Sample records for empirical nursing ethics
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Melia, K M
1994-01-01
This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this is to ask practising nurses about the ...
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Nursing students and teaching of codes of ethics: an empirical research study.
Numminen, O H; Leino-Kilpi, H; van der Arend, A; Katajisto, J
2009-12-01
To explore graduating nursing students' perception of nurse educators' teaching of codes of ethics in polytechnics providing basic nursing education in Finland. Codes of ethics are regarded as an essential content in most nursing ethics curricula. However, little is known about how their teaching is implemented. Descriptive, cross-sectional design was used in this study. A total of 214 nursing students responded to a structured questionnaire with one open-ended question. The data was analysed statistically by SPSS and content analysis. Students perceived teaching of the codes as fairly extensive. The emphasis was on the nurse-patient relationship. Less attention was paid to nursing in wider social contexts. Educators' use of teaching and evaluation methods was narrow. Students whose teaching had been integrated into clinical training perceived that teaching had been more extensive. However, students did not perceive integration to clinical training as a much used teaching format. Students assessed their own knowledge and ability to apply the codes as mediocre. Those educators, whose knowledge about the codes students had assessed as adequate, were also perceived to teach the codes more extensively. Regardless of the responding students' positive description of the teaching, the findings should be interpreted with caution, due to the students' limited interest to respond. In teaching ethics, particular attention should be paid to more versatile use of teaching and evaluation methods, organization of integrated teaching, educators' competence in ethics, and student outcomes so that the importance of ethics would come across to all nursing students.
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Fostering nursing ethics for practical nursing
森田, 敏子; モリタ, トシコ; Morita, Toshiko
2014-01-01
Higher nursing ethics can raise nursing quality. The author attempts to define theproblem from the seedling of sensibility in practical nursing and focuses on the clinical environment surrounding nursing ethics from its pedagogical and historicalaspects. On the basis of these standpoints, the author discusses issues on the practical nursing as a practitioner of nursing ethics.
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Empirical ethics, context-sensitivity, and contextualism.
Musschenga, Albert W
2005-10-01
In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen because of its associations with "descriptive ethics." Unlike descriptive ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position.
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Stating the Case for Nursing Research Ethics Committees: A Discussion Paper.
Mitchell, Theresa; Fletcher, Ian
1998-01-01
Nurse-led research ethics committees are generally more tolerant of diversity in research proposals than are medical committees steeped in empirical traditions. However, national trends in nursing in Britain may influence a preference for multidisciplinary over nurse-led committees. (SK)
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Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris
2014-05-01
As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice.
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Towards a strong virtue ethics for nursing practice.
Armstrong, Alan E
2006-07-01
Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse-patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.
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Multicultural Ethics in Nursing Education: A Potential Threat to Responsible Practice.
Kikuchi, June F.
1996-01-01
Responsible nursing practice cannot be realized under multicultural, relativist ethics. An alternate ethical basis for practice that is grounded in moderate realism is transcultural ethics, which argues that natural human needs, inherent in common human nature, can be determined empirically and what constitutes a good can be derived therefrom.…
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Scepticism about the virtue ethics approach to nursing ethics.
Holland, Stephen
2010-07-01
Nursing ethics centres on how nurses ought to respond to the moral situations that arise in their professional contexts. Nursing ethicists invoke normative approaches from moral philosophy. Specifically, it is increasingly common for nursing ethicists to apply virtue ethics to moral problems encountered by nurses. The point of this article is to argue for scepticism about this approach. First, the research question is motivated by showing that requirements on nurses such as to be kind, do not suffice to establish virtue ethics in nursing because normative rivals (such as utilitarians) can say as much; and the teleology distinctive of virtue ethics does not transpose to a professional context, such as nursing. Next, scepticism is argued for by responding to various attempts to secure a role for virtue ethics in nursing. The upshot is that virtue ethics is best left where it belongs - in personal moral life, not professional ethics - and nursing ethics is best done by taking other approaches.
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Newham, Roger; Curzio, Joan; Carr, Graham; Terry, Louise
2014-01-01
This paper's philosophical ideas are developed from a General Nursing Council for England and Wales Trust-funded study to explore nursing knowledge and wisdom and ways in which these can be translated into clinical practice and fostered in junior nurses. Participants using Carper's (1978) ways of knowing as a framework experienced difficulty conceptualizing a link between the empirics and ethics of nursing. The philosophical problem is how to understand praxis as a moral entity with intrinsic value when so much of value seems to be technical and extrinsic depending on desired ends. Using the Aristotelian terms poesis and praxis can articulate the concerns that the participants as well as Carper (1978) and Dreyfus (in Flyvbjerg, 1991) among others share that certain actions or ways of knowing important for nursing are being devalued and deformed by the importance placed on quantitative data and measurable outcomes. The sense of praxis is a moralized one and most of what nurses do is plausibly on any account of normative ethics a morally good thing; the articulation of the idea of praxis can go some way in showing how it is a part of the discipline of nursing. Nursing's acts as poesis can be a part of how practitioners come to have praxis as phronesis or practical wisdom. So to be a wise nurse, one needs be a wise person. © 2013 John Wiley & Sons Ltd.
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Heritage ethics: Toward a thicker account of nursing ethics.
Fowler, Marsha D
2016-02-01
The key to understanding the moral identity of modern nursing and the distinctiveness of nursing ethics resides in a deeper examination of the extensive nursing ethics literature and history from the late 1800s to the mid 1960s, that is, prior to the "bioethics revolution". There is a distinctive nursing ethics, but one that falls outside both biomedical and bioethics and is larger than either. Were, there a greater corpus of research on nursing's heritage ethics it would decidedly recondition the entire argument about a distinctive nursing ethics. It would also provide a thicker account of nursing ethics than has been afforded thus far. Such research is dependent upon identifying, locating, accessing and, more importantly, sharing these resources. A number of important heritage ethics sources are identified so that researchers might better locate them. In addition, a bibliography of heritage ethics textbooks and a transcript of the earliest known journal article on nursing ethics in the US are provided. © The Author(s) 2015.
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Academic dishonesty in nursing schools: an empirical investigation.
McCabe, Donald L
2009-11-01
Academic dishonesty, whether in the form of plagiarism or cheating on tests, has received renewed attention in the past few decades as pervasive use of the Internet and a presumed deterioration of ethics in the current generation of students has led some, perhaps many, to conclude that academic dishonesty is reaching epidemic proportions. What is lacking in many cases, including in the nursing profession, is empirical support of these trends. This article attempts to provide some of that empirical data and supports the conclusion that cheating is a significant issue in all disciplines today, including nursing. Some preliminary policy implications are also considered. Copyright 2009, SLACK Incorporated.
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[Nursing ethics and the access to nursing care].
Monteverde, Settimio
2013-08-01
The increasing number of ethical issues highlighted in everyday nursing care demonstrates the connectedness between nursing ethics and nursing practice. However, what is the role of ethical theories in this context? This question will be examined in this article by analysing the contribution made by the ethics of care, in particular in understandings of gender roles, asymmetries of power, professional knowledge and experience. The adoption and criticism of an emergent nursing ethics is discussed and stated from different viewpoints. The actuality of the caring approach is affirmed by a new reading of the given situation. This article first describes the traditional perception of nurses as marginalised actors in the health sector. By making reference to the current and growing global scarcity of nursing care, it contends that nursing will no longer be marginalised, but instead at the centre of public health attention and reputation. Nevertheless, marginalisation will persist by increasingly affecting the care receivers, especially those groups that are pushed to the fringes by the consequences of the healthcare market, such as persons of extreme old age, suffering from multiple morbidities, or with poor health literacy. Whereas the "classical" understanding of the ethics of care focuses on the nurse-patient relationship and on individual care and understanding of ethics, the new understanding confirms the classical, but adds an understanding of social ethics: caring for the access to care is seen as a main ethical goal of social justice within a nursing ethic.
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Searching for ethical leadership in nursing.
Makaroff, Kara Schick; Storch, Janet; Pauly, Bernie; Newton, Lorelei
2014-09-01
Attention to ethical leadership in nursing has diminished over the past several decades. The aim of our study was to investigate how frontline nurses and formal nurse leaders envision ethical nursing leadership. Meta-ethnography was used to guide our analysis and synthesis of four studies that explored the notion of ethical nursing leadership. These four original studies were conducted from 1999-2008 in Canada with 601 participants. Ethical approval from the original studies covered future analysis. Using the analytic strategy of lines-of-argument, we found that 1) ethical nursing leadership must be responsive to practitioners and to the contextual system in which they and formal nurse leaders work, and 2) ethical nursing leadership requires receiving and providing support to increase the capacity to practice and discuss ethics in the day-to-day. Formal nurse leaders play a critical, yet often neglected role, in providing ethical leadership and supporting ethical nursing practice at the point of patient care. © The Author(s) 2014.
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Everyday ethics: ethical issues and stress in nursing practice.
Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine
2010-11-01
This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.
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Why the history of nursing ethics matters.
Fowler, Marsha D
2017-05-01
Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing's movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics (later bioethics) course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing's ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing's ethical history, literature, and theory; a neglect of nursing's ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing's rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly.
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Nursing informatics and nursing ethics
DEFF Research Database (Denmark)
Kaltoft, Mette Kjer
2013-01-01
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...
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Ethical climate and nurse competence - newly graduated nurses' perceptions.
Numminen, Olivia; Leino-Kilpi, Helena; Isoaho, Hannu; Meretoja, Riitta
2015-12-01
Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses' professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically. This study examined newly graduated nurses' perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction. Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically. Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate. Nurses' overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively. Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses' work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers' ethical leadership in creating ethical work environments. There
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Ethical leadership outcomes in nursing.
Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan
2017-01-01
Leadership style adopted by nursing managers is a key element in progress and development of nursing and quality of healthcare services received by the patients. In this regard, the role of ethical leadership is of utmost importance. The objective of the study was to elaborate on the ethical leadership and its role in professional progress and growth of nurses in the light of work condition in health providing institutes. The study was carried out as a qualitative study following conventional content analysis method. In total, 14 nursing faculty members and nursing managers at different levels were selected through purposive sampling method. Semi-structured interviews were used for data gathering. The data were analyzed using latent content analysis and constant comparison analysis. Ethical considerations: This study was conducted in accordance with ethical issues in research with human participants and national rules and regulations related to informed consent and confidentiality. The study was approved by the Committee of Ethics in Research at the Shahid Beheshti University of Medical Sciences in Tehran, Iran, under the code: sbmu.rec.1393.695 on 15 February 2015. Five subcategories were obtained based on the analysis, which constituted two main categories including "all-inclusive satisfaction" and "productivity." Nursing leaders highlighted the point that their ethical behavior creates "inner satisfaction of the leader," "employees' job satisfaction," and "patients' satisfaction." Improvement of productivity was another outcome of ethical behavior of the leaders. This kind of behavior resulted in "providing better services" and "inspiring ethical behavior in the employees." It has great influence on progress and growth of the nursing profession. By creating an ethical climate, ethical leadership leads to positive and effective outcomes-for the patients as well as for the nurses and the leaders-and professional progress and development of the nursing profession
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Two concepts of empirical ethics.
Parker, Malcolm
2009-05-01
The turn to empirical ethics answers two calls. The first is for a richer account of morality than that afforded by bioethical principlism, which is cast as excessively abstract and thin on the facts. The second is for the facts in question to be those of human experience and not some other, unworldly realm. Empirical ethics therefore promises a richer naturalistic ethics, but in fulfilling the second call it often fails to heed the metaethical requirements related to the first. Empirical ethics risks losing the normative edge which necessarily characterizes the ethical, by failing to account for the nature and the logic of moral norms. I sketch a naturalistic theory, teleological expressivism (TE), which negotiates the naturalistic fallacy by providing a more satisfactory means of taking into account facts and research data with ethical implications. The examples of informed consent and the euthanasia debate are used to illustrate the superiority of this approach, and the problems consequent on including the facts in the wrong kind of way.
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Ethics and Transcultural Nursing Care.
Eliason, Michele J.
1993-01-01
Argues that nursing practice and theory cannot be ethical unless cultural factors are taken into consideration and that ethical/transcultural nursing is central to the philosophy and practice of nursing. (Author)
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Nursing's Code of Ethics, Social Ethics, and Social Policy.
Fowler, Marsha D
2016-09-01
Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six-part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: "to establish and maintain a code of ethics." While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias. © 2016 The Hastings Center.
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Ethics, culture and nursing practice in Ghana.
Donkor, N T; Andrews, L D
2011-03-01
This paper describes how nurses in Ghana approach ethical problems. The International Council of Nurses' (ICN) Code for Nurses (2006) that serves as the model for professional code of ethics worldwide also acknowledges respect for healthy cultural values. Using the ICN's Code and universal ethical principles as a benchmark, a survey was conducted in 2009 to ascertain how nurses in Ghana respond to ethical and cultural issues in their practice. The study was qualitative with 200 participant nurses. Data were obtained through anonymous self-administered questionnaires. Descriptive statistics were used to analyze the data. Nurses' approaches to ethical problems in Ghana do not always meet expectations of the ICN Code for Nurses. They are also informed by local ethical practices related to the institutional setting and cultural environment in the country. While some cultural values complemented the ICN's Code and universal ethical principles, others conflicted with them. These data can assist nurses to provide culturally competent solutions to ethical dilemmas in their practice. Dynamic communication between nurses and patients/clients, intentional study of local cultural beliefs, and the development of ethics education will improve the conformity between universal ethical standards and local cultural values. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.
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Furthering the sceptical case against virtue ethics in nursing ethics.
Holland, Stephen
2012-10-01
In a recent article in this journal I presented a sceptical argument about the current prominence of virtue ethics in nursing ethics. Daniel Putman has responded with a defence of the relevance of virtue in nursing. The present article continues this discussion by clarifying, defending, and expanding the sceptical argument. I start by emphasizing some features of the sceptical case, including assumptions about the nature of sceptical arguments, and about the character of both virtue ethics and nursing ethics. Then I respond to objections of Putman's such as that, according to virtue ethics, virtue is relevant to the whole of a human life, including one's behaviour in a professional context; and that eudaimonia should be central in explaining and motivating a nurse's decision to enter the profession. Having argued that these objections are not compelling, I go on to discuss an interesting recent attempt to reassert the role of virtue ethics in the ethics of professions, including nursing. This centres on whether role-specific obligations - e.g. the obligations that arise for a moral agent qua lawyer or mother - can be accommodated in a virtue ethics approach. Sean Cordell has argued that the difficulty of accommodating role-specific obligations results in an 'institution-shaped gap' in virtue ethics. He suggests a way of meeting this difficulty that appeals to the ergon of institutions. I endorse the negative point that role-specific obligations elude virtue ethics, but argue that the appeal to the ergon of institutions is unsuccessful. The upshot is further support for scepticism about the virtue ethics approach to nursing ethics. I end by gesturing to some of the advantages of a sceptical view of virtue ethics in nursing ethics. © 2012 Blackwell Publishing Ltd.
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Poikkeus, Tarja; Suhonen, Riitta; Katajisto, Jouko; Leino-Kilpi, Helena
2018-03-12
Organizations and nurse leaders do not always effectively support nurses' ethical competence. More information is needed about nurses' perceptions of this support and relevant factors to improve it. The aim of the study was to examine relationships between nurses' perceived organizational and individual support, ethical competence, ethical safety, and work satisfaction. A cross-sectional questionnaire survey was conducted. Questionnaires were distributed to nurses (n = 298) working in specialized, primary, or private health care in Finland. Descriptive statistics, multifactor analysis of variance, and linear regression analysis were used to test the relationships. The nurses reported low organizational and individual support for their ethical competence, whereas perceptions of their ethical competence, ethical safety, and work satisfaction were moderate. There were statistically significant positive correlations between both perceived individual and organizational support, and ethical competence, nurses' work satisfaction, and nurses' ethical safety. Organizational and individual support for nurses' ethical competence should be strengthened, at least in Finland, by providing more ethics education and addressing ethical problems in multiprofessional discussions. Findings confirm that organizational level support for ethical competence improves nurses' work satisfaction. They also show that individual level support improves nurses' sense of ethical safety, and both organizational and individual support strengthen nurses' ethical competence. These findings should assist nurse leaders to implement effective support practices to strengthen nurses' ethical competence, ethical safety, and work satisfaction.
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The ethical enterprise of nursing.
Allmark, P
1992-01-01
This paper examines the ethical nature of nursing. Examples are taken from coronary care units. A critical view is taken whereby it is felt that nursing models do not truly reflect this nature. It is suggested that nurses make most ethical decisions without dilemma using intuition. The traditions behind using this intuition are examined. Such normative traditions may be summarized as teleological, deontological and axiological. Lastly, it is suggested that nurses would benefit in several ways from some education in ethics.
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Ethics in Turkish nursing education programs.
