Are Nurses Free to Be Moral Agents? Revisiting the Moral Foundation of Nursing in Uncertain Times

In 1986, Yarling and McElmurry published a provocative article in Advances in Nursing Science that challenged the notion of nurses as moral agents. They argued that the hierarchical structure of hospitals, which placed physicians at the center of decision-making, limited nurses' autonomy and ethical agency. While nurses today continue to face complex ethical challenges, significant strides have been made. Nurses are now widely recognized as moral agents whose primary commitment is to their patients, families, and communities. This essay underscores the central role of moral agency in ethical nursing practice. To fully support this role, healthcare institutions must foster environments that respect and empower nurses. This includes recognizing their contributions to patient safety and quality care, and ensuring they have the resources needed to navigate the evolving demands of modern nursing.