[...]... conditions must be met for ethical caring Hanford speaks of nursing having to practise in a ‘chronically ethically diminished state’ Nursing administration needs to create an environment, she suggests, where conditions for care may flourish In chapter 12 Dickenson also raises questions about care, examining nurse time treated as a resource I think her case runs into great difficulties, pointing to a deeper question—does... reductionist in one way or another’ (p 196) Noddings’ book has been seminal in the United States, especially in the debate about moral education, but has hardly entered into the debate about nursing Noddings sees care as the true basis of ethical behaviour If this is true, since caring is said by many to be the essence of nursing, 16 INTRODUCTION Noddings’ work might be expected to have something important...x Linda Smith is a Lecturer-Practitioner in Nursing, based at the Hammersmith Hospital and is a specialist in care of the elderly and in nursing research Deborah Taplin is Lecturer-Practitioner in Nursing, based at the Hammersmith Hospital and is a specialist in critical care Paul Wainwright is Programme Manager (Graduate Studies) for the Mid and West Wales College of Nursing & Midwifery,... of machines and operating instructions, can easily be separated from a way of thinking in terms of machines, a machine-like way of thinking The recovery of nursing care requires not so much more thinking about the ‘proper place of technology’, but rather less technological thinking Feeding has always been a part of nursing care, but of late it has become more of a technical process and a part of medical... etc.? Nursing is defined and moulded and driven by forces outside nursing and which nursing has never really understood or challenged How far is self-regulation and upward (line 14 INTRODUCTION management) accountability able to serve the public good and thus serve the truth in nursing, the truth of nursing? The circle is broken, can it be closed, and how? I am critical of an imposed discipline which... from instruction in professional ethics and the law I take it for granted that the debate is illuminating and the instruction useful What one has to beware of is making the problem appear to be one of finding the technically right procedure or method for dealing with ethical decisions’, as though the problem were similar in kind to finding the right medication or the right diagnosis or the right administrative... unease in one way or another More often than not discussions end up in an exploration of the constraints on their freedom to care Two general and related constraints, nearly always emerge: the way in which medicine defines health and illness, reflected in the way doctors think about and ‘approach’ people in care (the ‘biomedical model’); and the way in which the whole business of health care, including nursing, ... for nursing ethics She distinguishes between natural caring and ethical caring and maintains that the latter arises from the former Nursing has always faced what Hanford refers to as ‘the difficulty of caring for someone for whom we do not naturally care’ Noddings appears to give us a clue as to how this works One may not naturally care for the patient x, or even wish to do so, but ethical caring still... always been more than a training in anatomy, physiology and nursing tasks—it has been an ideological preparation, even an indoctrination The fear is that nursing ethics, while hoping or pretending to break with the old, may be appropriated, may become part of that metaphysics of procedure Ethics has made its appearance on the nursing agenda because of a crisis of legitimation in the health care of the... has come to accept the norms of the institution To undertake this kind of negative and exploratory ethics requires the opportunity and the freedom openly to tease out the inconsistencies in thinking about the nature of nursing and to seek their origin, to discuss the history and politics of nursing, its place in contemporary life and its relation to major social issues such as the environment and civil .