Görgülü, Refia Selma; Dinç, Leyla
2007-11-01
This descriptive study investigated the current status of ethics instruction in Turkish nursing education programs. The sample for this study comprised 39 nursing schools, which represented 51% of all nursing schools in Turkey. Data were collected through a postal questionnaire. The results revealed that 18 of these nursing schools incorporated an ethics course into undergraduate and three into graduate level programs. Most of the educators focused on the basic concepts of ethics, deontological theory, ethical principles, ethical problems in health care, patient rights and codes of ethics for nurses. More than half of the educators believed that students' theoretical knowledge of ethics is applied to their clinical experiences. The teaching methods used included discussion in class, lectures, case studies, small group discussion, dramatization and demonstration. Assessment was carried out by means of written essays and written examinations.
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Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.
Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto
2013-05-01
Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.
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Nursing students' responses to ethical dilemmas in nursing practice.
Dierckx de Casterlé, B; Grypdonck, M; Vuylsteke-Wauters, M; Janssen, P J
1997-01-01
In literature as well as in nursing practice a growing concern about nurses' ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students' ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg's definition of morality was refined by adding a care perspective. The results show that the majority of students can be located in the fourth moral stage according to Kohlberg's theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions.
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Empirical data and moral theory. A plea for integrated empirical ethics.
Molewijk, Bert; Stiggelbout, Anne M; Otten, Wilma; Dupuis, Heleen M; Kievit, Job
2004-01-01
Ethicists differ considerably in their reasons for using empirical data. This paper presents a brief overview of four traditional approaches to the use of empirical data: "the prescriptive applied ethicists," "the theorists," "the critical applied ethicists," and "the particularists." The main aim of this paper is to introduce a fifth approach of more recent date (i.e. "integrated empirical ethics") and to offer some methodological directives for research in integrated empirical ethics. All five approaches are presented in a table for heuristic purposes. The table consists of eight columns: "view on distinction descriptive-prescriptive sciences," "location of moral authority," "central goal(s)," "types of normativity," "use of empirical data," "method," "interaction empirical data and moral theory," and "cooperation with descriptive sciences." Ethicists can use the table in order to identify their own approach. Reflection on these issues prior to starting research in empirical ethics should lead to harmonization of the different scientific disciplines and effective planning of the final research design. Integrated empirical ethics (IEE) refers to studies in which ethicists and descriptive scientists cooperate together continuously and intensively. Both disciplines try to integrate moral theory and empirical data in order to reach a normative conclusion with respect to a specific social practice. IEE is not wholly prescriptive or wholly descriptive since IEE assumes an interdepence between facts and values and between the empirical and the normative. The paper ends with three suggestions for consideration on some of the future challenges of integrated empirical ethics.
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Evidence-based Nursing Education - a Systematic Review of Empirical Research
Reiber, Karin
2011-01-01
The project „Evidence-based Nursing Education – Preparatory Stage“, funded by the Landesstiftung Baden-Württemberg within the programme Impulsfinanzierung Forschung (Funding to Stimulate Research), aims to collect information on current research concerned with nursing education and to process existing data. The results of empirical research which has already been carried out were systematically evaluated with aim of identifying further topics, fields and matters of interest for empirical research in nursing education. In the course of the project, the available empirical studies on nursing education were scientifically analysed and systematised. The over-arching aim of the evidence-based training approach – which extends beyond the aims of this project - is the conception, organisation and evaluation of vocational training and educational processes in the caring professions on the basis of empirical data. The following contribution first provides a systematic, theoretical link to the over-arching reference framework, as the evidence-based approach is adapted from thematically related specialist fields. The research design of the project is oriented towards criteria introduced from a selection of studies and carries out a two-stage systematic review of the selected studies. As a result, the current status of research in nursing education, as well as its organisation and structure, and questions relating to specialist training and comparative education are introduced and discussed. Finally, the empirical research on nursing training is critically appraised as a complementary element in educational theory/psychology of learning and in the ethical tradition of research. This contribution aims, on the one hand, to derive and describe the methods used, and to introduce the steps followed in gathering and evaluating the data. On the other hand, it is intended to give a systematic overview of empirical research work in nursing education. In order to preserve a
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A comparison of ethical issues in nursing practice across nursing units.
Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun
2014-08-01
The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.
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ETHICAL ASPECTS OF ENTREPRENEURSHIP IN NURSING
Kaya, Nurten; Turan, Nuray; Ozdemir Aydin, Gulsun
2017-01-01
Ethics is one of the characteristics of contemporary civilization.Health care system faces uniquely complex ethical problems. Many points of seriousconcern need to be raised under the concept of ethics. For nurse entrepreneursto be professionally credible they have to be competent and accountable. Whilefundamental responsibility lies with the individual nurse entrepreneur, theprofessions have to evidently improve these essential attributes as well. Thecode of nursing ethics would constitute s...
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DEFF Research Database (Denmark)
Pedersen, Birgith; Sivonen, K
Aim The aim of this paper is to deepen our understanding of how nursing students’ ethical formation is affected by their meeting with vulnerability and suffering in clinical practice. Background In clinical practice the students can learn authentic, caring, and respectful nursing adjusted to the ...... to attain authenticity and moral integrity by cultivating their own ethical ideals. Nevertheless, clinical practice may expose them to the risk of ethical decline and becoming non-caring nurses.......Aim The aim of this paper is to deepen our understanding of how nursing students’ ethical formation is affected by their meeting with vulnerability and suffering in clinical practice. Background In clinical practice the students can learn authentic, caring, and respectful nursing adjusted...... to the patients’ situation and the practice of distant and general nursing. Reflective processes can support the ethical dimension of nursing, but there is a lack of knowledge concerning the source of students’ ability to maintain and develop their moral integrity. Methods Twenty-four students were interviewed...
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Nursing ethics in a developing country
Directory of Open Access Journals (Sweden)
Annatjie Botes
1999-09-01
Full Text Available Nursing is a true profession, distinguished by its philosophy of care, its full-time commitment to human well being, its particular blend of knowledge and skills and its valuable service to the community (Curtin & Flaherty, 1982:92. Ethics is vital to nursing. Being a professional implies ethical behaviour and knowledge of what it means to be ethical (Pera & Van Tonder, 1996:v. Ethics is the foundation of committed service to humankind. When nurses practice in an ethical manner they should adhere to ethical principles like autonomy, beneficence, justice, veracity, fidelity, confidentiality and privacy.
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Effect of Simulation on Undergraduate Nursing Students' Knowledge of Nursing Ethics Principles.
Donnelly, Mary Broderick; Horsley, Trisha Leann; Adams, William H; Gallagher, Peggy; Zibricky, C Dawn
2017-12-01
Background Undergraduate nursing education standards include acquisition of knowledge of ethics principles and the prevalence of health-care ethical dilemmas mandates that nursing students study ethics. However, little research has been published to support best practices for teaching/learning ethics principles. Purpose This study sought to determine if participation in an ethics consultation simulation increased nursing students' knowledge of nursing ethics principles compared to students who were taught ethics principles in the traditional didactic format. Methods This quasi-experimental study utilized a pre-test/post-test design with randomized assignment of students at three universities into both control and experimental groups. Results Nursing students' knowledge of nursing ethics principles significantly improved from pre-test to post-test ( p = .002); however, there was no significant difference between the experimental and control groups knowledge scores ( p = .13). Conclusion Further research into use of simulation to teach ethics principles is indicated.
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Empirical ethics as dialogical practice
Widdershoven, G.A.M.; Abma, T.A.; Molewijk, A.C.
2009-01-01
In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and
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Professional ethics in nursing: an integrative review.
Kangasniemi, Mari; Pakkanen, Piiku; Korhonen, Anne
2015-08-01
To conduct an integrative review and synthesize current primary studies of professional ethics in nursing. Professional ethics is a familiar concept in nursing and provides an ethical code for nursing practice. However, little is known about how professional ethics has been defined and studied in nursing science. Systematic literature searches from 1948-February 2013, using the CINAHL, PubMed and Scopus electronic databases to look at previously published peer-reviewed studies. A modified version of Cooper's five-stage integrative review was used to review and synthesize current knowledge. Fourteen papers were included in this research. According to our synthesis, professional ethics is described as an intra-professional approach to care ethics and professionals commit to it voluntarily. Professional ethics consist of values, duties, rights and responsibilities, regulated by national legislation and international agreements and detailed in professional codes. Professional ethics is well established in nursing, but is constantly changing due to internal and external factors affecting the profession. Despite the obvious importance of professional ethics, it has not been studied much in nursing science. Greater knowledge of professional ethics is needed to understand and support nurses' moral decision-making and to respond to the challenges of current changes in health care and society. © 2015 John Wiley & Sons Ltd.
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Fostering Ethical Integrity in Nursing Education.
Eby, Ruth A; Hartley, Patricia Lynn; Hodges, Patricia J; Hoffpauir, Rebecca Baldwin
Nursing students bring an array of morals, values, and ethics that may be inconsistent with ethical integrity. This study explored nurse educator perceptions of student ethical integrity and how educators can foster an ethical foundation in students and novice educators. Four major themes influencing ethical integrity emerged: the learning environment, behaviors, ethical principles, and a toolbox of strategies. Strategies for fostering ethical integrity included: modeling ethical integrity, effective communication, grading accuracy, faculty perceptions, and faculty peer mentoring.
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The nursing contribution to ethical decision making
Directory of Open Access Journals (Sweden)
Barbara Dinten-Schmid
2016-11-01
Full Text Available Background: In the neonatal care units of the University Hospitals of Zurich and Bern, the nurse´s role in ethical decision-making is well established. However, nurses often reported uncertainty with regard to introducing the premature infant’s situation from the nursing perspective in ethics rounds. Aims: To empower neonatal nurses in fulfilling their role in the multiprofessional decision-making process, we performed a practice development project. On the basis of the Iowa model we developed a checklist for presenting the nursing history of premature infants in an ethically competent and responsible way. Conclusions: The ‘checklist for nursing assessment in the context of ethical decision-making’, equips nurses for their professional contribution to ethics rounds, making them better prepared to present the nursing perspective in a structured and thorough manner. Implications for practice: The Iowa model supports practice development even with limited data availability The instrument invigorates the neonatal nurse´s role in the multiprofessional ethical decision-making process It is crucial to involve peers in practice development
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How American Nurses Association Code of Ethics informs genetic/genomic nursing.
Tluczek, Audrey; Twal, Marie E; Beamer, Laura Curr; Burton, Candace W; Darmofal, Leslie; Kracun, Mary; Zanni, Karen L; Turner, Martha
2018-01-01
Members of the Ethics and Public Policy Committee of the International Society of Nurses in Genetics prepared this article to assist nurses in interpreting the American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements (Code) within the context of genetics/genomics. The Code explicates the nursing profession's norms and responsibilities in managing ethical issues. The nearly ubiquitous application of genetic/genomic technologies in healthcare poses unique ethical challenges for nursing. Therefore, authors conducted literature searches that drew from various professional resources to elucidate implications of the code in genetic/genomic nursing practice, education, research, and public policy. We contend that the revised Code coupled with the application of genomic technologies to healthcare creates moral obligations for nurses to continually refresh their knowledge and capacities to translate genetic/genomic research into evidence-based practice, assure the ethical conduct of scientific inquiry, and continually develop or revise national/international guidelines that protect the rights of individuals and populations within the context of genetics/genomics. Thus, nurses have an ethical responsibility to remain knowledgeable about advances in genetics/genomics and incorporate emergent evidence into their work.
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DEFF Research Database (Denmark)
Pedersen, Birgith; Sivonen, Kerstin
Aim The aim of this paper is to deepen our understanding of how nursing students’ ethical formation is affected by their meeting with vulnerability and suffering in clinical practice. Background In clinical practice the students can learn authentic, caring, and respectful nursing adjusted...... to the patients’ situation and the practice of distant and general nursing. Reflective processes can support the ethical dimension of nursing, but there is a lack of knowledge concerning the source of students’ ability to maintain and develop their moral integrity. Methods Twenty-four students were interviewed...... for their ethical formation but the students’ ethical formation may decline in the course of clinical practice. Conclusion Nursing students possess moral sensitivity which is challenged when they meet a clinical practice culture that is incongruent with their ethical ideals. In clinical practice the students seek...
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Helm, A
1984-08-01
Professional responsibilities, tradition, and personal conscience along with legal, philosophical, and religious convictions dictate nursing interventions. Inevitably, these factors embrace life-sustaining therapies; however, in view of complications, prognosis, pain and suffering, and their own views of quality of life, some patients express wishes inconsistent with life-sustaining measures. In other situations, the health care provider as well as the patient may view heroic efforts as more debilitating than resortative. Resolving the conflict while preserving the patient's best interests requires a confrontation with the status of "do-not resuscitate" policies within th e nurse's institution, informed consent, refusal, and competency as the necessary underpinnings for the development of an ethical and legal posture within the profession, with which to approach significant decisions regarding life-sustaining therapies. Literally every hour of every day nurses are immediately and directly involved with resolving ethical dilemmas based upon judgements and interpretations of oral or written orders, patient and family wishes, professional training, and an infinite number of other factors. When clear policies or orders are lacking, the nurse is left with the burden of making a life or death decision. It is imperative that professional nurses assess the administrative, legal, and ethical ramifications of their actions in terms of ethical codes of practice, patients' rights, institutional and personal liability, civil and criminal laws, and private conscience. An understanding of these issues, passive and active euthansia, state and national trends, and uniform legislation can assist in resolutions of the no-code dilemma. Nursing as a profession must strive to develop sound and consistent guidelines and rationale for the scope of practice in ethical dilemmas.
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Public health nursing, ethics and human rights.
Ivanov, Luba L; Oden, Tami L
2013-05-01
Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. © 2013 Wiley Periodicals, Inc.
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2012-01-01
Background The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. Discussion A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. Summary High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis. PMID:22500496
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Nursing Ethics: A Lifelong Commitment.
Gibbons, Susanne W; Jeschke, E Ann
2016-01-01
Over the past 30 years, the health-care context as well as the roles and responsibilities of nurses have drastically changed. Leaders in nursing around the world recognize that the health-care system is stressed and the well-being of the nursing workforce plagued by the pressures and challenges it faces in everyday practice. We do not intend to make a strong normative argument for why nursing ethics education should be done in a certain way, but instead show from where we have come and to where we can go, so that educators are positioned to address some of the current shortcomings in ethics education. Our goal is to provide an illustration of ethics education as an interwoven, ongoing, and essential aspect of nursing education and professional development. By developing professional identity as character, we hope that professional nurses are given the skills to stand in the face of adversity and to act in a way that upholds the core competencies of nursing. Ultimately, health-care organizations will thrive because of the support they provide nurses and other health-care professionals.
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Professional Ethical Competence in nursing: the role of nursing instructors.
Borhani, Fariba; Alhani, Fatemeh; Mohammadi, Easa; Abbaszadeh, Abbas
2010-01-01
Teaching ethics to nurses leads to their involvement in providing high quality care, enable them to duly encounter ethical issues. One of the key elements of educational systems is nursing instructors. Even though lots of studies show the role of instructors in students' learning, their role in promotion of professional ethics has been attended to less. The objective of this study is surveying the experience of nursing students with respect to the role of instructors in promotion of professional ethics. This qualitative study enrolled 15 undergraduate nursing students from three nursing schools in Teheran whom depth interview was performed. The interview was semi-structured with open ended questions. The analysis was accomplished by use of qualitative content-analysis method. Data analysis demonstrated 2 main themes and 7 subcategories in regard to the role of instructors in promotion of professional ethics in nursing students including: 1) the effective professional role model 2) facilitating creative learning. The effective professional role model encompasses individual characteristics and beliefs, clinical skills and professional commitment of role model. Creative learning facilitates by encouraging critical thinking and decision-making, Providing supportive learning conditions, providing proper space for sharing knowledge followed by evaluation and creative feedback. The findings of this study provides a background for strengthening the role of instructors in promotion of professional ethics with more emphasis on research which increase capability of instructors at nursing education centers.
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Nursing ethical values and definitions: A literature review.
Shahriari, Mohsen; Mohammadi, Eesa; Abbaszadeh, Abbas; Bahrami, Masoud
2013-01-01
Ethical values offer a framework for behavior assessment, and nursing values influence nurses' goals, strategies, and actions. A literature review was adopted in order to determine and define ethical values for nurses. This literature review was conducted based on the Centre for Reviews and Dissemination guidelines. The key words used to search relevant sources were nursing, ethics, ethical values, and nursing values. The search of articles in English was carried out in Medline, CINAHL, PubMed, Scopus, Ovid, and Proquest databases. The search of articles in Persian was conducted in databases of Magiran, SID, and Irandoc publications. After assessing and analyzing the obtained data, 17 articles which had a distinct definition of ethical values were chosen and subjected to a thorough study. The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency. This study showed that common ethical values are generally shared within the global community. However, in several areas, influences of social, cultural, and economical status and religious beliefs on values result in a different definition of these values. This study revealed that based on humanistic nature of nursing, common values in nursing protect human dignity and respect to the patients. Recognizing and definition of ethical values can help to improve nursing practice and develop codes of ethics.
