The purpose of this sample unit is to provide suggestions and ideas about how to exploit the different types of activities and materials contained in Camino, highlighting their flexible nature and showing how the different sections in each unit can be used to complement each other. It also provides a clearer insight into the language teaching methodology and language acquisition theories that inform this course.

The focus of this chapter is the moral aspects of the nurse–patient relationship. Some people might think Carole is treating Christine with disrespect by misleading and then avoiding her. Others might think Carole is just being realistic. After all, the doctor really is busy and will not be free until 11.30 a.m. In order to work out whether or not this is an appropriate way to treat a patient, the nurse will need to have a good understanding of their responsibilities to their patients and the moral basis of those responsibilities.

Rights and obligations are like two sides of the same coin. A legal right comes with a corresponding obligation, or duty. A right is a legal entitlement to do something, and an obligation is the constraint upon individuals’ behaviour that comes with that entitlement. However, the nurse–patient relationship involves more than legalities. As discussed in Chapter 1, interpersonal relationships involve moral values, such as respect, beneficence and compassion.

This chapter will further explore the moral and legal aspects of the nurse–patient relationship, with special attention paid to the role of trust. Lena’s situation demonstrates how a patient can be disempowered and rendered increasingly vulnerable through careless use of professional power. Lena’s sadness at being parted from her friend (a normal reaction) has been turned into a medical condition (or ‘medicalised’), which is then recorded in her file as if it is a fact about her. Then this purported medical condition is used as a reason to pry into Lena’s private life – and all without any consultation with Lena herself. When Lena expresses quite justifiable outrage, she is further cast as a problem patient, and her anger is regarded as part of her emotional instability.

Chapter 2 explained the main areas of the law, including the differences between civil and criminal law. This chapter will focus on one of the main parts of the civil law that is relevant for nurses: the law of negligence. The law of negligence allows a person to bring legal proceedings against another person to correct a wrong or harm that the other person has done to them. Usually the person who has been harmed (the plaintiff) will seek payment of money (called ‘damages’) in compensation for their injury from the person whose act or omission caused the harm (the defendant).

This chapter will outline the key parts of the law of negligence, with a particular focus on the special rules that have developed in relation to health-care professionals, including nurses. By understanding how the law applies to things nurses do that can cause people harm, it should be possible for nurses to better avoid acting negligently.

Some of the philosophical and ethical aims of this book are most acutely demonstrated in examining the challenges facing the nurse in the area of aged care. We have proffered a conception of human identity as embodied and socially constructed: our embodiment makes us vulnerable to being affected by, and consequently responding to, other people and our environment in both positive and negative ways. That is, it is by virtue of the fact that we are embodied that we engage with others and the world. It follows from this that our individual autonomy is fundamentally tied up with our relations with others. It is through the opportunities or barriers created by us and others, as we participate in society as a whole, that we each can experience (or be denied the experience of) freedom. This means that my being free is built upon the liberties of others. Therefore, my freedom is contingent on me also recognising and respecting your freedom. We have argued that it is this interrelation of the self with others that allows us to develop personhood, which itself allows us to care.

Just like everyone else, nurses sometimes make mistakes that can result in harm to others. This chapter looks at how errors can occur in nursing practice and some ethical issues involved in responding to them. The Nursing and Midwifery Board of Australia’s (NMBA) Code of Conduct for Nurses (NMBA 2018b) makes a number of statements in relation to the safe conduct of nursing practice – for example.

The focus of this chapter is consent. Consent concerns the granting or withholding of permission to receive care. It may seem surprising that Ping Le would let a surgeon operate on her without wanting to know exactly what is going to happen to her, but some people do occasionally respond in this way – for example, when they can no longer tolerate a painful condition. But is this acceptable from a legal point of view? What if Ping Le had a mental health condition that affected her ability to understand the surgery being proposed? Who could consent for her in that case? This chapter addresses the legal requirements of consent for adults and children, and looks at the place of guardianship and advocacy in decision-making. It also considers the situation of people who are not mentally competent and may require emergency care or need to be restrained against their will.

Although nursing is a health-care profession, and nurses are required to have clinical skills in order to practise, the law establishes expectations that must be met. When a health-care professional such as a nurse fails to meet these standards, the law can intervene in a number of ways that can have very significant consequences.

For example, in 2011 a six-year-old boy named Jack was admitted to the Children’s Assessment Unit at Leicester Hospital in England around 10.30 a.m. Jack had Down syndrome and a known heart condition. He had been suffering from vomiting and diarrhoea, and had difficulty breathing. He was cared for by a trainee paediatrician, Dr Hadiza Bawa-Garba, and nursing staff, including Ms Isabel Amaro. Jack died that evening from an infection. His death was immediately reported to the Coroner.

The focus of this chapter is culture, and in particular developing nursing care that is culturally sensitive and culturally safe. In the vignette above, Li Wong’s family requested that information about her illness and prognosis be withheld from her because she was vulnerable, and they believed she would be severely affected by this information and the implications of it for her future well-being. In their view, emotional stability and well-being were essential to improving health. But to many nurses in Australian culture, the idea of concealing the truth from Li Wong would seem improper. Truthfulness underpins our practices of informed consent. In Australia, a patient is expected to give fully informed consent before treatment is provided, and should be provided with information about the risks and benefits of a procedure; otherwise, the nurse may be liable for assault (see Chapter 5). Truthfulness also forms the basis of clear communication and trust in the nurse–patient relationship.

Issues relating to life and death go to the heart of human experience and the value we place on our own existence and that of others, especially in those relationships we care about most. This is no doubt because we are mortal and we know we are all going to die at some point in time. Our mortality makes us fundamentally vulnerable. This book has considered ethics in the context of human vulnerability. We are vulnerable because we can be affected by things across the lifespan, and we can be affected by things because we are physical beings – part of the world around us and subject to the passage of time. Consequently, a life can come to an end at any time. For this reason, death is not only completely normal, but inevitable. Nevertheless, death is typically regarded as something regrettable. As philosopher Bernard Williams notes, our experience of being alive is essentially of having an open-ended and indeterminate future. From this perspective, death is ‘an abrupt cancellation of indefinitely extensive possible goods’ (Nagel 1979: 9–10).