Susan Benedict

Factors influencing choice between mastectomy and lumpectomy for women in the Carolinas

The Carolinas have been documented to have a low rate of breast‐conserving surgery. The purpose of this study was to determine factors that influence womens choice between mastectomy and lumpectomy.

An ethics of testimony: prisoner nurses at Auschwitz.

This historical research report presents and analyzes 2 recently identified narratives of women who underwent sterilization experiments at the Auschwitz concentration camp during World War II. A description of the historical and contextual background is presented in which involvement of the prisoner nurse occurred in the sterilization experiments. Using a critical feminist perspective, the ethics of nursing involvement are discussed in these experiments, with an emphasis on the political dimension. Salient implications are explored for contemporary nursing.

Ethical dilemmas in HIV/AIDS care: Should a nurse participate in a patient's suicide?

Dr. H is a 35-year-old male college professor who had end-stage AIDS. He has been hospitalized several times within the past year for Stage IVB nonHodgkins lymphoma. Chemotherapy was not successful in producing a remission. Although he has little pain, he has an unrelenting cough produced by the tumor infiltration of the nerves. He takes codeine tablets, cough syrup with codeine, and Valium to suppress the cough. Dr. H had stated on numerous occasions that he is terrified of choking to death during a coughing attack. Dr. H currently is receiving daily home health care from an RN. This RN has seen him several days a week for the past 3 months. Dr. H has, with the assistance of home care, been able to continue to live alone in his apartment. He has a side circle of friends and professional colleagues, but their visits have decreased in frequency within the past weeks due to Dr. Hs inability to sustain conversation without producing a coughing attack. He is estranged from his family of origin and has not had any contact with them for more than 5 years. Recently, the home health nurse noticed the book Final Exit on Dr. Hs bedside table, along with material printed from the Internet on assisted suicide. When the nurse asked about these items, Dr. H acknowledged that he was planning his suicide and asked the nurse to be with him to assure that it went well. Dr. H told the nurse that he had already arranged with a physician friend to provide the medications recommended in Final Exit; however, the physician was unwilling to be present. Dr. H asked the nurse to be present for the suicide and to be responsible for notifying his primary physician of the death after the nurse is assured that no vital signs are present.

A nurse working for the Third Reich: Eva Justin, RN, PhD.

Eugenics underpinned the Nazi race theories which saw the murder of over 10 million people from “undesirable” groups, including Sinti (referred to in Nazi times as “Gypsies”), during the Holocaust. Eva Justin, from Dresden, completed a doctoral dissertation which examined a group of Sinti children of St Josef’s Home in Mulfingen, Germany. She aimed to prove the racial inferiority of these children; her work was done with no informed consent, and the children were sent to Auschwitz after her experiments. The study was supported by senior Nazis, supervised by Nazi “scientists” and examined by committed Nazis. We argue that her work was biased, poorly designed, and ultimately unethical, but was in keeping with methods of the emerging disciplines of anthropology and racial hygiene, in Germany and other countries, at the time. It is not possible to say that her work caused the children to meet their deaths (of the 39 children she included, only four survived); however, she did reinforce the Nazi racial theories. It is unfortunate that one of the first nurses in the world to receive a PhD did so through research attempting to prove that a group of children were “racially inferior” in support of National Socialism.

Nurse participation in legal executions: An ethics round-table discussion

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a range of opinions were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion.

Wanda Ossowska (1912-2001) and Stanislawa Leszczynska (1896-1974): Polish nurses working under Nazi occupation

Poland was invaded by Nazi Germany on 1 September 1939 and World War II began on 3 September. Polish nurses have their place in this difficult history. In the first months of occupation, nurses focused on caring for wounded soldiers. In order to protect them from prisoner-of-war camps and execution, nurses sought safe havens for the wounded in private homes and transported them there. After their regular jobs, the nurses visited them, changed their dressings and provided them with civilian clothes so that soldiers could eventually escape. This paper describes the work of two of these nurses, Wanda Ossowska and Stanisława Leszczyńska. The first three authors (BD, SH, AJS) were nurses in Poland at that time and they present some of the information in this paper as primary source data.