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Osingada, Charles Peter; Nalwadda, Gorrette; Ngabirano, Tom; Wakida, John; Sewankambo, Nelson; Nakanjako, Damalie
2015-07-29
High disease burden and scarcity of healthcare resources present complex ethical dilemmas for nurses working in developing countries. We assessed nurses' knowledge in ethics and their perceptions about Continuous Nurses' Ethics Education (CNEE) for in-service nurses. Using an anonymous, pre-tested self-administered questionnaire, we assessed nurses' knowledge in basic ethics concepts at three regional hospitals in Uganda. Adequate knowledge was measured by a score ≥50% in the knowledge assessment test. Nurses' perceptions on CNEE were assessed using a six-point Likert scale. Of 114 nurses, 91% were female; with mean age 44.7 (SD 10) years. Half were diploma, 47 (41%) certificates, 6 (5%) bachelors' degrees and one masters' level training. Overall, 18 (16%) scored ≥50% in the ethics knowledge test. Nurses with diploma or higher level of nursing training were less likely to fail the ethics knowledge than certificate-level nurses (OR 0.14, 95% CI: 0.02-0.7). Only 45% had ever attended at least one CNEE session and up to 93% agreed that CNEE is required to improve nurses' ethics knowledge and practice. Nurses exhibited low knowledge in ethics and positive attitudes towards CNEE. We recommend structured CNEE programs to address basic concepts in nursing ethics and their application in clinical practice.
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Poikkeus, Tarja; Leino-Kilpi, Helena; Katajisto, Jouko
2014-09-01
The aim of this study was to analyse how nurse leaders support the ethical competence of nurses during recruitment and performance reviews. Ethical competence of nurses refers to ethical behaviour and action requiring ethical knowledge and reflection. Nurse leaders have a key role in supporting the ethical competence of nurses, but little is known about just how this should be done. The data were collected using a structured questionnaire and analysed statistically. The target sample consisted of nurse leaders (n = 198) from two university hospitals in two healthcare districts in Finland. Nurse leaders support the ethical competence of nurses more often during performance reviews than during recruitment. During recruitment, nurse leaders ensure the ethical behaviour and knowledge of nurses to varying degrees. During performance reviews, nurse leaders ensure that nurses meet the requirements for collegiality and comply with ethical guidelines and that they do so according to nursing values and principles. There seems to be a need to examine and improve support for the ethical competence of nurses, both during recruitment and performance reviews. Future priorities should include a focus on supporting the ethical knowledge, reflection and behaviour of nurses. An important aspect in terms of supporting the ethical competence of nurses has to do with the ethical knowledge and education of nurse leaders and organisational policies or recommendations for ethical support. © 2013 John Wiley & Sons Ltd.
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Integrated empirical ethics: loss of normativity?
van der Scheer, Lieke; Widdershoven, Guy
2004-01-01
An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances.
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Nurse middle manager ethical dilemmas and moral distress.
Ganz, Freda D; Wagner, Nurit; Toren, Orly
2015-02-01
Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.
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Robertson, D W
1996-01-01
OBJECTIVES: To study empirically whether ethical theory (from the mainstream principles-based, virtue-based, and feminist schools) usefully describes the approaches doctors and nurses take in everyday patient care. DESIGN: Ethnographic methods: participant observation and interviews, the transcripts of which were analysed to identify themes in ethical approaches. SETTING: A British old-age psychiatry ward. PARTICIPANTS: The more than 20 doctors and nurses on the ward. RESULTS: Doctors and nurses on the ward differed in their conceptions of the principles of beneficence and respect for patient autonomy. Nurses shared with doctors a commitment to liberal and utilitarian conceptions of these principles, but also placed much greater weight on relationships and character virtues when expressing the same principles. Nurses also emphasised patient autonomy, while doctors were more likely to advocate beneficence, when the two principles conflicted. CONCLUSION: The study indicates that ethical theory can, contrary to the charges of certain critics, be relevant to everyday health care-if it (a) attends to social context and (b) is flexible enough to draw on various schools of theory. PMID:8910782
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Academic ethical awareness among undergraduate nursing students.
Cho, Ok-Hee; Hwang, Kyung-Hye
2017-01-01
Academic ethical awareness is an important aspect especially for nursing students who will provide ethical nursing care to patients in future or try to tread the path of learning toward professional acknowledgement in nursing scholarship. The purpose of this study was to explore academic ethical awareness and its related characteristics among undergraduate nursing students. This study commenced the survey with cross-sectional, descriptive questions and enrolled convenient samples of 581 undergraduate nursing students from three universities in South Korea. It was investigated with structured questionnaires including general characteristics and academic ethical awareness related. Ethical considerations: This study was reviewed and approved by the Institutional Review Board at National University. Academic ethical awareness was the highest regarding behaviors violating the respect or confidentiality of patients and cheating on exams, while it was the lowest for inappropriate behaviors in class. From the result of general characteristics difference, male students showed higher score than female students in relative; first-year students showed higher score than other year students; the higher score was rated from students who were highly satisfied with their major than the other not satisfied with their major; and students with low academic stress showed higher ethical awareness score than persons with higher stress. Personal behaviors were rated with low ethical awareness in relative, but items related to public rules and actual effects on patients or others were rated with higher score. Nursing satisfaction and academic stress are main factors on ethical awareness. To improve overall ethical awareness level of nursing students, it is required to provide more education about the importance of personal behaviors in class and need to improve the understanding of how it will be connected with future situation and effect.
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The effect of nurses' ethical leadership and ethical climate perceptions on job satisfaction.
Özden, Dilek; Arslan, Gülşah Gürol; Ertuğrul, Büşra; Karakaya, Salih
2017-01-01
The development of ethical leadership approaches plays an important role in achieving better patient care. Although studies that analyze the impact of ethical leadership on ethical climate and job satisfaction have gained importance in recent years, there is no study on ethical leadership and its relation to ethical climate and job satisfaction in our country. This descriptive and cross-sectional study aimed to determine the effect of nurses' ethical leadership and ethical climate perceptions on their job satisfaction. The study sample is composed of 285 nurses who agreed to participate in this research and who work at the internal, surgical, and intensive care units of a university hospital and a training and research hospital in İzmir, Turkey. Data were collected using Ethical Leadership Scale, Hospital Ethical Climate Scale, and Minnesota Satisfaction Scale. While the independent sample t-test, analysis of variance, Mann-Whitney U test, and Kruskal-Wallis test were used to analyze the data, the correlation analysis was used to determine the relationship between the scales. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Dokuz Eylül University. The nurses' mean scores were 59.05 ± 14.78 for the ethical leadership, 92.62 ± 17 for the ethical climate, and 62.15 ± 13.46 for the job satisfaction. The correlation between the nurses' ethical leadership and ethical climate mean scores was moderately positive and statistically significant (r = +0.625, p = 0.000), was weak but statistically significant between their ethical leadership and job satisfaction mean scores (r = +0.461, p = 0.000), and was moderately positive and statistically significant between their ethical climate and job satisfaction mean scores (r = +0.603, p = 0.000). The nurses' ethical leadership, ethical climate, and job satisfaction levels are moderate, and there is a positive relationship between them. The nurses' perceptions of ethical
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Wangmo, Tenzin; Hauri, Sirin; Gennet, Eloise; Anane-Sarpong, Evelyn; Provoost, Veerle; Elger, Bernice S
2018-02-07
A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is changing, that is, what are the characteristics of the empirical works published in these nine bioethics journals. A review of the same nine journals (Bioethics; Journal of Medical Ethics; Journal of Clinical Ethics; Nursing Ethics; Cambridge Quarterly of Healthcare Ethics; Hastings Center Report; Theoretical Medicine and Bioethics; Christian Bioethics; and Kennedy Institute of Ethics Journal) was conducted for a 12-year period from 2004 to 2015. Data obtained was analysed descriptively and using a non-parametric Chi-square test. Of the total number of original papers (N = 5567) published in the nine bioethics journals, 18.1% (n = 1007) collected and analysed empirical data. Journal of Medical Ethics and Nursing Ethics led the empirical publications, accounting for 89.4% of all empirical papers. The former published significantly more quantitative papers than qualitative, whereas the latter published more qualitative papers. Our analysis reveals no significant difference (χ2 = 2.857; p = 0.091) between the proportion of empirical papers published in 2004-2009 and 2010-2015. However, the increasing empirical trend has continued in these journals with the proportion of empirical papers increasing from 14.9% in 2004 to 17.8% in 2015. This study presents the current state of affairs regarding empirical research published nine bioethics journals. In the quarter century of data that is available about the nine bioethics journals studied in two reviews, the proportion of empirical publications continues to increase, signifying a trend towards empirical research in bioethics. The growing volume is mainly attributable to two
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The code of ethics for nurses.
Zahedi, F; Sanjari, M; Aala, M; Peymani, M; Aramesh, K; Parsapour, A; Maddah, Ss Bagher; Cheraghi, Ma; Mirzabeigi, Gh; Larijani, B; Dastgerdi, M Vahid
2013-01-01
Nurses are ever-increasingly confronted with complex concerns in their practice. Codes of ethics are fundamental guidance for nursing as many other professions. Although there are authentic international codes of ethics for nurses, the national code would be the additional assistance provided for clinical nurses in their complex roles in care of patients, education, research and management of some parts of health care system in the country. A national code can provide nurses with culturally-adapted guidance and help them to make ethical decisions more closely to the Iranian-Islamic background. Given the general acknowledgement of the need, the National Code of Ethics for Nurses was compiled as a joint project (2009-2011). The Code was approved by the Health Policy Council of the Ministry of Health and Medical Education and communicated to all universities, healthcare centers, hospitals and research centers early in 2011. The focus of this article is on the course of action through which the Code was compiled, amended and approved. The main concepts of the code will be also presented here. No doubt, development of the codes should be considered as an ongoing process. This is an overall responsibility to keep the codes current, updated with the new progresses of science and emerging challenges, and pertinent to the nursing practice.
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Enhancing ethical climates in nursing work environments.
Storch, Janet; Rodney, Patricia; Pauly, Bernadette; Fulton, Thomas Reilly; Stevenson, Lynn; Newton, Lorelei; Makaroff, Kara Schick
2009-03-01
In the current era of providing health care under pressure, considerable strain has been placed on nurses workplaces. Underneath the economic and organizational challenges prevalent in health-care delivery today are important values that shape the ethical climate in workplaces and affect the well-being of nurses, managers, patients and families. In this article, the authors report on the outcomes of Leadership for Ethical Policy and Practice, a three-year participatory action research study involving nurses, managers and other health-care team members in organizations throughout British Columbia. By using an ethics lens to look at problems, participants brought ethical concerns out into the open and were able to gain new insights and identify strategies for action to improve the ethical climate. Nurse leader support was essential for initiating and sustaining projects at six practice sites.
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Impact of ethical factors on job satisfaction among Korean nurses.
Jang, Yujin; Oh, Younjae
2017-01-01
Although numerous studies on job satisfaction among nurses have been conducted, there is a lack of research considering the ethical perspectives of leadership and organizational climate in job satisfaction. The purpose of this study was to clarify the impact of the ethical climate and ethical leadership as perceived by nurses on job satisfaction in South Korea. A descriptive and correlational study was conducted with a convenience sample of 263 nurses from four general hospitals in South Korea. Ethical considerations: This study was approved by the Institute Review Board of Hallym University before data collection. Job satisfaction was positively correlated with ethical climate and ethical leadership. The ethical climate in relationship with hospitals and people orientation leadership were influential factors in the level of job satisfaction among nurses. Organizations in the nursing environment should pay attention to improving the ethical climate with acceptable ethical norms in the workplace and nurse leaders should respect, support and genuinely care about their nurses in ethical concerns.
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Ethical competency of nurse leaders: A qualitative study.
Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan
2018-02-01
Ethics play an important role in activating the manpower and achieving the organizational goals. The nurse leaders' ethical behavior can promote the care quality by affecting the nurses' performance and bringing up several positive consequences for the organization. The aim of this study was to identify and describe the ethical competency of nurse leaders in cultural domains and the working conditions of the Iranian healthcare setting to arrive at a more comprehensive and specific perspective. This was a qualitative conventional content analysis study conducted with the participation of 14 nurse leaders at various levels. The participants were selected using the purposive sampling method, and the required data were collected using deep interview and also semi-structured interview. A deductive method of content analysis was applied in data analysis. Ethical considerations: This study was conducted in accord with the principles of research ethics and national rules and regulations relating to informed consent and confidentiality. Data analysis resulted in 17 subcategories that were subsequently grouped into three major categories including empathetic interactions, ethical behavior, and exalted manners. Our findings are consistent with previous ones, yet presenting a more complete knowledge about aspects of ethical competency of nurse leaders. The nurse leaders can provide a proper behavioral model for the work environment through the use of new information. The nurse leaders introduced various aspects of ethical competency, so the leaders' ethical competency could be promoted via planning and managing some ethical development programs. More future research is needed regarding the experiences of the subordinates and other related parties.
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Trends in nursing ethics research: Mapping the literature production.
Blažun Vošner, Helena; Železnik, Danica; Kokol, Peter; Vošner, Janez; Završnik, Jernej
2017-12-01
There have been a number of debates in the field of nursing ethics. Researchers have focused on various aspects of nursing ethics, such as professional ethics, professional, nursing and ethical values. Within this research, a variety of literature reviews have been conducted, but to the best of our knowledge, bibliometric mapping has not yet been used. This article aims to analyse the production of literature within nursing ethics research. In order to examine publishing patterns, we focused on publishing dynamics, prolific research entities and the most-cited articles. We additionally visualised the content of the literature using a novel mixed-method approach, combining bibliometric analysis and mapping with thematic analysis. Ethical considerations: In our study, ethical review was not required. A total of 1416 information sources were found in the Scopus database. Overall, literature production has increased; however, in recent years, the quantity of published material has begun to decrease. The most prolific countries are the United States, the United Kingdom and Canada, and the most prolific source titles are Nursing Ethics, Journal of Advanced Nursing and Nursing Times. Lately, research in the field of nursing ethics has been focused more on life care (providing for the basic needs of older residents), moral distress and community nursing. The dynamics of research literature production showed an exponential rise in the number of published information sources - a rise which started in the period between 1974 and 1998. Since that period, the trend has stabilised, which might indicate that nursing ethics research is starting a transition to a mature phase. The innovative use of bibliometric analysis and mapping, together with thematic analysis, is a useful tool for analysis of research production in the field of nursing ethics. The results presented can be an excellent starting point for literature reviews and more exhaustive data, information and knowledge
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Ethical challenges in neonatal intensive care nursing.
Strandås, Maria; Fredriksen, Sven-Tore D
2015-12-01
Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice. The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns. Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to interpret the data. Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site. The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration. Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement. A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality. The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care. © The Author(s) 2014.
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Organisational and individual support for nurses' ethical competence: A cross-sectional survey.
Poikkeus, Tarja; Suhonen, Riitta; Katajisto, Jouko; Leino-Kilpi, Helena
2018-05-01
Nurses' ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses' ethical competence is needed. This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses' and nurse leaders' ethical competence, perceptions of support for nurses' ethical competence at the organisational and individual levels and background factors associated with this support. A descriptive, cross-sectional study design was employed. The Ethical Competence and Ethical Competence Support questionnaires were used to measure the main components. Descriptive statistics and multifactor analysis of variance were used for data analysis. The participants were 298 nurses and 193 nurse leaders working in specialised (48%/52%), primary (43%/36%) or private healthcare (5%/7%) in Finland. Ethical considerations: Ethical approval was obtained from the university ethics committee. Nurses estimated their own ethical competence to be at an average level, whereas nurse leaders estimated their own competence at a high level. Nurses' and nurse leaders' perceptions of provided support for nurses' ethical competence was not at a high level. The positive agreement percentage related to organisational support was 44% among nurses and 51% among nurse leaders. The positive agreement percentage related to individual support was lower, that is, 38% among nurses and 61% among nurse leaders. University education had a positive association with some items of individual support. Despite the findings that ethical competence was estimated at a high level among nurse leaders, perceptions of support for nurses' ethical competence were not at a satisfactory level. At the organisational level, nurse leaders need to inform of ethical procedures and practices in orientation; encourage multidisciplinary ethics discussions and collaboration; and support
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Mohajjel-Aghdam, Alireza; Hassankhani, Hadi; Zamanzadeh, Vahid; Khameneh, Saied; Moghaddam, Sara
2013-09-01
Nursing profession requires knowledge of ethics to guide performance. The nature of this profession necessitates ethical care more than routine care. Today, worldwide definition of professional ethic code has been done based on human and ethical issues in the communication between nurse and patient. To improve all dimensions of nursing, we need to respect ethic codes. The aim of this study is to assess knowledge and performance about nursing ethic codes from nurses' and patients' perspective. A descriptive study Conducted upon 345 nurses and 500 inpatients in six teaching hospitals of Tabriz, 2012. To investigate nurses' knowledge and performance, data were collected by using structured questionnaires. Statistical analysis was done using descriptive and analytic statistics, independent t-test and ANOVA and Pearson correlation coefficient, in SPSS13. Most of the nurses were female, married, educated at BS degree and 86.4% of them were aware of Ethic codes also 91.9% of nurses and 41.8% of patients represented nurses respect ethic codes. Nurses' and patients' perspective about ethic codes differed significantly. Significant relationship was found between nurses' knowledge of ethic codes and job satisfaction and complaint of ethical performance. According to the results, consideration to teaching ethic codes in nursing curriculum for student and continuous education for staff is proposed, on the other hand recognizing failures of the health system, optimizing nursing care, attempt to inform patients about Nursing ethic codes, promote patient rights and achieve patient satisfaction can minimize the differences between the two perspectives.
