Experiences of mothers in five countries whose child died of cancer.

Although increasing attention is being focused on the emotional aspects of caring for dying children and their families, few research reports concentrate on the experiences of mothers, particularly in different countries. This article describes the findings of an exploratory, descriptive study that investigated the experiences of mothers from five different countries who each had a child die from cancer in the past 6 months. Principal investigators, members of the International Work Group on Death, Dying, and Bereavement, conducted semistructured interviews with 21 mothers in their own countries. No culturally related differences were noted among mothers, and the mothers' recall of their experiences are more similar than different. All mothers, irrespective of country, described similar reactions to the diagnosis, management of the end-stage illness, and challenge of coping with bereavement. Lessons learned from this project provide suggestions for future research across countries.

Developing moral imagination and the influence of belief.

Moral imagination has been described by Murdoch as 'a way of seeing'. The focus of concern here is the influence of belief upon moral imagination and those attitudes that are needed if moral imagination is to be developed. The perspective adopted endorses a Humean recognition of the potent influence of personal experience upon those beliefs that are held, and therefore upon how we see the world. Kantian commitment to the power of the will, and to the ability of individuals to choose who they wish to be, allows room for optimism, a view which is supported by the findings of Liaschenko.

Trust: an essential component of nursing practice--implications for nurse education.

This paper offers a philosophical analysis of trust and its influence upon nursing practice. The paper begins by examining the meaning of trust, its influence upon health care and upon patients ability to place their trust in health care professionals. Influences upon individuals' capacity for trust are considered, and expectations within relationships are examined. Particular attention is given to that which patients entrust to their nurse, and to expectations where social or contractual trust exists. Obstacles to trust within health care are also considered. The United Kingdom Central Council for Nursing, Midwifery and Health Visiting is shown to be an example of institutional distrust, rather than a statement about the trustworthiness of nurses. Nurse education is one potential influence upon the formation of trust and distrust relationships within health care. Suggestion is therefore made as to how nurse education might seek to overcome distrust and promote trust between all those who are involved in health care.

Guilt and nursing practice: implications for nurse education and the climate of care.

This paper considers the influence of guilt within nursing practice. The author draws on her experience as a nurse tutor to show how guilt has implications for the well-being of both nurses and patients. It is suggested that nurses' experience of guilt, and the fear that they may be considered guilty, are indicative of a moral climate that rests predominantly upon rules. While rules fulfil a requirement for professional and organizational accountability, they need not be perceived as statements about the trustworthiness of nurses, or as a disciplinary threat. Nurses need to feel trusted to bring judgement to their practice.