Dangerous Times, Deliberate Acts: A Talk on Violence, Agency and Some Possibilities for Response

In a world marked by escalating violence—interpersonal, institutional and structural—how do we respond without succumbing to despair or paralysis? This talk explores the ethical imperative of action in dangerous times, centring agency as both a personal and collective force. Nurses are well-positioned both as clinicians and agents of structural change. Underpinning actions and language with structural analysis and extending such understanding to others holds the potential to inspire more deliberate, justice-oriented responses. Rather than offering simple solutions, this talk invites reflection on the complexities of acting ethically and effectively in contexts of harm. It is a call to resist hopelessness, to claim agency and to imagine responses rooted in courage, care and structural change. It is both an honour and a daunting task to be invited to open this, the 26th Nursing Network on Violence Against Women (NNVAWI) conference. It is an honour because I hold such deep respect for you, people working against violence in all its forms. I have been calling NNVAWI my intellectual home since 1997 when I attended my first conference in West Virginia. Here I have found kindred spirits, colleagues and friends to admire, follow, and try to emulate. I hope that those of you who are new to this conference will find strength and companionship and a widening of your network here. It is daunting because there is so much wisdom at this conference; it seems presumptuous for me to say anything. It is also daunting because it seems difficult to find a way to be hopeful, uplifting and potentially useful in these times. But it is a responsibility and challenge that I appreciate being offered. I think we are all joined by at least two things: obviously a concern with violence, but also by a desire for change toward peace—peaceful relationships, communities and beyond. So, I am going to pair a couple of promising ideas about change with what I think are some promising ideas that might help us in our work to prevent and mitigate the impacts of violence. You are now part of my ‘World Domination Plan’. About 8 years ago I came to a point in my work where I realised that all the work I and my colleagues had done, all efforts of the thousands of women who had participated in our research, the hopes of all people who provide services who also have done so in trust that we would make a difference would come to naught unless it somehow became widely and meaningfully embedded in ways of thinking and acting. I half-jokingly claimed I wanted a world domination plan—specifically to dominate health care and social services with action toward social justice and equity—terms today much maligned and under siege in some quarters. But my colleagues and friends took me seriously. Central to that quest is pushing for greater structural analysis—of violence, of racism, of misogyny, of all forms of stigma and exclusion. In terms of violence, Nadine Wathen and I and our co-authors (Wathen and Varcoe 2023) have argued that putting a ‘V’ in ‘trauma-informed care’ to become ‘trauma-and violence-informed care’ can draw attention to how interpersonal violence is deeply entwined with structural violence. How gendered violence is entwined with patriarchy, colonialism, racism and so on. I think perhaps the anti-violence sector is more likely entrenched in such a view, whereas the health care system, at least in Canada, is mired in biomedical and individualistic views. Subjective violence is just the most visible portion of a triumvirate that also includes two objective kinds of violence: symbolic and systemic. The first is present in the violence of language and representation. The second, more insidious, is there in the violence embedded in political and economic systems (Žižek 2008, 1). Despite that the highest prevalence of CN&A is related to neglect, emotional abuse, or the harms of intimate partner violence, The Monstrous Perpetrator supports the focus on the visible and abject horrors of physical and sexual abuse, detracting from the social conditions that contribute to children's vulnerability (Einboden et al. 2024, 5). I have long been struck by the inverse relationship between the emphasis in research on child sexual abuse and its relatively lower incidence. I now see that it is part of a larger pattern- what is called for in funding calls, what gets funded and so on—driven by collective focus on the spectacular. I want to stress that the structural analysis I am arguing for doesn't stand in opposition to, obscure, or render personal agency impotent. Far from it. I think that structural analysis can guide our individual actions toward the greatest impact. I have been asking myself for a few years (probably since my children started asking whether they should bring children into the world), do we live in the worst of times? It certainly can feel like it. The overturning of Roe versus Wade, the apparent disregard for values such as integrity, truth and compassion, the declaration by the US military leaders that they will return to the highest MALE standards (Jaffe 2025), the seeming global indifference or worse in the face of wars and humanitarian disasters around the globe, the undeniable effects of climate change, not only in environmental disasters but in the pandemic levels of anxiety experienced, particularly by young people. So, are we in the worst of times? My first