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Cannaerts, Nancy; Gastmans, Chris; Dierckx de Casterlé, Bernadette
2014-12-01
To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. A total of 15 articles with a quantitative, qualitative, or mixed-methods design published between January 1992 and March 2012 were analyzed. According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments. © The Author(s) 2014.
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Workplace distress and ethical dilemmas in neuroscience nursing.
Silén, Marit; Tang, Ping Fen; Wadensten, Barbro; Ahlström, Gerd
2008-08-01
This study concerns Swedish nurses' experiences of workplace stress and the occurrence of ethical dilemmas in a neurological setting. Qualitative interviews were conducted with 21 nurses. The interview results were subjected to qualitative latent content analysis and sorted into 4 content areas: workplace distress, ethical dilemmas, managing distress and ethical dilemmas, and quality of nursing. Common workplace stressors were high workload and lack of influence. These were perceived to have negative consequences for the quality of nursing. Ethical dilemmas mainly concerned decision making on initiation or withdrawal of treatment, which was experienced as a troublesome situation where conflicts could arise. The nurses managed the distress and ethical dilemmas by accepting and adjusting to the situation and seeking support from colleagues. They also endeavored to gain new strength in their private lives.
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Milton, Constance L
2003-10-01
The American Nurses Association Code of Ethics for Nurses calls for the nurse to practice with compassion and respect for every individual. What are the ethics and challenges of practicing professional nursing with expertise and educating a new generation of nurses while incorporating the interpretive statements into practice? This column differentiates the traditional biomedical views on human dignity and respect while exploring the embedded ethics of respect and self-determination and what it truly means to be an expert of nursing from the theoretical perspective of the human becoming school of thought.
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Directory of Open Access Journals (Sweden)
Sara Moghaddam
2013-08-01
Full Text Available Introduction: Nursing profession requires knowledge of ethics to guide performance. The nature of this profession necessitates ethical care more than routine care. Today, worldwide definition of professional ethic code has been done based on human and ethical issues in the communication between nurse and patient. To improve all dimensions of nursing, we need to respect ethic codes. The aim of this study is to assess knowledge and performance about nursing ethic codes from nurses' and patients' perspective.Methods: A cross-sectional comparative study Conducted upon 345 nurses and 500 inpatients in six teaching hospitals of Tabriz, 2012. To investigate nurses' knowledge and performance, data were collected by using structured questionnaires. Statistical analysis was done using descriptive and analytic statistics, independent t-test and ANOVA and Pearson correlation coefficient, in SPSS13.Results: Most of the nurses were female, married, educated at BS degree and 86.4% of them were aware of Ethic codes also 91.9% of nurses and 41.8% of patients represented nurses respect ethic codes. Nurses' and patients' perspective about ethic codes differed significantly. Significant relationship was found between nurses' knowledge of ethic codes and job satisfaction and complaint of ethical performance. Conclusion: According to the results, consideration to teaching ethic codes in nursing curriculum for student and continuous education for staff is proposed, on the other hand recognizing failures of the health system, optimizing nursing care, attempt to inform patients about Nursing ethic codes, promote patient rights and achieve patient satisfaction can minimize the differences between the two perspectives.
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Work engagement in nursing practice: a relational ethics perspective.
Keyko, Kacey
2014-12-01
The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments. © The Author(s) 2014.
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The Nursing Code of Ethics: Its Value, Its History.
Epstein, Beth; Turner, Martha
2015-05-31
To practice competently and with integrity, today's nurses must have in place several key elements that guide the profession, such as an accreditation process for education, a rigorous system for licensure and certification, and a relevant code of ethics. The American Nurses Association has guided and supported nursing practice through creation and implementation of a nationally accepted Code of Ethics for Nurses with Interpretive Statements. This article will discuss ethics in society, professions, and nursing and illustrate how a professional code of ethics can guide nursing practice in a variety of settings. We also offer a brief history of the Code of Ethics, discuss the modern Code of Ethics, and describe the importance of periodic revision, including the inclusive and thorough process used to develop the 2015 Code and a summary of recent changes. Finally, the article provides implications for practicing nurses to assure that this document is a dynamic, useful resource in a variety of healthcare settings.
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The ethics curriculum for doctor of nursing practice programs.
Peirce, Anne Griswold; Smith, Jennifer A
2008-01-01
Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.
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Nurses' perception of ethical climate at a large academic medical center.
Lemmenes, Donna; Valentine, Pamela; Gwizdalski, Patricia; Vincent, Catherine; Liao, Chuanhong
2016-09-07
Nurses are confronted daily with ethical issues while providing patient care. Hospital ethical climates can affect nurses' job satisfaction, organizational commitment, retention, and physician collaboration. At a metropolitan academic medical center, we examined nurses' perceptions of the ethical climate and relationships among ethical climate factors and nurse characteristics. We used a descriptive correlational design and nurses (N = 475) completed Olson's Hospital Ethical Climate Survey. Data were analyzed using STATA. Approvals by the Nursing Research Council and Institutional Review Board were obtained; participants' rights were protected. Nurses reported an ethical climate total mean score of 3.22 ± 0.65 that varied across factors; significant differences were found for ethical climate scores by nurses' age, race, and specialty area. These findings contribute to what is known about ethical climate and nurses' characteristics and provides the foundation to develop strategies to improve the ethical climate in work settings. © The Author(s) 2016.
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Ethical and legal challenges associated with disaster nursing.
Aliakbari, Fatemeh; Hammad, Karen; Bahrami, Masoud; Aein, Fereshteh
2015-06-01
In disaster situations, nurses may face new and unfamiliar ethical and legal challenges not common in their everyday practice. The aim of this study was to explore Iranian nurses' experience of disaster response and their perception of the competencies required by nurses in this environment. This article discusses the findings of a descriptive study conducted in Iran in 2012. This research was conducted in Iran in 2012. Participants included 35 nurses who had experience in healthcare delivery following a disaster event in the past 10 years, either in a hospital or out-of-hospital context. This research study was approved by the Ethics Committee of the Isfahan University of Medical Sciences. From this study, five themes emerged as areas that nurses require competence in to work effectively in the disaster setting. This article focusses on one theme, the ethical and legal issues that arise during disaster response. Within the theme of ethical and legal issues, two sub-themes emerged. (1) Professional ethics explores professional responsibility of nurses as well as sense of ethical obligation. (2) Adherence to law refers to nurses' familiarity with and observation of legal requirements. This article adds to a growing pool of literature which explores the role of nurses in disasters. The findings of this study emphasize the need for nurses working in the disaster setting to be aware of professional responsibilities and familiar with legal requirements and the challenges related to observing ethical responsibilities. In highlighting these issues, this article may provide a useful starting point for the development of an educational framework for preparing nurses and other health professionals to work in the disaster setting. © The Author(s) 2014.
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De Vries, Martine; Van Leeuwen, Evert
2010-11-01
In ethics, the use of empirical data has become more and more popular, leading to a distinct form of applied ethics, namely empirical ethics. This 'empirical turn' is especially visible in bioethics. There are various ways of combining empirical research and ethical reflection. In this paper we discuss the use of empirical data in a special form of Reflective Equilibrium (RE), namely the Network Model with Third Person Moral Experiences. In this model, the empirical data consist of the moral experiences of people in a practice. Although inclusion of these moral experiences in this specific model of RE can be well defended, their use in the application of the model still raises important questions. What precisely are moral experiences? How to determine relevance of experiences, in other words: should there be a selection of the moral experiences that are eventually used in the RE? How much weight should the empirical data have in the RE? And the key question: can the use of RE by empirical ethicists really produce answers to practical moral questions? In this paper we start to answer the above questions by giving examples taken from our research project on understanding the norm of informed consent in the field of pediatric oncology. We especially emphasize that incorporation of empirical data in a network model can reduce the risk of self-justification and bias and can increase the credibility of the RE reached. © 2009 Blackwell Publishing Ltd.
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Nursing and Theater: Teaching Ethics Through the Arts.
Coleman, Jennifer J; Dick, Tracey K
2016-01-01
Prelicensure nursing education needs to prepare students for their future roles as professional nurses with ethical and moral decision-making skills. This article describes the use of theater as one approach to teaching nursing ethics at the prelicensure level. Students perform as actors, directors, and discussion leaders in a series of simulated ethical scenarios designed to encourage individual accountability and responsibility for action.
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Symbiotic empirical ethics: a practical methodology.
Frith, Lucy
2012-05-01
Like any discipline, bioethics is a developing field of academic inquiry; and recent trends in scholarship have been towards more engagement with empirical research. This 'empirical turn' has provoked extensive debate over how such 'descriptive' research carried out in the social sciences contributes to the distinctively normative aspect of bioethics. This paper will address this issue by developing a practical research methodology for the inclusion of data from social science studies into ethical deliberation. This methodology will be based on a naturalistic conception of ethical theory that sees practice as informing theory just as theory informs practice - the two are symbiotically related. From this engagement with practice, the ways that such theories need to be extended and developed can be determined. This is a practical methodology for integrating theory and practice that can be used in empirical studies, one that uses ethical theory both to explore the data and to draw normative conclusions. © 2010 Blackwell Publishing Ltd.
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Ethical principles in the work of nurse educator-A cross-sectional study.
Salminen, Leena; Stolt, Minna; Metsämäki, Riikka; Rinne, Jenni; Kasen, Anne; Leino-Kilpi, Helena
2016-01-01
The application of ethical principles within the teaching profession and nursing practice forms the core of the nurse educator's professional ethics. However, research focusing on the professional ethics of nurse educators is scarce. To describe ethical principles and issues relating to the work of nurse educators from the perspectives of both nurse educators themselves and nursing students. A descriptive study using cross-sectional data and content analysis. Nursing education program involving students from nine polytechnics in Finland. Nursing students (n=202) and nurse educators (n=342). Data were derived from an online survey, with two open-ended questions: Nursing students and nurse educators were asked to name the three main ethical principles that guide the work of nurse educators and also to describe ethical issues involved in the work. Students most often named professionalism, justice, and equality as the main ethical principles for a nurse educator. Nurse educators considered justice, equality, and honesty as the main ethical principles. The content analysis showed that professionalism and the relationship between educator and student were the key categories for ethical issues as perceived by nursing students. Nursing students most often identified inequality between the nurse educator and nursing student as the ethical issue faced by the nurse educator. Nursing students and nurse educators differed somewhat both in their views of the ethical principles guiding an educator's work and in the ethical issues arising in the work. Copyright © 2015 Elsevier Ltd. All rights reserved.
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An ethical leadership program for nursing unit managers.
Jeon, Sang Hee; Park, Mihyun; Choi, Kyungok; Kim, Mi Kyoung
2018-03-01
The aims of this study were to evaluate the effect of an ethical leadership program (ELP) on ethical leadership, organizational citizenship behavior (OCB), and job outcomes of nursing unit managers (UMs) and to examine changes in staff nurses' perception about UMs' EL, OCB, job outcomes, and ethical work environments (EWEs) post-ELP. A quasi-experimental (pre- and post-test design) study conducted six-month intervention (ELP) using self-reported UM survey (n=44), and staff nurses (n=158) were randomly extracted by two steps. The Korean version of Ethical Leadership at Work for UMs' self-ethical leadership, the Ethical Leadership Scale for staff nurses' perceived ethical leadership, a 19-item OCB scale, and six dimensions of the medium-sized Copenhagen Psychosocial Questionnaire II for job outcomes and EWEs were administered at baseline and post-intervention. UMs' ethical leadership scores differed significantly over time in people orientation (p=0.041) and concern for ethical leadership sustainability (p=0.002) adjusting for UM experience duration and nursing unit type. Total mean and level of power-sharing of ethical leadership among UMs with leadership, OCB, job outcomes, and EWEs, significant improvement over time appeared only in EWEs' work influence level (p=0.007). This study provides useful information for clinical ELP development and examining the program's effect on leadership skills and followers' outcomes. Program facilitation relies on practical training methods, participant motivation, and assessment outcome designs by controlling clinical confounding factors. Findings have implications as an attempt for intervention to promote competencies related to ethical leadership of nursing unit managers. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Nurses' attitudes toward ethical issues in psychiatric inpatient settings.
Eren, Nurhan
2014-05-01
Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. The study design was descriptive and cross-sectional. RESEARCH CONTEXT: Methods comprised of a questionnaire administered to psychiatric nurses (n=202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience. PARTICIPANTS consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n=202), which were selected with cluster sampling method. Ethical considerations: Written informed consent of each participant was taken prior to the study. The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence. The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor. In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a
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Teaching Ethics to Nursing Students.
Thompson, Joyce E.; Thompson, Henry O.
1989-01-01
The authors discuss the ethics content to be taught in nursing education and the goals of ethics education for both undergraduate and graduate students. Teacher qualifications and evaluation of learning are also considered. (CH)
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[Professional ethics, an essential element of nursing practice].
Debout, Christophe
2017-09-01
The context of contemporary practice exposes nurses to a wide variety of ethical dilemmas. In 1978, nurses were granted autonomy within the scope of their therapeutic role but there was also a need for the profession to embark on a new stage by introducing a code of ethics. It was not until 2016 that the first code of ethics for nurses was published in France, 63 years after the publication of a code by the International Council of Nurses. Copyright © 2017. Published by Elsevier Masson SAS.
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Goodness! The empirical turn in health care ethics
Willems, D.; Pols, J.
2010-01-01
This paper is intended to encourage scholars to submit papers for a symposium and the next special issue of Medische Antropologie which will be on empirical studies of normative questions. We describe the ‘empirical turn’ in medical ethics. Medical ethics and bioethics in general have witnessed a
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Ethical dimensions of paediatric nursing: A rapid evidence assessment.
Bagnasco, Annamaria; Cadorin, Lucia; Barisone, Michela; Bressan, Valentina; Iemmi, Marina; Prandi, Marzia; Timmins, Fiona; Watson, Roger; Sasso, Loredana
2018-02-01
Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, 'What are the most common ethical dimensions and competences related to paediatric nursing?' A rapid evidence assessment. According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses' perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.
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[Educational needs assessment on research ethics among nursing researchers].
Jeong, Ihn Sook; Gu, Mee Ock; Kim, Keum Soon; Lee, Kwang Ja; Yang, Soo
2010-08-01
This study aimed to investigate the educational needs of research ethics among nursing researchers. Convenience sample of 161 nursing professors and 262 master or doctoral nursing students participated in the study. Data was collected with self-reported questionnaire from June to August 2009, and analyzed with descriptive statistics using SPSS WIN (version 14.0). Among 161 nursing professors, about 31.7% has educated nursing ethics in the postgraduate course. The most common course was nursing research or methodology (62.7%), and median education time was 2 hr. Areas that showed difficulty in understanding was the conflict of interest and plagiarism for professors and falsification and fabrication for graduate students. Average knowledge on the research ethics was 75.4 points for professors and 61.6 points for students based on the 100 points. Educational needs of research ethics among nursing professors and students in the postgraduate course was high. We recommend both basic and advanced research ethics educational programs for the nursing researchers. The basic course should be at least 6 hr and include various cases and something to discuss.
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Nurses' contributions to the resolution of ethical dilemmas in practice.
Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P
2018-03-01
Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Four major themes emerged: 'best for the patient', 'accountability', 'collaboration and conflict' and 'concern for others'. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing
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Ethical behavior of nurses in decision-making in Iran.
Ebrahimi, Hossein; Nikravesh, Mansoure; Oskouie, Fatemeh; Ahmadi, Fazlollah
2015-01-01
Ethical caring is an essential in nursing practice. Nurses are confronted with complex situations in which they are expected to autonomously make decisions in delivering good care to patients. Although a wide range of studies have examined ethical behavior of nurses, there are still many issues requiring further investigation. The aim of this article is to describe the ethical behavior of nurses in decision-making in patients' care in Iran. This study was conducted through grounded theory method. Participants were 17 Iranian nurses, employed in Tabriz University of Medical Sciences hospitals. Unstructured, semi-structured, and in-depth interviews were used for data gathering. Interviews were transcribed and coded according to Strauss and Corbin method in open, axial, and selective coding. Nurses showed three major approaches in ethical behavior: Beyond the legal duty and protection of the patients, which includes dedication and full availability to nurses' job and the client, spending time for the patients and delayed exit from the workplace, and arbitrary practice; legal duty and the protection of patients and nurses, which includes caretaking for the patient, responding to the client, and implementing the physician's prescription; and below the legal duty and the protection of one's self, that is, finding evidence and having witness in case of false documentation, and shortcoming, negligence, and mistake. Because of the importance of the ethical behavior of nurses in decision-making, it is necessary to find ways to promote moral reasoning and moral development of nurses. Empowerment of nurses, nurse educators, and nursing students to acquire knowledge and develop ethical behavior skills is important.
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Relationship between ethical ideology and moral judgment: Academic nurse educators' perception.
Abou Hashish, Ebtsam Aly; Ali Awad, Nadia Hassan
2017-01-01
Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent. This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing
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Nurse ethical awareness: Understanding the nature of everyday practice.
