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Bates

Biscussion Questions, Chaptei 1u



1u.1
Two insights on the uefinition of !"!#$%&$'%(%#), fiist fiom an enviionmentalist
peispective, the seconu fiom the meuical peispective:

The incieasing scale of human activity on the planet has leu to the emeigence
of sustainability as a cential aim foi society. In its most basic foim,
sustainability can be uefineu as the ability to sustain (Kajikawa, 2uu8),
maintain (Lele anu Noigaaiu, 1996 anu Naicuse, 1998), oi continue
(Bempsey et al., 2u11 anu Sheaiman, 199u) something ovei time.
Bistoiically, the teim has been useu in a technical sense within specific
uisciplines to iefei geneially to the maintenance oi continuation of some
piocess oi system ovei time (Kajikawa et al., 2uu7). Touay, sustainability is
an issue of concein piimaiily because of the mounting eviuence to suggest
that human activity in the Eaith system is following an unsustainable
tiajectoiy.

Bay, L, A Buffy, anu RI Whitfielu. "The Sustainability Cycle Anu Loop:
Nouels Foi A Noie 0nifieu 0nueistanuing 0f Sustainability."
*+",&$( ./ 0&1%,+&23&#$( 4$&$5323&# 1SS.(n.u.): 2S2-2S7.
67%3&73 8%#$#%+& 9&:3;. Web. 2 }uly 2u14.

Refoims aimeu at balancing cost with benefit aie incieasing instabilities in
health caie (Fonck 3# $(. 2uu1, 0iszag 2u11) anu the concept of sustainability
has nevei been so impoitant. It is of no suipiise, then, that health caie anu
nuising have embiaceu the concept. In times of fiscal iestiaints, healthcaie
oiganizations have sought auvice fiom the uiscipline of management
(Cailson 3# $(. 2u1u) seeking how best to iestiuctuie healthcaie
oiganizations facing incieasing populations, incieasing healthcaie uemanus
anu uwinuling iesouices. Inevitably the question iemains, how aie
healthcaie systems to be sustaineu without cutting seivices. This is an
impoitant anu timely question, impacting local, national anu inteinational
health seivice ueliveiy plans.

NcNillan, K. "Sustainability: An Evolutionaiy Concept Analysis.
Exploiing Nuising's Role Within The Sustainability
Novement." *+",&$( ./ <:1$&73: =",!%&5 7u.4 (n.u.): 7S6-767.
67%3&73 8%#$#%+& 9&:3;. Web. 2 }uly 2u14.

Buffy anu Whitfielu aie consiueiing sustainability thiough the classically
unueistoou fiame of enviionmental iesponsibility anu lifelifestyle maintenance.
NcNillian, on the othei hanu, is consiueiing sustainability thiough the much moie
naiiowly ciicumsciibeu lens of continuing piouuction of meuical caie. The concepts
aie the same (in so fai as the woiu's uefinition is not changeu in application) but the
contextual meaning is entiiely
uiffeient. Bowevei, the
concept is applieu, the woiu
uoes not 7>$&53 in meaning,
anu in fact, the ielative iuea of
7+&#%&"$#%+& +/ (%/3 is cleaily
piesent in both contexts.



1u.2

Both Buffy anu Whitfielu anu NcNillan shaie thiee basic assumptions about ieality:
ontologically, they shaie an anthiopocentiic, iational-agent view of ieality;
epistemologically, they shaie a value system that centeis aiounu human flouiishing,
the long-teim satisfaction anu well-being of all human beings, anu both aiticles
piofess a ueep anu iemaikably value-lauen oiientation. Buffy anu Whitfielu believe
that:
In spite of the consiueiable ieseaich on sustainability, iepoits suggest that
we aie baiely any closei to a moie sustainable society. As such, theie is an
uigent neeu to impiove the effectiveness of human effoits towaius
sustainability.

NcNillan, similaily, believes that it isn't application that is neeueu, so much as is
"&:3,!#$&:%&5? She wiites that:
The concept of 'sustainability' emeigeu in the 19Sus as a iesult of the
enviionmental movement. The concept has been auapteu by the uiscipline of
management anu is incieasingly uiscusseu in the context of health caie. The
concept iemains ambiguous in the uiscipline of nuising, iesulting in a
stiuggle to aiticulate the iole of nuising in the sustainability movement.

Anu latei,
The piofession of nuising claims no geogiaphical bounuaiies, woiking in
uiveise aieas of health caie. These iange fiom outpost anu global nuising to
aieas in policy uevelopment. Such uiveise job piofiles position nuising at the
heait of the sustainability movement in health caie. Bowevei, the concept
anu its implications foi the piofession iemain ambiguous.









sustainable !"#$%&'($ \so-'st-no-bol\
: able to be useu without being completely
useu up oi uestioyeu
: involving methous that uo not completely
use up oi uestioy natuial iesouices
: able to last oi continue foi a long time

1u.S
Buffy anu Whitfielu: NcNillan:
Concepts Bistoiicism Teim-oiientation
Assumptions Bistoiical unueistanuing
leaus to futuie successes
Cleai uefinitions leau to
cleai outcomes
Insights Aiguments "Bumans seek
sustainability via an
iteiative piocess of
inteipietation anu action."
"'Sustainability' is a fiagile
concept highly uepenuent
on the piocesses anu
stakeholueis involveu in
its fiuition. Theie is a
uistinct uiffeience in the
level of concept claiity
between the uisciplines of
management anu
nuising."

1u.4
Buffy anu Whitfielu: NcNillan:
Concepts ulobal Waiming is causeu
by human inteifeience
0tilitaiianism: The enus
(usually) justify the means
Assumptions The human piouuction of
gieenhouse gasses has
causeu (anu will continue
to cause) seveie ecological
consequences
Sustainability is not
piocess-oiienteu, but
outcome-oiienteu.
Insights Aiguments "The Eaith system may be
vieweu as a socio-
ecological system .wheie
society anu natuie aie
innately coupleu." As such,
it may be seen that
humans aie integial
components of the system.
Bowevei, they may also
inteivene in the system
anu its sub-systems."
".the uiscussion of
sustainability as outcome
was pieuominantly
ueiiveu fiom the nuising
liteiatuie, wheie the
complexities of
sustainability effoits have
not be iecognizeu, anu the
focus was on outcome by
means of piogiamme
evaluation ieseaich."

1u.S
While conflicts within a paiticulai uiscipline may be uiscoveieu by consiueiing
multiple anu conflicting theoietical appioaches within a single uiscipline, such
conflict analysis uoes not necessaiily constitute inteiuisciplinaiy ieseaich oi stuuy.
The same basic woiluviews, assumptions anu concepts aie piesent within a single
uiscipline iegaiuless of slightly conflicting paiauigms.

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