Nurses’ refusals of patient involvement in their own palliative care
Glasdam, Stinne LU
; Jacobsen, Charlotte Bredahl
and Boelsbjerg, Hanne Bess
(2020)
In Nursing Ethics
27(8).
p.1618-1630
- Abstract
- Background:
Ideas of patient involvement are related to notions of self-determination and autonomy, which are not always in alignment with complex interactions and communication in clinical practice.
Aim:
To illuminate and discuss patient involvement in routine clinical care situations in nursing practice from an ethical perspective.
Method:
A case study based on an anthropological field study among patients with advanced cancer in Denmark.
Ethical considerations:
Followed the principles of the Helsinki Declaration.
Findings:
Two cases illustrated situations where nurses refused patient involvement in their own case.
Discussion:
Focus on two ethical issues, namely... (More) - Background:
Ideas of patient involvement are related to notions of self-determination and autonomy, which are not always in alignment with complex interactions and communication in clinical practice.
Aim:
To illuminate and discuss patient involvement in routine clinical care situations in nursing practice from an ethical perspective.
Method:
A case study based on an anthropological field study among patients with advanced cancer in Denmark.
Ethical considerations:
Followed the principles of the Helsinki Declaration.
Findings:
Two cases illustrated situations where nurses refused patient involvement in their own case.
Discussion:
Focus on two ethical issues, namely ‘including patients’ experiences in palliative nursing care’ and ‘relational distribution of power and knowledge’, inspired primarily by Hannah Arendt’s concept of thoughtlessness and a Foucauldian perspective on the medical clinic and power. The article discusses how patients’ palliative care needs and preferences, knowledge and statements become part of the less significant background of nursing practice, when nurses have a predefined agenda for acting with and involvement of patients. Both structurally conditioned ‘thoughtlessness’ of the nurses and distribution of power and knowledge between patients and nurses condition nurses to set the agenda and assess when and at what level it is relevant to take up patients’ invitations to involve them in their own case.
Conclusion:
The medical and institutional logic of the healthcare service sets the framework for the exchange between professional and patient, which has an embedded risk that ‘thoughtlessness’ appears among nurses. The consequences of neglecting the spontaneous nature of human action and refusing the invitations of the patients to be involved in their life situation call for ethical and practical reflection among nurses. The conditions for interaction with humans as unpredictable and variable challenge nurses’ ways of being ethically attentive to ensure that patients receive good palliative care, despite the structurally conditioned logic of healthcare. (Less) - Abstract (Swedish)
- Background: Ideas of patient involvement are related to notions of self-determination and autonomy, which are not always in alignment with complex interactions and communication in clinical practice.
Aim: To illuminate and discuss patient involvement in routine clinical care situations in nursing practice from an ethical perspective.
Method: A case study based on an anthropological field study among patients with advanced cancer in Denmark.
Ethical considerations: Followed the principles of the Helsinki Declaration.
Findings:Two cases illustrated situations where nurses refused patient involvement in their own case.
Discussion: Focus on two ethical issues, namely ‘including patients’ experiences in palliative nursing... (More) - Background: Ideas of patient involvement are related to notions of self-determination and autonomy, which are not always in alignment with complex interactions and communication in clinical practice.
Aim: To illuminate and discuss patient involvement in routine clinical care situations in nursing practice from an ethical perspective.
Method: A case study based on an anthropological field study among patients with advanced cancer in Denmark.
Ethical considerations: Followed the principles of the Helsinki Declaration.
Findings:Two cases illustrated situations where nurses refused patient involvement in their own case.
Discussion: Focus on two ethical issues, namely ‘including patients’ experiences in palliative nursing care’ and ‘relational distribution of power and knowledge’, inspired primarily by Hannah Arendt’s concept of thoughtlessness and a Foucauldian perspective on the medical clinic and power. The article discusses how patients’ palliative care needs and preferences, knowledge and statements become part of the less significant background of nursing practice, when nurses have a predefined agenda for acting with and involvement of patients. Both structurally conditioned ‘thoughtlessness’ of the nurses and distribution of power and knowledge between patients and nurses condition nurses to set the agenda and assess when and at what level it is relevant to take up patients’ invitations to involve them in their own case.
