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Struggling with the Fragility of Life: a relational-narrative approach to ethics in palliative nursing

Tineke A Abma

Institute for Healthcare Ethics and Philosophy, University of Maastricht, Post Box 616, 6200 MD Maastricht, The Netherlands, T.abma{at}ZW.unimaas.nl

In nursing ethics the role of narratives and dialogue has become more prominent in recent years. The purpose of this article is to illuminate a relational-narrative approach to ethics in the context of palliative nursing. The case study presented concerns a difficult relationship between oncology nurses and a husband whose wife was hospitalized with cancer. The husband’s narrative is an expression of depression, social isolation and the loss of hope. He found no meaning in the process of dying and death. The oncology nurses were not able to recognize his emotional and existential problems. A narrative perspective inspired by relational ethics indicates that participants may develop a relational narrative that seeks good for all involved in a situation. In palliative nursing this entails open communication about the fragility of life and approaching death. In relational narratives, answers to these ethical dilemmas are co-authored, contingent and contextual.

Key Words: dialogue • family involvement • palliative nursing • relational narratives

Nursing Ethics, Vol. 12, No. 4, 337-348 (2005)
DOI: 10.1191/0969733005ne799oa
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