REFLECTION ARTICLE

CRITICAL THEORY FOR NURSING: AN INTRODUCTION

Patrick Martin1, Emilie Morand2, Enéas Rangel Teixeira3

1 Laval University, Faculty of Nursing; Quebec Heart and Lung Institute. Québec, Canada. ORCID: 0000-0003-3966-9257. E-mail: Patrick.martin@fsi.ulaval.ca.

2 Laval University, Faculty of Nursing; Quebec Heart and Lung Institute. Québec, Canada. ORCID: 0000-0002-0161-9724. E-mail: emilie.morand.1@ulaval.ca.

3 Universidade Federal Fluminense, Escola de Enfermagem Aurora de Afonso Costa. Niterói, RJ, Brasil. ORCID: 0000-0002-1721-2056. E-mail: erteixeira@id.uff.br.

ABSTRACT

Objective: To present the historical origins of Critical Theory within the Frankfurt School tradition, clarify conceptual distinctions between Critical Theory and related intellectual movements, and discuss their relevance and applications in nursing. Method: Theoretical reflection based on classical literature and the authors’ experiences in teaching nursing epistemology. Four thematic areas were examined: Post-structuralist Theory, Postmodern Theory, Feminist Theory, and Postcolonial Theory. Results: The analysis highlighted persistent conceptual confusion regarding Critical Theory, particularly in relation to the first- and second-generation Frankfurt School thinkers and subsequent theoretical movements. Distinctions were established between Critical Theory and poststructuralist, postmodern, feminist, and postcolonial approaches. Examples were presented demonstrating how these perspectives have been incorporated into nursing research, education, and practice. Conclusion: Critical Theory offers important pathways for reflecting on nursing science and professional practice. By outlining key concepts grounded in socio-historical and epistemological perspectives, this article provides a relevant reference framework for nursing professionals and students.

Descriptors: Critical theory in nursing, poststructural theory, postmodern theory, feminist theory, postcolonial theory

What is already known:

• Critical Theory, originating in the Frankfurt School, is frequently confused with related intellectual movements such as poststructuralism, postmodernism, feminism, and postcolonialism.

• These theoretical frameworks have been increasingly used in nursing research, education, and practice, often without conceptual clarity about their origins and distinctions.

• The lack of a clear differentiation between these frameworks hinders their rigorous application in nursing knowledge production.

What this article adds:

• Presents the historical origins of Critical Theory within the Frankfurt School tradition and its first and second generations of thinkers.

• Clarifies the conceptual distinctions between Critical Theory and poststructuralist, postmodern, feminist, and postcolonial theories.

• Offers examples of how these frameworks have been applied in nursing research, education, and practice, providing a reference for professionals and students.

INTRODUCTION

Critical theory is also known as the critical paradigm, the critical theory of society and the critical perspective. At its base, it is descriptive and normative and helps lay bare the inherent contradictions of the social order. The reflexive and emancipatory character of critical theory, its intimate and sustained link with practice, and the opportunities it offers people in vulnerable circumstances to have a voice, to increase their autonomy, to free them from entrapment, and to reduce their social domination, are certainly factors in the attention it has garnered in a practice discipline such as nursing.

Historically, early foundations of critical thought can be traced to Jean-Jacques Rousseau (1712 -1778), one of the first critics of the causes of the corruption of social life. In A Discourse upon the Origin and Foundation of Inequality among Mankind (2010), Rousseau was convinced that the natural “good” essence of human beings  was perverted by the social problems brought about by  “progress”. He would be the first thinker to turn his attention to the corruption in the new ways of life that to him was associated with the power of money and private property and which brought about domination,  servitude and injustice. He would be the first thinker proposing a way to guarantee civil liberty by a social contract. Hegel (1770-1831), in his first writings at the turn of the nineteenth century, was strongly influenced by the problematic Rousseau raised; so, too, was the young Marx (1818-1883). In addition to being influenced by Rousseau, Marx was strongly inspired by Hegel and his ideas. For three years Marx had been a member of the leftist Young Hegelians group in Berlin(1), though he subsequently became a fierce critic, as the first fragment of The German Ideology(2) clearly attests. For Marx, human beings were fundamentally characterized by sociability and the material conditions of life in each historical period: A stream of thought that came to be called historical materialism. The economic structure had an important role in the evolution of society divided into social classes. Marx spoke of the alienation of labor, which he explained by the fact that the workforce had become a commodity; where man abandons his true nature, having no control of  what he does. He believed that capitalist society created an additional disposition by suggesting that the desire to have and possess dominated and replaced the sense of being.

