Page 139 - Nursing: The Philosophy and Science of Caring

F r o m ca ra t i v e F a c t o r 6 t o C a r it a s P roC e s s 6
a health profession” fit in a culture currently dominated by evidence-
based medical thinking?
Reminding us of different forms of evidence, Martinsen refer-
ences Finnish nursing scholar Katie Eriksson (1999). Together, they
point out that “linguistically, the meaning of evidence is to see and to
gain insight into; the word ‘evidence’ is related to ‘knowing,’ which
again may mean to attend to, to become familiar with, to experience,
and based on this, [to] reach an indisputable certainty regarding some
issue” (Martinsen 2006:123). Thus, evidence has strong ties to the obvi-
ous, the palpable, the incontestable, the distinct and clear, as well as to
the proof of natural events.
Therefore, such expanded and deepened notions of evidence and
seeing relate to theory in the Latin/Greek word sense, in that the word
theoria can be translated as “to see.” When these notions are linked,
we focus on gaining insight into, attending to, knowing, experiencing,
judging: using all ways of knowing. Thus, these notions give a much
wider and deeper meaning to “adequacy of evidence,” beyond simply
proving or measuring or validating an empirical fact.
In this more expanded and broader view of evidence, we can seek
to distinguish between complete (adequate) evidence and incomplete
(inadequate) evidence (Martinsen 2006:124). Further, in clarifying this
line of thinking, we can begin to unravel certain forms of evidence,
such as subject matter, some experiences, situations, phenomena, and
even pre-scientific, pre-conscious notions, as well as objective external
givens, facts, and so forth. Each form of evidence may yield differ-
ent forms of knowledge pertaining to certain situations and objects of
analysis: inner or outer phenomena. One form of evidence may not
conform to another form of evidence needed for adequate decision
making; congruence between different forms of evidence is necessary
to understand human experiences in this living human-environmental
field of complexities, ambiguities, and unknowns.
While it is critical to have evidence and scientific-technical, empiri-
cal knowledge for professional practice, the phenomenon of nursing evi-
dence has to be expanded and deepened in the fullest sense of the word
for professional care to occur; thus, the notion and process of evidence
need to be critiqued, discussed, and unraveled for the best practice.

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