Original article

Nursing and justice as a basic human need

Megan-Jane Johnstone RN BA PhD FRCNA

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School of Nursing and Midwifery, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Melbourne, Victoria, Australia

Abstract

This paper explores the idea that justice is a basic human need akin to those famously depicted in Maslows hierarchy of human needs and, as such, warrants recognition as a core element in representative ideas about nursing. Early nurse theorists positioned the principles and practice of nursing as having their origins in universal human needs. The principle of deriving nursing care from human needs was thought to provide a guide not only for promoting health, but for preventing disease and illness. The nursing profession has had a longstanding commitment to social justice as a core professional value and ideal, obligating nurses to address the social conditions that undermine peoples health. The idea of justice as a universal human need per se and its possible relationship to peoples health outcomes has, however, not been considered. One reason for this is that justice in nursing discourse has more commonly been associated with law and ethics, and the legal and ethical responsibilities of nurses in relation to individualized patient care and, more recently, changing systems of care to improve health and health outcomes. Although this association is not incorrect, it is incomplete. A key aim of this paper is to redress this oversight and to encourage a broader conceptualization of justice as necessary for human survival, health and development, not merely as a professional value, or legal or ethical principle for guiding human conduct. Keywords: justice, health, basic human needs, ethics, human rights, care, nursing.

Correspondence: Dr Megan-Jane Johnstone, Professor of Nursing, School of Nursing and Midwifery, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Vic. 3125, Australia. Tel.: + 61 3 9244 6120; fax: + 61 3 9244 6159; e-mail: megan.johnstone@deakin.edu.au

Introduction
One of the most inuential core elements in representative ideas of nursing to emerge over the past three decades has been that of the nursing professions unique emphasis on care as an essential human need for the full development, health maintenance

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and survival of human beings in all world cultures (Leininger, 1984, p. 3) and its derivative activity of caring as the moral foundation and essence of nursing (Watson, 1985; Benner & Wrubel, 1989; Leininger, 1990). The nursing professions pre-eminent focus on care and caring has, however, resulted in another equally important human need being overlooked, notably justice. Social justice (of which justice is a component) has long been posited as a core professional value, ideal, and concept in nursing and even described as being critical to nursings professional identity (Bekemeier & Buttereld, 2005; Boutain, 2005, 2008; Giddings, 2005; Kirkham & Browne, 2006; Schim et al., 2006; Fahrenwald et al., 2007; Bell & Hulbert, 2008). However, justice as a basic human need per se and its fundamental importance to human survival, health, and development has not been comprehensively considered. Moreover, although social justice has been interpreted as imposing on nurses an obligation to engage in social action and to collaborate with others (including the people and populations most impacted by negative social conditions) to address failures in health and social systems that undermine the health of people (Bekemeier & Buttereld, 2005, p. 154), consideration of the notion has stopped short of positioning justice as a need, i.e. as something that is vital to the essentials of life and to the owering of the human spirit (Taylor, 2006a, p. xi) and that requires fullment like any other basic human need. Justice, like care, has been identied as being essential for the full development, health maintenance, and survival of human beings in all world cultures (Sluka, 2006; Taylor, 2006b). As Tolman has observed:
While we can and do live with injustice, we cannot live without justice altogether. It is in this sense that justice is the absolutely necessary condition for the existence of humanity. (Tolman, 2006, p. 23)

nursing work (Bekemeier & Buttereld, 2005, p. 153). The key aim of this paper is to explore the idea that justice is a basic human need and to encourage a broader conceptualization of justice as being not just a legal or ethical principle for systematically guiding human conduct, but as fundamental to our being human (Tolman, 2006, p. 13) and a compelling component of human welfare (Taylor, 2003, p. 209). In the discussion to follow, attention will be given to exploring the origins of the contemporary proposition that justice is a basic human need and as such warrants recognition alongside other basic human needs such as those famously depicted in Maslows hierarchy of human needs (Maslow, 1943, 1987). It will be suggested that, given the nursing professions longstanding commitment to the ethical ideals and goals of social justice, the idea of justice as a basic (universal) human need warrants being formally recognized as an additional basis from which the principles and practice of nursing may be derived. It will also be suggested that justice as a basic human need warrants being clearly delineated and explicated in the philosophic, theoretical, research, ethical, and practice posture of nursing.