Assoum(3) would prefer the Frankfurt School not to be placed in any particular classification such as: school of philosophy, sociological discourse, or political movement, since none of these terms seem appropriate. The institutional basis for the development of the Frankfurt School was the Institute for Social Research, which was officially established in 1923(4). The idea of an independent, permanent Institute for Social Research was born during the First Marxist Work Week organized by Weil with Lukacs, Korsch, Pollock, and Wittfogel in attendance.

The Institute’s reflections at the time revolved mainly around classic German philosophy, Marxism, psychoanalysis, and research on culture, the State, and authority. The members of the Institute, including Adorno, Horkheimer, Benjamin, Marcuse, and Fromm, would enjoy wide recognition; they were all proponents of the idea of the will for freedom. The Institute’s theoretical activities focused initially on the transition from the capitalist economic and social system to socialism(5).

This first phase ended quickly with Horkheimer’s arrival as head of the Institute in 1931. It was he, who, in 1930, dubbed the theoretical substance of the Frankfurt School: Critical Theory. He did it formally in the article Traditional and Critical Theory, which is for all intents and purposes his personal manifesto on the subject(3). For Horkheimer a critical theory is adequate only insofar as it is simultaneously explanatory, practical, and normative(6). It is oriented toward critiquing and changing society, in contrast to traditional theory that seeks merely to understand or explain. The ongoing currency of this definition is evidenced by De Munck’s explanations regarding the general architecture of a program of critical sociology: “an epistemological basis, which refers being intended to describe and explain social reality; a normative basis, which refers being aimed at a normative assessment of reality; and a social-criticism basis, which links social suffering with substantiated criticism and under certain conditions gives rise to transformative action (social movements). A program of critical sociology must link these three bases together in a coherent manner without reducing one to the other.”(7:p.3)   

The transformative action alluded by De Munck is also considered a primary foundation of critical theory by Horkheimer, who conceived it through the prism of critical emancipatory knowledge. The construction of emancipatory knowledge makes it possible to free human beings from the circumstances that give rise to their subjugation. In Horkheimer’s view, the purpose of critical theory is to prevent man’s submission to the various concepts and types of behavior proposed or demanded by institutions. The examination, of the complex modes of domination, of the individual through social relationships, remains today at the center of the different research approaches associated with critical theory.

In its infancy, the critical theory took up a position against logical positivism as a mode of thinking that inaccurately represented a realistic social process, which were a force for capitalism and an epistemology of truth. Both, Adorno, who did not formally join the Institute for Social Research, until 1938, and Horkheimer, who continued to lead it until its decline, took positions against what Horkheimer later called positive barbarism(5). This concept was also developed by Benjamin(8). The positivist paradigm, they argued, is totally at odds with any consideration of the problems of intentionality and meaning that comprise human subjectivity. It thus reduced the social researcher to an anonymous, apathetic coder; lacking ideological idiosyncrasy(9).

Habermas, a disciple of Adorno and Horkheimer, took their position as a point of departure for his own reflections. He deemed the technical rationalism and instrumentalism of positivism as being destructive of any possibility of acritical reflexivity - dialectical and emancipatory - that, in his view, necessitated researchers identifying with the subject of their research. A researcher, who wishes to explain a range of choices, made by men and women, must accordingly make the epistemological choice to personally engage in dialogue with them and become involved in a deep, hermeneutic, intersubjective relationship governed by the principles of communicative, rather than instrumental, rationality(10).

Habermas(11) in a manner of speaking, by introducing bidimensionality into the heart of the critical theory through a series of dualisms of instrumental reason/communicative reason; system/experiential world… [and] by initiating a reflection on democracy, has been the liquidator of a Frankfurt School that had become utterly attached to a one-dimensional definition of the idea of universal reason(12). The period following the Second World War, with the return of members of the Institute, from their forced exile, marked the end of any further development of the Frankfurt School.

Over time the critical theory came to reject the demand for a scientific basis of criticism grounded in a grand theory(6) as it had been conceived initially by the Institute. Despite the abandonment of the Frankfurt School’s initial program to develop critical theory –within the framework of a single theory – as contemporary reality was too complex and subject to rapid change(13) – the School left a legacy of multitude new movements, which are inextricably connected with it, notably oriented toward critiquing and changing society, which currently comprises what is now known as the Critical Theory. We shall now explore some of them.

