Review

Ethics in caring

ETHICS IN NURSING: THE CARING RELATIONSHIP
Verena Tschudin
Butterworth Heinemann, 1992

The second edition of this book is a thorough revision of the first. It is longer, though still of manageable length, and rather more extensively referenced.

The book ‘s central theme is that of an ethic based on caring. Adopting the scheme of a Canadian nursing philosopher, the author defines caring as: compassion, competence, confidence, conscience and commitment.

In looking at the various problems and dilemmas nurses face, Tschudin uses the problem solving approach of assessment, planning, implementation and evaluation, which nurses have adopted energetically under the label of ‘nursing process’. This approach is taking on many aspects of dogma and I would prefer nurses to think for themselves.

But this is a minor reservation. The book is better than many other ethics texts in British nursing because Tschudin avoids concentrating on ethics as the description of a range of behaviour available within a set code of professional conduct. Too much writing in this area has as its underlying theme the assumption that good nursing means following the code of conduct.

Tschudin moves away from this legalistic approach, and focuses instead on one individual person, a nurse, caring for another individual, the client. She sees this in its best form as the ‘I-Thou’ relationship described by Martin Buber.

She leaves it to nurses to relate their ethical decisions to what best serves this relationship, and as a result the book is about ethics based on personal philosophy applied in differing situations rather than, as some nursing ethics writers attempt to do, trying to construct fool-proof algorithms for every occasion.

As a result this is a humane book, which can be recommended to anyone concerned with health care, not only nurses.