The case for “structural missingness:” A critical discourse of missed care

Jane Hopkins Walsh, Jessica Dillard-Wright

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Stimulated by our conversations at the 2018 International Philosophy of Nursing Society Conference and our shared interests, the coauthors present an argument for augmenting the broader discussion of “missed care” with our synthesized concept called structural missingness. We take the problem of missed care to be largely grounded on a particular economic construction of the healthcare system within an era of what some are calling the Capitalocene, capturing the pervasive influence of capitalism on nature, humanity and the world order. Our perspective is that of the United States, however, extrapolations can be made to the social and healthcare systems in other countries. We are concerned with the underlying conditions that structurally reify inequality and ultimately undermine nursing practice. To situate the discussion, we briefly review existing literature on the contextualization of missed care. We understand contemporary circumstances of missed care as a function of the neoliberalization of healthcare, including the idea of nursing as a commodity. From this, we discuss the implications of missed care, which forms the basis of our critique. Synthesizing the term “structural missingness, we locate a moral imperative in the professional and disciplinary commitments of nursing to consider who and what have been left out. This moral imperative for the nursing profession, along with other social and health related professions, underscores our obligation to be involved in uncovering inequities and conceptualizing upstream solutions for structural missingness.

Original languageEnglish (US)
Article numbere12279
JournalNursing Philosophy
Issue number1
StatePublished - Jan 1 2020
Externally publishedYes


  • Capitalocene
  • emancipatory nursing
  • missed care
  • neoliberalism
  • structural missingness

ASJC Scopus subject areas

  • Research and Theory
  • Issues, ethics and legal aspects


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