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This chapter discusses the troubling legal and ethical issues raised by admissions to nursing homes. Current practice and the existing legal framework for involuntary admissions are discussed and it is argued that there is a need for safeguards in relation to such admissions in Ireland as these constitute a deprivation of liberty. The chapter also deals with how decisions are made by families and healthcare professionals in relation to possible involuntary nursing home admission. This includes consideration of how a functional assessment of capacity in such cases should be approached and the arguments for and against involuntary admission in the person’s ‘best interests.’

The Kingdom of Swaziland (population 1, 069, 000) is a small landlocked country in Southern Africa covering an area of 17, 364 km² between South Africa and Mozambique. Four NGOs provide six hospice-palliative care services in Swaziland: Hope House; Swaziland Hospice at Home; Parish Nursing; and the Salvation Army. In addition, several community-based church organizations provide supportive care to terminally ill patients. All the hospice services are charities and rely heavily on donations for their income. Yet, funds come from a variety of sources. At a meeting of palliative care providers held in June 2003, a commitment was made to form a national palliative care association. The palliative care coverage and the palliative care workforce capacity of these services are reviewed. The chapter then outlines the history and development of hospice-palliative care in Swaziland.

In 1965, a paper by Cicely Saunders in the American Journal of Nursing attracted considerable interest and correspondence with the author and gave further impetus to her growing reputation on both sides of the Atlantic. Here, she argued that the last stages of life should not be seen as defeat, but rather as life's fulfillment. Describing the work at St Joseph's as ‘the endless fascination of watching each individual come to terms with his own illness in his own way and come along his own path to life's ending’, the paper sets out the broad principles of the approach. There are numerous short case illustrations and the paper focuses particularly on the nursing aspects of care, especially the taxing responsibility of telling or not telling, concluding with a description of three patients who had died recently at St Joseph's Hospice.

1976 saw the republication and updating of the series of articles that had originally appeared in Nursing Times in 1959. Rather than concentrate on assertion and counter-assertion, the article focuses on the argument that people are suffering when they need not. It is noted that there have been many therapeutic advances in the seventeen years since the articles were written, and some add to the problems — particularly when no clear rationale for continuing treatment exists. It introduces the notion of ‘living wills’, ‘furore therapeutics’, and ‘meddlesome medicine’. Much more thought and consultation is required on the question of euthanasia and in particular two additional questions need to be answered: ‘Do patients ask for euthanasia’? and ‘What would they do and feel if mercy killing became a legal option’?

This chapter opens with the controversies following publication of U.S. journalist Katherine Mayo's Mother India. While Mayo's reincarnation of the colonial "woman question" ultimately backfired in the face of mounting Indian anti-colonial mobilization, her less noted connections with the Rockefeller Foundation and its version of public health and medicine survived. Chapter four shows how the Indian nationalist elite took on scientific medicine as part of their path to progress, and at the same time instituted themselves at the lead of "sanitizing" India's oppressed castes and classes. This combined with the influence of Rockefeller funded professional nursing to create a space for the emergence of Indian nursing leadership. The chapter details the establishment of baccalaureate nursing in Delhi and at Vellore, and the critical role that foundation fellowships and its international network played in maintaining the ties between professionalization, migration and empire after Indian independence/partition.

The introduction provides an overview of the book’s focus, structure and remit, outlining commonalities as well as differences between the experiences of colonial nurses discussed in the book. Drawing from their experience in researching and writing gender and racial social histories and in colonial and post-colonial nursing history respectively, the editors tease out emerging themes placing them within a clear chronological and historiographical framework. They examine how this field has developed in the history of medicine and identify questions which current research still leaves unanswered, but for which nursing’s history is uniquely placed. The chapters in this book reveal the presence (or absence) of underlying racial and cultural tensions between nurses and their patients, nurses and professional colleagues or their indigenous counterparts; and the editors question whether past histories have not been grossly oversimplified by projecting images of imperial collaboration/cooperation onto all forms of colonial nursing, by all countries, across a long timespan. We evaluate the difficulties of discussing and analysing the impact of colonial nursing from the indigenous population’s viewpoint to present balanced analyses, and explore different experiences of colonial/post-colonial nursing over more than a century whilst considering the impact of peacetime or conflict on nurses and nursing.

At the commencement of the Second Anglo-Boer War the small cohort of nurses available for service in South Africa were insufficient to meet the demands inherent with the exigencies of modern warfare and ever-increasing numbers of sick and wounded. Around 1,400 civilian nurses from across the Empire served in varying capacities during the South African campaign, yet there was no defined overall control of those lay women and trained nurses who offered their services. From 1891 Nurse Registration in the Cape had been established in law, yet there was no demarcation over the role and responsibilities of British nurses serving in South Africa. Concerns were raised that some nurses were motivated for wartime service owing to a search for adventure in the colonies. Yet there were a number of motivators, including those of a humanitarian nature, combined with a patriotic sense of duty. This chapter will examine how accusations that nurses were ‘frivolling’ in South Africa, raised concerns over control and organization of nurses in future military campaigns and had an impact on discussions over levels of authority female nurses might be allowed in the new Queen Alexandra’s Imperial Military Nursing Service, established at the close of war in 1902.