Nursing and its origins in universal human needs

Nurse theorists have long positioned the principles and practice of nursing as having their origins in universal human needs, i.e. needs that are culturally universal and fundamentally necessary for human survival. An early inuential exponent of this view was the late American nurse theorist, Virginia Henderson who, in her classic work Basic principles of nursing care (rst published in 1960 and subsequently revised in 1969), explained that the principle of deriving nursing care from human needs provided a guide not only for promoting health, but for preventing disease and illness as well (Henderson, 1991). While acknowledging that all welfare services have their origin in (biological and social) human needs, Henderson went on to stress that what distinguished the pre-eminence of nursing in this regard was its unique function, ability, and ethical mandate to contribute to

The oversight of justice as a basic human need in nursing is therefore interesting, especially when placed in the context of the modern nursing professions historical commitment to social justice concerns and the stance taken by early nurse reformers that social justice together with collaborative leadership was central to nursing and inseparable from

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what makes for a healthy citizenry (Henderson, 1977 edn, p. 3). Unlike physicians, who Henderson regarded were unique on account of being preeminent in diagnosis, prognosis, and therapy, the uniqueness of nursing in this instance lay in the role of the nurse in assisting
the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he [sic] would perform unaided if he [sic] had the necessary strength, will or knowledge. And to do this in such a way as to help him [sic] gain independence as rapidly as possible. (Henderson, 1977 edn, pp. 34)

tions in nursing practice and education were identied and ultimately progressed, and in some cases accelerated (Styles, 2006).

The concept of justice

For the purposes of this discussion, some clarication of what is meant by the notions of justice and social justice is warranted and is presented below. Justice (from the Latin justus meaning righteous) is a complex and contested notion, which dees precise denition. Signicantly, questions concerning what justice is and what its origins are have occupied the minds of philosophers for nearly 3000 years, and to this day remain the subject of philosophical debate. Signicantly, the end result of this philosophical debate has not been the development of a singular and rened universal theory of justice, but the development of a range of rival theories of justice (Johnstone, 2009a, p. 43). Among the different conceptions of justice to have emerged through the ages of ongoing philosophical debate are: justice as revenge (retributive justice); justice as mercy; justice as harmony in the soul and harmony in the state; justice as equity (impartiality and fairness); justice as equality (equals must be treated equally, and unequals unequally); justice as an equal distribution of benets and burdens (distributive justice and redistributive justice); justice as what is deserved (each according to ones merit or worth); justice as love; and justice as reconciliation and reparation (restorative justice) (Johnstone, 2009a, pp. 4344). In nursing discourse, justice is commonly used in two related senses: distributive justice and justice as fairness (Johnstone, 2009a). Distributive justice pertains to the theorized stance that the material burdens and benets of a society (including privileges and opportunities) must be distributed equally among its members. The only exception to this is where an unequal distribution is necessary so as to ensure that that least well off are enabled to have access to a minimally decent level of societys material benets (Beauchamp & Childress, 2009). Justice as fairness, in turn, pertains to a largely intuitive sense of justice, which involves subjective

Henderson was critical of what she saw as a misplaced emphasis on the fundamental human need for shelter and the related activity of protecting the person from the elements (Henderson, 1991, p. 16). Reecting on this narrow conceptualization of human need (and her own related personal observations of the environmental constraints imposed on individuals in healthcare settings, particularly hospitals), she warned:
If for too long we deprive a person of what he [sic] values most love, approval, fruitful occupation this condition of deprivation is often worse than the disease we are attempting to cure. (Henderson, 1991, p. 17)