METHOD

This article is a theoretical reflection grounded in classical literature and the authors’ experience in teaching nursing epistemology. The paper adopts an interpretive and analytical approach to examine the historical origins and conceptual development of critical theory, beginning with its consolidation in the Frankfurt School.

Given the continuing conceptual confusion surrounding critical theory, the reflection seeks to clarify and demarcate related intellectual movements that have contributed to its transformation over time. Particular attention is devoted to four theoretical perspectives: Poststructuralist Theory, Postmodern Theory, Feminist Theory, and Postcolonial Theory.

Following the conceptual and historical discussion of each movement, examples are presented to illustrate how these perspectives have been applied in the field of nursing.   

Poststructuralist theory

The terms poststructuralist theory and postmodern theory are often used interchangeably because they share similar skepticism in Universalist proclamations. However, there are a number of issues where they have different viewpoints, and they cannot be regarded as equivalent. The postmodernism in social theory decries the alleged Enlightenment project of cultural and technical progress, whereas postructuralism focuses on radicalizing within the framework of structuralism and determinism.

 Bataille(14), Derrida(15), Deleuze(16), Foucault(17), and Lacan(18) are among the thinkers associated with poststructuralist theory, although none of them really adopted the label. Lacan challenges classical structuralism, but is based on linguistic structure, originating from Jakobson, Saussure and Lévi Straus. Poststructuralist theory is generally known as poststructuralism, deconstructionism or genealogy. Lawlor(19) describes it as a philosophy of interrogation. According to Belsey(20) it is one theory, or group of theories, that deal with the relationship between human beings; the world they live in; and the use and reproduction of their own meanings. Poststructuralism is generally associated with language, social organization, power, subjectivity, and it focuses on the analysis of literary and cultural “texts.” The term “text” refers to a representation of any aspect of reality(21).

For poststructuralists, everything is thus a “text.” They are rather seen as constitutive of individuals’ social reality and of their own subjectivity.  Words and discourses are thus “texts” – they are interrelated and can be understood only in the relations to other texts – a phenomenon conceptualized in the term “intertextuality”(22). Thus, no texts stand alone; they are inextricably interlinked and associated with the context in which they are produced.

This phenomenon is consistent with one of the epistemological bases of poststructuralism: anti foundationalism(23) with the notion that the structure of knowledge is not derived from logical deductions and a set of first principles but draws rather on every point into a network develop through the reciprocal influence of various conceptions and observations(24). Poststructuralism strongly “rejects the notion of anything being natural and/or pre-existent”(25).

Since the inherent structures of modern civilization have authority, directing the circular logic by which knowledge is built, whether prior, in the course of, or following any investigation, it seems inevitable, from a poststructuralist standpoint, that some of these structures should be contained in the conclusions of the investigations(25). Poststructuralists also fiercely criticize traditional science to use these conclusions, which are deemed pretentions to “truth” and ‘dominant’ discourses, to legitimate itself and to define a space that buttresses its structure.

Since the way in which the ontological foundations of poststructuralism are apprehended differs somewhat from one author to another, we shall deal separately with the reflections of two thinkers associated with this movement, while undertaking the risky exercise of seeking to unify some foundations of their thinking. Foucault(17), apparently influenced by Nietzsche and Bataille(26), associated ontology with transgression, which he considered the essential test of original thought. Foucault contended that only by seeking boundaries, and transgressing them, may empower the subject to think of oneself as a being. Foucault then came to demand a “critical ontology of ourselves”(27). Since this “ourselves” was, in his view, necessarily run through by power relationships, it must offer them biopolitical resistance in order to gain access to the original life force, in a sort of ethic of “ourselves,” a political ethic akin to Deleuze’s ethic of deterritorialization(28).

The distinction between power (pouvoir) and force (puissance) is more closely related to a Spinozist reading of Deleuze than to Foucault himself. According to Revel(26), it was from Deleuze that Foucault borrowed his way of thinking of being based on the positivity of difference.  Deleuze constructed his ontology around concepts of force and intensity. Boundas(29) describes it as a “veritable diacritics of forces in motion”. These forces are “different/ciated”, that is, “they are what they are only because of the differential relation that they have with other forces. The differential quantity of forces is called ‘intensity’... or better, ‘intensifications’”. These “intensifications” are also responsible for the genesis of entities since they become virtual and constitute real events that actualize themselves in states of affairs(29). The multiple characters of states of affairs and especially of entities seem to us to be in line with what Honneth(13) considers the internal multiplicity of identity, a view characteristic of the poststructuralism of the 1980s.

