It is with deep regret that I have chosen not to renew my membership in the American Nurses Association (ANA).

I have read the ANA board of directors' stated reasons for refraining from making an endorsement in this year's presidential election: that the ANA is a nonpartisan policy organization, and that the ANA supports its members' autonomous deliberations on the critical issues, including those of health and social justice, facing the electorate.1

These reasons remain predicated on (and are credible only when based on) the assumption that the nominees of both political parties have health policy positions grounded in what nurses say they hold dear: a belief in the power of reasoned inquiry, a commitment to health care access and equity, and an obligation to promote prevention in the populations we serve. There were no intellectual or policy equivalents facing voters in this year's presidential election. The ANA's decision not to endorse a presidential candidate is a stark abdication of responsibility in the name of representation. It is a decision to passively follow and not to lead.

And it will have consequences. The ability to affect policy requires power. Power comes to those who seize it and who are prepared to take risks to achieve it.

As a historian, I hear echoes of past debates from occasions when organized nursing deferred on taking political positions. But as a nurse who believes our very disciplinary values are at stake, I can no longer support a purportedly disinterested, nonpartisan approach by an organization that represents me and those for whom I care. I speak only for myself. I do resign, though, with a heavy heart.

Patricia D'Antonio, PhD, RN

Philadelphia September 30, 2020

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