"By the early 1890s nurses had begun seriously to discuss ethical issues in nursing. In 1899 the International Council of Nurses was established, professional journals, such as “The American Journal of Nursing”, sprang up and in 1901 Isabel Hampton Robb, a leader of nursing at the time, wrote one of the first books on nursing ethics, entitled Nursing Ethics for Hospitals and Private Use(Robb 1901). The vast majority of nurses are women and, until fairly recently, the vast majority of doctors have been men. Not surprisingly, the relationship between doctors and nurses reflected the different roles of women and men, and their relative status in society. One of the manifestations of this was the assumption that the primary responsibility of nurses was to doctors rather than to patients, and that nurses had to show absolute obedience to their medical colleagues. As one American nursing leader put it in 1917: “The first and most helpful criticism I ever received from a doctor was when he told me that I was supposed to be simply an intelligent machine for the purpose of carrying out his order”(Dock 1917: 394). The view that the nurse’s primary responsibility was to the doctor prevailed until the 1960s, and was still reflected in the 1965 version of the International Code of Nursing Ethics. Item 7 of the Code states: “The nurse is under an obligation to carry out the physician’s orders intelligently and loyally.” The revival of feminist thinking in the late 1960s paralleled the developing self-consciousness and self-assertiveness of nurses, and in the 1973 International Council of Nurses’ Code for Nurses, the nurse’s “primary responsibility” is no longer seen to be to doctors but to patients – “to those people who require nursing care.” This questioning by nurses of their traditional role and their relationship with doctors and patients eventually converged with a movement by feminist philosophers that challenged the traditional (and therefore male-dominated) view of ethics as a matter of abstract, impartial, and universal principles or rules. Instead of this conception of ethics, feminist philosophers like Nel Noddings (1984) conceived of ethics as a fabric of care and responsibility arising out of personal relationships. Building on this“female” approach to ethics, both philosophers and nurses sought to construct a new ethics for nurses based on the concept of care. Jean Watson, a nurse and a prominent proponent of a nursing ethics of care, applies to the nursing situation Noddings’s view that an ethics of care “ties us to the people we serve and not to the rules through which we serve them” (Watson 1988: 2)."