reason to suppose that either feeling less vulnerable necessarily equates to being less
vulnerable nor that getting patients to feel less vulnerable is necessarily an appropriate
aim of nursing practice. It is possible to imagine nursing interventions that succeed in
enabling a patient to reduce her or his feelings of vulnerability while at the same time
actually making them more likely to be harmed.
While it is true that people do wish, in general, to reduce their feelings of vulnerability
and while it may be that in some instances in nursing this may have some therapeutic
value, there may be instances where reducing feelings of vulnerability is unhelpful or
even counterproductive. The competent adult surgical patient may well feel less
vulnerable once she or he understands the safeguards that exist to protect patients while
under general anesthesia. But apart from the suspicion that this may be merely an
exercise in anxiety reduction the patient will still actually be vulnerable during an
operation. The patient in a coma being nursed in an intensive care unit will actually be
less vulnerable when certain protective procedures and protocols are observed but is
unlikely to feel less vulnerable while she or he remains unconscious. The patient who is
unable to judge the extent of risk from certain sorts of behaviour or threats would not be
well served by the nurse who led them to believe they were less vulnerable than they
actually are. The patient who believes she or he can fly would better served by being
encouraged to feel more rather than less vulnerable when about to launch her or himself
from the third floor of a building.
Thus to merely accept that helping people to feel less vulnerable is a good thing is not a
position that can be sustained. Encouraging people to feel less vulnerable may lead to
foolish risk taking and consequently compromise human flourishing. So the claim of a
therapeutic reduction of the perception of vulnerability may apply where perceptions of
vulnerability get in the way of human flourishing, as in the case of the earlier example
where that perception was based on a false belief, but it cannot be assumed that it will
be a good thing in all situations. From this it should be clear that judgment is required to
ensure that in any therapeutic attempt to reduce feelings of vulnerability an individual’s
sense of vulnerability remains consistent with human flourishing. To do otherwise is to
effect rather than avoid harm. This, it seems is no simple task for it requires a normative
ontology absent in the account offered by these authors.
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