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Pensar Enfermagem / v.27 n.01 / October 2023
DOI: 10.56732/pensarenf.v27i1.296
Theoretical Article
How to cite this article: Watson J. Unitary Caring Science: Caritas Compassion Transpersonal Theory.
Pensar Enf [Internet]. 2023 Oct; 27(1):106-109. Available from:
https://doi.org/10.56732/pensarenf.v27i1.296
Unitary Caring Science: Caritas Compassion
Transpersonal Theory
Lisbon, June 27, 2023. Portugal Conference - Encontro Internacional da
Rede Portuguesa da Ciência de Enfermagem para o Cuidado Humano 2023.
Abstract (written by editors)
This article presents a transformative perspective on contemporary nursing, emphasizing
unity and interconnectedness in the post-Covid world. Prof. Jean Watson introduces
"Unitary Caring Science" as a holistic approach to nursing, rooted in three ethical principles:
The Ethic of Belonging, The Ethics of Face, and The Ethics of Hands. These principles
guide the paradigm shift in nursing philosophy and practice.
Dr. Watson discusses the "Ten Caritas Processes®," a foundational language for
understanding and practicing human care. She highlights the importance of "Transpersonal
Caring Moments," where nurses' presence and authenticity influence patient experiences.
The article aligns this approach with the American Nurses Association's new definition,
emphasizing compassion and presence in nursing care, and advocates for a holistic,
interconnected nursing approach to uphold human dignity and compassion.
Keywords
Ethics Nursing; Holistic Nursing; Nursing Care.
Resumo (escrito pelos editores)
Este artigo apresenta uma perspetiva transformadora sobre a enfermagem contemporânea,
enfatizando a unidade e a interligação no mundo pós-Covid. A Prof. Jean Watson apresenta
a "Ciência Cuidadora Unitária" como uma abordagem holística para a enfermagem,
fundamentada em três princípios éticos: A Ética da Pertença, A Ética do Rosto e A Ética
das Mãos. Estes princípios orientam a mudança de paradigma na filosofia e prática da
enfermagem.
A Dra. Watson discute os "Dez Processos Caritas®", uma linguagem fundamental para
compreender e praticar o cuidado humano. Ela destaca a importância dos "Momentos de
Cuidado Transpessoal", onde a presença e autenticidade das enfermeiras influenciam as
experiências dos doentes.
O artigo alinha esta abordagem com a nova definição da Associação Americana de
Enfermagem, enfatizando a compaixão e a presença no cuidado de enfermagem, e defende
uma abordagem holística e interligada à enfermagem para preservar a dignidade e a
compaixão humanas.
Palavras-chave
Ética em Enfermagem; Enfermagem Holística; Cuidado de Enfermagem.
Jean Watson
1
orcid.org/0000-0003-1777-7636
1
Watson Caring Science Institute; Professor/Dean
Emerita University of Colorado Denver, CON, USA.
Corresponding author:
Dr. Jean Watson
E-mail: jean@watsoncaringscience.org
Pensar Enfermagem / v.27 n.01 / October 2023 | 107
DOI: 10.56732/pensarenf.v27i1.296
Theoretical Article
Introduction
Tumultuous times in our world require a new/old unitary
worldview; an evolving consciousness about converging
ideas of nursing, because we dwell in the sacred circle of life
and death and beyond. Post Covid has awakened us to the
reality of oneness of all, encompassing a quantum leap for a
new worldview, a worldview of unity and connectedness of
all things.
In my writing I refer to this shift as unitary caring science
for nursing, caring, healing and health care. We are faced
with one world/ one humanity/ one Planet.
1,2
The framework of unitary caring science and transpersonal
theory includes the following principles: The Ethic of
Belonging; The Ethic of Face; and the Ethic of Hands. Each
one of these informs the transformative unitary paradigm
for Nursing and specifically my work in philosophy and
science of caring as well as transpersonal caring theory.
