Reflective assent in basic care : A study in nursing ethics

Sammanfattning: This study discusses nursing ethics in relation to basic care. The practice of basic care andrelated knowledge are often understood as tacit knowledge, a kind of familiarity-knowledgethat often has been neglected by philosophical scrutiny.The main aim of the study is to present an alternative approach to principle-based ethicsthat dominate text-books in medical and nursing ethics. It is suggested that nurses' unique experiences of basic care contain cognitive significance. Bodily knowledge and consent­giving plays a central role in this study. It recognises autonomy as a fragile ability of patients in intimate situations, defined by Josalyn Lawler.Central concepts in the study are the principle of informed consent and the reconstructedprinciple of reflective assent. The alternative approach to nursing ethics that is presented in this study examines communicative ethics, feminist ethics, and virtue ethics. The evaluation of the discourse ethics of Jürgen Habermas has resulted in a further development from ideal speech-acts to include bodily communication. The feminist contribution is new insights of how oppressive structures work on practices of basic care. A feminine approach to ethics, as presented by Nel Noddings, is rejected as too powerless to advance the autonomous status of nursing ethics. A post-structural approach of Marie Fortune is presented as a better alternative. A neo-Aristotelian approach to virtue ethics is used to explore which character-traits nurses need to develop in practice for being able to empower patients and themselves.From the philosophical framework set by Charles Taylor, in dialogue with other philosophers as Martin Heidegger, Emmanuel Levinás, Knud Ejler Lögstrup, Alasdair MacIntyre, and Donald Schön, six nursing values are affirmed as irreducibly social values. These are induced from the practice of basic care as being particularly essential in this thesis. Additionally six virtues are connected to these values. Embodiment-Sensuality, Reciprocity-Loyalty, Interdependent Autonomy-Openness, Consolation-Courage, Maintaining Human Dignity-Fairness, and Empowerment-Solidarity.