Although Hendersons views pertained primarily to the provision of individualized nursing care in institutional settings, for which she has been criticized (see Clark, 2006), she was nonetheless acutely aware of the need for all healthcare personnel to constantly evaluate their roles and be ready to modify them for the common good and modify the programmes that prepare them for their work (Henderson, 1978, 2006 edn, p. 21). She also strongly believed that in order for nurses to be successfully prepared for their work (which she accepted also involved the promotion of the universal human right to health care), their teaching and learning programs must include whatever gives them the broadest possible understanding of humanity and the world in which they live (Henderson, 1978, 2006 edn, p. 21). As a result of Hendersons (1978) ongoing attempts to identify the common elements, if they exist, in representative ideas about nursing (p. 22), new direc-

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perceptions and judgements about whether the procedures followed (i.e. how a distribution decision is made) and the outcomes resulting from a given act or omission are positive (benecial) or negative (harmful) and fair (Beauchamp & Childress, 2009). According to Leventhal (1980), in order for a procedure (distribution decision) to be perceived as being fair, the following six criteria must be met; namely, the procedures must: 1 2 3 4 5 6 Be followed consistently Lack self-interest Be based on accurate information Allow for opportunities to correct decisions Represent the important interests of all concerned Comply with ethical standards.

comparative research has also been undermined. These decits have led for calls for more critical attention to be given to both the notion and practice of social justice by the nursing profession. As Boutain (2008) explains,
Without a more complex and nuanced view of social justice, nurses [will be] less able to fully utilize this concept as a framework to redress unjust conditions in healthcare delivery and health attainment. (p. 47)

A seventh criterion, enabling stakeholders to have a voice in decision-making processes, has also been identied as inuencing peoples perceptions of fairness (Lind & Tyler, 1988). Social justice, of which justice is an element, is also a complex and contested notion. Dened by Levy & Sidel (2006) as an ethical concept grounded in principles of distributive justice (p. 9), social justice prescribes equity in the distribution of resources as is necessary to sustain and/or improve health (Fahrenwald et al., 2007, p. 193). In nursing, social justice discourse has historically emphasized the responsibility and obligation of nurses to improve the health of underserved, marginalized, or vulnerable members of society (Boutain, 2005, p. 405) and to address the social conditions that underlie health problems in these populations, including the delivery of health services (Bekemeier & Buttereld, 2005, p. 153). Although social justice is not a new concept in nursing, it is nonetheless poorly articulated and poorly understood in nursing education, research, and practice. A review of the nursing literature for the years 19902006, for example, found that nursing conceptualizations of social justice were supercial, ambiguous, incomplete, and inconsistent, making it difcult for the concept to be taught let alone applied in practice (Bekemeier & Buttereld, 2005; Boutain, 2005, 2008). Without a consensus denition of social justice, the capacity of nurses to undertake robust

Nurses will likewise be less able to contribute to understandings of how an interdisciplinary concept of social justice is useful in promoting just health and social relationships in society (Boutain, 2008, p. 47). The consideration of justice as a basic human need, as proposed in this paper, provides a timely opportunity for a more complex and nuanced view of social justice to be considered and developed.

Justice as a basic human need

The notion of justice as a basic human need can be traced back to the original and innovative work of Anthony Taylor, a New Zealand-based Emeritus Professor of Psychology, who was prompted to undertake a psychological reappraisal of justice after being on assignment in Fiji following the May 2000 attempted coup by a group of armed insurgents (Taylor, 2003). Upon directly encountering the bewilderment, disappointment, and shock of a group of Parliamentarians and their families who had been held hostage during the coup attempt, Taylor observed that some of psychological reactions that were being manifest by the victims fell outside of the familiar categories of stress/ trauma reactions (Taylor, 2003, 2006c). This raised for him unfamiliar questions about the nature of justice and of inviolable human rights and how attacks on these alone might manifest as a stressor needing therapeutic intervention (Taylor, 2003, p. 210). What particularly stood out for Taylor were the shock, horror, disillusionment, and disbelief the hostages felt, which they attributed to the shattering of their legitimate expectations from being members of a community (Taylor, 2003, p. 210). This led him to reect on the psychological nature of justice and how violations of it might compound the emotional,

