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No one denies the importance of ‘laughter and humour ' in life. We can hardly imagine life without laughter. A world without humour is a dead world. Even when there is little to laugh at, there is laughter. As a small goodness.1 the positive effects of laughter and humour on human’s health and well-being have been widely documented, especially on physical and psychosocial level.

But is laughter and humour in healthcare acceptable? In times of crisis, such as the Covid-19 pandemic, can we make it to encourage caregivers to pay attention to humour? Can we ethically support using humour in care when being so close to dying people, to patients totally isolated from their loved ones?2 Or is humour perhaps just what is needed to persevere as a caregiver, to survive difficult situations in care? In any case, humour in care is not something to laugh at, it is a very serious topic.

Listening carefully to the patient’s voice makes us think that laughter and also humour may play a more important role in care than we think. For patients, laughing and humour are among the essential qualities needed in the nurse-patient relationship.3 Humour helps maintain dignity, it can help patients feel ‘human’ and not just a recipient of care. Using humour means that you do not underestimate the other (“you are strong enough to deal with this”). Moreover, laughing and humour also possess the property to connect people, to strength the bond between persons, to bring out of isolation; they create a feeling of sharing, of belonging.

And let us also be aware of the transformative power of laughter and humour in caring and care-relations.4 It is remarkable how nurses using humour can make things move in care, between patients and caregivers, between patients and family, but also within the team. Use of humour in care can help interrupt, defrost, relax, disarm and reinforce values, create or strengthen trust in the patient-nurse relationship. Humour is a form of self-compassion and compassion for the other. It is also a way of relating to the other. No matter how different you are, how different the world you and the other person live in, if you can laugh together, there is a lot that connects you both.

The message is clear: laughter and humour do belong in care, they allow the nurses to add value and dignity in patient’s life. Humour can be seen as a virtue: an essential element of virtuous caring and of a flourishing professional life as a nurse.5 The potential of humour in nursing care should not be underestimated.

Why is it then that we feel a certain reluctance among nurses to use humour? Patients who are having a hard time should not be burdened with jokes, right? “There’s just no time to laugh and joke around in healthcare”, a nurse might say. Or “In my organization, humour and laughter are seen as unprofessional and unethical nurse behaviors”.

Laughter takes courage.6 You have to be willing to venture out, sometimes to push the boundaries of the caring relationship. You have to be willing to make yourself vulnerable. If you do venture too far, it takes courage not to give up. After such an experience, it asks courage to not throw the baby out with the bathwater (i.e.: never dare to use humour again). As a virtue, a balance has to be struck between ‘too much’ and a ‘too little’ (the ‘mean’ in Aristotle’s ethics). That balance is different in every situation. If we want to encourage virtuous humour in nursing relations, we need room to also fail in finding the right balance. That also includes space to reflect (ethically).

So, yes, humour is a matter of ethics…

全文翻譯（僅供參考）

沒有人否認(rèn)"笑和幽默"在生活中的重要性。我們很難想象沒有笑的生活。一個(gè)沒有幽默的世界是一個(gè)死氣沉沉的世界。即使沒有什么可笑的，也有笑。作為一種小小的美德。1 笑和幽默對(duì)人類健康和幸福的積極影響已被廣泛記錄，特別是在身體和心理社會(huì)層面。

但是，醫(yī)療保健中的笑聲和幽默可以接受嗎？在危機(jī)時(shí)期，比如新冠肺炎大流行時(shí)期，我們能否鼓勵(lì)護(hù)理人員注意幽默？在如此接近垂死之人、與親人完全隔絕的患者時(shí)，我們能否在倫理上支持在護(hù)理中使用幽默？2 或者幽默也許正是作為一個(gè)照顧者堅(jiān)持下去，在照顧中度過困境所需要的？無論如何，照顧中的幽默不是一件可笑的事情，它是一個(gè)非常嚴(yán)肅的話題。

仔細(xì)傾聽病人的聲音使我們想到，笑和幽默在護(hù)理中可能比我們想象的更重要。對(duì)病人來說，笑和幽默是護(hù)患關(guān)系中所需的基本素質(zhì)之一。3 幽默有助于維護(hù)尊嚴(yán)，它可以幫助病人感受到“人”的存在，而不僅僅是一個(gè)接受護(hù)理的人。使用幽默意味著你不低估對(duì)方（“你有足夠的力量來處理這件事”）。此外，笑和幽默還具有連接人與人、加強(qiáng)人與人之間的聯(lián)系、走出孤立的屬性;它們創(chuàng)造了一種分享和歸屬感。

讓我們也意識(shí)到笑聲和幽默在照顧和照顧關(guān)系中的變革力量。4 值得注意的是，護(hù)士如何使用幽默可以使事情在護(hù)理中，病人和護(hù)理人員之間，病人和家人之間，以及團(tuán)隊(duì)內(nèi)部移動(dòng)。在護(hù)理中使用幽默可以幫助打斷，解凍，放松，解除武裝和加強(qiáng)價(jià)值觀，在護(hù)患關(guān)系中建立或加強(qiáng)信任。幽默是一種自我關(guān)懷和對(duì)他人關(guān)懷的形式，也是一種與他人相處的方式。不管你們有多不同，你們和對(duì)方生活的世界有多不同，如果你們能一起笑，你們之間就有很多聯(lián)系。

信息很明確：笑聲和幽默確實(shí)屬于護(hù)理，它們讓護(hù)士為病人的生活增添價(jià)值和尊嚴(yán)。幽默可以被視為一種美德：作為一名護(hù)士，這是有道德的關(guān)懷和繁榮的職業(yè)生活的基本要素。5 幽默在護(hù)理中的潛力不應(yīng)低估。

那么，為什么我們覺得護(hù)士們不太愿意使用幽默呢？那些日子不好過的病人不應(yīng)該被笑話所累，對(duì)嗎？"在醫(yī)療保健行業(yè)，沒有時(shí)間大笑和開玩笑"，一位護(hù)士可能會(huì)說?；蛘?在我的組織里，幽默和大笑被視為不專業(yè)、不道德的護(hù)士行為"。

笑需要勇氣。6 你必須愿意冒險(xiǎn)，有時(shí)候是為了突破關(guān)愛關(guān)系的界限。你必須愿意讓自己變得脆弱。如果你真的冒險(xiǎn)太遠(yuǎn)，那就需要勇氣不給予。在這樣的經(jīng)歷之后，就需要勇氣不把孩子和洗澡水一起倒掉（即：再也不敢使用幽默）。作為一種美德，必須在“太多”和“太少”（亞里士多德倫理學(xué)中的“中庸”）之間取得平衡。這種平衡在每種情況下都是不同的。如果我們想在護(hù)理關(guān)系中鼓勵(lì)良性幽默，我們也需要在找到正確平衡時(shí)失敗的空間。這也包括（倫理學(xué)上的）反思空間。

所以，是的，幽默是一個(gè)道德問題...

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