Abstract

This dissertation articulates the conceptual foundation for, and moral significance of, clinical intimacy in nurse-patient relationships. American bioethics has embraced the paradigm of professionalism in characterizing appropriate relationships between healthcare providers and their patients. Contrary to other professional-client relationships, however, the fundamental qualities of nurse-patient relationships frequently oblige nurses and their patients to work together in ways not adequately captured by the professionalism paradigm. Clinical intimacy is put forth as a form of co-meaning making between nurses as their patients, a phenomenon that is revealed when one shifts from a paradigm of professionalism to a paradigm of nurses and patients encountering each other already in relationship. The reconstruction of meaning, and the structures via which patients create and understanding meaning, is argued to be a central moral obligation in certain nursing relationships with patients who have experienced severe and unexpected trauma, disability, and illness