Milliken, Aimee; Grace, Pamela
2017-08-01
Much attention has been paid to the role of the nurse in recognizing and addressing ethical dilemmas. There has been less emphasis, however, on the issue of whether or not nurses understand the ethical nature of everyday practice. Awareness of the inherently ethical nature of practice is a component of nurse ethical sensitivity, which has been identified as a component of ethical decision-making. Ethical sensitivity is generally accepted as a necessary precursor to moral agency, in that recognition of the ethical content of practice is necessary before consistent action on behalf of patient interests can take place. This awareness is also compulsory in ensuring patient good by recognizing the unique interests and wishes of individuals, in line with an ethic of care. Scholarly and research literature are used to argue that bolstering ethical awareness and ensuring that nurses understand the ethical nature of the role are an obligation of the profession. Based on this line of reasoning, recommendations for education and practice, along with directions for future research, are suggested.
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Analysis of the claim to distinct nursing ethics: normative and nonnormative approaches.
Twomey, J G
1989-04-01
Nursing ethics has been declared to exist only as a subset of medical ethics. If this statement is to be refuted, any defense of a claim to a discrete nursing ethic must clarify what type of moral theory is being held as distinctly a nursing ethic. Several examples of nursing ethical theory are used to challenge Veatch's view that nursing ethics is a subset of medical ethics. The methodology used to provide the analysis is to group the ethical theories studied under the topics of normative and nonnormative ethics to provide for appropriate inquiry.
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Ethics in nursing: A systematic review of the framework of evidence perspective.
Yıldız, Erman
2017-01-01
To determine the current state of knowledge on nursing and ethics and to assess the knowledge and experience based on the evidence in this regard. Although ethics is at the center of the nursing profession and the ethical issues affecting nurses are given much importance, few studies have focused on professional ethics in nursing. In this respect, ethics has become a concept that contains controversial and ambiguous situations. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guide, a basic search algorithm, was taken. Cochrane, PubMed, CINAHL Complete, PsycINFO, and ULAKBIM from 2012 to 2016. Following a systematic search strategy, all papers were assessed in relation to inclusion criteria and type of study. When sufficient information was not available in the title and summary of the works, the necessary data were evaluated in full texts. This review was completed with 27 articles meeting the research criteria. The evaluation identified six themes: (1) ethics and nursing, (2) ethical difficulties/ethical dilemmas and nursing, (3) ethical competence and nursing, (4) professional ethics and nursing, (5) ethics, education, and nursing, and (6) ethics in health research. As a result of the review, a synthesis of high evidence-level research relating to nursing ethics was obtained. The emphasis was on the importance of further research and education so that the ethical aspects of nursing can be better understood throughout the studies. Nursing researchers' level of evidence on ethics and their orientation to high research design will shed light on uncertain and controversial aspects of the subject. Ethical consideration: Since this was a systematic review, no ethical approval was required. There is no conflict of interest in this literature review.
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Nurses' ethical conflicts in performance of utilization reviews.
Bell, Sue Ellen
2003-09-01
This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse's self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city. A cross-sectional survey design was used to collect demographic data and to ask closed-response, short-answer and open-ended questions. Ethical conflicts reported by nurses were similar across utilization review settings and many were justice orientated. Self-reported ethical orientations were similar across organizations, with beneficence dominating. Implications of these findings are discussed.
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Resolving the ethical dilemma of nurse managers over chemically-dependent colleagues.
Chiu, W; Wilson, D
1996-12-01
This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers.
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A proposal for a code of ethics for nurse practitioners.
Peterson, Moya; Potter, Robert Lyman
2004-03-01
To review established codes for health care professionals and standards of practice for the nurse practitioner (NP) and to utilize these codes and standards, general ethical themes, and a new ethical triangle to propose an ethical code for NPs. Reviews of three generally accepted ethical themes (deontological, teleological, and areteological), the ethical triangle by Potter, the American Academy of Nurse Practitioners (AANP) standards of practice for NPs, and codes of ethics from the American Nurses Association (ANA) and the American Medical Association (AMA). A proposal for a code of ethics for NPs is presented. This code was determined by basic ethical themes and established codes for nursing, formulated by the ANA, and for physicians, formulated by the AMA. The proposal was also developed in consideration of the AANP standards of practice for NPs. The role of the NP is unique in its ethical demands. The authors believe that the expanded practice of NPs presents ethical concerns that are not addressed by the ANA code and yet are relevant to nursing and therefore different than the ethical concerns of physicians. This proposal attempts to broaden NPs' perspective of the role that ethics should hold in their professional lives.
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Building locally relevant ethics curricula for nursing education in Botswana.
Barchi, F; Kasimatis Singleton, M; Magama, M; Shaibu, S
2014-12-01
The goal of this multi-institutional collaboration was to develop an innovative, locally relevant ethics curriculum for nurses in Botswana. Nurses in Botswana face ethical challenges that are compounded by lack of resources, pressures to handle tasks beyond training or professional levels, workplace stress and professional isolation. Capacity to teach nursing ethics in the classroom and in professional practice settings has been limited. A pilot curriculum, including cases set in local contexts, was tested with nursing faculty in Botswana in 2012. Thirty-three per cent of the faculty members indicated they would be more comfortable teaching ethics. A substantial number of faculty members were more likely to introduce the International Council of Nurses Code of Ethics in teaching, practice and mentoring as a result of the training. Based on evaluation data, curricular materials were developed using the Code and the regulatory requirements for nursing practice in Botswana. A web-based repository of sample lectures, discussion cases and evaluation rubrics was created to support the use of the materials. A new master degree course, Nursing Ethics in Practice, has been proposed for fall 2015 at the University of Botswana. The modular nature of the materials and the availability of cases set within the context of clinical nurse practice in Botswana make them readily adaptable to various student academic levels and continuing professional development programmes. The ICN Code of Ethics for Nursing is a valuable teaching tool in developing countries when taught using locally relevant case materials and problem-based teaching methods. The approach used in the development of a locally relevant nursing ethics curriculum in Botswana can serve as a model for nursing education and continuing professional development programmes in other sub-Saharan African countries to enhance use of the ICN Code of Ethics in nursing practice. © 2014 International Council of Nurses.
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Nursing ethics in the seventh-day adventist religious tradition.
Taylor, Elizabeth Johnston; Carr, Mark F
2009-11-01
Nurses' religious beliefs influence their motivations and perspectives, including their practice of ethics in nursing care. When the impact of these beliefs is not recognized, great potential for unethical nursing care exists. Thus, this article examines how the theology of one religious tradition, Seventh-day Adventism (SDA), could affect nurses. An overview of SDA history and beliefs is presented, which explains why 'medical missionary' work is central to SDAs. Theological foundations that would permeate an SDA nurse's view of the nursing metaparadigm concepts of person, health, environment (i.e. community), and nursing (i.e. service) are presented. The ethical principles guiding SDA nurses (i.e. principled, case-based, and care ethics) and the implications of these theological foundations for nurses are noted in a case study.
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Ethical behavior of nurses in decision-making in Iran
Ebrahimi, Hossein; Nikravesh, Mansoure; Oskouie, Fatemeh; Ahmadi, Fazlollah
2015-01-01
Background: Ethical caring is an essential in nursing practice. Nurses are confronted with complex situations in which they are expected to autonomously make decisions in delivering good care to patients. Although a wide range of studies have examined ethical behavior of nurses, there are still many issues requiring further investigation. The aim of this article is to describe the ethical behavior of nurses in decision-making in patients? care in Iran. Materials and Methods: This study was co...
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Ethics of rationing of nursing care.
Rooddehghan, Zahra; Yekta, Zohreh Parsa; Nasrabadi, Alireza N
2016-09-21
Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values. The present research sought to explore aspects of rationing nursing care in Iran. This study applied qualitative content analysis, a method to explore people's perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions. The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran. The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants. According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses' feeling of guilt. Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people's lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon
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Factors that impact on emergency nurses' ethical decision-making ability.
Alba, Barbara
2016-11-10
Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.
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Professional values, self-esteem, and ethical confidence of baccalaureate nursing students.
Iacobucci, Trisha A; Daly, Barbara J; Lindell, Debbie; Griffin, Mary Quinn
2013-06-01
Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg's Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses.
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O'Donnell, Lolita T
2007-01-01
To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the
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O'Donnell, Lolita T
2007-01-01
The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between
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Virtue ethics and nursing: on what grounds?
Newham, Roger A
2015-01-01
Within the nursing ethics literature, there has for some time now been a focus on the role and importance of character for nursing. An overarching rationale for this is the need to examine the sort of person one must be if one is to nurse well or be a good nurse. How one should be to live well or live a/the good life and to nurse well or be a good nurse seems to necessitate a focus on an agent's character as well as actions because character is (for the most part) expressed in action (e.g. see Laird). This paper will give an overview of the reasons for the role and importance of character in nursing practice and explain its relation to nursing's frequent use of virtue ethics in order to recommend caution. While the paper agrees that the role of character is important in nursing caution is needed in both how much moral and thus normative, emphasis is being placed on the psychology of character and on the drift to virtue ethics. The psychological which may be explanatory needs to be linked with the normative, and a justification for the normative is needed. A justification as virtue ethics is contested, and nursing practice does not need to take on this explanatory and justificatory burden. A tentative proposal raised but not discussed in depth in this paper is that when an ultimate explanation or explanatory ground is needed, nursing practice leads quite naturally to a form of consequentialism as well as a realist metaethic. On this account, there are two levels of moral thinking, and nursing practice entails the virtues at one level and leads quite naturally to moral thinking at another more critical level of the criterion of what makes something right and good independently of character. © 2014 John Wiley & Sons Ltd.
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Making the hard decisions: Ethical care decisions in wartime nursing practice.
Agazio, Janice; Goodman, Petra
Codes of ethics set forth standards of ethical conduct for nurses. However, nurses involved in wartime operations, or disasters, may often have their moral compass challenged by the patient care decisions necessary under adverse conditions. Reverse triage, resource allocation, and promotion of patient autonomy present multiple challenges to meeting commonly applied ethical principles. The purpose of this study was to use the International Council of Nursing code of ethics as a framework to organize the ethical issues emerging from wartime nursing. This article represents a secondary analysis of two studies using thematic analysis to identify ethical issues encountered by military nurses during the recent conflicts in Iraq and Afghanistan. Data were collected from nurses deployed from 2002 to 2015 and from 111 military nurses during focused interviews. Across both studies, issues such as resource allocation, patient triage, cultural differences, and equitable treatment for all emerged as challenges within the wartime environment. Nurses were at a loss at times as to how best to manage the situations and recommended that more education is needed in ethical decision making before, during, and after deployment as a debriefing strategy. Similar issues have been documented in military and disaster literature indicating that such challenges are not limited to the recent conflicts but cross time and location. By better understanding how nurses define, assess, and manage the ethical situations they encounter in wartime nursing practice, military nurses can better prepare for future conflicts, provide mentorship and targeted education to hopefully reducing any feelings of moral distress, and promote ethical decision making that will best promote outcomes in accordance with nursing's ethical codes. Copyright © 2017 Elsevier Inc. All rights reserved.
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Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home
Vondras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory
2009-01-01
This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global…
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[Brain death and organ transplantation: ethical dilemmas for nursing?].
Windels-Buhr, D
1997-06-01
According to the WHO Program, nurses should be active in public health care as equal members of a multiprofessional team. This position requires competent professional action, which also implies moral competence, especially necessitated by the coming paradigmatic changes caused by shifts in the previous and current boundaries of the paradigm human being. One reason for this shift are the greater medical technical possibilities. The medical definition of brain death as the death of a human being per se is one example of the altered boundary and its consequences. Must future components of the nursing metaparadigm be changed because of this? To what extent is nursing ethically obligated to integrate changes in social values into its metaparadigm, ethics and objectives? The nursing metaparadigm, Henderson's definition of nursing, the ICN's Basic Code of Ethics, and the nursing model according to Roper, Logan & Tierney were used as the basis in the analysis of the subject matter and problems. Furthermore, philosophical viewpoints of Jonas & Harris will be included to clarify the deontological and teleological aspects of standard ethics. Finally, conclusions are drawn about the intra- and interprofessional ethical discourse about brain death and organ transplantation among nursing professionals.
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Nursing practice implications of the year of ethics.
Harris, Karen T
2015-01-01
e 2015 ANA Code of Ethics is foundational to professional nursing practice and is aligned with AWHONN’s core values, standards of care and position statement on ethical decision-making in the clinical setting. Understanding the roles and responsibilities of nurses to ensure an ethical practice environment is critical to perinatal health outcomes and sta engagement and to the prevention of moral distress.
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Nursing and euthanasia: a review of argument-based ethics literature.
Quaghebeur, Toon; Dierckx de Casterlé, Bernadette; Gastmans, Chris
2009-07-01
This article gives an overview of the nursing ethics arguments on euthanasia in general, and on nurses' involvement in euthanasia in particular, through an argument-based literature review. An in-depth study of these arguments in this literature will enable nurses to engage in the euthanasia debate. We critically appraised 41 publications published between January 1987 and June 2007. Nursing ethics arguments on (nurses' involvement in) euthanasia are guided primarily by the principles of respect for autonomy, nonmaleficence, beneficence and justice. Ethical arguments related to the nursing profession are described. From a care perspective, we discuss arguments that evaluate to what degree euthanasia can be considered positively or negatively as a form of good nursing care. Most arguments in the principle-, profession- and care-orientated approaches to nursing ethics are used both pro and contra euthanasia in general, and nurses' involvement in euthanasia in particular.
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Effects of ethics education on moral sensitivity of nursing students.
Yeom, Hye-A; Ahn, Sung-Hee; Kim, Su-Jeong
2017-09-01
While nursing ethics education is commonly provided for undergraduate nursing students in most nursing colleges, consensus on the content and teaching modules for these ethics courses have still not been established. This study aimed to examine the effects of nursing ethics education on the moral sensitivity and critical thinking disposition of nursing students in Korea. A one-group pre- and post-test design was used. Moral sensitivity was measured using the Korean version of the Moral Sensitivity Questionnaire. Critical thinking disposition was measured using the Critical Thinking Disposition Questionnaire. Participants and research context: Participants were 70 undergraduate nursing students who were attending a university located in Seoul, Korea. The nursing ethics education was provided 7 times, from September to December 2010, and comprised 90-min sessions each week. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines. After the education, the levels for the patient-oriented care, a sub-domain of moral sensitivity, and inquisitiveness, a sub-domain of critical thinking disposition, significantly improved. There were no changes in overall scores for moral sensitivity and critical thinking disposition. There were significant positive correlations between moral sensitivity and critical thinking disposition both pre- and post-intervention. These results reflect the need for ongoing efforts to develop innovative content, structure, and instructional methods for undergraduate nursing ethics education programs.
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Directory of Open Access Journals (Sweden)
F Jahanpour
2014-06-01
Full Text Available Background & aim: Nurses' ethical responsibility in practice and care is required to be aware of the principles of professional ethics. The aim of this study was to determine nursing students' knowledge of ethics in nursing of Bushehr University of Medical Sciences. Methods: In the present analytical-descriptive sectional study, in which the participants are 4-8 semester nursing students of Bushehr University of Medical Sciences. The research tools for collecting information were tow-section questionnaires consisting of demographic data and specialized questions about ethic and rules in the nursing profession. Data analysis was performed using the SPSS software by using independent t-tests and chi-square. Results: Total awareness of 4-8 semester nursing students about ethic and rules in nursing profession was intermediate (53.78 percent. There was a considerable relation between sexuality and satisfaction (p.436. A considerable relation between students' educational semester and satisfaction amount was not also not observed (p>.927. Conclusions: Students' awareness about professional ethic wasn't very desirable so it is suggested that by holding moral workshops in nursing or settling moral courses in nursing students curriculum will increase the amount of nursing students' awareness about nursing ethics.
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Salloch, Sabine; Wäscher, Sebastian; Vollmann, Jochen; Schildmann, Jan
2015-04-04
Empirical-ethical research constitutes a relatively new field which integrates socio-empirical research and normative analysis. As direct inferences from descriptive data to normative conclusions are problematic, an ethical framework is needed to determine the relevance of the empirical data for normative argument. While issues of normative-empirical collaboration and questions of empirical methodology have been widely discussed in the literature, the normative methodology of empirical-ethical research has seldom been addressed. Based on our own research experience, we discuss one aspect of this normative methodology, namely the selection of an ethical theory serving as a background for empirical-ethical research. Whereas criteria for a good ethical theory in philosophical ethics are usually related to inherent aspects, such as the theory's clarity or coherence, additional points have to be considered in the field of empirical-ethical research. Three of these additional criteria will be discussed in the article: (a) the adequacy of the ethical theory for the issue at stake, (b) the theory's suitability for the purposes and design of the empirical-ethical research project, and (c) the interrelation between the ethical theory selected and the theoretical backgrounds of the socio-empirical research. Using the example of our own study on the development of interventions which support clinical decision-making in oncology, we will show how the selection of an ethical theory as a normative background for empirical-ethical research can proceed. We will also discuss the limitations of the procedures chosen in our project. The article stresses that a systematic and reasoned approach towards theory selection in empirical-ethical research should be given priority rather than an accidental or implicit way of choosing the normative framework for one's own research. It furthermore shows that the overall design of an empirical-ethical study is a multi-faceted endeavor which has to
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Aristotle, nursing and health care ethics.