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physical, and other losses that a person can experience when their need of justice is violated, frustrated, or unfullled (Taylor, 2003, 2006a, 2009a, 2009b). His reections ultimately informed the development of the following argument:
Justice is not simply an idealistic concept with implications for the development of individuals and their communities towards the highest goals of human endeavour. Nor is it just the interpretation and application of common law and statute law that applies in every jurisdiction. Rather, it is an inherent human need, the violation of which compounds the emotional, physical, and property loss that victims of crime [and other injustices] suffer. (Taylor, 2009a, p. 3)

(a) a major motivating factor essential for individual, social, and community development, (b) an essential precondition for approximating the good life, (c) the reciprocal quality of relationship that obtains between people for their mutual well-being. (Taylor, 2009a, p. 2)

In his emerging works Taylor came to the conclusion that psychologists and others working with victims of injustice need to pay closer attention to building a more realistic picture of the complex framework within which people live and to pay attention to
the effect of the deprivation of justice as well as to its fullment, and join forces with other scientists and scholars to validate the concept, consider the remedies for injustice, and help to bring about a more just society for the greater good of all its members. (Taylor, 2003, p. 217)

Taylors thesis on the psychology and motivational function of justice nds further support in the work of Fischer & Skitka (2006) who suggest that people have an inherent need to believe in a just world i.e. to believe that good things happen to good people and bad things happen only to bad people (Fischer & Skitka, 2006, p. 86). These authors go on to explain that the reason people need to believe in a just world is, in part, because the belief provides a sense of predictability and meaning in life as well as giving some assurance that behaviour and characteristics will be appropriately rewarded or punished in the long run (Fischer & Skitka, 2006, p. 87). Recognizing justice as a basic human need serves other important human interests as well, including peoples: Long-term self-interest (in order to survive and thrive, people need to be able to engage in socially cooperative behaviour with those who behave fairly) Social identity (when people are treated fairly, this communicates the degree to which they are valued and respected as a member of the group; as Rosenelds (1997) research exemplies, in instances where disadvantage and inequality are linked, this can pose serious threats to a persons self-worth (esteem) and self-efciency (identity), the accumulative effect of which over time can translate into anger and a desire for restitution Need to express or defend themselves as morally authentic beings (also a constituent of social identity, listed above) (after Fischer & Skitka, 2006, p. 88). When people experience an injustice, it is universally experienced as oppression, which if not remedied may inevitably lead to resistance and conict (Sluka, 2006). This, in turn, can leave those most affected feeling shocked, hurt, bewildered, disillusioned, dehumanized, anxious, depressed, frustrated, and in a state of disbelief that their expectations as members of a moral community have been so gravely betrayed (Taylor, 2003, 2006a). These and similar feelings

Taylor further concluded that, taking these considerations into account, justice needs to be recognized as being much more than merely a utilitarian procedure for resolving conict (Taylor, 2006a, p. xi). In a landmark anthology addressing the subject, Taylor and colleagues assert on philosophical, theoretical, and research grounds that justice is just as vital to the essentials of life as are other more conventionally recognized basic human needs, such as food, warmth, water, and other bodily needs (Taylor, 2006b). Emphasizing the necessity of justice for safety and belonging (both of which are generally accepted as being essential for human development), Taylor and his colleagues argue that it is time for justice to be given its proper place in the classical hierarchy of basic human needs as originally proposed by Maslow (1943) and be given full recognition as a psychological motivating force (Taylor, 2006a). These ideas have been developed further in more recent works (Taylor, 2009a, 2009b), in which Taylor more clearly denes the origins and function of justice notably as:

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evoked by an injustice are such that, in addition to the more material consequences of a specic violation (e.g. being taken hostage, being physically injured by an unprovoked assault, having ones culture and identity assaulted, being robbed of ones precious possessions, having ones children stolen and/or abused, being denied education and employment opportunities because of the colour of ones skin or the capacity to speak English as a second language), the incomprehensibility of the injustice at issue is such that it may be sufcient in and of itself to serve as a stressor that is detrimental to the health and well-being of the people affected (Summereld, 2000; Taylor, 2006a). Indeed, the hurt of an injustice can be so profound that those affected may stand in need of therapeutic intervention (Taylor, 2003, p. 210). People who, in the face of an injustice, can nd no meaningful answer to the existential question Why?, and whose traditional methods of handling crises are overwhelmed and rendered incapable of helping, are particularly vulnerable in this regard and may stand in particular need of therapeutic justice as an intervention (Summereld, 2000; Taylor, 2003).