activity in Grade 1 was practicing diving under my desk in preparation for a nuclear bomb, but how does the state of the world that activity suggests compare to today? I kept wondering how today compares to Europe prior to and during WWII. Then I began to see people in the United States asking similar questions, such as Should We Hide Immigrants in Our Attics? I then heard Bregman (2025), a Dutch historian, being interviewed about his idea of moral ambition. By moral ambition, he means ‘the will to make the world a wildly better place’ (2025, 1). He said that COVID essential workers, ‘from cleaning staff to trash collectors, from teachers to firefighters, from bus drivers to registered nurses…don't need a lecture on moral ambition’ (p. 5). I daresay that applies to anyone attending this conference—those providing direct service, those leading those services, those teaching and researching how to prevent and mitigate the impacts of violence. You don't need a lecture on moral ambition. But could history help us be more intentional? Could we amplify our efforts in some way? I cannot believe that the purpose of life is to be happy. I think the purpose of life is to be useful, to be responsible, to be compassionate. It is, above all to matter, to count, to stand for something, to have made some difference that you lived at all. (Cited in Bregman, p. 1) This fully resonated with me. I didn't ‘retire’ (from my job, not from my work) until I was 70 because I was terrified of the idea of being a person of high privilege in the world but contributing nothing. I was worried for nothing of course—there are endless opportunities for people of privilege to do useful things—but it took me a while to refuse dominant ideas about retirement and to learn to say ‘I have retired from my job to focus on my work.’ Like you, I want to make a difference. So, what can history and Bregman offer us? He offers a very hopeful outlook, claiming that we have the means to reverse climate change, end war, feed every person, and have clean water for everyone. The purpose of his book is to urge people to make these (and other important things) happen. However, he warns that a structural analysis can be used as an excuse for inaction when we cry ‘it's the system, it's the system’ and fail to act. First, he cites historians studying who harboured Jews in Nazi Germany. Who hid people in their attics? Did they know the people they harboured? Did it matter whether they had extra space? Were they ‘good’ people? And what about all the ‘good people’ who did nothing? It was one simple thing. It turns out, he writes, ‘you had to be asked… The resistance worked like a virus’ (p. 36). Few who were asked refused and most also asked someone else. Bregman takes this notion of being asked and demonstrates through multiple examples that you can amplify your impact by strategically asking. He uses the contemporary example of how Roe versus Wade was overturned through the building of a network of over 5000 lawyers, by a small group of thoughtful citizens. He also uses the famous example of Rosa Parks refusing to move to the back of the bus to show that this was a well-planned, thoughtfully executed strategy by a small group of thoughtful citizens. (I had no idea that the group had done a test run with another woman before Rosa Parks.) These examples helped me see how I had been misunderstanding this famous quote from Margaret Mead: ‘Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.’ Bregman points out that this quote ‘may sound like a happy little quote for idealistic do-gooders, but really it's a cold hard observation’ (p. 25). If those of us committed to peace don't galvanise others into action, someone else will and likely in a different direction. What does this mean for us? It means asking. Asking people to join you, asking people to do more, asking people to do better, to be more morally ambitious, perhaps to take risks. And I think small asks can be impactful. When I was a master's student, my dear friend and colleague, Dr. Sally Thorne, was my professor (uncomfortably as we had been friends for a decade by that time). She assigned us the task of writing a paper critiquing some piece of nursing dogma. I brightly said ‘I know! I'll critique the nursing process.’ She said, ‘well, you could. But what if you critiqued the critiques of the nursing process?’ Which I did (Varcoe 1996). This may sound trivial, but from it I learned to look deeper in ways that have served my career and life. To look beyond surface, seemingly common-sense notions and to try to pass on to others the practice of doing so. Today, I am looking at ways to harness ‘asking’ in service of our world domination plan. It means galvanising ourselves and others into action. As Bregman advises, ‘join a cult, or start one of your own.’ I am hoping that I and my colleagues can turn our work into a cult. The illusion of good intentions: This goes beyond the familiar idea that good intentions are not enough to posit that support for well-intended interventions is not only not enough, but a waste of resources if such interventions are not effective. The appearance of something being done diminishes the chances of something effective being undertaken. We have systems obsessed with efficiency in the absence of attention to effectiveness. Today in [some jurisdictions] in Canada, we are faced with politically imposed mandatory treatment for substance use, which is contrary to all scientific evidence regarding effectiveness. This is made more egregious by the fact that people who want treatment cannot get it because of inadequate treatment availability and long wait lists. In British Columbia where I live, in terms of mental health treatment, similar policy directions have led to a situation in which involuntary treatment is almost the only way people can get help (Kolar et al. 2022). For us, as people focusing our work on peace in the face of violence, I think facing such an illusion means at least three things: (1) we need to refuse to participate in supporting ineffective interventions; (2) we need to focus our research on unflinchingly seeking effectiveness; and (3) we need to seek ways to embed effectiveness in systems. Currently, under the leadership of my friend and colleague Dr. Marilyn Ford-Gilboe, our research on iHEAL (a health-promotion intervention for women experiencing partner violence) is on the doorstep of the latter. We have shown effectiveness (Ford-Gilboe et al. 2024), but how can we get such a resource-intensive intervention embedded in systems? How can we convince the world that women are worth it? The illusion of right reasons: Here, Bregman is challenging the idea that good things can only happen for the right reasons with the insight that the right thing can happen for the wrong reasons. Among other examples, Bregman shows how British abolitionists pivoted from lobbying based on the plight of people who were enslaved to lobbying based on the plight of British seamen on slave ships. They were deemed by slavers as less valuable and more expendable than people who were enslaved, and thus died in greater proportions, a fact that provoked empathy among the British public. the experience of being seriously compromised as a moral agent in practicing in accordance with accepted professional values and standards. It is a relational experience shaped by multiple contexts, including the socio-political and cultural context of the workplace environment (Varcoe et al. 2012, 58, emphasis added). Importantly, I want to turn attention to structural distress. In tandem, for too long we have used the term ‘burned out.’ Again, this locates the problem in the individual obscuring the conditions that produce distress. I invite you to replace that phrase with ‘used up,’ drawing attention, again, to the structural conditions of work. Related, I have for far too long narrowly understood the idea of vicarious trauma—thinking of it as the idea that being exposed to the traumatic experiences of others, such as through hearing their stories, is harmful. Of course, such exposure is hard. But where does this idea place responsibility? Finally, the illusion of purity: in this Bregman critiques the potential risks associated with intersectionality, a concept fundamental to my research. He asks whether the ‘duty to declare… solidarity with anyone and everyone’ can ‘stifle cooperation instead of facilitating it’. This challenged me on my willingness to compromise. In the work we are doing to support folks in the gender-based violence sector to develop more equitable approaches to substance use and promote the idea of substance use health, I have been taken aback by two things: first, a strong resistance to engaging with people with living expertise of substance use and substance use stigma; second, a strong resistance to treating people who use violence in their relationships as human (including resistance to reconsidering the use of the term ‘perpetrators’ as a reductionist label). Although I have some understanding as to why these resistances exist, believing that both shifts are essential to effectiveness, I have been bullheaded. In fact, I may have come close to alienating partners in my insistence. Now I am compromising better toward coalition and looking for approaches to these resistances based on understanding of their roots and a structural analysis. In relation to resistance, to taking direction from people with lived experience, I think part of the issue is how lived experience is framed. I am fond of doing shock tricks—there is nothing more fun than saying to a group of feminists ‘I don't believe in woman-centered care’ and then, after the collective in-drawn gasps, saying ‘I am committed to woman-led care.’ In this case, I am saying to people, both those leading with their lived experience and those leading with their service provision roles, ‘lived experience is not a competency.’ Again, indrawn gasps, especially from those leading with their lived experience. I follow by clarifying, ‘the competency lies in what you DO with your lived experience to make the world a wildly better place.’ I learned to navigate how I use my own lived experiences of violence and of racism by trial and error. How to use those experiences without making my experience central, or treating it as generalizable, or pandering to the desire for voyeurism or being dismissed as only self-interested. From this learning I think we can help deploy the experiences of those with whom we do research or to whom we provide care and services in ways that draw attention to the upstream causes of social suffering and violence. For example, our EQUIP research team has made a series of EQUIP Equity Essentials videos that do just that. I think if we focus on competencies, expertise and outcomes, instead of experiences, we can hone our tools. As Ford-Gilboe and colleagues argued three decades ago (1995), science needs both stories and numbers, and now, more than ever, the world needs science.