo & Doherty’s textbook. What does that figure mean to you? How do you as a professional nurse demonstrate good citizenship?

this is page 405

Spheres of Moral Agency

As you recall from Chapter 3, agency means that you have an authoritative voice in a matter and society affirms that you are in a position to legitimately exercise that authority. Because of the moral dimensions of a professional’s role, this agency is interpreted as moral agency. So that you do not think you are compelled to respond to every civic issue that comes your way, a helpful schema was developed by Gruen, Pearson, and Brenan to delineate spheres of moral agency, distinguishing different kinds of circumstances in which health professionals could become involved. Although their model was designed for physicians’ and physician organizations’ advocacy role in public life, we find it equally helpful for all health professionals (Figure 16-1).1

FIGURE 16-1 Health professional responsibility and good citizenship. (Modified from Gruen RL, Pearson SD, Brennan TA: Physician-citizens: public roles and professional obligations. JAMA 29[1]:94–98, 2004.)

Sphere One pertains to direct patient care decisions that fall within your area of professional expertise. Understandably, this remains the major focus of your moral agency in the clinic and beyond.

Sphere Two describes an area of moral authority that exists when you encounter a situation that is not direct patient care but you have important professional knowledge, insight, or skills that can help to effectively address the issue. In Sphere Two, the more your role as a professional prepares you better than any other group in society to address it, the more you will be looked to as an authority. For example, the more education a dietician has on the effects of snack food on childhood obesity, the more other parents on the school PTA board will look to her for advice regarding the proposed debate to institute a public mandate regulating the vending machine contents. And because of the moral role of the professional in society, the professional has the added power of being viewed as a moral agent who upholds deep societal values.

Sphere Three shifts the emphasis from your professional knowledge and skills base to the fact that professionals are held in high regard in society. Health professionals, lawyers, and religious leaders generally enjoy a high status, although they become the brunt of deep criticism when they do not stand up to society’s realistic (or even unrealistic) expectations. Often the gravity or urgency of a situation is expressed more forcefully when professionals get behind the cause and provide leadership in endorsing it. This is seen in everything from television ads to appeals for financial contributions for societal issues. Your voice can influence the outcome by virtue of being a professional, although you may have little significant or unique professional knowledge regarding the issue under consideration. In this outermost sphere, you represent someone who is viewed as a moral leader simply because you are a professional.

These three spheres provide general guidelines for the relationship of your role as a professional to your role as a citizen. A commonsense conclusion is that the greatest pull on you is for issues in Sphere One. As you can probably quickly conclude, there are not hard and fast boundaries separating these three spheres. Your clinical expertise may be operative in any of them to some degree, and your position of high regard in society supports your societal role as a moral agent with decision-making authority in all spheres. Still, as you move from issues that involve the first to ones that involve the third sphere, the direct claim on you to exercise your authority lessens.

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