Healthcare justice and the nursing profession

The modern nursing profession has a rich and distinctive history of promoting healthcare justice for the individuals, groups, and communities it serves. One of the foremost proponents of a justice perspective in nursing was the noted reformer of hospital, district, and workhouse nursing, Florence Nightingale (1820 1910) (Barritt, 1973). Nightingales model of nursing and hospital reform was profoundly inuenced by the works of the ancient Greek philosopher Plato (circa 427347 BC), especially his classic treatise on the ideal state The Republic (Plato, 1955edn). The Republics emphasis on science of the soul, which included moral science (ethics), resonated deeply with Nightingale (LeVasseur, 1998). Of particular inuence, however, was The Republics emphasis on the right education for the states guardians who, according to Plato must be completely devoted to what they judge to be the interests of the community, and never be prepared to act against them, the prevalence of

justice, the importance of good character, and the processes for ensuring a just and harmonious society between all classes (Plato, 1955edn, p. 157). Plato argued that a just society is one in which people do what they are best suited to doing. Observing that we care most for what we love, he reasoned that if people loved what they did (e.g. being guardians of the state) they would make the right choices, i.e. choices that were in the best interests of the community they were serving (Plato, 1955edn, p. 157). Nightingales reforms and model of nursing strongly emphasized the right education, which included character training and the acquisition of moral qualications (Johnstone, 1994, p. 54), the possession of justice as a character trait that was good in its own right, a strong sense of responsibility to society (which included the moral government of the world), and a passion for reform (see Nightingale, 1915 edn). In regard to the latter, as LeVasseur (1998) explains in her insightful essay on Plato, Nightingale, and contemporary nursing, for Nightingale it was not enough merely to have knowledge of the good, but it was imperative to put that knowledge into action as a guardian of the people (p. 282). As can be discerned from her writings and works, Nightingale was a passionate advocate of love and justice and freedom and progress and of the role of nurses in advancing these values in society (Nightingale, 1852, 1979edn, 1915edn). Doubting the capacity and commitment of the political rulers and law makers of her day to promote justice, freedom, and progress, and to achieve the social reforms necessary for the good of the community, Nightingale (1915edn) was acutely aware that if nurses were to successfully full their role as guardians of the communitys interests, they needed to: guard themselves against becoming stagnant women (p. 5), engage in constant self-directed learning and work to improve their own mind and character every day (p. 50), develop prociency and always striving to know the reason why (p. 70), and resist becoming enamoured with the good opinion which men have of you else fall prey to neglecting themselves and become conceited and arrogant (p. 58). Mindful that no one can trample upon others, and govern them, Nightingale was also at pains to remind her Sisters and Head Nurses of

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their responsibility always to be just when exercising their authority over and leading others (Nightingale, 1915edn, p. 16). In a talk given in May 1872, she advised those present:
We must not give an order, much less a reproof, without being fully acquainted with both sides of the case [. . .] The person in charge every one must see to be just and candid, looking at both sides, not moved by entreaties or, by likes and dislikes, but only by justice; and always reasonable, remembering and not forgetting the wants of those of whom she is in charge. (Nightingale, 1915edn, p. 14)

dening and advancing human well-being (Mann et al., 1994, p. 8). This idea has also been wholly endorsed by the World Health Organisation, as reected in its ground-breaking Health and Human Rights Publication Series (WHO, 2001, 2002, 2003, 2005), which sets a global agenda for social and political reform aimed at improving health for all.

