Article Text

Download PDFPDF
Caring as the unacknowledged matrix of evidence-based nursing
  1. Victoria Min-Yi Wang1,
  2. Brian Baigrie2
  1. 1Department of Philosophy, University of Toronto, Toronto, Ontario, Canada
  2. 2Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Victoria Min-Yi Wang, Department of Philosophy, University of Toronto, Toronto, ON M5R 2M8, Canada;{at}


In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework.

  • philosophy- nursing
  • ethics- medical
  • philosophy- medical
  • feminism
  • quality of health care

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

View Full Text


  • Twitter @vwang93, @DrBaigrie

  • Contributors VM-YW conceived of and wrote the first drafts of this paper. VM-YW and BB revised the paper and approved the final version. As guarantor, VM-YW accepts full responsibility for the finished work and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Other content recommended for you