Natascia Bobbo

According to Gramsci, one of the most important tasks of educators should be to make children equal in the face of peril (1918/2023, p. 23). Gramsci would argue that educators should be to empower every child and adolescent, regardless of gender, socioeconomic background or ethnic origin, to acquire, recognise and express the resources necessary to confront and overcome peril. However, given that we have evidently failed in this mission, and considering the malaise experienced by our teenagers, this study aims to explore the nature of the perils perceived by our youth, what we as educators should do to help them overcome these challenges, and, above all, our responsibility in making them so vulnerable. Three hypotheses are put forward and discussed: _i_) perceived dangers for adults and children change over time; _ii_) our parents were emotionally stronger than we are now; _iii_) and we have allowed the neoliberal ideology of competition to influence our educational intentions, whereas our parents did not. Critical pedagogists could suggest us how to free ourselves and our children from the oppression of competition.

Maria’s case, involving a progressive neurological condition, shows how clinical urgency, parental meaning-making, and clinical deterioration can become ethically entangled in palliative care. After a femur fracture, prolonged immobilization, worsening dysphagia, recurrent respiratory infections, and long-term nasogastric tube (NGT) feeding, the clinical team proposed percutaneous endoscopic gastrostomy (PEG). Maria’s mother repeatedly refused, describing PEG as invasive and incompatible with her daughter’s dignity. This case study, written from the perspective of the clinical team, distinguishes between documented clinical events, reported statements, and retrospective interpretation. It argues that the conflict cannot be reduced to beneficence versus parental autonomy nor to a simple contrast between clinical time and caregiver lived time. Rather, temporary reliance on NGT, increasing nutritional risk, and delayed trust widened the gap between what clinicians judged non-deferrable and what the mother could accept. The case highlights both the necessity and limits of shared decision-making.

One of the most unpredictable things the pandemic brought to our societies was the closure of hospitals and other health services to visitors. Preventing the spread of infection was the main reason for these decisions in the early days of the pandemic when there was no clarity about the means of transmission and the origin of the virus. However, in view of the persistence of the restrictions to date and the numerous negative consequences they have had on the professional and personal quality of life of doctors, nurses, patients and carers, the aim of this article is to analyse in depth the reasons why these decisions have been and, above all, are still being applied, also considering the hypothesis that the choices made so far in the training of health professionals should be questioned. The persistence of restrictions, the constant reduction of human and economic resources in the face of an increase in the demand for care have exacerbated the distance between health professionals and users, to the point of escalating into actual acts of violence and aggression. According to the Critical Pedagogy approach, educators can play a central role in activating formative and collaborative strategies, such as maieutic groups, to rebuild an alliance between those who today find themselves on opposite sides: health professionals on the one hand, and patients and families on the other.

Living with a chronic condition represents a strenuous experience that often could be lived as a sequence of waiting and crisis times. Therapeutic path incidents could represent however a catalysts and revelatory time, useful to patients to discover their own resources. A qualitative study according to the phenomenological hermeneutic perspective was conducted to understand the kind of skills expressed by the patients during a difficult episode, and the characteristics that identify patients who can overcome them better. From September 2019 to August 2020 twenty-three patients followed-up in four Hospital Units of Northeastern of Italy were enrolled. All the patients described an episode linked whit their pathological condition; they mentioned mainly supportive, reactive, or behavioral strategies and an acceptance attitude. The sample characteristics may explain the recurring acceptance attitude; however, the younger individuals, those with a higher level of education and those who faced precedent negative life experiences seem to better overcome challenging events. It can’t be taken for granted that patients possess all the skills necessary to overcome the frequent challenging episodes they have to face; for this reason, healthcare professionals should assess their learning and reactive attitude in order to tailor for them therapeutic education paths.

The illness immersion condition prevents patients from enjoying everything worth living life for. In any case, according to Frank, this condition could represent one of the most insightful experiences towards understanding the meaning of life. Using the metaphor of phoenix taken from May, Frank identified four kinds of embodiments through which the phoenix can reveal itself in a patient after an illness immersion experience: the phoenix that could ever be and the phoenix that might have been; the recurrent and cumulative phoenix and the reluctant phoenix. Based on these considerations, a qualitative study was conducted in order to give voice to the different phoenix embodiments focusing on several autobiographies of patients afflicted with severe or terminal illness. The analysis highlights several similarities that the different phoenixes shared ; however, a deep difference emerged in their worldview which proves able to lead them towards different epiphanies. These evidences reveal that every sick person should be understood, stimulated and accompanied throughout his lived experience of illness by an expressly designed and dedicated care.