By Bernie Pauly, RN, PhD
Recently, I met with Dr. Janet Storch to discuss her distinguished career in nursing and health care ethics. Jan is well known for leading the revisions of three editions of the Canadian Nurses Association (CNA) Codes of Ethics, serving as ethics scholar in residence at CNA, researching ethical practice in nursing and spearheading early work on patients’ rights and ethics committees.
While she has received honorary doctorates and numerous other awards for this work, she remains steadfast and motivated by her desire to improve the health care system for patients. She says, “I am still on that quest today”, a desire that was kindled during her initial nursing education and her experiences as a parent. “I remember being distressed about things that went on in hospital” like the way patients were treated like objects. As a parent, working to improve kindergartens, she realized how much power parents could have and wondered where do patients in health care get their power? “That was really on my mind in my Master’s program. How can we look at the system differently and how can we give people a voice?” Based on her Master’s research she published a formative book on patients’ rights that focused on a range of issues in health care relationships and the importance of more power for patients in these relationships.
Jan’s research and work has always had a practical focus. From humble beginnings in Alberta, she began to work with Dr. John Dossetor, and was a founding member of the University of Alberta John Dossetor Health Ethics Centre. She was then asked by the Alberta government to work as Co-Chair with John in the development and implementation of the Provincial Health Ethics Network (PHEN). This provincial network is unique in Canada and operates to strengthen health care ethics in the province through workshops, conferences, library resources and scholarship. When a colleague asked her, how do we know if ethics committees are doing any good, it prompted the development of a NHRDP funded project on the effectiveness of ethics committees in Canada. This research informed the development of clinical ethics committees. No surprise, she sites the establishment of the University of Victoria Nursing Ethics Research Team with Paddy Rodney, Rosalie Starzomski, Gweneth Doane and Colleen Varcoe (and later Bernie Pauly) as pivotal. “Here was a unique team of nurses with a common focus.” We found that “if they (nurses) could talk to each other about what they were experiencing, they could manage that and mitigate their sense of distress (moral distress).” With funding from SSHRC and CHSRF, the team designed a series of research projects that focused on what would help improve practice. “Our research has had an impact. I think the kind of research we have done in nursing ethics has really counted for many people because it became integrated into things
nurses can use practically. That team was and is such a big part of my life. I realized how much you could do with a team. “She advises new nurses to work with teams. “Don’t ever think you need to do it alone. Find a team, find people who are thinking similarly to you, who share your ideas, and find some common ground to do some research.”
Jan has been a pioneer in establishing nursing ethics. “I remember feeling nursing ethics was so excluded and peripheral. Even in the patients’ rights book, I tried to bring it center stage. “ She recalls challenging people at the Hastings Centre and the Kennedy Bioethics Centre about the focus on biomedical ethics. “They were puzzled and couldn’t see what nursing ethics would be.” This started to change when she began to talk about nursing ethics through codes of ethics and the recognition that nurses could and should take a broader responsibility for what they were doing. Recently, she helped to develop the eLearning Modules on CNA’s Code of Ethics, “…using many situations/cases from our [nursing ethics] research”.
Nursing ethics has informed the work of other professions and nursing has made a significant contribution in work on moral distress. “I do think nursing ethics will continue to have a real impact on other disciplines and hopefully an effect on the system overall. “ She urged the importance of working within nursing and across professions to create collectively the energy that is needed to improve the health care system. As a professor emeritus, Dr. Janet Storch is continuing her work to make the health care system better and is currently working on research related to patient safety and the stories of clients in home care that contain insights into how to improve the health care system. She also devotes significant time to chairing the Research Ethics Board for Health Canada and the Public Health Agency of Canada.
Bernie Pauly is an Associate Professor at the UVic School of Nursing.
From the 2012 Autumn Communiqué — Nursing Ethics
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