Navigating the ethical "space in-between" nurses' lived experiences in forensic inpatient care interpreted through Løgstrup's ethical philosophy.

Abstract

Purpose: This study examines the nurse-patient relationship in forensic psychiatric care (FPC) from a philosophical perspective, with a focus on ethical complexities. Using Løgstrup's ethical philosophy, the work explores how trust, moral responsibility, and relational tensions shape caregiving.

Materials and methods: A theoretical analysis was conducted based on five empirical qualitative studies of nurses' lived experiences in forensic inpatient care. These studies, rooted in phenomenology and hermeneutics, were re-analysed using reflective lifeworld research (RLR), a phenomenological approach grounded in the lifeworld theory of Husserl and Merleau-Ponty, that emphasizes openness and reflection to capture the meaning of lived experiences. The analysis was interpreted through Løgstrup's ethical framework.

Findings: Five key themes emerged: Having Trust or Feeling Distrust, Being Compassionate or Being Indifferent, Having Courage or Being Afraid, Being Genuine or Pretending, and Being a Ballerina or Being a Bulldozer. These themes highlight the "space in-between", where nurses navigate ethical tensions, institutional constraints, and patient interactions.

Conclusions: Forensic psychiatric nursing requires balancing institutional control and compassionate care. Ethical encounters emerge through both self-reflection and relational engagement. Structured reflection and dialogue help nurses navigate ethical challenges, foster professional growth, and enhance patient-centred care.