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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Bearing witness: an existential position in caring
1Karolinska Institute, Section of Nursing, Stockholm, Sweden.
Abstract:
A basic assumption for the study is that perceiving a person's deepest needs and desires to be on hand for another person, and their attempt to do so, have, in an ontological sense, the power to bear witness of goodness and eternity. The study was based on a theoretical basis of a caring science view of suffering, as well as the ethics of the philosopher Lévinas. The aim was to explore and clinically validate nuances of witnessing as a caring act.A Socratic dialogue was performed and an interpretive (hermeneutic) method was employed in this study. The Socratic dialogue with four nurses in palliative care focused on and analysed one clinical example of witnessing in palliative care. As basis for the findings are the participating nurses jointly formulated assumptions on the subject: To be a witness you have to be with the patient and refer back to him or her what you have seen; but also to act in accordance with what you have perceived. In the moment you witness, a window is opened onto the unknown; you become vulnerable as a caregiver and require courage. Being a witness encompasses existential and spiritual aspects; being a fellow human being, having a heart to heart relationship is a wilful act on the part of the nurse. Our theoretical discussion focuses on the language of the body, courage as a bridge to an existential encounter and the alleviation of patients' suffering through caregivers' witnessing. A conclusive aspect is that being a witness may bring a new understanding of life in the face of death and suffering. The existential position of being a witness requires the caregiver to be courageous because of its transformative prospect, but may utterly enrich both parties' inner life of shared meaning.
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