This paper explores the nature of trust in nurse–patient relationships from the perspective of the patient's trust in the nurse and what might be said to then render such a relationship trustworthy, from the patient's point of view. The paper commences with a general examination of the nature of trust, followed by consideration of the nature of professional–patient relationships in healthcare, with emphasis on nurse– patient relationships in particular. The nature of this relationship is used to provide grounds for arguing, (...) both morally and conceptually, that the nature of patients’ trust in those who nurse them is generally such that for the nurse to respond in a trustworthy way, she must careabouther patients, not justforthem. In arriving at this conclusion, the paper deliberately restricts its focus to nurse–patient encounters where patients are adults and a relationship, as opposed to a brief engagement between two people, can be said to have taken place. The context for this focus is public sector health care in the United Kingdom. In the text, gendered pronouns referring to doctors, nurses and patients are meant to be inclusive of both sexes. (shrink)

This paper explores the nature of trust in nurse–patient relationships from the perspective of the patient's trust in the nurse and what might be said to then render such a relationship trustworthy, from the patient's point of view. The paper commences with a general examination of the nature of trust, followed by consideration of the nature of professional–patient relationships in healthcare, with emphasis on nurse– patient relationships in particular. The nature of this relationship is used to provide grounds for arguing, (...) both morally and conceptually, that the nature of patients’ trust in those who nurse them is generally such that for the nurse to respond in a trustworthy way, she must care about her patients, not just for them. In arriving at this conclusion, the paper deliberately restricts its focus to nurse–patient encounters where patients are adults and a relationship, as opposed to a brief engagement between two people, can be said to have taken place. The context for this focus is public sector health care in the United Kingdom. In the text, gendered pronouns referring to doctors, nurses and patients are meant to be inclusive of both sexes. (shrink)

Nursing practice invites nurses to embody caring practices that meet, comfort and empower vulnerable others. Such a practice requires a commitment to meeting and helping the other in ways that liberate and strengthen and avoid imposing the will of the caregiver on the patient. Being good and acting well (phronesis) occur in particular situations. A socially constituted and embodied view of agency, as developed by Merleau‐Ponty, provides an alternative to Cartesian and Kantian views of agency. A socially constituted, embodied view (...) of agency is less mechanistic and less deterministic than Descartes' and Kant's radical separation of mind and body, and more responsive and generative than Kant's vision of moral agency as constituted by autonomous choice makers who are uninfluenced by emotion. The role of emotion in perception and judgement is explored in this paper. Distinctions between techne and phronesis are drawn. The role of emotion in market relationships and procedural ethics drawn for the abstract, general other are strategies for exchange of goods and services, but these same market relationships are dependent on well‐functioning nonmarket relations of noncalculated giving and receiving. (shrink)

Debates the difficult moral issues of today such as abortion and euthanasia. Explores the nature of ethics and how we make moral decisions.

Recent work in clinical nursing ethics has been influenced by two main areas of insight associated with the challenge levelled by the women's movement to traditional thinking about morality and ethics. Broadly speaking these two realms have been distinguished as articulating ‘feminist’ socio‐political and ‘feminine’ ethic of care concerns. Often these two impulses are seen as pulling against each other, or worse, the ‘feminine’ emphasis on the ethics of care is seen as reinforcing the dynamics that elicit the ‘feminist’ concern. (...) In this paper I suggest how an expanded understanding of an ethic of care in clinical settings can provide resources for dealing with both concerns. A discussion of the way institutional relations can ride rough‐shod over the ‘feminist’ insights of ethical care, in the second part of the paper, provides evidence for my conclusion that ethical nursing care depends on recognizing that both areas of insight are imperative for its success. (shrink)

First-person accounts from practicing nurses provide students with expert role models in this authoritative yet personal text that focuses on patients' responses to stress. The breadth and value of the nursing experience is reinforced as nurses share how their caring made a critical difference for patients and their families. This text, winner of two American Journal of Nursing Book of the Year Awards in 1988, is an ideal supplement for courses in advanced medical/surgical nursing, community health nursing, and particularly for (...) nursing trends and issues courses. (shrink)

The ethics of care, adopted in much of the nursing literature, is usually framed in opposition to the Kantian ethics of principle. Irrespective of whether the ethics of care is grounded in gender, as with Gilligan and Noddings, or inscribed on Heidegger's ontology, as with Benner, Kant remains the philosophical adversary, honouring reason rather than emotion, universality rather than context, and individual autonomy rather than interdependence. During the past decade, however, a great deal of Kantian scholarship – including feminist scholarship (...) – has rendered this series of oppositions questionable, challenging the view that an ethics of care and Kant's moral law are irreconcilable. This paper therefore re‐examines Kant's writings, drawing on recent scholarship, and argues both that they provide the care ethicists with everything they require, and that they offer something beyond an ethics of care, something that repairs the deficits in philosophies of caring. It concludes by suggesting that a Kantian ethics of care has significant implications for the construction of nursing knowledge. (shrink)

Nursing as normative praxisThe purpose of this paper is twofold. First, it introduces a variety of concepts of ‘praxis’, and argues in support of those which reflect the normative dimension of the critical social perspective. This begins with the Aristotelian concept, and moves through a variety of sources, including Hannah Arendt and Paulo Freire, but focuses primarily, and uniquely in the nursing literature, upon the work of the Yugoslavian ‘praxis Marxists’. Second, specific ways of conceiving nursing as praxis are outlined, (...) including political, aesthetic and ethical forms which have immediate import for nurses. The paper concludes with brief suggestions as to how these ways of conceiving praxis may be used by nurses to develop a more intimate and productive understanding of their own practices. (shrink)