Scott, P A
1995-12-01
Even a brief consideration of the nature of nursing will indicate that an ethical dimension underlies much, if not all, of nursing practice. It is therefore important that students and practitioners are facilitated in developing an ethical awareness and sensitivity from early in their professional development. This paper argues that Aristotelian virtue theory provides a practice-based focus for health care ethics for a number of reasons. Also, because of his emphasis on the character of the moral agent, and on the importance of perception and emotion in moral decision-making, Aristotelian virtue theory provides a useful supplement to the traditional duty-based approaches to health care ethics analysis, which are increasingly being identified in the literature as having limits to their application within the health care context.
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From painful busyness to emotional immunization: Nurses' experiences of ethical challenges.
Storaker, Anne; Nåden, Dagfinn; Sæteren, Berit
2017-08-01
The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses' professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their daily work and that this has become a major problem for the nursing profession. The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are "What ethical challenges do nurses experience in their daily practice?" We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses' experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched.
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Bollig, Georg; Schmidt, Gerda; Rosland, Jan Henrik; Heller, Andreas
2015-12-01
Many ethical problems exist in nursing homes. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources. The aim of the present study was to investigate nursing home staffs' opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes. The study used a two-tiered approach, using a questionnaire on ethical challenges and systematic ethics work, given to all employees of a Norwegian nursing home including nonmedical personnel, and a registration of systematic ethics discussions from an Austrian model of good clinical practice. Ninety-one per cent of the nursing home staff described ethical problems as a burden. Ninety per cent experienced ethical problems in their daily work. The top three ethical challenges reported by the nursing home staff were as follows: lack of resources (79%), end-of-life issues (39%) and coercion (33%). To improve systematic ethics work, most employees suggested ethics education (86%) and time for ethics discussion (82%). Of 33 documented ethics meetings from Austria during a 1-year period, 29 were prospective resident ethics meetings where decisions for a resident had to be made. Agreement about a solution was reached in all 29 cases, and this consensus was put into practice in all cases. Residents did not participate in the meetings, while relatives participated in a majority of case discussions. In many cases, the main topic was end-of-life care and life-prolonging treatment. Lack of resources, end-of-life issues and coercion were ethical challenges most often reported by nursing home staff. The staff would appreciate systematic ethics work to aid decision-making. Resident ethics meetings can help to reach consensus in decision-making for nursing home patients. In the future, residents' participation should be encouraged whenever possible. © 2015 The Authors. Scandinavian Journal of Caring
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Surgical nurses' perceptions of ethical dilemmas, moral distress and quality of care.
DeKeyser Ganz, Freda; Berkovitz, Keren
2012-07-01
To describe surgical nurses' perceived levels of ethical dilemmas, moral distress and perceived quality of care and the associations among them. Nurses are committed to providing quality care. They can experience ethical dilemmas and moral distress while providing patient care. Little research has focused on the effect of moral distress or ethical dilemmas on perceived quality of care. Descriptive, cross-sectional study. After administration and institutional Research Ethics Committee approval, a researcher requested 119 surgical nurses working in two Israeli hospitals to fill out three questionnaires (personal background characteristics; Ethical Dilemmas in Nursing and Quality of Nursing Care). Data collection took place from August 2007 to January 2008. Participant mean age was 39·7 years. The sample consisted mostly of women, Jewish and married staff nurses. The majority of nurses reported low to moderate levels of ethical dilemma frequency but intermediate levels of ethical dilemma intensity. Frequency of ethical dilemmas was negatively correlated with level of nursing skill, meeting patient's needs and total quality of care. No important correlations were found between intensity of ethical dilemmas and quality of care. Levels of ethical dilemma frequency were higher than intensity. Nurses tended to be satisfied with their level of quality of care. Increased frequency of ethical dilemmas was associated with some aspects of perceived quality of care. Quality of care is related to ethical dilemmas and moral distress among surgical nurses. Therefore, efforts should be made to decrease the frequency of these feelings to improve the quality of patient care. © 2011 Blackwell Publishing Ltd.
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Operational effectiveness of blended e-learning program for nursing research ethics.
Cho, Kap-Chul; Shin, Gisoo
2014-06-01
Since 2006, the Korean Ministry of Education, Science and Technology, and the National Research Foundation of Korea have taken the lead in developing an institutional guideline for research ethics. The purpose was to identify the effectiveness of the Good Research Practice program, developed on a fund granted by the National Research Foundation of Korea, for nurses and nursing students whose knowledge and perception of research ethics were compared before and after the implementation of the Good Research Practice program. This study was conducted to compare the levels of knowledge and perception of research ethics in the participants before and after the program was implemented. The participants included 45 nurses and 69 nursing students from hospitals, colleges of nursing, and the Korean Nurses Association, located in Seoul, Korea. This study was approved by the Institutional Research Board in Korea. Based on the Analysis, Design, Development, Implementation, and Evaluation model, the Good Research Practice program was made up of a total of 30 h of the blended learning both online and off-line. The results of this study showed that there were statistically significant differences in both knowledge and perception of research ethics in nursing students and nurses before and after the program had been implemented. The concepts of professional nursing ethics, moral issues, and bioethics were often confused with one another and not clearly defined. Therefore, the concept and scope of bioethics, moral judgment, and overall nursing ethics should be well defined and conceptualized in the future. This study suggested integrating research ethics education in the nursing curriculum as a required course of study for nursing students and as part of the in-service training program for nurses in order to improve research ethics in nursing research in Korea. © The Author(s) 2013.
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Kaltoft, Mette Kjer
2013-01-01
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities in the clinical-disciplinary landscape. Each sees itself as providing decision support by way of information inputs and ethical insights, respectively. Both have reasons - ideological, professional, institutional - for their task construction, but this simultaneously disables each from engaging fully in the point-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched virtual learning environment (VLE). This provides an enhanced TIGER-vision for educational reform to deliver ethically coherent, person-centered care transparently.
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Ethical issues regarding human cloning: a nursing perspective.
Dinç, Leyla
2003-05-01
Advances in cloning technology and successful cloning experiments in animals raised concerns about the possibility of human cloning in recent years. Despite many objections, this is not only a possibility but also a reality. Human cloning is a scientific revolution. However, it also introduces the potential for physical and psychosocial harm to human beings. From this point of view, it raises profound ethical, social and health related concerns. Human cloning would have an impact on the practice of nursing because it could result in the creation of new physiological and psychosocial conditions that would require nursing care. The nursing profession must therefore evaluate the ethics of human cloning, in particular the potential role of nurses. This article reviews the ethical considerations of reproductive human cloning, discusses the main reasons for concern, and reflects a nursing perspective regarding this issue.
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Deontological aspects of the nursing profession: understanding the code of ethics
Directory of Open Access Journals (Sweden)
Terezinha Nunes da Silva
Full Text Available ABSTRACT Objective: to investigate nursing professionals' understanding concerning the Code of Ethics; to assess the relevance of the Code of Ethics of the nursing profession and its use in practice; to identify how problem-solving is performed when facing ethical dilemmas in professional practice. Method: exploratory descriptive study, conducted with 34 (thirty-four nursing professionals from a teaching hospital in João Pessoa, PB - Brazil. Results: four thematic categories emerged: conception of professional ethics in nursing practice; interpretations of ethics in the practice of care; use of the Code of Ethics in the professional practice; strategies for solving ethical issues in the professional practice. Final considerations: some of the nursing professionals comprehend the meaning coherently; others have a limited comprehension, based on jargon. Therefore, a deeper understanding of the text contained in this code is necessary so that it can be applied into practice, aiming to provide a quality care that is, above all, ethical and legal.
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Deontological aspects of the nursing profession: understanding the code of ethics.
Silva, Terezinha Nunes da; Freire, Maria Eliane Moreira; Vasconcelos, Monica Ferreira de; Silva Junior, Sergio Vital da; Silva, Wilton José de Carvalho; Araújo, Patrícia da Silva; Eloy, Allan Victor Assis
2018-01-01
to investigate nursing professionals' understanding concerning the Code of Ethics; to assess the relevance of the Code of Ethics of the nursing profession and its use in practice; to identify how problem-solving is performed when facing ethical dilemmas in professional practice. exploratory descriptive study, conducted with 34 (thirty-four) nursing professionals from a teaching hospital in João Pessoa, PB - Brazil. four thematic categories emerged: conception of professional ethics in nursing practice; interpretations of ethics in the practice of care; use of the Code of Ethics in the professional practice; strategies for solving ethical issues in the professional practice. some of the nursing professionals comprehend the meaning coherently; others have a limited comprehension, based on jargon. Therefore, a deeper understanding of the text contained in this code is necessary so that it can be applied into practice, aiming to provide a quality care that is, above all, ethical and legal.
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Korean nurses' ethical dilemmas, professional values and professional quality of life.
Kim, Kyunghee; Han, Yonghee; Kim, Ji-su
2015-06-01
In the changing medical environment, professional stress continuously increases as the individual's quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants' demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. The nurses' professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses' values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values. © The Author(s) 2014.
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Nursing research ethics, guidance and application in practice.
Doody, Owen; Noonan, Maria
2016-07-28
Ethics is fundamental to good research practice and the protection of society. From a historical point of view, research ethics has had a chequered past and without due cognisance there is always the potential for research to do harm. Research ethics is fundamental to research practice, nurse education and the development of evidence. In conducting research, it is important to plan for and anticipate any potential or actual risks. To engage in research, researchers need to develop an understanding and knowledge of research ethics and carefully plan how to address ethics within their research. This article aims to enhance students' and novice researchers' research ethics understanding and its application to nursing research.
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Code of ethics and conduct for European nursing.
Sasso, Loredana; Stievano, Alessandro; González Jurado, Máximo; Rocco, Gennaro
2008-11-01
A main identifying factor of professions is professionals' willingness to comply with ethical and professional standards, often defined in a code of ethics and conduct. In a period of intense nursing mobility, if the public are aware that health professionals have committed themselves to the drawing up of a code of ethics and conduct, they will have more trust in the health professional they choose, especially if this person comes from another European Member State. The Code of Ethics and Conduct for European Nursing is a programmatic document for the nursing profession constructed by the FEPI (European Federation of Nursing Regulators) according to Directive 2005/36/EC On recognition of professional qualifications , and Directive 2006/123/EC On services in the internal market, set out by the European Commission. This article describes the construction of the Code and gives an overview of some specific areas of importance. The main text of the Code is reproduced in Appendix 1.
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A study of nurses' ethical climate perceptions: Compromising in an uncompromising environment.
Humphries, Anne; Woods, Martin
2016-05-01
Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice - hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind carried out in New Zealand. The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate. This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research. Ethics approval for this study was granted by the New Zealand Ministry of Health's Central Regional Health and Disability Ethics Committee on 14 June 2012. The themes identified in the data centred on three dominant elements that - together - shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff. While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses' ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere. Moral distress is inevitable in an ethical climate where the organisation's main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care. © The Author(s) 2015.
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Practical ethical theory for nurses responding to complexity in care.
Fairchild, Roseanne Moody
2010-05-01
In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.
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Historical Roots and Future Perspectives Related to Nursing Ethics.
Freitas, Lorraine
1990-01-01
This article traces the evolution of the development and refinement of the professional code from concerns about the ethical conduct of nurses to its present state as a professional code for all nurses. The relationship of the Ethics Committee of the American Nurses' Association to the development of the code is also discussed. (Author/MLW)
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Applying an ethical decision-making tool to a nurse management dilemma.
Toren, Orly; Wagner, Nurith
2010-05-01
This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses' rights collide with patients' rights to quality care in a world of cost-effective and economic constraint? Managers' responsibility is to ensure and facilitate a safe and ethical working environment in which nurses are able to give quality care to their patients. In nursing it is frequently declared that managers' main obligations are to patients' needs and their rights to receive quality care. However, managers' ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients' and nurses' rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model.
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[Conflicts between nursing ethics and health care legislation in Spain].
Gea-Sánchez, Montserrat; Terés-Vidal, Lourdes; Briones-Vozmediano, Erica; Molina, Fidel; Gastaldo, Denise; Otero-García, Laura
2016-01-01
To identify the ethical conflicts that may arise between the nursing codes of ethics and the Royal Decree-law 16/2012 modifying Spanish health regulations. We conducted a review and critical analysis of the discourse of five nursing codes of ethics from Barcelona, Catalonia, Spain, Europe and International, and of the discourse of the Spanish legislation in force in 2013. Language structures referring to five different concepts of the theoretical framework of care were identified in the texts: equity, human rights, right to healthcare, access to care, and continuity of care. Codes of ethics define the function of nursing according to equity, acknowledgement of human rights, right to healthcare, access to care and continuity of care, while legal discourse hinges on the concept of beneficiary or being insured. The divergence between the code of ethics and the legal discourse may produce ethical conflicts that negatively affect nursing practice. The application of RDL 16/2012 promotes a framework of action that prevents nursing professionals from providing care to uninsured collectives, which violates human rights and the principles of care ethics. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
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National scientific literature on nursing ethics: a systematic Review
Directory of Open Access Journals (Sweden)
Ilka Nicéia D’Aquino Oliveira Teixeira
2010-03-01
Full Text Available Objective: To identify the most prevalent nursing ethical issues published in scientific Brazilian journals. Methods: A systematic literature review with the following inclusion criteria: (1 articles on Nursing Ethics written in Portuguese, English, French, and Spanish; (2 published in Brazilian journals; (3 in the period from January 1997 to February 2009. The search was carried out in four databases BDENF, LILACS, MEDLINE, and SCIELO. The key-words were ethics AND nursing. The selected studies were classified into categories. The content of the articles were analyzed using the Collective Subject Discourse. The categories generated discourses by organizing the main excerpts from the abstracts of the selected studies, which are the “key expressions”. Results: A hundred and thirty three articles that met the inclusion criteria were classified into eight categories: 1. Nursing Care; 2. Dilemmas and Controversies; 3. Education; 4. Legal Aspects; 5. Research; 6. Management; 7. Values and Beliefs; 8. Perspectives and Health Policies. The category “Nursing Care” prevailed in 36% of the selected articles, and it was classified into six subcategories. “Dilemmas and Controversies” was the second most prevalent category (15%. Conclusion: The number of theoretical papers on ethical issues is high, but there is little research on the ethical experiences in nursing practice.
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Ethical issues in patient safety: Implications for nursing management.
Kangasniemi, Mari; Vaismoradi, Mojtaba; Jasper, Melanie; Turunen, Hannele
2013-12-01
The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in 'the ethical imperative' of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers' decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected.
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Exploring the relevance of social justice within a relational nursing ethic.
Woods, Martin
2012-01-01
In the last few decades, a growing number of commentators have questioned the appropriateness of the 'justice view' of ethics as a suitable approach in health care ethics, and most certainly in nursing. Essentially, in their ethical deliberations, it is argued that nurses do not readily adopt the high degree of impartiality and objectivity that is associated with a justice view; instead their moral practices are more accurately reflected through the use of alternative approaches such as relational or care-based ethics. Yet, it has also been argued that this viewpoint does not necessarily 'do justice' to the broader moral responsibilities of nurses towards humanity in general, i.e. to the wider socio-cultural and socio-political issues in society, and to the concept of social justice in particular. This criticism has triggered a much closer examination of relational and care-based ethics in nursing at levels beyond individual responsiveness within relationships and brought into the spotlight the need for a more ethically refined nursing response to an increasingly complex set of socio-cultural inequalities. This article explores a relational ethic within nursing practices with contemporary ideas regarding social justice. In particular, it is argued that the synergy between the two actually produces an ethic that is capable of not only challenging the continuing predominance of justice-based ethics within health care, but of replacing it. Subsequently, in the discussion that follows, it is suggested that a combined social justice and relational care-based approach, as a social ethic, should guide the moral deliberations and actions of nurses. It is maintained that such an approach is not only possible, but crucial if nurses are to realize their full potential as ethical agents for individual and social good. © 2011 Blackwell Publishing Ltd.
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Ethical issues experienced by healthcare workers in nursing homes: Literature review.
Preshaw, Deborah Hl; Brazil, Kevin; McLaughlin, Dorry; Frolic, Andrea
2016-08-01
Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues. Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. The review highlighted a need for improved ethics education for care-providers. © The Author(s) 2015.
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Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences.
Zydziunaite, Vilma; Suominen, Tarja
2014-01-01
Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.
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Ethical responsibilities in nursing: research findings and issues.