Conclusion:The medical and institutional logic of the healthcare service sets the framework for the exchange between professional and patient, which has an embedded risk that ‘thoughtlessness’ appears among nurses. The consequences of neglecting the spontaneous nature of human action and refusing the invitations of the patients to be involved in their life situation call for ethical and practical reflection among nurses. The conditions for interaction with humans as unpredictable and variable challenge nurses’ ways of being ethically attentive to ensure that patients receive good palliative care, despite the structurally conditioned logic of healthcare. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/dccb76ae-4ad3-42cb-bce3-ab9033d653ae
- author
- Glasdam, Stinne
LU
; Jacobsen, Charlotte Bredahl
and Boelsbjerg, Hanne Bess
- organization
- publishing date
- 2020-12-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Patient involvement, nursing refusal, Foucault, Arendt, palliative care, power, Thoughtfulness
- in
- Nursing Ethics
- volume
- 27
- issue
- 8
- pages
- 13 pages
- publisher
- SAGE Publications
- external identifiers
-
- pmid:32627661
- scopus:85087564495
- pmid:32627661
- ISSN
- 1477-0989
- DOI
- 10.1177/0969733020929062
- language
- English
- LU publication?
- yes
- id
- dccb76ae-4ad3-42cb-bce3-ab9033d653ae
- date added to LUP
- 2020-07-06 16:32:41
- date last changed
- 2024-06-21 02:20:57
@article{dccb76ae-4ad3-42cb-bce3-ab9033d653ae,
abstract = {{Background:<br/>Ideas of patient involvement are related to notions of self-determination and autonomy, which are not always in alignment with complex interactions and communication in clinical practice.<br/><br/>Aim:<br/>To illuminate and discuss patient involvement in routine clinical care situations in nursing practice from an ethical perspective.<br/><br/>Method:<br/>A case study based on an anthropological field study among patients with advanced cancer in Denmark.<br/><br/>Ethical considerations:<br/>Followed the principles of the Helsinki Declaration.<br/><br/>Findings:<br/>Two cases illustrated situations where nurses refused patient involvement in their own case.<br/><br/>Discussion:<br/>Focus on two ethical issues, namely ‘including patients’ experiences in palliative nursing care’ and ‘relational distribution of power and knowledge’, inspired primarily by Hannah Arendt’s concept of thoughtlessness and a Foucauldian perspective on the medical clinic and power. The article discusses how patients’ palliative care needs and preferences, knowledge and statements become part of the less significant background of nursing practice, when nurses have a predefined agenda for acting with and involvement of patients. Both structurally conditioned ‘thoughtlessness’ of the nurses and distribution of power and knowledge between patients and nurses condition nurses to set the agenda and assess when and at what level it is relevant to take up patients’ invitations to involve them in their own case.<br/><br/>Conclusion:<br/>The medical and institutional logic of the healthcare service sets the framework for the exchange between professional and patient, which has an embedded risk that ‘thoughtlessness’ appears among nurses. The consequences of neglecting the spontaneous nature of human action and refusing the invitations of the patients to be involved in their life situation call for ethical and practical reflection among nurses. The conditions for interaction with humans as unpredictable and variable challenge nurses’ ways of being ethically attentive to ensure that patients receive good palliative care, despite the structurally conditioned logic of healthcare.}},
author = {{Glasdam, Stinne and Jacobsen, Charlotte Bredahl and Boelsbjerg, Hanne Bess}},
issn = {{1477-0989}},
keywords = {{Patient involvement; nursing refusal; Foucault; Arendt; palliative care; power; Thoughtfulness}},
language = {{eng}},
month = {{12}},
number = {{8}},
pages = {{1618--1630}},
publisher = {{SAGE Publications}},
series = {{Nursing Ethics}},
title = {{Nurses’ refusals of patient involvement in their own palliative care}},
url = {{http://dx.doi.org/10.1177/0969733020929062}},
doi = {{10.1177/0969733020929062}},
volume = {{27}},
year = {{2020}},
}