We also recognize that the Code (ANA, 2015) in its current form is a thoroughly secular or “nontheistic” document. That is, it makes no claims about the existence or nature of God. That does not mean that it directly denies or expresses doubts about the existence of God. It simply brackets out the question of God and assumes that the validity of the ethical standards it upholds does not depend on the validity of any given system of religious beliefs and practices.
Thus, we cannot read the Bible as a manual of nursing (cf. Verhey, 2003, pp. 32–67), nor do we find any explicitly “religious” content in the Code (ANA, 2015). Nevertheless, we argue that the Bible’s ways of structuring the character and conduct of Christian individuals and communities can richly inform the way nurses and healthcare facilities (or at least Christian nurses and church-affiliated healthcare facilities) do their business. We argue further that the nine provisions of the Code are in many respects congruent with the moral and religious values of Christian Scripture, and stipulate qualities of a nurse’s personal character and professional practice that resonate closely with the complex account of godliness found in the Bible. Indeed, as Marsha Fowler (2015) argues, several of the Code’s key concepts, such as compassion and human dignity, have their roots in one or more of the world’s great religions and reflect the Christian convictions of Florence Nightingale and other founders of modern nursing (pp. 1–3, 41–42).
The book contains five chapters. Chapters 1–4 follow the pattern shown in Table 1 above. Chapter 5 discusses their interrelationships.
Chapter 1, “The Nurse as Citizen, Professional, and Public Servant,” examines the legal strand of Scripture, with special attention to the Ten Commandments of Moses and the so-called Love Commandment of Jesus. It then correlates these texts to Provisions 1–3 in the Code (ANA, 2015), which deal with human dignity and patient rights. This analysis is followed by a discussion of the theme of law in the theological writings of Florence Nightingale (1992, 2002).
Chapter 2, “The Nurse as Healing Presence,” relates the biblical theme of holiness, as delineated in the Levitical Holiness Code and Jesus’ Sermon on the Mount, with Provisions 5 and 6 in the Code (ANA, 2015), which deal with the personal and professional virtues required for skillful and ethical nursing practice.
Chapter 3, “The Nurse as Savvy Problem-Solver,” looks at the wisdom strand in Scripture, as exemplified in passages on healing from the book of Sirach and the letter of James. It then compares these texts with Provisions 4 and 7 in the Code (ANA, 2015), which focus on professionalism in nursing and the skills required for effective problem-solving and decision-making in clinical situations.
Chapter 4, “The Nurse as Patient Advocate and Social Critic,” focuses on the prophetic strand of biblical moral discourse. This strand is exemplified by Jesus’ programmatic sermon in the synagogue of Nazareth, and by two stories that Jesus mentions in that sermon about healings performed by Old Testament prophets. These prophetic texts are then correlated with Provisions 8 and 9 in the Code (ANA, 2015), which pertain to human rights, social justice, health diplomacy and health policy.
Chapter 5, “Moral Maturity in Christian Nursing,” summarizes and synthesizes what we have learned in chapters 1–4 about the congruence between faithful Christian discipleship, as delineated in Christian Scripture, and the vocation of nursing, as normed by the Code (ANA, 2015).