Cassidy, V R
1991-01-01
Discussions in the literature assert that nurses are becoming increasingly cognizant of their ethical responsibilities, but that they are often ill prepared to participate in ethical decision making. A review of selected research literature from 1970 to 1987 was undertaken to validate these assertions. A total of 12 studies related to ethical responsibilities was identified in the review; all studies were published between 1980 and 1987. The majority of studies were at the descriptive and exploratory levels and employed Kohlberg's cognitive theory of moral development as their conceptual framework. Significant findings related to educational level and ethical responsibilities were consistent across studies. Findings related to age and clinical experience were mixed; the effects of economic level, religion-religiosity, ethnicity, and other variables on ethical responsibilities were not significant. Issues raised in the light of the existing research include the use of Kohlberg's theory as a conceptual orientation in nursing groups and limited data on the reliability and validity of instruments used in measuring ethical constructs. Recommendations for future research on ethical responsibilities include the validation of Kohlberg's theory for nursing investigations, exploration of other frameworks for developing a multidimensional view of ethical responsibilities, and the use of qualitative research designs.
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Nursing students’ understanding of factors influencing ethical sensitivity: A qualitative study
Borhani, Fariba; Abbaszadeh, Abbas; Mohsenpour, Mohaddeseh
2013-01-01
Background: Ethical sensitivity is considered as a component of professional competency of nurses. Its effects on improvement of nurses’ ethical performance and the therapeutic relationship between nurses and patients have been reported. However, very limited studies have evaluated ethical sensitivity. Since no previous Iranian research has been conducted in this regard, the present study aimed to review nursing students’ understanding of effective factors on ethical sensitivity. Materials an...
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A study of an ethics education topic for undergraduate nursing students.
Kalaitzidis, Evdokia; Schmitz, Karl
2012-01-01
The study aims to explore nursing students' perceptions of the relative value of various aspects of the ethical component of the undergraduate topic, 'Ethics and Law applied to Nursing' (topic NURS2104). To enable time for reflection on ethics in nursing, sampling occurred 1 year after successful completion of the above-mentioned topic and after successful completion of all but the final clinical experience components of the Bachelor of Nursing (BN) degree. A significant proportion of respondents perceived ethics education as relevant to professional practices. It is also noteworthy that the ethical decision-making strategies that had been incorporated into the topic (NURS2104) became transformed by the clinical experience of each particular student. While results of this study are not conclusive, they nevertheless provide important information for future nursing students on the evolutionary development of ethics education. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Crucial contextual attributes of nursing leadership towards a care ethics.
Gustafsson, Lena-Karin; Stenberg, Maja
2017-06-01
It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. The design of the study was descriptive and qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee's aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager's role, which probably has different attributes and more focus on an organizational level. Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care.
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Continuing Education in Research Ethics for the Clinical Nurse.
Jeffers, Brenda Recchia
2002-01-01
Review of professional nursing statements, federal policy, and recommendations for protection of human research subjects resulted in a topic and content outline for research ethics training for nurses. Suggestions for continuing education programs on research ethics were formulated. (SK)
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Community health nursing, wound care, and...ethics?
Bell, Sue Ellen
2003-09-01
Because of changing demographics and other factors, patients receiving care for wounds, ostomies, or incontinence are being referred in increasing numbers to community health nursing organizations for initial or continued care. As home-based wound care becomes big business, little discussion is being focused on the moral and ethical issues likely to arise in the high-tech home setting. Progressively more complex and expensive home care relies on family members to take on complicated care regimens in the face of decreasing numbers of allowable skilled nursing home visits. A framework and a principle-based theory for reflection on the character and content of moral and ethical conflicts are provided to encourage informed and competent care of patients in the home. Common moral and ethical conflicts for WOC nurses in the United States are presented. These conflicts include issues of wound care supply procurement; use of documentation to maximize care or profit; problems of quality, care consistency, and caregiver consent; and dilemmas of tiered health care options. The advantages of a framework to address ethical conflicts are discussed.
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Ethical problems experienced by oncology nurses.
da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins
2015-01-01
To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.
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Ethical challenges related to next of kin - nursing staffs' perspective.
Tønnessen, Siri; Solvoll, Betty-Ann; Brinchmann, Berit Støre
2016-11-01
Patients in clinical settings are not lonely islands; they have relatives who play a more or less active role in their lives. The purpose of this article is to elucidate the ethical challenges nursing staff encounter with patients' next of kin and to discuss how these challenges affect clinical practice. The study is based on data collected from ethical group discussions among nursing staff in a nursing home. The discussions took place in 2011 and 2012. The data were analysed and interpreted by using hermeneutic methodology. All the data have been anonymised and handled with confidentiality. Written informed consent was obtained from all participants. Ethical challenges relating to patients' next of kin were found to be an issue frequently discussed in the groups. Our findings indicate that next of kin have different characteristics, categorised as 'the professionals' and 'the shadows'. In this article, we will describe the next of kin's characteristics and the ethical challenges and practical implications that nursing staff experience in this connection. We will discuss the findings in the light of the four basic principles of medical ethics and propose interventions to help nurses manage ethical challenges related to next of kin. The study reveals the need to enhance nursing staffs' communicative and ethical skills on an individual level, but most importantly, to establish routines in clinical settings for informing and following up next of kin in a systematic and structured way. © The Author(s) 2015.
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Saxén, Salla
2018-03-01
This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations-one for nurses and one for physicians-were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well as to speculate what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians' ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians' ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward.
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Toward a Consensus in Ethics Education for the Doctor of Nursing Practice.
Laabs, Carolyn A
2015-01-01
The purpose of this study was to begin to develop a consensus as to the essential content and methods of ethics education for advanced practice nurses. An online Delphi technique was used to survey ethics experts to determine whether items were essential, desirable, or unnecessary to ethics education for students in doctor of nursing practice programs. Only the American Nurses Association Code of Ethics and ethics terminology were deemed essential foundational knowledge.
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Environmental ethics and wilderness management: an empirical study
William A. Valliere; Robert E. Manning
1995-01-01
The underlying hypothesis of this study is that environmental ethics influence public attitudes toward wilderness management. To study this hypothesis, environmental ethics were defined, categorized, and measured empirically. Additionally, attitudes toward selected wilderness management issues were measured. Associations were found between beliefs in selected...
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A European multicenter study on systematic ethics work in nursing homes.
Bollig, Georg; Rosland, Jan Henrik; Gjengedal, Eva; Schmidt, Gerda; May, Arnd T; Heller, Andreas
2017-09-01
There are many existing ethical challenges in nursing homes. Although different methods and approaches to discussing the ethical challenges have been established, systematic ethics work is not yet a standard in all nursing homes. The aim of the present study was to explore ethical challenges and approaches to implementing systematic ethics work in nursing homes. Data from five institutions in Austria, Germany and Norway were collected, and a mixed-methods two-tiered study approach was chosen. Documentation of ethics discussions was combined with qualitative focus group interviews with staff members regarding the implementation of systematic ethics work in nursing homes. One hundred and five ethics meetings were documented. The main topics were advance care planning, ethical challenges associated with artificial nutrition, hospitalisation and end-of-life decision-making. Of the meetings, 33% focused mainly on everyday ethical challenges. In 76% of prospective case discussions, agreements about a solution were reached; however, in 29% of these no residents or relatives participated. The advantages of systematic ethics work described by the staff were enhanced openness and dialogue, overall, and a greater ethical awareness. Many voiced a need for structure and support from the administration. Systematic ethics work is greatly appreciated by the staff and helps to reach a consensus in the majority of case discussions. It should be implemented in all nursing homes. Attention to everyday ethical challenges is important. The participation of relatives and physicians could be improved. The participation of the residents' in ethics discussions should be encouraged to strengthen their autonomy and dignity. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.
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Ethics in Nursing Practice and Education.
Benoliel, Jeanne Quint
1983-01-01
The fact that ethics has become important to nurses is a reflection of two types of developments: (1) rapid expansion and application of biomedical technology, and (2) the human rights movement. Therefore, nursing involves an increasing number of activities with both moral and technical implications. (SSH)
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Nurses' attitudes towards euthanasia in conflict with professional ethical guidelines.
Terkamo-Moisio, Anja; Kvist, Tarja; Kangasniemi, Mari; Laitila, Teuvo; Ryynänen, Olli-Pekka; Pietilä, Anna-Maija
2017-02-01
Despite the significant role of nurses in end-of-life care, their attitudes towards euthanasia are under-represented both in the current literature and the controversial debate that is ongoing in several countries. What are the attitudes towards euthanasia among Finnish nurses? Which characteristics are associated with those attitudes? Cross-sectional web-based survey. Participants and research context: A total of 1003 nurses recruited via the members' bulletin of the Finnish Nurses Association and social media. Ethical considerations: Ethical approval was obtained from the Committee on Research Ethics of the university to which the authors were affiliated. The majority (74.3%) of the participants would accept euthanasia as part of Finnish healthcare, and 61.8% considered that Finland would benefit from a law permitting euthanasia. Most of the nurses (89.9%) thought that a person must have the right to decide on his or her own death; 77.4% of them considered it likely that they would themselves make a request for euthanasia in certain situations. The value of self-determination and the ability to choose the moment and manner of one's death are emphasized in the nurses' attitudes towards euthanasia. A continuous dialogue about euthanasia and nurses' shared values is crucial due to the conflict between nurses' attitudes and current ethical guidelines on nursing.
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Towards an empirical ethics in care: relations with technologies in health care.
Pols, Jeannette
2015-02-01
This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the 'empirical turn' in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings.
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Using Gaming To Help Nursing Students Understand Ethics.
Metcalf, Barbara L.; Yankou, Dawn
2003-01-01
An ethics game involves nursing students in defending actions in ethics-based scenarios. Benefits include increased confidence, ability to see multiple perspectives, values clarification, and exposure to decision-making models, professional responsibilities, ethical principles, social expectations, and legal requirements. Difficulties include…
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Validity of the Italian Code of Ethics for everyday nursing practice.
Gobbi, Paola; Castoldi, Maria Grazia; Alagna, Rosa Anna; Brunoldi, Anna; Pari, Chiara; Gallo, Annamaria; Magri, Miriam; Marioni, Lorena; Muttillo, Giovanni; Passoni, Claudia; Torre, Anna La; Rosa, Debora; Carnevale, Franco A
2016-12-07
The research question for this study was as follows: Is the Code of Ethics for Nurses in Italy (Code) a valid or useful decision-making instrument for nurses faced with ethical problems in their daily clinical practice? Focus groups were conducted to analyze specific ethical problems through 11 case studies. The analysis was conducted using sections of the Code as well as other relevant documents. Each focus group had a specific theme and nurses participated freely in the discussions according to their respective clinical competencies. The executive administrative committee of the local nursing licensing council provided approval for conducting this project. Measures were taken to protect the confidentiality of consenting participants. The answer to the research question posed for this investigation was predominantly positive. Many sections of the Code were useful for discussion and identifying possible solutions for the ethical problems presented in the 11 cases. We concluded that the Code of Ethics for Nurses in Italy can be a valuable aid in daily practice in most clinical situations that can give rise to ethical problems. © The Author(s) 2016.
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Iranian pediatric nurse's experience: The facilitators of the learning of ethical practices
Directory of Open Access Journals (Sweden)
Kobra Karami
2017-01-01
Full Text Available Background: Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses' daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses. Materials and Methods: This study is a conventional qualitative content analysis based on the Graneheim and Lundman method. It was conducted through semi-structured interviews with two focus groups, incorporating 28 nurses working in pediatric wards. Unstructured observation and field notes were other methods of data collection. Purposive sampling continued until data saturation was ensured. All interviews were tape recorded and transcribed in verbatim. Results: Three main categories and 12 subcategories emerged from this study. The facilitating factors include (1 individual competencies (knowledge, experience, emotional intelligence, and loving children, (2 ethical imprinting (responsibility, reflection, empathy, and ethical beliefs, and (3 an environment that nurtures moral values (organizational, spiritual, family, and cultural environments as facilitating factors. Conclusions: The promotion of nurses' competencies, ethical virtues, and imprinting, as well as improvement of the quality of nursing care must be the top priority of the health team. Undoubtedly, the success of the health care system is not possible without ensuring that pediatric nurses learn ethical practices.
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Leadership styles in ethical dilemmas when head nurses make decisions.
Zydziunaite, V; Lepaite, D; Suominen, T
2013-06-01
The overlooked aspect in Lithuania is the dearth of leaders among head nurses, who bear the responsibility for decisions in ethical dilemmas. Understanding the application of leadership styles is fundamental to ensuring head nurses' abilities to influence outcomes for healthcare providers and patients. To identify the leadership styles applied by head nurses in decision making in ethical dilemmas on hospital wards. The data were collected by questionnaires completed by head nurses (n = 278) working in five major state-funded hospitals in each of the five regions of Lithuania. The data were analysed using SPSS 16.0, calculating descriptive statistics and analysis of variance. Head nurses apply democratic, affiliative, transformational and sustainable leadership styles when resolving ethical dilemmas. The application of leadership styles is associated not only with specific situations, but also with certain background factors, such as years of experience in a head nurse's position, ward specialization and the incidence of ethical dilemmas. Nurses having been in a head nurse's position over 10 years use primitive leadership styles, notably bureaucratic leadership, more often than do those head nurses with only a few years of experience in such a position. The results highlight the need for head nurses to reflect on their practices and to find new ways of learning from practice, colleagues and patients. Head nurses' managerial decisions due to their 'executive power' can turn into a new state-of-the-art leadership in nursing. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.
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Nurses' perception of ethical climate and organizational commitment.
Borhani, Fariba; Jalali, Tayebe; Abbaszadeh, Abbas; Haghdoost, Aliakbar
2014-05-01
The high turnover of nurses has become a universal issue. The manner in which nurses view their organization's ethical climate has direct bearing on their organizational commitment. The aim of this study was to determine the correlation between nurses' perception of ethical climate and organizational commitment in teaching hospitals in the southeastern region of Iran. A descriptive analytical design was used in this study. The sample consisted of 275 nurses working in four teaching hospitals in the southeastern region of Iran. The instruments used in this study included a demographic questionnaire, Ethical Climate Questionnaire, and Organizational Commitment Questionnaire. Data analysis was carried out using Pearson's correlation, t-test, and descriptive statistic through Statistical Package for Social Science, version 16. The result of this research indicated a positive correlation among professionalism, caring, rules, independence climate, and organizational commitment. Therefore, findings of this study are a guideline for researchers and managers alike who endeavor to improve organizational commitment.
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[A reconsideration of nursing ethics from the perspective of téchne].
Wang, Wen-Sheng
2014-10-01
Our current age of technology sets high expectations for clarity and exactness in all professions, including nursing. This article introduces nursing ethics as a nebulous form of art (téchne) and then considers the new aspects that may be developed from nursing ethics. We first introduce the Aristotelian concept of téchne and then explain how téchne addresses experiential knowledge without claims to exactness. A discussion then follows about the relationship of téchne to rigorous and serious philosophy. While téchne is not an exact science, this concept addresses the difference between the exactness claimed by ancient Greek physical science (phúsis) and wisdom and the exactness claimed by Westerners today due to the changes in modern Western attitudes toward beings. In discussing nursing ethics as téchne, this article shows that the discussions of ethics within the medical and nursing professions nowadays are still influenced by age-of-technology claims to exactness. Finally, we propose the following: 1) nursing ethics should develop standards for ethics of care (or care ethics) wherein action is more important than theoretical argument and 2) some ideas and methods of rhetoric and narration should be integrated into the process of communication between nurses and patients.
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A proto-code of ethics and conduct for European nurse directors.
Stievano, Alessandro; De Marinis, Maria Grazia; Kelly, Denise; Filkins, Jacqueline; Meyenburg-Altwarg, Iris; Petrangeli, Mauro; Tschudin, Verena
2012-03-01
The proto-code of ethics and conduct for European nurse directors was developed as a strategic and dynamic document for nurse managers in Europe. It invites critical dialogue, reflective thinking about different situations, and the development of specific codes of ethics and conduct by nursing associations in different countries. The term proto-code is used for this document so that specifically country-orientated or organization-based and practical codes can be developed from it to guide professionals in more particular or situation-explicit reflection and values. The proto-code of ethics and conduct for European nurse directors was designed and developed by the European Nurse Directors Association's (ENDA) advisory team. This article gives short explanations of the code' s preamble and two main parts: Nurse directors' ethical basis, and Principles of professional practice, which is divided into six specific points: competence, care, safety, staff, life-long learning and multi-sectorial working.
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Ethical sensitivity, burnout, and job satisfaction in emergency nurses.
Palazoğlu, Cansu Atmaca; Koç, Zeliha
2017-01-01
Rising levels of burnout and decreasing job satisfaction can inhibit healthcare professionals from providing high-quality care due to a corresponding decrease in their ethical sensitivity. This study aimed to determine the relationship between the level of ethical sensitivity in emergency service nurses and their levels of burnout and job satisfaction. This research employed a descriptive and cross-sectional design. Participants and research context: This study was conducted with a sample of 236 nurses, all of whom worked in emergency service between 24 July 2015 and 28 April 2016. Data were collected using the Moral Sensitivity Questionnaire, Maslach Burnout Inventory, and Minnesota Job Satisfaction Scale. Ethical considerations: This study was approved by the Institutional Ethics Review Board of Ondokuz Mayıs University. There was a weak and negative correlation (r = -0.158, p = 0.015) between Moral Sensitivity Questionnaire and Maslach Burnout Inventory scores. There was also a weak and negative correlation (r = -0.335, p Burnout Inventory and Minnesota Job Satisfaction Scale scores. Decreased job satisfaction and increased burnout levels among emergency service nurses might result in them indulging in improper practices, frequently facing ethical problems, and a decrease in the overall quality of service in hospitals. In order for emergency service nurses to recognize ethical problems and make the most accurate decisions, a high level of ethical sensitivity is critical. In this respect, it is suggested that continuing education after graduation and training programs should be organized.
