Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing's movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics (later bioethics) course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing's ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing's ethical history, literature, and theory; a neglect of nursing's ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing's rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly.

The large body of literature labeled "ethics in nursing education" is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any systematic analysis and explication of ethical issues or dilemmas that occur within the context of nursing education. The objective of this article is to identify the spectrum of ethical issues in nursing education to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for research by identifying and provisionally typologizing the ethical issues that occur within the context of academic nursing.

There is a historical emphasis on duties to self, or self-regarding duties, in nursing’s ethics heritage literature from the 1860s to 1965. Yet, as nursing education shifted to university settings and society and nursing moved away from a virtue-based ethics to a duty-based ethics, the emphasis on self-regarding duties was lost. In the 2001 revision of the American Nurses Association’s Code of Ethics for Nurses with Interpretive Statements, that emphasis is reclaimed and restored. The 2015 version of the Code further develops and expands the ethical obligation of duties to self. The aggregate duty or principle of “duties to self” includes attention to personal health, safety, and well-being, preserving one’s wholeness of character and integrity, maintaining competence, and continuing personal and professional growth.

American nursing has an extraordinary body of nursing ethics literature from the 1880s to the mid-1960s. This literature developed prior to the rise of the field of medical ethics (later termed biomedical ethics, then bioethics) in the mid-1960s, and bears little resemblance to its later counterparts. Early nursing ethics was nurse-centric; relationally based; addressed nurses’ ethical comportment in all roles; advanced the social ethics of nursing (especially in response to health disparities); and set forth ethical expectations for the profession as a whole. This first wave of nursing ethics is distinctive and differs significantly from contemporary bioethics, yet it remains grossly under-researched. It offers nurses a wise, comprehensive, generous, and learned ethics that deserves to be reclaimed for today’s nursing practice. This article will offer an author backdrop and an historical review of early nursing ethics literature; consider the nursing profession as a calling; discuss the pivot to bioethics and the Code of Ethics as anomaly.

From nursing's history comes the impetus and grounding for our current voice in gender/trans dialogue. Modern nursing struggled its way into being against restrictive, unjust, and oppressive social structures. Many of the obstructions and constraints that nurses and nursing leaders faced were shared by the general populace of women, and yet nurses were different from other women. Nurses worked outside the home, caring for strangers, including unrelated men, in a period when women were otherwise confined to the home. Nurses fought for women's suffrage, for child labor laws, for the welfare of factory workers, for garment workers, for unionization, for vaccination, for housing reform, for the humane treatment of mentally ill persons, for access to birth control, for the amelioration of a panoramic terrain of terrible social injustices, and for the control of nursing education, registration, and practice. For 150 years, nursing has been intrinsically, practically, and politically feminist. The hard-fought gains would eventually position nursing in tension with emerging trans issues. And yet, its history is exactly what situates nursing for fruitful participation in the developing trans discourse and to address issues of transinvisibility and unjust social and health structures that impede dignified and respectful health care.