Use of the poststructuralist perspective in nursing holds great potential, in part because its epistemological foundations provide grounds for questioning the dominant discourses ingrained in the healthcare system. Griscti, Aston, Warner, Martin-Misener, and McLeod(30) are doing it in questioning the huge space occupied by experts’ advice over the patients’ voice in hospitals. The biomedical corporatist and the neoliberal discourses are both teleological, we ought to be concerned about. Adoption of poststructuralist perspective makes it possible, from a critical standpoint, to question the tendency of the nursing discipline to subscribe to these discourses of fierce imposition of norms and regimes of truth(31).

The propensity of the discipline to adopt modes of production, such as evidence-based nursing practice, which attaches no great value to the many types of nursing knowledge employed  traditionally - marginalizing knowledge derived from interpretative or hermeneutic inquiry research - has been deconstructed by Holmes, Murray, Perron and Rail(32), Rolfe(33), and Wall(34). They drew their inspiration from the poststructural perspectives of such authors as Derrida, Foucault, Deleuze and Guattari. Holmes, Murray, Perron and McCabe(35) who similarly criticized the strong tendency of healthcare institutions to impose “best practices” or Nursing Best Practice Guidelines on nurses, which from a poststructuralist standpoint can be considered an instrumentalization of nurses’ judgement as part of a cost-reduction approach in line with neoliberal ideology. These authors used Baudrillard’s critique of contemporary thinking to conceptualize best nursing practices as a dangerous delusion devoid of substance that puts the autonomy of nurses at stake. It is precisely such totalizing thought, which is based on inductive reasoning and ignoring exceptions that poststructural criticism has the potential to undermine.

Postmodern theory

It seems inappropriate to treat “postmodernism” and “postmodernity” as equivalent concepts. Therefore, each of these terms is dealt separately here, as well as the related term  “postmodern theory”. Before embarking on an in-depth definition of “postmodernism,” we shall deal very briefly with “postmodern,” the first of the related terms to come into use(36). Originally utilized to describe English impressionist painting of the 1870s, “postmodern” was employed to refer to the Nietzschean superman, a period in Spanish literature (1905-1914), and Western history after 1875. The impossibility of eliciting a clear meaning for the term from these first “occurrences” is strangely similar to the confusion that exists over “postmodernism.” For the latter term had—and still has today—a wide variety of meanings; a non-exhaustive list includes a chronological period, a style in contemporary art, architecture, and literature, a property of the social structure, a change in values of certain societies, as well as a specific way of thinking and theorizing about language, knowledge, and identity(37). Despite this evident diversity and notwithstanding its “catch-all” nature the term is often charged with, we believe too like Boisvert(38) that postmodernism constitutes a current of thought with coherent and logical foundations that fit into a specific theoretical framework and a particular conception of intellectual activity.

A theoretical framework

This framework may in some measure be summarized as follows: the abandonment of the apprehension of the subject as autonomous and rational; the break with a foundationalist philosophy and epistemology; the perception from the impossibility of a universal reason’s a priori, or of one within the individual capacity of the subject, and the death of what constitutes the notion of social, and moral progress, through the rational application of scientific theories(39). The critique of scientific objectivity that is associated with postmodernism(40) is generated ontologically by a relativistic, existential posture. Through the prism of postmodernism, all forms of knowledge are legitimate and have equal status(41), for no truth is demonstrable.

Lyotard, in The Postmodern Condition: A report on knowledge(42) was a stern critic of the doctrines of the Enlightenment project of cultural growth and techno-scientific progress by reference to the term postmodernism. He defines “postmodern” as a generalized incredulity regarding the metanarratives of modernity. Lyotard(42) puts postmodernism in a temporality that suggests to us the gradual elimination of the notion of modernity in a “dyschronic” process (at a speed that varies by country and by field of activity), which, he maintained, and began in the late 1950s. Only after being subjected to criticism, by Habermas(11), was Lyotard(42) led to redefine his vision of postmodernity. In The Inhuman: Reflections on Time, he is careful to consider the postmodern age, in the modern age, as a rewriting of features of modernity(36). Other authors share various forms of this view. Ayleswoth(43) contends that the difference between postmodernism and modernity is situated in modernity itself, while Smith(44) views it as a strategy applied by intellectuals to deal with the impacts of modernity.

