Therapeutic relationships and reflective practice

Mick McKeown & Dave Mercer
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Discuss the contribution that nurses and other
health workers can make to resisting the neofascist manifesto of the British National Party
(BNP) and other groups such as the EDL & SDL
Discuss institutionalised racism and healthcare in
the context of politically divisive and
discriminatory political ideologies
Explore the persecution of the mentally ill,
learning disabled and other vulnerable groups in
Nazi Germany
Think about professional ethics and political
struggle in a broader critical engagement with
human suffering, power relations and community
organising
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Increasing visibility and electoral ambitions of right-wing nationalist
parties across Europe
The racist extremism of the 1980s National Front reinvented and repackaged as the British National Party and more recently the violence
of groups such as EDL & SDL
Exploitation of depressed economic circumstances and targeting of
disaffected white working class areas
On race
“We affirm that non-whites have no place here at all and will not rest until every last one
has left our land” (Nick Griffin, BNP Leader)
On disability
“[mourners] unhealthily dominated by an excess of sentimentality towards the weak and
unproductive...there is actually not a great deal of point in keeping these sorts of people
alive after all” (Jeff Marshall, BNP Organiser)
On rape
“Rape is simply sex. Women enjoy sex, so rape cannot be such a terrible physical ordeal.
To suggest that rape, when conducted without violence, is a serious crime is like
suggesting that force feeding a woman chocolate cake is a heinous offence. A woman
would be more inconvenienced by having her handbag snatched” (Nick Erikson, BNP
Organiser).
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BNP membership list leaked
Public sector workers exposed
as members
Clear relevance for nursing
Raises questions over
compatibility with professional
ethics and practice
Unison policy to exclude from
registration
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The Nursing and Midwifery Code
of Conduct (2008)
A professional requirement to
‘treat people as individuals’
Equivocal advice suggests that
personal and political views can
be balanced with a commitment
to equality and diversity
Equality issues are reinforced in
the new standards for preregistration education
“You must not discriminate in any
way against those in your care”
(NMC 2008)
“The NMC does not forbid anyone
on the register from being a
member of any lawful party or
organisation. However, your
fitness to practice could be
called into question if you allow
your political views or personal
beliefs to contribute to behaviour
that was contrary to your Code”
(NMC 2009).
The value of the nursing code (NMC 2008)
is that it enshrines the core values of
the profession. It places nursing in the
vanguard of actively:
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Promoting social justice
Safeguarding human rights
Upholding patient dignity
Resisting discrimination and
persecution
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Over-representation in diagnosis
More coercive introduction via
police, courts and mental health
legislation
Less psychotherapy and talking
treatments
More physical treatments such
as medication and ECT
More and longer seclusion
More physical restraint
More deaths in custody
Concentration at hard end of
psychiatry, secure units
Direct racism, institutional
racism, and staff support for far
right groups
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Real higher incidence of
mental disorder for black men
◦ Biological or genetic accounts
◦ Effects of social disadvantage and
racism
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Ethnocentric bias in the system
◦ Mis-diagnosis due to lack of cultural
sensitivity
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Social construction of race and
mental disorder
◦ Power of language and
representation
◦ Big Black & Dangerous
◦ Black otherness
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Physicians and academics were early
supporters of National Socialism, and
psychiatry was most involved (Seeman 2005).
Racial legislation and eugenics laws
introduced from the early 1930s, led to
sterilisation, euthanasia and genocide
(Friedlander 1997).
Killing centres established at psychiatric
hospitals. The physician selected patients for
death, but nurses and caregivers undertook
the killing (Benedict & Kuhla 2007).
The nurse was the ‘political soldier’ of the
health service (Steppe 1992)
“Official notions of difference, which would
later find their most diabolical expression
in the murder of the Jews, were first
expressed in state-sanctioned killings of
children and adults with a wide range of
physical, emotional, and intellectual
disabilities” (Mostert 2002: 157).
“Some of the nurses put their moral duty to obey
proper orders ahead of their moral duty not to
kill. Others believed that what they did was not
killing but merely the outcome of obeying a
morally licit command” (Benedict & Kuhla 2007:
791).
“The narratives that emerge from this clearly
documented evidence of active involvement of
professional nurses in mass murder, torture, and
unethical experimentation are uniformly chilling
and extremely significant for consideration for
contemporary nursing” (Georges 2006: 161).
Annie Altschul survived anti-Semitism in Austria
and escaped Nazi persecution
Witnessed discriminatory treatment while
training as a nurse in Britain
Lifelong commitment to socialist and humanist
politics as a philosophical basis for caring
“It behoves nurses to listen, to
understand, to restore dignity
and to place personhood at the
very centre of their practice now
and in the future” (McKie 2004:
147)
“The narratives that emerge from
this clearly documented
evidence of active involvement
of professional nurses in mass
murder, torture, and unethical
experimentation are uniformly
chilling and extremely
significant for consideration for
contemporary nursing” (Georges
2006: 161).
Why do you keep dragging
up history?
Survivor stories could be
from Guantanamo ,
Rwanda,
Zimbabwe,
Former Yugoslavia ,
Palestine ,
Afghanistan,
Iraq ...
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History of health care workers
active in resistance to fascism
In trade unions
Community activism
Anti-fascist groups and
alliances
Making links at the level of
occupation and activism
10 things your union can do
1 Invite a HOPE not hate speaker to your National Executive Committee, regional committees and branch
meetings – we want to maximise the involvement of union members in our campaign, especially among those
groups targeted by the BNP and who are least likely to be currently involved.
2 Recruit branch volunteers to take part in campaigning activity.
3 Set up anti-fascist pages on your union’s website, including a link to the HOPE not hate website. Keep it
updated and add your own information, including union events and activities, and briefings for union members
about why your union opposes the far right.
4 Work with us to produce specific briefings for your members in different employment sectors and equality
groups. We already have material for black members, women members and LGBT members.
5 Encourage branches to affiliate to the HOPE not hate campaign. We can supply model motions.
6 Get your NEC to donate to the HOPE not hate campaign.
7 Set up training events for your members on how they can help to combat the far right in their workplaces and
communities.
8 Link up with local community activists and other trade unions to campaign against the far right. Encourage
involvement in trades councils.
9 Promote the HOPE not hate campaign to union learning reps; organise learning-at-work days.
10 Run a “register to vote” campaign in your workplaces, produce branch briefings about the HOPE not hate
campaign and encourage all your members to get involved.
•The BNP would kick out all those people who were not born in Britain. What if every other
country in the world kicked out the Brits? A staggering 5.5 million people would be sent back here –
far more than would leave our shores. This includes 800,000 from Spain, most of whom are
pensioners.
• If non-white people were ordered out of Britain then the NHS would collapse overnight.
16% of nurses are from minority ethnic communities, as are 40% of new dentists and 58% of new
doctors!
•The BNP would introduce apartheid into Britain. The BNP call for whites to be given first
preference in housing, education and jobs. This is no different from apartheid South Africa, a racist
regime which the BNP supported.
•Mixed-race relationships would be outlawed. The BNP constitution opposes any racial
integration. Articles in BNP journals condemn mixed-race relationships as “mongrelising the white
race”.
•The BNP’s answer to violent crime is to allow every household to have a gun. We kid you
not. This barmy idea was in the BNP’s 2005 general election manifesto.