Nursing and upholding justice as a basic need

The notion of justice as primarily used in nursing and related discourse is more commonly associated with law and ethics. Only rarely have other perspectives (e.g. restorative justice) been considered (Johnstone, 2009a). In the case of law (whereby justice is said to be achieved when law is upheld) attention has primarily been focussed on the legal responsibilities of the nurse and on the processes required for maintaining systems of justice rather than the underlying motivations and reasons for doing so. Ethics likewise has tended to emphasize the maintenance of systems (whereby justice is said to have been achieved when universal moral principles have been upheld), although in doing so it has also placed strong emphases on the underlying reasons for the maintenance of such systems. A key underpinning philosophic assumption here is that people need to have a means of self-regulating their behaviour towards one another and to achieve peaceable bonds among persons without brute force so as to be able to achieve and live cooperatively in a peaceable community (Engelhardt, 1986; Beauchamp & Childress, 2009). The idea of justice being a basic human need thus stands as a signicant challenge to the way justice has been conventionally conceptualized and applied in nursing. Moreover, it raises important questions about how justice is really understood and applied in nursing contexts and how a psychological theory of justice (such as that posed by Taylor, 2003, 2006a, 2009a, 2009b) might reorientate the attention and behaviour of nurses in regard to both individual nursepatient encounters as well as their encounters and relationships with the broader communities and societies they serve. Equally important, it raises the

Human rights, justice and health

Any examination of the question of justice as a basic human need would be less than complete without some attention also being given to human rights and the injustice of human rights violations. There are two reasons for this: rst, as Levinson (2004), the United Nations Commissioner for Human Rights, points out human rights are above all a question of justice (quoted in Taylor, 2006c, p. 5); second, like justice, human rights have been profoundly linked to human health and well-being and, in several respects, likewise stand as a basic human need (see Mann et al., 1999). The contemporary relationship between human rights, justice, and health can be traced back to 1994, when Jonathan Mann and colleagues published a landmark article on the then rarely considered, yet basic link between health and human rights (Mann et al., 1994; Gostin, 2001). Recognizing the need to reorientate peoples thinking about major global health challenges, the authors proposed a provisional framework for structuring discussions about exploring the potential for health and human rights collaboration in public health research, education, and practice. Two years later Mann (1996) pointedly called for the health and human rights agenda to be broadened so as to ensure the engagement of heath professionals in human rights related work (p. 1). As a result of Manns and others work (see Mann et al., 1999; Gostin, 2001), there has been increasing international recognition that health and human rights are both powerful, modern approaches to

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question that if the conceptualization of justice as a basic human need is to be adopted and treated as a core element in representative ideas of nursing, how is this idea to be operationalized in nursing domains and used effectively to focus individual and collective nursing attention and social actions aimed at satisfying the human need for justice of the constituents that the profession serves? To operationalize the idea of justice as a basic human need and to use it effectively to focus nursing interventions aimed at meeting this need, at least three processes can be employed. Drawing on the work of Boutain (2008), these minimally include: awareness, amelioration, and transformation. In the case of awareness, nurses need to ask critical questions about the justice needs of people and how people feel when they have been treated unfairly. This entails conducting self-reection and getting others to reect on what it feels like to experience an injustice and/or to not have a justice need met. It also entails identifying what happened (what was the incident), why the incident occurred, what were the contributing factors, what were the underlying social or system factors that possibly contributed it, and what can be done to prevent it from happening again. It may also involve saying sorry and employing the devices of restorative justice to heal breaches and repair and restore broken relationships (Johnstone, 2009a, pp. 4647). Amelioration, in turn, entails addressing the immediate results/consequences or antecedents to unjust conditions (Boutain, 2008, p. 46). Addressing the antecedents could range from engaging in social activism to a more localized activity such as educating nurses about the principles and practice of social justice and its counterpart restorative justice. It might also include giving personal acknowledgement to those at the sharp end of an injustice in a way that enables them to feel valued, included, and approved of as members of the community. Transformation, meanwhile, involves critically deliberating about the relationship between justice and health, with the aim of identifying and redressing the conditions that ignore this relationship, and which can lead to justice as a basic human need being frustrated, denied, and ultimately left unfullled.

