Ethics Of Suffering And The Hermeneutic Process Essay

Suffering manifests patients’ perception about themselves and life. The symptoms of suffering indicate the deeper pain that patients encounter. Suffering reveals a narrative that patients have regarding their health and life. The suffering becomes a face that embodies the entire realm of patient illness. Patients depend on nurses for care. This dependence exists between the trusting bond that occurs between the patients and the nurse in light of the prevailing narratives. Nurses have a moral, ethical, and professional responsibility to attend to ‘whole’ patients and serve as responsible advocates of patients’ needs. However, nursing students and novice nurses may not apply their training to understand the patient’s narrative. This paper examines how ethics of suffering can be useful in ‘The Walk’. It explores the Raholm’s concepts of ethics of suffering in the case of Matthew in the story.

Understanding as a hermeneutic process

The response by nurses to the needs and desires of patients in wholeness form the essence of ethic of suffering. Nurses need to have the compassion and a positive determination to handle patients by listening to their side of the story. Suffering induces in the patients the ability to reveal what they might have been hiding previously. In this regard, nurses must be the true custodians of patient’s privacy on their needs. The stories that patients narrate offer access to subjective reality (63). Thus, the truths and meanings of patients’ experiences are contained in the narratives that they give. Nurses have an ethical obligation to hear the stories of the patients. What they do with the stories also determine their level of ethical responsibility. Their actions in light of the patients’ narrative matter during the period of medication.
Application of ethics of suffering in the case of Matthew and Lindsay in “The Walk,” reveals a demonstration high level of ethical responsibility on the part of the transplant nurse. Lindsay calls Matthew by name despite inability to hear her. Due to his condition, Matthew is scheduled to undergo an operation to donate his liver. This usually occurs when there is evidence that patients have few years to live or their conditions would eventually lead to death. Matthew might have been in s similar situation in which his chances of gaining better life are narrowed by the suffering that he is undergoing. Lindsay’s dedication and commitment to her work is amazing. Despite working the previous day and attempting to notify Matthew’s family members and relatives about his condition, she manages to arrive the following morning to continue with her work.
Illness creates a strange world for sick people. This is an isolated world that in the eye of the suffering where one loses his locus of control. This world is marked by suffering, despair and uncertainty. This is the reason human beings have little understanding on the subject of suffering (64). Against this backdrop, it is imperative that nurses and caregivers develop a sense of humanity while handling patients. Suffering can be manifested in various forms. The first form is suffering that result from an illness as well as the treatment procedures involved. Patients can also experience suffering attributed to dearth of care or negligence by care givers. But such suffering undermines the dignity of patients. A person that suffers usually goes encounters paradoxes such as hope and hopelessness. Such patients are torn between whether to hope for a better life or anticipate death. People who suffer feel alienated. They lose a sense of closeness and connection with the real world. Thus, to initiate a moment of healing, there has to be a movement from alienation to a moment of healing by use ethical narrative.

Interpretation as hermeneutic process

The essence of interpretation in the hermeneutic process becomes relevant after understanding of the of patient’s narrative breaks down. It reinforces Aristotle’s conceptualization of phronesis as a practical application characterized by occurrence of ‘meaning as a process of coming into being’. Thus, horizon of suffering becomes a movement when nurses engage patients into a dialogue that yield a dynamic play. Nurses engage in this dialogue as a way of letting what seems to be far away and alienated speak again. This is evident when Lindsay calls out for Matthew by name. It is also seen when Jen, the nurse that took care of Matthew when he was admitted for the first time, arrives at the hospital on a day she is not scheduled to work. Jen requests to go into the operating room with Matthew and takes part in preparing Martin for the operation. Jen’s actions manifest her close association with patient’s plight while they undergo suffering. By sacrificing her time to come to the hospital and assist Matthew, Jen tries to connect with Matthew’s inner world. In addition, she has demonstrated ethical, professional and moral responsibility.
Interpretation also involves the use of translation to ensure that the original narrative is not lost. Sufferers demand certain amount of sensibility on the part of caregivers. Interpreting a patient’s world helps caregivers to be with them and understand their needs during the moment of suffering (65). Professionalism demands that nurses should remain in the diverse world of patients and help them adjust to the hermeneutic process. During the first hermeneutic movement, nurses should listen and allow the patients to narrate their story. The patient’s narrative should be able to speak to the nurses about the fundamental needs that the patients want. During such moments, nurses enter the alien world of the patients and try to understand their perspective. This occurs until a common language is sought and the horizons of the patient and the nurse are said to fuse (67) in a common language of hermeneutic conversation. Unless both parties are speaking the same language, it is difficult to have a mutual understanding of the same subject matter.
Nurses should seek the historical horizon of patients to enable them to perceive and understand the true dimensions of their stories. Failure to have such historical understanding may lead to misunderstanding of the significance the patients’ narratives (67). This proposition can be useful in The Walk if Matthew is able to listen, comprehend and respond to what is being said by the nurses. The inability to hear and respond to Lindsay’s calls limits Matthew to narrate his side of the story about what he feels. The process of sharing stories between patients and nurses transforms people’s thinking about meaning of illnesses and suffering among patients. Patients’ first language is that of lamentation and signifies deeper calls to care from nurses. Thus, language, words and concepts play an instrumental role in formation of knowledge.

Application as a hermeneutic process

Application comes after understanding and interpretation. It helps to make concrete the inherent meaning in the narrative. For a nurse to apply the meaning in a narrative she must have a deeper understanding and interpretation of what is contained in it. Application of moral decision relative to the patient’s narrative occurs when a nurse has been formed by education. Education helps in knowing what is morally right and wrong. Education and custom shapes them to make moral decisions throughout their profession. These actions prevent the risk to turn patients into objects during the application of ethics of suffering in the hermeneutic process. Suffering of patients allows them to open up to what they had concealed. Patients talk to us when they are in need. Their skin reflects vulnerability and susceptibility that are sometimes marked by traces of wounds. Thus, when they present themselves to nurses, they reveal their deepest needs (69). Even though Matthew remains silent in the story, the decision by Jen and Lindsay to take him through the operation processes reflects the nurses’ deeper understanding of the various applications of ethics in the practice of nursing. The narrator of “The Walk” indicates delight with the nurses for calling Matthew by name. Allowing the family members and relatives of Matthew to bid him good bye signifies their understanding of the inevitability of his death. The narrator concludes by appreciating the invaluable role that nurses play in providing care to patients.
This paper sought to examine how Raholm’s approach on ethics of human suffering can be useful in “The Walk.” The study finds out that understanding, interpretation and application of ethics is paramount in the medical practice. Nurses, as the foremost caregivers in healthcare organizations, showed abilities to understand the narratives of patients. The contribution of two nurses in the story reveals their understanding of their ethical responsibilities and abilities to develop a mutual understanding with the patients.