The Ethic of Belonging
The Ethic of Belonging was posed by French philosopher
Levinas in 1969
3
and submitted that we all ‘Belong to the
Infinite Field of Universal Cosmic Love’, before our
Separate Being. This worldview of unity and oneness of all
reflects a quantum universe of connectedness, which
transcends our separate ego physical self. This ethic also
represents the reality of the sacred circle of life and death
to which we all belong, before birth and after death,
awakening the sacred science of caring. Further, Levinas
posed Ethic of Belonging as the first principle of science.
Thus, it is a foundational starting point and worldview for
unitary caring science and my most current theoretical
philosophical perspective.
The Ethics of Face
The Ethics of Face, likewise was posited by Levinas
3
as a
core principle of human evolution and survival of
humanity. His work on Ethics of Face acknowledged that
humanity either evolves further as infinite evolution to
higher consciousness – Or – we totalize our humanity and
each other. The view is in spite of the paradox of virtual
reality; in that “the only way we can survive as humans at
this point in human history is through the Face -to-Face
connection”. ‘When we look into the face of another
person, we are looking into the mystery and infinity of
human soul; when we look into the mystery and infinity of
other, it mirrors back the infinity of our own soul. The Face
to Face connection also reflects the Ethic of Belonging that
unites us across time and space.
The Ethics of Hands
The third principle of Unitary Caring Science is posited by
Ethicist Logstrup,
4
a Danish philosopher. His philosophy
highlighted the metaphorical and literal reality that we hold
another person’s life in our hands. This ethic is core to
nursing and human caring practices. In his words he noted:
“The life in our hands is a sovereign expression of life as given to us,
before and beyond ego; with expressions of trust, love, honesty,
forgiveness, gratitude - beyond feelings that are negative expressions of
life...“.
4(p18)
He referred to this view as an Ethical Demand,
to take care of the life which is in our hands. Within caring
science and the infinite energy of love, it is important to
highlight that our hands are connected with our heart; the
heart is the very source of love, caring, compassion and our
inner truth. So the ethics of hands takes on important
meaning for nursing and the use of our hands in healing.
10 Caritas Processes®
The Ten Caritas Processes of the transpersonal caring
theory, provide core language of the universals of human
caring, which nurses are offering every day. However,
because Caring has not been named, it has been invisible,
without acknowledging, naming, documenting,
researching. Further caring language has not been used as
the foundational ethical, philosophical guide to micro and
macro caring practices, contributing to patient and nurse
caring-healing and health outcomes. It must be
acknowledged in this postmodern time, that any profession
without its own language does not exist. It is also important
to know that these 10 Caritas Processes are located within
the larger unitary caring science paradigm, the most mature
level for honoring nursing’s phenomenon and vicissitudes
of human experiences.
Transpersonal Caring Moment
The nurse-patient relation in any given moment is affected
by the presence, intentionality, consciousness, authenticity
of the nurse in a given moment. Each caring moment is
informed by nurse’s theory, philosophy, ethic and authentic
use of self in a given moment. Unitary Caring Science is
context for any and each transpersonal caring moment,
guided by the professional nurse’s evolution and
consciousness. Such mature practice at micro and macro
level can be framed as Caring Praxis, beyond usual practice
of Doing, transformed toward a Relational Ontology of Being.
The ten Caritas Processes provide the language and
theoretical foundation and structure of nursing. However,
where the theory lives is in a Caring Moment, which is
transpersonal, in that each moment is unique and goes
beyond two individuals; rather beyond ego of nurse or even
ego of nursing profession; rather nurse being authentically
108 | Watson, J.
Theoretical Article
present, open and receptive to ‘see’, ‘to hear’ and to honor
with dignity each individual.
Caritas Process 1: Embrace - Practice of Loving
Kindness, Compassion and Equanimity, for Self-first:
before one is able to offer another authentic caring.
Professional theory-guided practice requires informed
moral action, such as honoring each of the Caritas Processes
as guide for self as well as other.
