Editorial: All you need is love?

Abstract

In a country renowned for its contribution to the establishment of nursing as a profession, we are reeling from yet another report of poor care. The UK Health Service Ombudsman report ‘Care and compassion?’ detailed 10 investigations into the care of older people in the National Health Service (NHS). The report discussed the absence of the most fundamental aspects of care for older people. The journalist, Jenni Russell, recently shared her experiences of the NHS in a Sunday newspaper. She described how a friend’s father had moved ‘from an environment where staff were rude and mean to a micro civilisation where the ethos was kindness. ‘‘Honestly, he genuinely felt loved there’’’. Russell described the activities that contributed to this elderly gentleman feeling loved. She wrote ‘The nurses mushed up his food so that he could eat despite his mouth cancer; they were cheerful and tactful about his need for bedpans and bed baths; they talked to him with affection, took messages and rang his family with bulletins whenever they were asked to, even in the middle of the night. Even though he died from a hospital infection, the family has no regrets.’ The attitudes and behaviour of nurses and other staff can make a significant contribution to patient well-being and dignity. However, explanations for good and poor care go beyond individual behaviour. The review of organizational ethics by Riitta Suhonen and colleagues informs us of the state of research in this important area. Elleke Landeweer’s exploration of moral decision-making in relation to seclusion in mental health demonstrates the value of inter-disciplinary perspectives. Insights from the social intuitionist model help to explain the dynamics of enforced seclusion. Moral case deliberation is discussed as a practical tool to organize the moral reflections of nurses. The interaction between individual and organizational factors is explored in Sandra Pereira’s systematic review relating to burnout in palliative care. The research of Sandra van der Dam and her co-authors explore the contribution of moral case deliberation in improving the quality of care. They conclude that two implementation strategies – existing communication structures and a mixed moral case deliberation group – can complement each other. A second article on the topic of clinical ethics is by Iva Sorta-Bilajac. This study assessed nurses’ and physicians’ ethical dilemmas in clinical practice in Croatia. Findings suggest that nurses and physicians experienced similar ethical dilemmas and that the usage of clinical ethics consultations is low. Fang Pengqian and co-researchers surveyed health professionals’ attitudes towards information disclosure to cancer patients in China. Respondents placed a high value on patients’ desire and priority to know the truth. They recommend that health professionals should learn more about informed consent compatible with Chinese culture. An Iranian study of placebo use by nurses, conducted by Hamid Reza Koohestani, concludes that most nurses had used placebo and view this as ethically permissible. These studies suggest the need to consider contentious ethical issues in specific cultural contexts. The qualitative study reported by Christina Karlsson and Ingela Berggren explores nurses’ perceptions of factors that contribute to patients’ experiencing a ’good death’ in their own home. They conclude that good