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The ability to cope with an end-of-life situation is a key qualification in nursing care. All things considered, German nurses may be said to have seen their first exposure to a terminal patient as an initiation into the profession. When a young woman was able to deal with death and with dying patients, she was generally regarded as suitable for the nursing profession.1 Pivotal for this terminal care that nurses had to render was the question of whether a seriously ill patient should be told the truth about his or her imminent death and then, how this "truth" was to be dealt with. Under the rubric "truth at the bedside" ("truth telling" in the American debate), discussion is currently taking place in German-language literature on the medical ethics of whether and to what extent the physician should disclose his prognosis to a dying patient. In Germany, even nowadays, the question of how to deal with truth telling is something that has to be negotiated between nurses and physicians and sometimes gives rise to conflicts. From the legal point of view, diagnosis and prognosis as well as their disclosure to the patient are exclusively reserved to the physician. However, nurses are frequently confronted with questions from seriously ill patients and their wish for comprehensive disclosure of their condition. Th us, German nurses frequently feel quite powerless when, in their view, the patient is not, or only insufficiently, informed about an incurable and fatal disease.2
This article retraces the historical roots of the medical and nursing ethical question of truth telling back to the nineteenth century. It focuses on the perspective of the nurses trained at the first German deaconess motherhouse at Kaiserswerth and compares their way of dealing with dying patients, death, and truth telling with the reflections of physicians on this topic in the nineteenth century. The analyses in this article are based on everyday sources on Protestant nursing care, because a large number of these historical records exist, while hardly any records are available on daily work in Catholic nursing care.3 Consequently, the results presented in this article offer only limited insight into the daily routine of nurses in dealing with dying patients and truth telling and thus have to be understood as a...