In 2008 the United Kingdom Nursing and Midwifery Council (NMC) published the latest version of its code of conduct (The code: standards of conduct, performance and ethics for nurses and midwives). The new version marked a significant change of style in the Code compared with previous versions. There has been considerable controversy and the accrual of an extensive body of literature over the years in the UK and Europe criticizing nursing codes of ethics and questioning their ethical standing and their (...) usefulness. In this article we review the current NMC Code. We argue that the NMC has been misguided in labelling the Code as a code of ethics, and suggest that the new document falls short in many respects. (shrink)

This special issue of Health Care Analysis originated in an conference, held in Birmingham in 2014, and organised by the group Think about Health. We introduce the issue by briefly reviewing the understandings of the concept of ‘flourishing’, and introducing the contributory papers, before offering some reflections on the remaining issues that reflection on flourishing poses for health care provision.

The purpose of this paper is to offer an account of ‘flourishing’ that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as ‘happiness’, ‘well-being’ or ‘quality of life’, ‘flourishing’ uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is (...) argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one’s life as a narrative. To flourish, it is argued, is to tell a story of one’s life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one’s life. (shrink)

The purpose of this paper is to offer an account of ‘flourishing’ that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as ‘happiness’, ‘well-being’ or ‘quality of life’, ‘flourishing’ uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is (...) argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one’s life as a narrative. To flourish, it is argued, is to tell a story of one’s life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one’s life. (shrink)

The whole subject of values is surrounded by partiality, ignorance, confusion and ambiguity from the conceptual level down to the nitty gritty level of everyday practice. Some of these problems have been exposed in a preliminary way in this paper. A great deal more, and more detailed, work at conceptual and practical levels needs to be undertaken before we can really start to talk intelligibly and in a non-confusing way about value and values. One thing is clear. We will never (...) completely escape from the relativity and conceptual slipperiness that inheres in the very nature of valuing some things over others. Values are created in an ongoing dynamic process, not revealed. In the short-term, however, this knowledge will not convince politicians and other ideologues that values may not be in and of themselves a wholly desirable thing! (shrink)

This paper raises some issues about understanding religion, religions and spirituality in health care to enable a more critical mutual engagement and dialogue to take place between health care institutions and religious communities and believers. Understanding religions and religious people is a complex, interesting matter. Taking into account the whole reality of religion and spirituality is not just about meeting specific needs, nor of trying to ensure that religious people abandon their distinctive beliefs and insights when they engage with health (...) care institutions and policies. Members of religious groups and communities form an integral part of the structure and fabric of health care delivery, whether as users or in delivery capacities. Religion is both facilitator and resistor, friend and critic, for health care institutions, providers and workers. (shrink)

This article aims to challenge and expand notions of health, health care and health promotion, particularly in relation to smoking, via a consideration of the autobiographical literary work of the English playwright, Simon Gray. Gray died in 2008, having written a series of reflective autobiographical books, The Smoking Diaries. Gray was a lifelong smoker, perpetually trying to give up his habit. This article introduces Gray’s diaries and their reflections on life, death, health care and smoking. It then enquires what can (...) be learned about contemporary health care practices and assumptions from Gray’s work. Finally, it reflects on the limits of views of health and health promotion when considered in the light of a fully lived life. In the life under consideration, health care risks are very differently understood to those prevalent in the medical community. Literary approaches to thinking about smoking are thus seen to place health and health care in broader, richer, and less instrumental perspectives than those that are common amongst contemporary health professionals and institutions. (shrink)

ConclusionThe whole subject of values is surrounded by partiality, ignorance, confusion and ambiguity from the conceptual level down to the nitty gritty level of everyday practice. Some of these problems have been exposed in a preliminary way in this paper. A great deal more, and more detailed, work at conceptual and practical levels needs to be undertaken before we can really start to talk intelligibly and in a non-confusing way about value and values. One thing is clear. We will never (...) completely escape from the relativity and conceptual slipperiness that inheres in the very nature of valuing some things over others. Values are created in an ongoing dynamic process, not revealed. In the short-term, however, this knowledge will not convince politicians and other ideologues that values may not be in and of themselves a wholly desirable thing! (shrink)

ConclusionThe whole subject of values is surrounded by partiality, ignorance, confusion and ambiguity from the conceptual level down to the nitty gritty level of everyday practice. Some of these problems have been exposed in a preliminary way in this paper. A great deal more, and more detailed, work at conceptual and practical levels needs to be undertaken before we can really start to talk intelligibly and in a non-confusing way about value and values. One thing is clear. We will never (...) completely escape from the relativity and conceptual slipperiness that inheres in the very nature of valuing some things over others. Values are created in an ongoing dynamic process, not revealed. In the short-term, however, this knowledge will not convince politicians and other ideologues that values may not be in and of themselves a wholly desirable thing! (shrink)