relationship for what it is, and for the instrumental purpose(s) for which it exists. Or
rather, it is to fail to recognise that a relationship between a nurse and a patient is
essentially instrumental in origin but need not remain wholly instrumental. Indeed, de
Raeve, amongst others would claim that a wholly instrumental relationship between a
nurse and a patient would (generally speaking) be taken to be a poor example of
professional nursing. The instrumental origin of the relationship does not, of itself,
preclude authenticity in interactions between nurse and patient, and it does not mean
that nurses are inherently untrustworthy (as MacIntyre implies). But what it does mean
is that the trust relationship between a nurse and a patient is essentially different from
that between friends (or from other sorts of everyday intimate relationships) and to
judge them by the same criteria is inappropriate. In addition, in making his claim
MacIntyre resorts to cynical characterisation of what it is that social workers might,
sometimes, be taught. He also assumes too much in making two sub-claims: i) that in
claiming that sometimes social workers are taught to become friends to their clients,
they are being taught to be friends with clients in the same way that they would become
friends with individuals outside of a professional-client relationship (that is, in the sense
of developing social friendships); and ii) that in becoming friends to clients there is an
intention to manipulate those clients. Neither of these claims withstands close scrutiny.
These claims cannot go unchallenged for to accept MacIntyre’s characterisation of
professional-client relationships is to accept that virtues play no part in the work of
nurses (and other health and social care professionals); indeed, it is to accept that
professionals misappropriate virtues for instrumental purposes and in so doing turn
them into vices.
MacIntyre does not source his evidence for the claim but it is difficult to imagine that
any curriculum (even one from the 1970s) would make any explicit statements of the
sort that social workers should be taught to become friends with their clients. It is
possible (even likely) that MacIntyre has misinterpreted the idea that in the 1970s social
workers might have been encouraged to befriend their clients but this is a different
proposition. The idea Ofbefriending clients (if, indeed, this idea is, or has been,
encouraged by those who teach social workers) is quite different from the idea of
becoming friends, and would be understood to be very different from friendship as such
by social care professionals. The everyday meaning Ofbefriending is, after all, to act as
a friend, not to be a friend.
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