Intellectual activity

We associate the notion of intellectual activity as it is applied in the theoretical framework of postmodernism specifically with the concept of “postmodernity.” Drawing on the writings of Boisvert(38), we conceive postmodernity as an instrument of sociopolitical analysis of the contemporary world, which allows us to do away with pretensions, certitudes, and absolute truth(s), encourages debate between divergent ideas, and fosters the coexistence of opposites through eclecticism and pluralism(45). The epistemology associated with postmodernity thus comprises a process of making a permanent break; a constant renewal of questioning; a concern, and a vigilance that compel the individual to  never remain in one place, never to succumb to certainty(46). The activity though nomad in character, is similar to a nomad researcher developing knowledge as he follows his own itinerary through its slow, unpredictable course, allowing him to better experience the world and the individuals around him(47).

This view of postmodernity as an instrument of sociopolitical analysis puts us at odds with Freitag(48), who conceived it as new “formal conditions for the regulation of social practices”. Our position also requires that we reject the viewpoint of Kincheloe and McLaren(49), who look at postmodernity as a postmodern condition characterized by hyperreality. We are nonetheless in perfect agreement with their conceptualization of “postmodern theory” as referring both to a more comprehensive notion, which includes anti foundationalist writings in social sciences, philosophy, including poststructuralist theory.

The interest of the discipline of nursing in postmodernism is of long standing, as evidenced by the writings of Parson(50), Fahy(51), Hall(52), and Benedict and Georges(53). The great majority of the authors in the nursing discipline dealing with this current of thought have been able to do so with coherence. But others seemed to have interpreted its essential philosophical — especially epistemological — foundations erroneously(41). O’Mathuna(54) affirms that “[a]nything the postmodernist says is meaningless”(54:p.11) because from a postmodern perspective every interpretation is unique. His assertion indicates a failure to grasp the value of relativist ontology into the nursing discipline that allows one to take eclectic, pluralistic positions. Francis(55), who postulates the theoretical incompatibility of nursing with postmodernism, also seems to betray a mistaken understanding; she refers to the writings of Cole and Hill(56) and to the idea that postmodern theory helps maintain marginalization and oppression because of the “rejection” of the notion of emancipation that they attribute to it. Lyotard(57) indeed associated postmodernism with incredulity towards the metanarrative of “the emancipation of the rational ... subject”(57:p.23), from an ethical perspective to undermine a notion of emancipation that conveys often unrealistic ideals.

Postmodernism is in accord rather with a pragmatic, realist hermeneutic that seeks to share new interpretations of the world with the other members of a society so that they can themselves decide their fate(38:p.187). Postmodernism, as a philosophy of undirected action, seems to us, on the contrary, particularly appropriate to combat marginalization and oppression of the subject, as Eriksson et al.(58) and Ogle and Glass(59) have been able to demonstrate through their research on the marginalization of nurses and nurse managers and tattooed nurses.

Feminist theory

The term “feminism” was first used in the mid-eighties but was not associated with the idea of the defense of women’s rights until after the first International Women’s Conference in Paris in 1892(60). According to Marcuse(61), the first counter-current in which female autonomy was proclaimed goes back to the second and third century, to the break in history that came with the appearance of the great heretical movements and the first great protest movements against a social hierarchy that was particularly repressive for women. These progressive movements, which represent the infancy of a fragile feminism, were brutally crushed. Engels(62) is likely to be the first thinker who proposed that the oppression of women was the product of social history and not the result of biological determinism. He proposed that the emancipation of women would be the consequence of the emancipation of the proletariat.

Pathways for a feminist ontology

“One is not born, but rather becomes, a woman. No biological, psychic, or economic destiny defines the figure that the human female takes on in society; it is civilization as a whole that elaborates this intermediary product between the male and the eunuch that is called feminine. Only the mediation of another can constitute an individual as Other”(63:p.283). These few sentences from a classic of feminism contain many of the elements still associated with feminist ontology. These include the ideas that gender is a social construct and not natural, that a woman, as a being, becomes woman because she is ontologically so, as a result constituted through a set of norms leading to a disadvantaged social role(63). According to Marcuse(64), “over and above the obviously physiological differences between male and female, the feminine characteristics are socially conditioned”(64:p.279). However, he emphasizes, the efficacy and recurrence of this conditioning process is such that so-called feminine characteristics become “second nature”; they become the norm. Some feminists remind us, though, that the stereotypes, related to the construction of female gender, and oppression, and its psychological consequences, can be changed for the very reason that they are conditional on this type of construction(65) and, thus, the importance of feminist activism. Haslanger(66) finds that the relational nature of the female “self” is also present in the writings of de Beauvoir(63), who maintained that it is through this relational nature that the female “self” takes ontological shape as an “Other” and not as an absolute subject; this “self” or “other” are the product of interactions which, according to Stanley and Wise(67), are unequivocally cultural and social.