Caritas Process 2: Inspire - Faith and Hope, through
authentic presence. Honoring the subjective beliefs and
inner life world of other; appreciating sacred presence.
Staying within other’s frame of reference. There is so much
research and knowledge about the role of faith and hope;
the role of religion and one’s inner belief system which
affects outcomes. In this process the nurse honors the
whole person and their inner world beliefs even if they differ
from mainstream medicine. Here the nurse works strictly
from patient/family beliefs, not judging or attempting to
impose own beliefs; while inspiring and enabling
patient/family practices.
Caritas Process 3: Trust - Transpersonal Self-being
sensitive to self/ others-going beyond ego to transpersonal
presence. Trust is immediately detected by the nurses’
presence, intentionality, heart-centered awareness; holding
space for pausing, listening, hearing beyond words. As soon
as the nurse walks into a patient’s room, the patient will
know whether they can trust this nurse or not.
Caritas Process 4: Nurture - Relationship. Heart to heart
authentic relation via trust and loving presence. Holding
Caritas Consciousness in relation with other. Everything is
in-relation and here the nurse moves beyond Doing Nursing
to Being authentically presence. Caritas Process 3 and 4 go
hand in hand.
Caritas Process 5: Forgive - All – Allow for expression of
positive and negative feelings; non-judgmental acceptance,
holding sacred space to listen to another’s story. Listening
to other’s story may be the greatest healing gift – where for
perhaps for the first time, they hear themselves beyond the
usual inner script; Nurse is there holding sacred space
allowing patient to hear self; result they often come up with
new solutions and new options for self; for self-care; self-
knowledge, even self-healing approaches.
Caritas Process 6: Deepen - Creative self; nurse and
patient move beyond ‘problems’ to strengths and creative
solutions; allow for creative emergence. Invite an Expanded
epistemology – allowing for multiple and all ways of
knowing to be considered, not just empirical data alone. It
is unethical to limit our knowledge and ways of knowing to
only one form of knowledge. Subjective meaning and inner
life experiences also count as knowledge, as well as personal,
intuitive, aesthetic, ethical, spiritual as well as empirical-
scientific knowledge.
Caritas Process 7: Balance - Learning with authentic
teaching; appreciating inner listening and subjective
meaning for understanding one’s inner life world, leading to
heart-centered wisdom. This process results in ‘coaching’
other in self-caring; self-knowledge; self-control; self-
choices; and self-healing approaches. Without learning,
there is no teaching. It requires realizing that information is
not knowledge; knowledge alone is not understanding;
understanding is not same as internalizing; internalizing
leads to wisdom.
Caritas Process 8: Co-create - Caritas Field; create healing
environment, by ‘being’ the caritas field of loving-trusting,
heart-to-heart connections. The Caritas Conscious nurse is
the Healing environment. We can have the most beautiful
physical environment, but if the humans in the field are not
caring the environment can be toxic or biocidic for nurse as
well as patients/families.
Caritas Process 9: Minister - Humanity and basic needs
with reverence as sacred acts; sustaining human dignity;
viewing bodyspirit as one. Helping another with basic
human needs when they are unable to do for self, is one of
greatest healing acts nurses offer to humanity. A Caritas
Conscious Nurse knows they are not just touching the body,
but also the mind, the heart and the soul of patient.
Requiring a Caritas loving Consciousness to minister to
another as a sacred gift.
Caritas Process 10: Open - To infinity and evolution of
consciousness; allowing to spiritual existential unknowns,
beyond conventional medical science, open to miracles and
mystery of caring-healing and infinite possibilities.
Conventional science and Western mindsets of medical
science do not have all the answers to human health and
healing. Nurses experience miracles and mystery in patient
outcomes every day.
5
Summary Note on Caritas Processes®
It is important to note that the Caritas Processes are not
linear. They are a gestalt of the whole Caritas Consciousness
in any given moment. It is like a hologram. The whole
Caritas Consciousness is present in any given moment.
