At the heart of the problem in this issue’s case scenario (see Case scenario box) is the difference in worldview between a district nurse and a patient. Faye, the patient concerned, appears to want to suffer for her faith and is hoping for a miracle cure. The district nurse, Mary, is concerned that this attitude is causing Faye to experience ‘unnecessary’ pain and suffering. She is also worried that Faye is being pressurised by her church leaders and parents to forego pain-relieving medication. Not surprisingly, patients with a religious worldview will frequently use spiritual narratives to make sense of their disease and symptoms. Conflict may arise between healthcare professionals and patients when such narratives are not respected. Faye’s case will be discussed from both a legal and an ethical standpoint. The article outlines the importance of assessing patients’ mental capacity to make and understand decisions and examines the issue of coercion. Once mental competence has been assured and coercion ruled out, the importance of respecting patients’ view of their world and individual choices is emphasised. Conflicts of interest: none
- Duty of care
- Religious/spiritual narratives
- Symptom management
- Vulnerable adults
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