Three waves

Feminist theory, better known as “feminism,” is generally associated with a critique of the subordination of women and an exploration of the links between sexism and other forms of subordination, such as heterosexism, class oppression, and racism(68). Although the term “feminism” still holds strong associations with the popular fight for women’s suffrage, of the late nineteenth and early twentieth century, neither of a period that marks neither the beginning nor even less the end of women’s many struggles for justice(60). Indeed, according to Haslanger(60), it is for this reason that the evolution of feminist thought is conceptualized as —and classified by—a series of waves. This typology has been criticized as dissonant with the real experience of feminists through history(69). Nevertheless, its explanatory power is such that we have opted to use it here. It should be noted, however, that the feminist waves should not be seen as divisions, but as one after the other in continuity(70).

The so-called “first-wave” feminists, among other things, gave women access to democracy(71) and brought about many institutional reforms. Starting especially from the mid-nineteenth century, these feminists made demands that were largely legal in nature and gave voice to their desire to be freed from the private (female) sphere to which they were confined and to join the public (male) sphere(71). The second wave emerged in the late 1960s and is associated with the turbulence that began with the Women’s Liberation Movement and the student revolt of May 1968. In contrast, to the first wave, it affirmed the differences between men and women(72). It was profoundly subversive(73) but also particularly productive on a theoretical level; it notably introduced new interpretative frameworks through which would emerge such concepts as patriarchy or patriarchal essentialism. From the 1990s on, a third wave developed under the influence of postmodern, poststructuralist, and postcolonial theory(73). Its parameters are focused on an ethic of heterogeneity and an ideology of individualism(74:p.5). It was more sensitive to women’s multiple realities and, unlike the second wave that was “obsessed” with gender inequalities(73), made it possible to apprehend such new concerns as the inequalities of race and class as well as those resulting from globalization. The rejection of a binary understanding of sex is one of the features of this wave, as expressed particularly in the work of Butler(75).

Three epistemological bases

Harding(76) posits the existence of three predominant feminist epistemologies in the form of empiricist, standpoint, and postmodern feminism. The first approach accords with the view that experience provides the primary justification for all knowledge, with empiricism in its various forms(67). It nonetheless stands at odds with classical empiricism, since it rejects the value of neutrality conferred on research. Feminist empiricists are deeply interested in how empirical inquiry can legitimately be informed by feminist values and social processes relating to inequality(77). This approach also rejects the notion of a single researcher who can claim all the credit for the results of an investigation(78).

The epistemology of standpoint feminism stems from Marxist and neo-Marxist analyses of class domination. Although no two theoreticians have precisely the same mind with regard to this epistemology, it is linked to the notion that the production of knowledge depends on the social position of the investigator and that lower positions in the economic and social hierarchies have greater epistemological value(79). According to Harding(76), adopting this epistemology also entails a particular intellectual and political commitment that allows one to perceive marginalized activities from the standpoint of those who perform them rather than from the dominant and perverse viewpoint of the sex in power. This epistemology does necessitate a high level of reflexivity(79), knowledge of oneself, and of one’s social position as a researcher.

The third, postmodern (and deconstructive) feminist epistemology, does not share the foundationalist character of the first two. It, too, has struck strong roots in feminist theory. Since postmodern feminism refuses to subscribe to “the same epistemological and ontological premises that have so successfully established the subordination of women”(80:p.197), it necessarily denies the epistemological primacy that the supporters of the standpoint epistemology attribute to perspectives emerging from lower levels of hierarchies. This third epistemology suggests rather the idea of a knowledge driven by nomadic thinking, which breaks down boundaries between disciplines, encourages crossbreeding between types of knowledge, extols the creative richness of aporia, and rejects totalizing representations and homogenizing classifications(74). Postmodern epistemology even suggests accepting self-contradiction(81) so that women may open themselves up to new reflections.

