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Challenging misconceptions in nursing education

Regressive legislators in a Southwestern state discovered that doctoral-level nursing students, future nurse practitioners at the state university, were receiving education in human sexuality. As watchdogs of public morality, and with a conviction that these students were being educated to “groom” children to become transgender individuals, they did not pause to verify the information, review course materials, or speak with the instructors. Instead, they immediately began complaining to the media about the “wokeness,” “liberal agenda,” and “sinfulness” of the training at a state-funded institution.

The students were required to have prior nursing experience for program acceptance. Did the legislators believe that before entering the doctoral program, the nurses led lives that were entirely sheltered from reality? Were they home-schooled through their BSN, without internet or TV, and whose only human contact was with equally cloistered individuals? Did they ignore or fail to comprehend what the students’ prior work experience included or what their future employment would entail?

These legislators, and far too many others like them at both state and federal levels of government, reside in a fantasy world constructed on three misconceptions. They desire to make this illusionary world a reality, with the certainty that it will make our country a better place to live.

Their first belief is that pre-Revolutionary, North American, religiously-based colonies were rigidly controlled communities of piety and clean living. However, this belief requires either ignorance or denial of history, even that written by religious leaders of the time (e.g., Cotton Mather, Pieter Stuyvesant).

Another conviction is that the pre-Reformation Christian Church dictated a life dedicated to Heaven in Western Europe. This church was powerful and influential, but the basis of this control was not the furtherance of religion, but the attainment of further dominance and wealth for high-ranking churchmen. They used entry into heaven and one’s reward once there as coercive tools over nobles and royalty to attain these goals. Here too, knowledge of, or acceptance of history would demonstrate the falsity of belief in the devotion of the early church to a higher cause.

The third misconception is that the television portrayal in the late 1950s and early 1960s of the ideal family is factual and biblical, though both history and sociology have demonstrated that this family structure rarely, if ever, existed. Patriarchy and the dominance of women have existed almost as long as humanity, but often if the “little woman” remained at home, families would not have survived, and childhood as we know it did not exist for the same reason.

Let us assume, however, that these arbiters of morality are correct and that nurse practitioners should not be taught human sexuality. Would not the same reasoning apply to physicians and mental health professionals? Perhaps this education should be eliminated altogether as inappropriate and unnecessary in a moral culture?

In 1963, for example, when I was in the 10th-grade honors biology, the entire section of our textbook on human reproduction was blacked out, and a children’s book explained that “when a mommy and a daddy love each other very much, a baby happens.” Would we once again limit birth control to married women with their husbands’ approval and treat abortions as something that only happened to “bad” girls, while never acknowledging post-abortion hemorrhages and infections (and deaths) that arose from poorly performed procedures? The idea that married women might use abortion, as did my grandmother, for child spacing would have been too alien to comprehend! In a few states, these individuals have had to define “male” and “female” by state law, as they have found biological explanations inadequate.

For millennia, the estimated lifespan was ±25 years. There were elderly people, those who lived into their 70s-80s, but the average was drastically reduced by horrendously high infant and early childhood mortality rates. Many women also died young in childbirth or shortly thereafter, and polygamy and serial monogamy were common practices. One regressive legislator has even stated that girls between 12-15 were suitable for marriage and pregnancy!

Many regressives have questioned the value of vaccines; not only the recent ones for COVID but also those for childhood communicable diseases. Perhaps they will do away with these as well, and we could welcome back a multitude of contagions that have been greatly diminished, if not eliminated, in the developed world. How many present-day U.S. physicians have treated Diphtheria or Polio? Could we even see the return of Bubonic Plague? Histrionic, possibly, but who expected potentially endemic Leprosy and Dengue Fever in Florida? To these, we could add increasing STIs and HIV. In a regressive world, not only would there be no education on these, but no specialty clinics and likely fewer treatments as well, that likely could only be accessed clandestinely, while more babies would be born with congenital infections and their associated disabilities.

This just scratches the surface, as other aspects of health care would be curtailed as well. Regressives in Congress have discussed reductions in Medicaid and Medicare, and it is possible that employer-based health insurance could be narrowed or eliminated. Certain lines of research and some medical procedures may be reduced or eliminated as immoral. Together, all of these would result in a “sicker” population and increased mortality at younger ages. We could easily regress health care to the level of the late 19th-early 20th century. All in all, I prefer what we have to this nightmare.

M. Bennet Broner is a medical ethicist.

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