An example of how conceptualizing justice as a basic human need might reorientate nurses attitudes, perceptions, and behaviours can be found in the widely publicized 2008 case of Mr Ward, a 47-year-old father of four and respected Aboriginal Elder from Western Australia, who was literally cooked to death in the back of an unventilated prison van while being transported to a court at a location 360 km away. Mr Ward was locked in the pod of the prison transport van for almost 4 h non-stop, during which time the internal air temperature of the pod rose to around 47C, with the surface metal temperature rising to around 56C. Unable to summon help, Mr Ward literally cooked to death over a 3-h period (Johnstone, 2009b, p. 29). Just before he died, Mr Ward was taken to a hospital after security guards, stopping to make a check, found him collapsed in the pod. Upon arrival at the hospital, staff described the air from the van as being . . . like a blast from a furnace (Johnstone, 2009b, p. 29). On his admission into the emergency department, Mr Ward had a core body temperature above 41C. He was found to also have a large full thickness burn on his abdomen, consistent with his having been in contact with the hot surface metal of the van. Despite hospital staffs desperate efforts to cool him, Mr Ward died of irreversible heat stroke (Johnstone, 2009b). A coronial inquest into Mr Wards death clearly identied who and what contributed to his avoidable and unnecessary death. A subsequent inquiry by the West Australian Department of Public Prosecution, however, determined that no charges would be laid, because a prima facie case did not exist for a criminal prosecution and there was no reasonable prospect for conviction (Department of Public Prosecutions, 2010). Bewildered by this decision, Marc Newhouse, from the Deaths in Custody Watch Committee, reportedly responded there is something seriously, seriously wrong with our criminal justice system, concluding justice has not been served (Newhouse cited in ABC News, 2010). Criticizing the decision, the West Australian State Government opposition leader reportedly stated:
My view is the DDP should have proceeded (with charges) because not to do so is to let down Aboriginal people in a set

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of circumstances where theyve been let down at every level with regard to this case and in a context where they have many, many historical grievances. Parker, 2010) (Ripper cited in

Conclusion
This paper has explored the idea that justice is a basic human need and as such warrants a broader conceptualization in nursing discourse that goes beyond its conventional conceptualization as a legal or ethical rule and principle of conduct. It was suggested that, given the nursing professions historical commitment to social justice, the idea of justice as a basic (universal) human need be formally recognized as an additional basis from which the principles and practice of nursing may be derived. To this end, justice as a basic human need needs to be clearly delineated and explicated in the philosophic, theoretical, research, ethical, and practice posture of nursing. Further research and scholarship on this issue is warranted and it is hoped that the discussion presented here will provide a beginning point for new work to be undertaken in this area.

The nursing professions response to this case was mute. There is room to speculate that if the nursing profession had a better understanding of justice as basic human need it might have viewed the case as being considerably more than yet another instance of the failure of the legal system (Johnstone, 2009b, p. 29). It might also have behaved more responsively to this case, such as by collectively speaking out against the injustice and calling for a deeper inquiry into how the injustice at issue was being felt by Mr Wards family and community, its impact on their health and well-being, its compounding of past wrongs and associated hurts, and the enormous collective effort that would be required across the State and nation to heal the broken relationships and make reparations for what had occurred. Cases of injustices like the one exemplied by Mr Wards wrongful death and lack of remedy highlight that recognizing justice as a basic human need will require nurses and other health professionals to go beyond the binding of wounds and the tradition of remaining morally and politically neutral (Summereld, 2000, p. 234). Nurses, like other health professionals, need also to activate for social reform as well as public recognition and reparation of the harmful health consequences of injustices that many people in our society bear silently, alone, and without recompense. As Summereld (2000) reminds us, the ill effects of witnessing and experiencing the destruction of ones sociocultural world, embodying ones history, identity, and living values, is not a private experience to be treated by an individualized care plan (p. 233). The distress of the tortured, the deprived, and the alienated individual is part of a greater collective suffering that requires acknowledgement and resolution in a social context. It is in this sense, as asserted by Summereld (2000), that social reform and public recognition of justice stands as the ultimate therapy, for which we all share responsibility in providing.

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