Since the birth of the “modern nursing movement” in the late 1800s, nurses have sought to affirm their independence. Many of them thus subscribed to feminism, beginning in the days of the first great movements for women’s suffrage(82). Nurses showed interest in feminism, which led them to incorporate such terms as “empowerment” and “praxis” into their discourse(83). Chinn and Kramer’s(84) concept of emancipatory knowledge is a good example of the significance that a teleology of feminist cultural and social change can have for nursing. It has been widely used as a theoretical foundation for discussions and community/participatory action research.

Conceiving praxis as a process of emancipatory knowledge that encourages joining reflection to action can help remedy the neglect of political action, a major issue and a great shortcoming in current theories of nursing for Butterfield(85). It is as if the ontological character of the political, which is constitutive of nurses’ reality, had been deliberately set aside, along with the notion of power. Fortunately, our research has revealed ongoing interest in poststructuralist feminism in nursing, and researchers Mselle et al.(86) and Aston et al.(87) have shown that it cannot only be a question of power in nursing research, but that this notion can, and in some case must, be central to our investigations.

Voirol(88) points out that domination (in our case, that of nurses) short-circuits the process that leads to the development of political will. We firmly believe that the deconstruction of dominant discourses suggested by poststructuralist feminist epistemology can foster more effective political action by nurses since it contributes to a better understanding of the mechanisms by which domination is consolidated.

Authors such as Francis(55) consider that poststructuralist feminism is theoretically incompatible with nursing because of the vocational character of the practice and its associated discourses on “truth.” We believe that viewing nursing as a vocation is precisely what may cause nurses to be subjected to what Honneth(13) called excessive demands(13:p.319). Mandatory overtime may be considered one of those excessive demands, one that may even be destructive to nurses’ morale, particularly in Canada(89). In our opinion, the conceptualization format of resistance, to counteract the process of domestication/disciplinarization, to which nurses are subjected, could be a major advantage for adopting this perspective.

Postcolonial theory

Postcolonial theory, also known as colonial discourse analysis, postcolonial studies and postcolonialism, subsumes several different schools of thought and several viewpoints. It can be considered to have originated in the school of thought that arose around the ideas advanced by Said(90) in his book, Orientalism. Influenced particularly by the writings of Griscti(30) and Foucault(17), Said laid the groundwork for a type of critical analysis that made it possible to deconstruct literary and historical texts and discursive practices, and to clarify the ways in which they reflect and reinforce imperialism(91). Orientalism was thus meant to expose the connection between the epistemological process of knowledge production and colonial domination(92). Said made great use of the notion of power-knowledge that Foucault(93) conceived as a “matri[x] of transformation”(93:p.131). He also stressed the idea that history is not shaped empirically — as fact — but rather as a construct conditioned by the subjectivity of those who produce it, and from the epistemology they employ; it is consequently often more revealing of the character of the author than of the culture he or she describes(94).

Bhabha(95), like Said(90), contemplated an epistemology that proposes the interrogation of representations, of discourses, of individual and collective identities. He is known particularly for his concept of the “unhomely,” by which he postulated a possible split in the binary and totalizing structure of power. He also associated this concept with resistance in the specific form of a gathering in the diaspora — the opposite of a system that produces exclusion through cultural and identity-based essentialism and categorization into an inferior normative space(92). The concept of “unhomely” points to a hybrid/nomadic ontology through a state of infinite mimesis, constitutive of the hybridity of the nomadic being, then suggesting an impossibility in the construction of a monoidentity(96). Though the conceptual link between postcolonialism and postmodernism seems obvious in Bhabha’s writings, he defines the concept to which it is not the “fragmentation” of the metanarratives of modernity and Enlightenment rationalism that are important, but rather “the awareness [of] the epistemological limits of ... ethnocentric ideas”(95:p.6).

Boehmer(97) used the notion of resistance but followed a rather different path that might be called “new school.” For her, postcolonialism is a critical term “signifying a theoretical and writerly force field preoccupied with resistance to empire and its post-imperial aftermath”(97:p.143). Postcolonial theory in this sense comprises a tool for keeping watch on hegemonies, but it must also provide alternatives in order to contest and subvert them(98). This attribute of resistance, which Boehmer deemed one of the paradigmatic standpoints of postcolonialism, is in her view supported by the work of such authors as Harrison(99). He maintained that in postcolonial criticism the question of representation necessarily involves resistance to (neo) colonial diet, partly through the deconstruction of its rhetoric and retrieval of this process of deconstruction, which can be applied to a realist problematic and the safeguarding of cultural identity, the “survival” of being.

