Establishing Limits to Professional Autonomy: Whose Responsibility?

Abstract

The richness and complexity of the kaleidoscopic social phenomenon known as professional nursing requires viewing the nurse and nursing as embedded in a complex network of relationships at all levels of the health care system. This recognition precludes any simple or single answer to the question of responsibility in setting limits to professional autonomy. It seems useful at this time to look at various facets of the question, that is, some of the pieces that one puts into one’s kaleidoscope as one looks at the dimensions of autonomy. The asking of any question that involves multiple relationships and interactions risks finding several possible answers that then require significant decisions and choices having far-reaching implications for individuals and groups. Often “solutions” challenge tenaciously held assumptions and values. This question has proved to be no different as one journeys from the past into the present and future.

It was the best of times, it was the worst of times, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair.

Charles Dickens