From 1900 Dutch nurses arrived in the East Indies, but their numbers were wholly insufficient to meet the colony’s increased demand for competent nursing staff. Therefore European physicians started training native women as nurses. Initial endeavours were disappointing with problems closely connected to the position young women occupied in native society. Young women from poor families were uneducated, whilst those from middle and upper classes often considered it culturally improper to live outside their parents’ home at marriageable age. The poor reputation of governmental hospitals made them only appropriate as work places for lower-class women and women with dubious reputations. European nurses taught and supervised nursing and provided role models. After qualifying, nurses could spend a further two years studying midwifery which combined hospital and community experience. The nurses and midwives were deployed as intermediaries to spread the ideology of western care among the native population, who nevertheless continued to have an aversion to western medicine. The (student) midwives were distrusted because of their youth and unmarried status. Native women variously rejected or embraced such advice or accommodated it selectively. In the main they remained loyal to the indigenous healers, the dukun bayi.

The Ethiopian war (also known as the ‘Abyssinian War’) refers to the war waged by Italy during Mussolini's regime against the Empire of Ethiopia in 1935. It led to the proclamation of the AOI (Italian Oriental Africa) in 1936. Through analysis of primary and secondary sources the chapter explores how the Italian Army health care service was organised during the war, and the status of nursing in the Italian Army. From original reports, it was discovered that the male military nurse corps provided the majority of nursing care on the battlefield, in hospitals and clinics and in ambulances and radiological laboratories. Only 384 female Italian Red Cross volunteers participated in the war. They were called “Lady” nurses or Sisters because they belonged to the Italian nobility and to the upper class. These female nurses were joined by 200 missionary nuns of different religious orders. At the end of 1941, during the Second World War, the British Army freed Ethiopia. With reference to the data examined, the outcomes show that, in spite of what the official reports said, the real protagonists of nursing were male nurses.

Professional British nurse, Kate Luard, and highly-trained US nurse, Alice Fitzgerald, both served with the Queen Alexandra’s Imperial Military Nursing Service during the First World War. Both wrote powerful memoirs of their experiences. Their very different perspectives combine to offer an overview of the British military nursing services on the Western Front, which captures both a sense of their dedication to military nursing and the nature of the trauma they witnessed – and experienced themselves.

Some of the writings of soldier-memoirists have been likened to epic romances, because they describe the way in which the so-called ‘hero’ faces ordeal and achieves ‘apotheosis’, or personal transformation. Some nurses’ writings adopt a similar style. The romance trope was particularly powerful for writers on the Eastern Front. The memoirs of Florence Farmborough and Mary Britnieva reveal their authors’ attachment to the idea that nurses were transformed by the ‘ordeal’ of their experience.

This chapter explores the influence of the Red Cross Nursing Service in Florida after World War I when the American Red Cross focused on public health nursing. Central leadership from its Washington, DC headquarters directed policies and values that guided Red Cross nurses into the southernmost state. The policies and the nurses themselves illuminated the connections between the Red Cross, race, class, and a population in dire need of healthcare. Becuase the Red Cross was to some extentcolorblind with its policies and nurse recruitment, it paved the way for black public health nurses to forge new paths. From local Red Cross chapters, the white and few black nurses began to establish links with the communities. The Home Hygiene and Care of the Sick classes offered a particularly important means to serve all, regardless of race. The aftermath of Florida’s 1928 hurricane highlighted the more racially open policy towards the employment of African American nurses. Rosa Brown demonstrated the need for public health nurses to improve health in the neglected rural areas of Palm Beach County.

With the greatest need for improvements of maternity care in the south, this chapter returns the focus to the southern states. The National Organization of Public Health Nurses acknowledged the vital role African American nurse-midwives played in the public health education of black women and their families and two schools were established, one of which was the Tuskegee School of Nurse-Midwifery in Alabama. Much of the chapter is devoted to the specific training required to be effective in the isolated, poverty stricken communities of the rural south and shows how cultural sensitivity was central to nurse-midwives’ work.

This chapter explores visual representations of public health nurses who belonged to the National Organization for Public Health Nursing (NOPHN) in the 1930s, with particular emphasis on how the work of these women was quite literally “envisioned.” It first considers the NOPHN’s interest in visual culture and education during the period before discussing how new nursing uniforms worked symbolically to signal the nurse’s modernity. It then examines two of the most often-reproduced iconic images of public health nurses—the visiting nurse arriving at someone’s home, and the nurse within the home tending to a newborn—and suggests that these oft-repeated scenes depicted the public health nurse as a link, or mediator, between public and private institutions. Thus, the public health nurse emerged as a new kind of modern, mobile, independent young woman charged with securing the health of the nation.

This chapter comprises an introduction to Elizabeth Clinton, Countess of Lincoln (c.1574-c.1630) and seventeenth-century attitudes to breastfeeding, and the edited text of The Countesse of Lincolnes Nurserie (1622). In the early seventeenth century, it was fashionable for aristocratic families to employ a wet-nurse to breastfeed their children rather than for mothers to do this themselves, but there was a consensus among medical treatises that it was better for a child to be nursed by its own mother. Clinton expresses regret at not nursing her own babies and uses this text as a form of atonement, teaching younger women as the Bible instructs older women to do. She uses other examples from the Bible in order to support maternal nursing, and dedicates the work to her daughter-in-law, Bridget, Countess of Lincoln, who apparently nursed her own baby.

Chapter 2 addresses the question of preparedness for the Revolution. Marc-Antoine was a devoted reader of Jean-Jacques Rousseau and friend of abbé Mably. Rosalie wrote more frequently about La Fontaine and Samuel Richardson; she was also devout in her Catholic practices. Rosalie shared the common middle-class concern over the corrupting quality of wealth. She regretted her family’s subordinate social position as members of the Third Estate. This chapter argues that Rosalie and Marc-Antoine were potentially well prepared to become revolutionaries.