Theological Anthropology as an Ethical Foundation for Nursing Practice: Reframing Presence, Dignity, and Moral Responsibility in Contexts of Vulnerability

Abstract Contemporary nursing ethics is commonly grounded in principlist frameworks that emphasize autonomy, beneficence, nonmaleficence, and justice. While these approaches provide important guidance for ethical decision-making, they often rely on unexamined assumptions about personhood that privilege rationality, independence, and decisional capacity. In clinical contexts marked by cognitive impairment, severe illness, or end-of-life care, these assumptions can leave nurses uncertain about how to ethically justify practices of presence, accompaniment, and sustained relational care. This paper argues that theological anthropology—understood as a faith-informed, non-confessional account of inherent dignity and relational personhood—offers an ethical foundation capable of sustaining moral responsibility when autonomy is diminished. By making implicit anthropological assumptions explicit, theological anthropology clarifies why relational nursing practices are ethically necessary rather than optional expressions of compassion. This framework supports nurses in naming moral obligations, addressing moral distress, and affirming the ethical significance of presence and dignity-centered care within complex clinical and institutional environments.