Source
Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada.
Abstract
These
days, discussions of what might be the 'essence' or the 'core' of
nursing and nursing practice sooner or later end in a discussion about
the concept of care. Most of the 'newer' nursing theories use this
concept as a theoretical core concept. Even though these theoretical
approaches use the concept of care with very different philosophical
foundations and theoretical consistency, they concur in defining care as
the essence of nursing and thereby glorify goodness as the decisive
characteristic of nursing. These theoretical approaches neglect the fact
that nursing is above all a profession with a societal task and is
characterized by an asymmetrical power relation between nurses and their
patients. Based on the results of a research project that analysed the
role nurses played in the killing of psychiatric patients in Germany
during the
Nazi
regime, I demonstrate that an approach based on the concept of care is
not able to explain how nurses were able to commit crimes of such
atrocity. These crimes were bound to an emotional investment that
sustained the production of 'life unworthy of living'. In the case of
nurses under the
Nazi
regime, certainly a kind of sadism was at issue that can only be
explained if we recognize that the social bond is characterized by a
certain tension; 'goodness' that caring theories assign to the social
bond always coexists with the capacity for destruction. Using the
Foucauldian theoretical framework of biopower and biopolitics enables
one to analyse violence and power as integral parts of nurses' practice.
Seen from this perspective, the killing of patients was part of a
biopolitical programme and not a relapse into barbarism. The concept of
care obscures the political agenda of nursing and does not provide a
critical and political framework to analysing nursing practice.
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