Moral agency in nursing: Islamic ethical perspectives

Nursing ethics today is often guided by policies, professional codes, and principle-based frameworks. These structures are essential for protecting patients and ensuring professional accountability. However, ethical practice cannot be reduced to following rules alone. Many nurses continue to experience moral distress, emotional strain, and loss of professional meaning, even when they comply with institutional guidelines. This suggests that ethical principles, while necessary, are not sufficient to sustain morally grounded practice in complex healthcare environments. This paper argues that nursing ethics requires a stronger focus on moral agency - the capacity of nurses to act with integrity, reflection, and moral responsibility in challenging clinical situations. Drawing on Islamic ethical frameworks, particularly its emphasis on moral intention, trust (amanah), human dignity, and proportional responses to harm, the discussion offers a complementary perspective for strengthening ethical practice. In this sense, Islamic ethics is not presented as a replacement for existing frameworks; it is presented as a moral tradition that can enrich ethical reflection in diverse and plural healthcare settings. Through a structured normative conceptual analysis informed by contemporary scholarship in nursing ethics and Islamic bioethics, this paper proposes a reframing of nursing ethics that supports the development of reflective, ethically grounded practitioners in contemporary healthcare.