Guest Editorial

Who Will Speak and Who Will Act?

No group in our sociefy is more vulnerable than our children, and of these, none more so than the mentally ill and socially disenfranchised. Nursing is by its very nature a profession of human advocacy. Pioneers and leaders in the profession have provided a rich histo y and context for nursing action on behalf ofothers. Lillian Wald m e d as a role model for com- bining nursing knowledge with social and political action in order to do what was right for the commu- nity she served. Virginia Henderson's words, so familiar to each of us, characterize the v q essence of nursing as doing for others what they are unable to do for themselves. As so eloquently stated by contempo- ra y writers such as Lisa Robinson and Jean Watson, nursing is a human exchange of caring. Theoretical knowledge and technical skill are essential to profes- sional practice and yet thaj do not d+ne nursing.

Nursing is rooted in altruistic concern for others, built upon empathy and characterized by advocacy. It requires that practitioners act ethically on behalf of their clients. Many nurses, however, are silent and motionless in the face of both individual mistreat- ment and social injustice. Caught in the rapidly changing context of technological change and social reformation, nurses may lack the knowledge to detan- g1e ethical puzzles, the political s a y to act effec- tively, or the moral will to confront "the system."

In this issue of JCAPN, the authors provide ideas, strategies, and apoaches for nursing action on behalf of mlnerable children in a vari&j of settings and contexts. Dr. Elder addresses the very specific issue of treatment techniques for autistic and other severely dysfunctional children. She raises thought- provoking questions about 4ficacy us. morality in treatment choice for patients who are almost com-

pletely unable to articulate their needs and prqfer- ences. Dr. xhea and her associates consider the indi- rect victimization of children within the complex cir- cumstances of spouse abuse. Specific strategies for child advocacy interventions are identified. Ms. Schrers writing provides a broad ovmiew related to the ethical issues of child psychiatric research. She discusses the inherent threats, principles that can guide decision-making and the ethical and advocacy responsibilities of nurses. In my own manuscript, the broader social context is considered. Do nurses have a responsibility as professionals to take social, political, and economic action to improve the social context? I a r p e in the afirmative, with the clear intention of persuading each of us to action. All of the papers build upon the basic values of nursing and explicate their ethical implications. Each paper provides direc- tives for action within a given set of circumstances, as well as questions for maluation by the reader.

In preparing the issue, we were inotivated by the troubling situation of children and families without advocates in a society that seems increasingly unre- sponsive to mental health problems and the risk fac- tors that produce such problems. Nurses can be effective advocates for the rights and needs of chil- dren and famiIies. They also can be significant forces in changing and improving social situations. The papers included in this issue ofer both knowl- edge and motivation. It is my fewent hope that each of us, through the reading of them, zuill be informed and reawakened to our individual and collective pro- fessional responsibilities.

Kathleen Ann Long, PhD, RNCS, FAAN, is Professor, College of Nursing,

University of Florida, Gainesville, FL.

JCAPN Volume 9, Number 3, July - September, 1996 5