Ontological ethics of care: human dignity, autonomy and vulnerability of the older adult in the context of geriatric nursing

Abstract

Introduction: Geriatric nursing practice faces ethical tensions stemming from the frailty, dependency, and institutionalization of older adults. The ontological ethics of care offers a theoretical and conceptual framework that recognizes the person as a moral subject.

Objective: To analyze, from the perspective of the ontological ethics of care, the concept of human dignity and the ethical tension between autonomy and vulnerability in the context of geriatric nursing practice.

Methodology: A critical literature review of 26 academic sources (2020–2025) in Spanish and English was conducted, selected for their conceptual contributions to the ethics of care, dignity, relational autonomy, and vulnerability. The information was organized into thematic categories, and a narrative-critical analysis was performed, integrating philosophical, bioethical, and nursing categories.

Results: Nursing practice is configured as an ethical space, characterized by dignity, relational autonomy, and an understanding of vulnerability. To guarantee respectful and ethical care, it is crucial to distinguish between ontological vulnerability and clinical frailty.

Conclusion: To guide professional training, clinical practice, and institutional policies, the ontological ethics of care constitutes a transformative framework for humanizing geriatric nursing practice and preserving the dignity and moral responsibility of both the healthcare professional and the patient.