Transpersonal caring moment represents any of the Caritas
Processes which transcend time, space, and physicality. A
transpersonal caring moment of any of the Caritas processes
lasts with the patient and the nurse as long as they life,
informing the next moments of their life. Thus, the Ethic of
Belonging, the Ethic of Face and Ethic of Hand are present
through Transpersonal Caritas in any given moment. This
dynamic is a life-giving and life-receiving exemplar of
Caritas Praxis.
As a transition from overview of Caring Science Caritas
Processes and Transpersonal Moment it is helpful to
examine the congruence between Unitary Caring
Science/Caritas Processes and Transpersonal with the latest
definition of Nursing from American Nurses Association
(ANA).
Pensar Enfermagem / v.27 n.01 / October 2023 | 109
DOI: 10.56732/pensarenf.v27i1.296
Theoretical Article
Current Definition of Nursing: American Nurses
Association ANA (2021-22)
Nursing integrates the
art and science of caring
and
focuses on the protection, promotion, and optimization of
health and human functioning; prevention of illness and injury;
facilitation of healing
; and alleviation of suffering
through
compassionate presence
. Nursing is the
diagnosis and treatment of human responses and advocacy
in the care of individuals, families, groups, communities, and
populations
in recognition of the connection of all
humanity.
The highlighted areas with the latest ANA definition reflects
a Unitary Caring Science Paradigm and Transpersonal
Caring values as part of the evolved definition of nursing. It
is the first time ANA has included caring in its definition;
previously the definitions were medicalized-clinicalized
views of nursing and humanity, e.g. diagnosis and treatment
language.
Together Unitary Caring Science and Transpersonal Caring
Theory provide a mature disciplinary foundation for
Nursing for this time of change, so needed to sustain human
caring and human dignity for both nurses and patients alike.
Identifying the Ethics and Quantum Transformative
thinking for Unitary Caring Science provide a universal
timeless framework for nursing past, present and future.
In summary I have identified the essence and advantages of
expanding Nursing and Unitary Caring Science Paradigm
and Transpersonal Caritas as a way forward to sustain
nursing’s global covenant with humanity.
Watson Essence Of Unitary Caring Science
• Brings infinity of LOVE back into Nursing and
Health Care/ Science
• Provides Universal Nursing Language for Universals
of Caring Phenomena
• Introduces Transpersonal - Metaphysical – Sacred
• Integrates ancient and contemporary Energetic
Caring Healing Arts
• Provides a Full Circle of Caring Science evolution:
E.G. Unitary Philosophy - Ethic – Theory –
Micro/macro Caritas Praxis/Education-
Measurements and Research.
Final Summary
Unitary Caring Science: Transpersonal Human Caring
provides a full circle of knowledge to guide the practice,
research, education and leadership for Nursing’s’ future:
The core Philosophy; the Ethical principles of Unitary
Caring; Core Values that guide Caritas Processes as
theoretical frame for micro and macro practices; combined
with Measures and outcomes of Caring as essential to all
healthcare. Philosophy/ Ethic/ Values/ Theory/ Practice/
Research-Measures/ Outcomes Without nursing advancing
within its own philosophical - ethical – theoretical
framework, it is doomed to remain as very good technicians
of a totally new quantum universe, required for caring
healing and health for all.
References
1. Watson, J. Unitary caring science: the philosophy and
praxis of Nursing. Louisville: University press of Colorado;
2018. 204 p.
2. Watson, J. Caring science as sacred science. Boulder:
Lotus Library; 2021. 289 p.
3. Levinas, E.
Totality and infinity. Pittsburgh: Duquesne
University Press; 1996. 307p.
4. Logstrup, K. The Ethical demand. Paris: University of
Notre Dame; 1997. 342 p.
5. Watson, J. Nursing the philosophy and science of caring.
Boulder: University Press of Colorado; 2008. 313 p.
6. Watson, J. (Ed.). Miracle and mysteries: witnessed by
nurses. Deerfield Beach: Lotus Library; 2019. 174 p.
