Nurse strikes have been in the headlines all year: in New York, Kenya, New Zealand, Ireland, Australia and now Boston, where nurses at Brigham and Women’s Hospital have set an open-ended strike for 12 November. Every walkout reopens the same argument.
The question: Is it ever ethical for nurses to withdraw their labour when patients depend on them?
The case for
- Strikes are usually the last resort after years of failed talks on pay and staffing.
- Unsafe staffing harms patients every day. Short-term disruption can secure long-term safety.
- Most nurse strikes keep emergency, intensive care and life-saving services running through agreed “derogations”.
- The International Council of Nurses supports nurses’ right to take industrial action, provided essential care is maintained.
- Without the threat of strikes, employers have little reason to negotiate.
The case against
- Patients cannot choose to go elsewhere, and cancelled operations and appointments cause real harm.
- Strikes can damage public trust in nursing as a caring profession.
- Nurses who cross picket lines face pressure and resentment, which can break teams apart.
- Some countries restrict or ban strikes by essential health workers, and striking nurses may face dismissal or lost pay.
- Gains can be eroded by inflation, leaving nurses back where they started.
What the evidence says
Research on health worker strikes is mixed. Studies of planned strikes in high-income countries with emergency cover generally show little or no rise in deaths, partly because elective activity is cancelled and senior staff cover gaps. Strikes lasting weeks in places without emergency cover, especially in low-income settings, are linked to more serious harm.
What is clearer is the link between staffing and outcomes: international studies have found that each extra patient per nurse is associated with a higher risk of patients dying.
The bottom line
The fairest answer may be “yes, but”: nurses have the same right to collective action as other workers, but they also carry a duty to protect patients during it. The quality of the emergency cover plan often decides whether a strike is seen as principled or reckless.
Related: Nurse strikes 2026: every major strike
Where do you stand? Tell us in the comments. We read every one, and the best answers may feature in a follow-up article.
Sources: International Council of Nurses position statements on socio-economic welfare; Aiken et al., The Lancet (2014) on staffing and mortality; published reviews of health worker strikes and patient outcomes.
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