Ferry Efendi

Contemporary nursing practice increasingly takes place within culturally, religiously, and ethically plural healthcare environments. Although professional standards provide a shared ethical foundation, limited conceptual attention has been given to how nurses’ religious moral identities influence ethical reasoning during cross-gender care. Existing discussions of professionalism remain largely grounded in secular ethical perspectives, leaving insufficient exploration of how faith-based moral traditions may contribute to professional identity and moral agency. This paper examines gender interaction in nursing through Islamic ethical perspectives and proposes a conceptual framework of faith-informed professionalism to contribute to broader discussions of ethical pluralism in nursing ethics. A conceptual normative analysis was undertaken through critical engagement with literature on nursing professionalism, moral agency, ethical pluralism, and Islamic ethics. Relevant concepts were identified, interpreted, and synthesised to develop a conceptual framework integrating professional standards with Islamic ethical principles relevant to gender interaction in nursing practice. The analysis argues that gender interaction should be understood not only as a matter of professional conduct but also as an ethically significant encounter in which Muslim nurses negotiate professional responsibilities alongside religiously informed moral commitments. Drawing on the concepts of haya’, adab, niyyah, ikhtilat, darurah, and maqasid al-shariah, the paper develops faith-informed professionalism as a conceptual framework that explains how faith-based moral commitments may coexist with professional standards while maintaining patient welfare, professional accountability, and equitable care as overriding priorities. A clinical illustration demonstrates the framework’s application as a guide for ethical reflection rather than a prescriptive model for practice. Faith-informed professionalism extends contemporary discussions of moral agency, professional identity, and ethical pluralism by recognising that religious moral traditions may complement, rather than compete with, established professional standards. The proposed framework offers a theoretical contribution to nursing ethics and provides a foundation for future empirical research and educational development within multicultural healthcare environments.

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.

Indonesia is recognized as a nurse exporting country, with policies that encourage nursing professionals to emigrate abroad. This includes the country’s adoption of international principles attempting to protect Indonesian nurses that emigrate as well as the country’s own participation in a bilateral trade and investment agreement, known as the Indonesia–Japan Economic Partnership Agreement that facilitates Indonesian nurse migration to Japan. Despite the potential trade and employment benefits from sending nurses abroad under the Indonesia–Japan Economic Partnership Agreement, Indonesia itself is suffering from a crisis in nursing capacity and ensuring adequate healthcare access for its own populations. This represents a distinct challenge for Indonesia in appropriately balancing domestic health workforce needs, employment, and training opportunities for Indonesian nurses, and the need to acknowledge the rights of nurses to freely migrate abroad. Hence, this article reviews the complex operational and ethical issues associated with Indonesian health worker migration under the Indonesia–Japan Economic Partnership Agreement. It also introduces a policy proposal to improve performance of the Indonesia–Japan Economic Partnership Agreement and better align it with international principles focused on equitable health worker migration.