Kincheloe(100) considered the importance of reconnecting humans to a new way of being through a postcolonial curriculum. For him, critical ontology emerges from the study of “indigenous” ways of being and the power of difference. In his view, it is from this context that springs the desire to attain new levels of consciousness. Critical ontology, which might also be presented as “postcolonial ontology,” enables individuals to better understand how and why their political opinions, beliefs, sexual orientation, religious allegiances, and, notably, the gender roles assigned to them, are all shaped by the perspective of the dominant culture.

Not only have academic disciplines helped produce the current forms of colonial administration and subjugation(90,101), but they may also operate like empires in their own right, using their influence and discourses to reinforce or impose research practices, forms of education, and administrative methods. This tendency is precisely what authors in nursing such as Holmes, Roy and Perron(102) have criticized in the biomedical disciplines and in the ideologies they so fervently convey. Therefore, they propose using the postcolonial perspective to conduct an informed examination of the scientific patronage that has burdened the nursing discipline.

In a pragmatic of resistance, the political-ontological nature of research and knowledge leads them to turn to “an ethos that engages the self in the political arena”(103:p.48) in order to set in motion the “decolonization” of the nursing profession, a decolonization that nursing scholars like McGibbon et al.(103) firmly stressed the importance of. This strategy may deem a form of scientific activism geared to a “nomad science”(103:p.48) that has the potential to challenge all pretensions to truth. The authors put forward a strategy for action, which might be viewed as preventative: critical pedagogy that fosters habits of reading, writing and reflecting, to help challenge and process first impressions and dominant discourses(104). In our view, it may also thus be seen as political action (education is, after all, eminently political) empowering future people in the discipline of research to be critical of hegemonic biomedical epistemological positions.

It must be recognized that Latin America and Africa suffered greatly from the effects of domination resulting from United States colonialism and imperialism. Therefore, it is worth highlighting that some South American theorists adopted the critical and reflective perspective as an aspect in research, reflections and projects. As an example, we can cite Garcia(105), the Argentine theorist who articulated medicine and social issues in a critical and progressive way in the context of Latin America. In Brazil, we can highlight Paulo Freire(106), who absorbed the source of Karl Marx's thought, in addition to a humanist formation, whose classic work is The Pedagogy of the Oppressed (1967), which is adopted as a theoretical reference in many works in nursing education.

The critical theoretical current, which in Brazil is called historical and dialectical materialism based on Marx and Engels(2), has been adopted in postgraduate nursing education, stimulating a reflective and transformative critical approach to health, in a way that has led to the conception of nursing as a social practice. We can cite Almeida’s doctoral thesis(107), Nursing Knowledge and its Practical Dimension, published as a book, whose theoretical framework was Marxist and contributed to the view of nursing as a social practice. From this perspective, Egry(108) proposed a method for collective health nursing based on historical and dialectical materialism. These conceptual frameworks and theoretical models, among others, have contributed to a transformative perspective on nursing, considering social inequalities and the search for equity and inclusion of the most disadvantaged groups in health care.

CONCLUSION

Critical theory opens up many possibilities for nursing practice and science. In sketching the historical background and origins of critical theory and some of the movements related to it, we made an effort to follow a path that, though sometimes complex and often delicate, would help us get closer, however partially, to what we consider to be the substance of critical theory. Our focus on this substance stems in part from our priori belief that it could induce some clarity needed to distinguish these movements from each other. To retrieve this substance, we followed a process with particular attention to the onto-epistemological foundations of each of the discussed movements. This article also allowed us to a better grasp of the logic employed by authors in the nursing discipline to develop knowledge from a critical-theory perspective. This process was crucial to the course of our intellectual development, and we think that sharing it throw this article can help nursing students who have an interest for critical theory, but who do not know where to begin. It is undeniable that nurses ought to criticize the prevailing moral culture in our society and challenge the status quo.

CONFLICT OF INTERESTS

The authors declare that there is no conflict of interest.

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Submission: 23-Feb-2026

Approved: 13-Apr-2026

Editors:

Rosimere Ferreira Santana (ORCID: 0000-0002-4593-3715)

Geilsa Soraia Cavalcanti Valente (ORCID: 0000-0003-4488-4912)

Corresponding author: Patrick Martin (Patrick.martin@fsi.ulaval.ca)

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