Six Points of Clarification
We must clarify several matters before we proceed. First, the translation of the Bible that we use throughout this book is the New Revised Standard Version with the Apocrypha. Some readers may be unfamiliar with the Apocrypha, or suspicious of them, so a few words about them are in order. The Apocrypha are a group of sixteen books written between the fourth century BC and the first century AD, that is, after most or all of the books of the Old Testament (OT) had been composed, but before most of the books of the New Testament (NT) had been composed. Their authors were Jewish (like the authors of the OT), who wrote in Greek (like the authors of the NT) and concerned themselves with the problems faced by Jews living in the heavily Hellenized culture of that period. The Apocrypha certainly provide indispensable information about the historical, religious and political background of the NT—but do they belong in the Bible itself? Should they, in other words, be regarded as “canonical”? The term canon refers to the list of books that a particular church body accepts as its scripture. The problem is that different church bodies have somewhat different canons. Virtually all churches accept the thirty-nine books of the OT and the twenty-seven books of the NT as canonical, but opinions differ on the Apocrypha. Roman Catholic and Eastern Orthodox Christians generally accept them as sacred Scripture but often regard their religious authority as inferior to that of the original Hebrew Bible. Their secondary (“deuterocanonical”) status is disguised a bit in Catholic and Orthodox Bibles, however, because they are interspersed throughout the OT—apocryphal history books with canonical history books, apocryphal wisdom books with canonical wisdom books. In sharp contrast to Catholic and Orthodox practice, many Protestants and Evangelicals reject the canonicity of the Apocrypha altogether and exclude them from their published editions of the Bible. The New Revised Standard Version takes a middle way between these extremes. Reflecting contemporary ecumenical sensibilities, it includes the Apocrypha, but represents their deuterocanonical status by placing them together in a separate section between the Old and New Testaments. One of the OT Apocrypha, the book of Sirach, features prominently in chapter 3 below, and we will treat it as deuterocanonical Scripture.
A second important clarification pertains to the relationship between the books of the Bible and the strands of biblical moral discourse. In the OT and the OT Apocrypha, the relationship is quite close. For example, Strand 1 predominates in the five books of the Law, namely, Genesis, Exodus, Leviticus, Numbers and Deuteronomy. There are no OT books in which Strand 2 is dominant, but there is a long block of holiness material, known as the Holiness Code, found in chapters 17–26 of Leviticus. Strand 3 comes to the fore in a cluster of books known as the OT Writings, which include Job, several of the Psalms, Proverbs, Ecclesiastes and the Song of Solomon, as well as the apocryphal books of the Wisdom of Solomon and Sirach. Strand 4 predominates in the Former Prophets (Joshua, Judges, 1–2 Samuel, and 1–2 Kings) and the Latter Prophets (Isaiah, Jeremiah, Ezekiel, and the Twelve Minor Prophets). We must bear in mind, however, that even when a given strand of moral discourse “predominates” in a given biblical book, traces of the other strands may also be found there. For example, Moses, the lawgiver of Israel, is also called a “prophet” (Deut 18:15–22); conversely, Daniel the prophet gives thanks to God that he has been granted “wisdom and power” (Dan 2:23). With respect to the New Testament, the relationship between the books and the strands is still more complex, and the interweaving of the strands even more pronounced. The Gospels, for example, sometimes feature Jesus as a lawgiver (Strand 1), sometimes as a sage (Strand 3), and sometimes as a prophet (Strand 4); and his Sermon on the Mount (Matt 5–7) quite explicitly harkens back to the Levitical Holiness Code (Strand 2). Again, the letter of James, which represents the wisdom strand in chapter 3 below, also has many features of biblical prophecy (D. Nienhuis, personal communication, July 9, 2018). It is important, therefore, not to overidentify any one strand of biblical moral discourse with any one book or group of books in the Christian Scripture.
This leads to a third clarification. Not only are multiple strands sometimes found together in a given biblical book, but the simultaneous presence of multiple strands in many biblical books, taken one by one, and in canon of sacred Scripture, taken as a whole, provides a depth and richness of ethical insight that none of the strands by itself could offer. True, the representative texts we have chosen for each strand differ markedly in literary form and even to some extent in religious outlook. Yet these differences do not reflect contradiction. On the contrary, they demonstrate the variety of ways in which the Bible, in its rich diversity-amidst-unity, seeks to shape the lives of its readers. The four strands supplement, reinforce and enrich each other, and each strand helps to correct the excesses and deficiencies to which each of the others, taken by itself, might be prone. One way to visualize this is shown in Figure 0.2, which illustrates the technique of braid-making:
Figure 0.2.