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Ethical conflict in critical care nursing: Correlation between exposure and types.
Falcó-Pegueroles, Anna; Lluch-Canut, Teresa; Roldan-Merino, Juan; Goberna-Tricas, Josefina; Guàrdia-Olmos, Joan
2015-08-01
Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology. The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states. This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out. A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire-Critical Care Version. This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study. The index of exposure to ethical conflict was [Formula: see text]. The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict. The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict. The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse. © The Author(s) 2014.
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[Ethical dilemma for nurses who manage marital violence in clinical setting].
Hou, Wen-Li; Kuo, Ya-Wen; Huang, Mei-Chih
2008-06-01
Marital violence or intimate partner violence is a serious and recurring public health issue. In the clinical setting, battered women often seek medical advice, because of the health problems that result from marital violence. Thus, nursing staff are the first persons to come into contact with the battered women. Can nurses execute their notify responsibility to prevent continued injury before obtained the woman's agreement? Will this action violate the principle of autonomy or not? Nurses would face an ethical dilemma when they care for battered women. The purpose of this article is to use Aroskar's ethical decision making model to analyze and clarify the ethical dilemmas involved in managing marital violence, including: under the value systems of the person, the profession, and time to illustrate the basic information, decision theory dimensions, and ethical theories or positions. It is hoped that this article provides an ethical decision making model for the ethical dilemmas facing nurses who manage marital violence in the clinical setting.
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Nurses' workplace distress and ethical dilemmas in Tanzanian health care.
Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro
2008-07-01
The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.
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Controversies in nursing ethics: a historical review.
Olsen, D P
1992-09-01
The author critiques the dialectic between justice-based ethics and an ethic of caring from a historical perspective (by analogy with the dialectic between agape and friendship). Justice-based ethics have been problematic for nursing because of the decontextualized approach. The ethic of caring is problematic because caring, being contextual, is particularistic and therefore can be based on morally irrelevant factors, such as liking. There is a tradition of writing which seeks to reconcile the particularistic obligations of friendship with the moral duty to all others equally. Ideas from the following authors are reviewed for relevance to nursing: Aristotle, Aelred of Rievaulx, Augustine, John Cassian, Cicero, George Berkeley, Immanuel Kant, Michel de Montaigne, Jeremy Taylor and Max Weber. The authors concludes by noting that both sides of the dialectic are synthesized in the lived experience of individuals. A synthesis in thought is called for on this basis.
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Nursing management and organizational ethics in the intensive care unit.
Wlody, Ginger Schafer
2007-02-01
This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.
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Cultural and hierarchical influences: ethical issues faced by Taiwanese nursing students.
Yeh, Mei-Yu; Wu, Shu-Mei; Che, Hui-Lian
2010-05-01
OBJECTIVES Improving nurses' competence in resolving clinical ethical issues must start with ethics education in training and clinical practice. However, many students complain that they cannot apply classroom learning to actual clinical scenarios. This study explored ethical issues and dilemmas, and their impact experienced by student nurses in clinical practice. METHODS Focus groups were conducted with 44 first-year student nurses from a 2-year college course in northern Taiwan. Interviews were tape-recorded and verbatim transcripts were analysed using content analysis. RESULTS Students expressed and discussed their views in eight focus groups. Analysis of interviews revealed five themes: frustration at inability to help some patients; oppression caused by lower status; lack of honesty and ethical courage; powerlessness, and self-encouragement in adversity. CONCLUSIONS Taiwanese nurse ethics training was only recently introduced and the curriculum has not addressed the clinical reality in Taiwan. This reality includes limitations arising from the medical hierarchy and the socio-cultural role of families in medical decision making, which may inhibit ethical judgements and decision making. In clinical dilemmas, the most common problems faced by Taiwanese nursing students involved not knowing how to handle some situations, inability to abide by principles, and a lack of appropriate role models. Hence, we suggest that nursing ethics education should: (i) integrate scenarios involving ethical dilemmas into daily routines; (ii) give students opportunities to discuss their feelings about their experiences; (iii) allow teachers and students to talk about scenarios with ethical implications, and (iv) provide students with opportunities to reflect on clinical scenarios in order to clarify their values and learn how to respect the value of life.
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Political-ethical skill development in nursing undergraduates
Directory of Open Access Journals (Sweden)
Maria Dyrce Dias Meira
2013-10-01
Full Text Available This research aimed to identify political-ethical skills developed in a training process compatible with the expected profile set by the National Curriculum Guidelines for the Undergraduate Nursing Degree. A case study was conducted with units represented by 32 former students from a particular religious teaching institution who already were in the job market. The content of the interviews was analyzed using the thematic analysis technique, which resulted in the following categories: "Political-ethical skills in the formative process" and "Political-ethical skills as a product of the educational process." From the former students’ perspective, these categories reinforced the social role of the nurse and the need for students to be reflective, understanding and participative in the transformation of society.
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Ethics policies on euthanasia in nursing homes: a survey in Flanders, Belgium.
Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Verbeke, Geert; Van Craen, Katleen; Schotsmans, Paul; Gastmans, Chris
2008-01-01
In many European countries there is a public debate about the acceptability and regulation of euthanasia. In 2002, Belgium became the second country after the Netherlands to enact a law on euthanasia. Although euthanasia rarely occurs, the complexity of the clinical-ethical decision making surrounding euthanasia requests and the need for adequate support reported by caregivers, means that healthcare institutions increasingly need to consider how to responsibly handle euthanasia requests. The development of written ethics policies on euthanasia may be important to guarantee and maintain the quality of care for patients requesting euthanasia. The aim of this study was to determine the prevalence, development, position, and communication of written ethics policies on euthanasia in Flemish nursing homes. Data were obtained through a cross-sectional mail survey of general directors of all Catholic nursing homes in Flanders, Belgium. Of the 737 nursing homes invited to participate, 612 (83%) completed the questionnaire. Of these, only 15% had a written ethics policy on euthanasia. Presence of an ethics committee and membership of an umbrella organization were independent predictors of whether a nursing home had such a written ethics policy. The Act on Euthanasia and euthanasia guidelines advanced by professional organizations were the most frequent reasons (76% and 56%, respectively) and reference sources (92% and 64%, respectively) for developing ethics policies on euthanasia. Development of ethics policies occurred within a multidisciplinary context. In general, Flemish nursing homes applied the Act on Euthanasia restrictively by introducing palliative procedures in addition to legal due care criteria. The policy was communicated to the consulting general practitioner and nurses in 74% and 89% of nursing homes, respectively. Although the overall prevalence of ethics policies on euthanasia was low in Flemish nursing homes, institution administrators displayed growing
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The ethics of Foucault and Ricoeur: an underrepresented discussion in nursing.
Flaming, Don
2006-09-01
Paul Ricoeur and Michel Foucault enjoy a privileged status in nursing academia as two thinkers who influence both nursing research and philosophical explorations of nursing practice. Most nurse authors, however, focus only on the earlier works of these two philosophers and, for example, base qualitative research methodologies on Foucault's genealogy and Ricoeur's hermeneutics. In their later years, both these writers talk more explicitly about being an ethical self. Ideas from their earlier writing is evident in their writing on ethics and both writers could not discuss ethics without also exploring their ideas of the self and the other. I suggest that some of their thoughts on ethics connect with or complement each other quite well. I will first give an overview of Foucault's ethics, self and the other, and then do the same with Ricoeur's thought. In the third part of the paper I will describe how Foucault and Ricoeur complement each other, and conclude the paper by briefly suggesting how these writers influence my own practice as a nurse educator.
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Does Ethics Education Influence the Moral Action of Practicing Nurses and Social Workers?
Grady, Christine; Danis, Marion; Soeken, Karen L.; O’Donnell, Patricia; Taylor, Carol; Farrar, Adrienne; Ulrich, Connie M.
2009-01-01
Purpose/methods This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master’s degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. PMID:18576241
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Lotfi, Zahra; Atashzadeh-Shoorideh, Foroozan; Mohtashami, Jamileh; Nasiri, Maliheh
2018-03-12
To determine the relationship between ethical leadership, organisational commitment of nurses and their perception of patient safety culture. Patient safety, organisational commitment and ethical leadership styles are very important for improving the quality of nursing care. In this descriptive-correlational study, 340 nurses were selected using random sampling from the hospitals in Tehran in 2016. Data were analysed using descriptive and inferential statistics in SPSS v.20. There was a significant positive relationship between the ethical leadership of nursing managers, perception of patient safety culture and organisational commitment. The regression analysis showed that nursing managers' ethical leadership and nurses' organisational commitment is a predictor of patient safety culture and confirms the relationship between the variables. Regarding the relationship between the nurses' safety performance, ethical leadership and organisational commitment, it seems that the optimisation of the organisational commitment and adherence to ethical leadership by administrators and managers in hospitals could improve the nurses' performance in terms of patient safety. Implementing ethical leadership seems to be one feasible strategy to improve nurses' organisational commitment and perception of patient safety culture. Efforts by nurse managers to develop ethical leadership reinforce organisational commitment to improve patient outcomes. Nurse managers' engagement and performance in this process is vital for a successful result. © 2018 John Wiley & Sons Ltd.
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Team-based learning and ethics education in nursing.
Hickman, Susan E; Wocial, Lucia D
2013-12-01
This report describes the use of team-based learning concepts in an undergraduate nursing applied ethics course using established reporting guidelines. Team-based learning relies on actively engaging students in the learning process through small-group activities that facilitate the development of skills, including concept analysis, critical thinking, and problem solving. Students are divided into teams of five to seven members who collaborate throughout the semester to work through activities that build on ethics concepts introduced through reading and lectures. Nurse educators are challenged to develop educational approaches that will engage students and help them to apply what they learn from the study of ethics to the lived experience of clinical practice. The ultimate goal is to help students to develop into morally sensitive and competent professionals. Team-based learning represents a novel way to teach these skills to undergraduate nursing students. Copyright 2013, SLACK Incorporated.
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Hagedorn Wonder, Amy
Limited opportunities exist for prelicensure nursing students to observe the interprofessional process required to resolve complex ethical cases in practice. Therefore, a mock hospital ethics committee (MHEC) was assembled to teach the application of ethics in practice through simulation. The MHEC meeting is an example of how nursing education and practice can partner to create meaningful learning experiences.
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The ethical health lawyer: an empirical assessment of moral decision making.
Perry, Joshua E; Moore, Ilene N; Barry, Bruce; Clayton, Ellen Wright; Carrico, Amanda R
2009-01-01
Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives.
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Jafree, Sara Rizvi; Zakar, Rubeena; Fischer, Florian; Zakar, Muhammad Zakria
2015-03-19
The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan's healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners. The means of inquiry for this study was qualitative, with 20 interviews and four focus group discussions used to identify nurses' clinical experiences of ethical violations. Content analysis was used to discover sub-categories of ethical violations, as perceived by nurses, within four pre-defined categories of nursing codes of ethics: 1) professional guidelines and integrity, 2) patient informed consent, 3) patient rights, and 4) co-worker coordination for competency, learning and patient safety. Ten sub-categories of ethical violations were found: nursing students being used as adjunct staff, nurses having to face frequent violence in the hospital setting, patient reluctance to receive treatment from nurses, the near-absence of consent taken from patients for most non-surgical medical procedures, the absence of patient consent taking for receiving treatment from student nurses, the practice of patient discrimination on the basis of a patient's socio-demographic status, nurses withdrawing treatment out of fear for their safety, a non-learning culture and, finally, blame-shifting and non-reportage of errors. Immediate and urgent attention is required to reduce ethical violations in the healthcare sector in Pakistan through collaborative efforts by the government, the healthcare sector, and ethics regulatory bodies. Also, changes in socio-cultural values in hospital organisation, public awareness of how to conveniently report ethical
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A Calvinist account of nursing ethics.
Cusveller, Bart
2013-11-01
A relatively small but intellectually robust strand in the Christian religion is the Reformed tradition. Especially, its Calvinist sensibilities inform this Protestant stance towards human culture in general and vocations in particular. Correspondingly, there are some small but robust contributions to academic discourse in nursing ethics. So far there has been no attempt to bring those together as a distinct approach. This article suggests such a Reformed Christian, especially Calvinist, account of nursing ethics. Central to the Reformed perspective is the notion that God is sovereign over all of creation and culture and hence that there can be no religiously or morally neutral area in human life. Consequently, nursing is not seen as professional to the extent it is based on research evidence or theoretical models, but to the extent it serves the ultimate purpose of the practice of care. In the Reformed view, this purpose is fostering the well-being of human beings in need as intrinsically valuable. Nurses are professionals who accept this responsibility, that is, the whole of expectations holding for personal qualities, conduct and outcomes, required to serve the purpose of care. As this is a moral purpose, succeeding or failing to live up to these expectations is the source of moral issues in nursing.
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Truth-telling, decision-making, and ethics among cancer patients in nursing practice in China.
Ling, Dong-Lan; Yu, Hong-Jing; Guo, Hui-Ling
2017-01-01
Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. This paper initially present a case scenario and then critically discuss the ethical issue in association with ethical principles and philosophical theories. Instead of focusing on attitudes toward truth disclosure, it aims to provide strategies regarding this issue for nurses. It highlights and discusses some of the relevant ethical assumptions around the perceived role of nurses in healthcare settings by focusing on nursing ethical virtues, nursing codes of ethics, and philosophical perspectives. And Confucian culture is discussed to explicate that deontology does not consider family-oriented care in China. Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.
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[The ethic dimension of daily tasks in the formation process of nurses].
Fernandes, Josicélia Dumêt; Rosa, Darci de Oliveira Santa; Vieira, Therezinha Teixeira; Sadigursky, Dora
2008-06-01
This theoretical article had as its object of study the ethic dimension of the formation process of nurses taking in consideration the National Curricular Directives for Nursing Courses. It was based on the presuppositions of ethics and their relationship with the implementation of changes in the formation process of nurses, using as reference elements of ethical behavior in the formation and attempting to bring the reflection to current times and thus contribute to define a direction to Nursing education. It was concluded that the ethical dimension in the formation of nurses involves values that permeate the relations between the subjects of this process and nature itself. The study points out the need to transform the practices of students and teachers and change the current curriculum framework, highlighting elements that indicate that the concern with ethics when developing the curriculum framework is not limited to how a discipline is taught, but pass through as practices that take place in the education process.
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Riedel, Annette
2015-01-01
Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice. PMID:27417590
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Lecture-based versus problem-based learning in ethics education among nursing students.
Khatiban, Mahnaz; Falahan, Seyede Nayereh; Amini, Roya; Farahanchi, Afshin; Soltanian, Alireza
2018-01-01
Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics. The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students. This is a repeated measurement quasi-experimental study. Participants and research context: The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software. Ethical considerations: The program was explained to the students, all of whom signed an informed consent form at the baseline. The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning, practical considerations, and familiarity with the ethical issues among nursing students.
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Debunking Confabulation : Emotions and the Significance of Empirical Psychology for Kantian Ethics
Kleingeld, Pauline; Cohen, Alix
2014-01-01
It is frequently argued that research findings in empirical moral psychology spell trouble for Kantian ethics. Sometimes the charge is merely that Kantianism is mistaken about the role of emotions in human action, but it has also been argued that empirical moral psychology ‘debunks’ Kantian ethics
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Barriers to ethical nursing practice for older adults in long-term care facilities.
Choe, Kwisoon; Kang, Hyunwook; Lee, Aekyung
2018-03-01
To explore barriers to ethical nursing practice for older adults in long-term care facilities from the perspectives of nurses in South Korea. The number of older adults admitted to long-term care facilities is increasing rapidly in South Korea. To provide this population with quality care, a solid moral foundation should be emphasised to ensure the provision of ethical nursing practices. Barriers to implementing an ethical nursing practice for older adults in long-term care facilities have not been fully explored in previous literature. A qualitative, descriptive design was used to explore barriers to ethical nursing practice as perceived by registered nurses in long-term care facilities in South Korea. Individual interviews were conducted with 17 registered nurses recruited using purposive (snowball) sampling who care for older adults in long-term care facilities in South Korea. Data were analysed using qualitative content analysis. Five main themes emerged from the data analysis concerning barriers to the ethical nursing practice of long-term care facilities: emotional distress, treatments restricting freedom of physical activities, difficulty coping with emergencies, difficulty communicating with the older adult patients and friction between nurses and nursing assistants. This study has identified methods that could be used to improve ethical nursing practices for older adults in long-term care facilities. Because it is difficult to improve the quality of care through education and staffing alone, other factors may also require attention. Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study. © 2017 John Wiley & Sons Ltd.
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Ethics and human rights issues experienced by nurses in leadership roles.
Redman, Barbara A; Fry, Sara T
2003-01-01
The aims of this study were to identify (1) the ethics and human rights issues experienced by nurses in leadership roles (NLs); (2) how frequently these issue occurred in the NLs'practices; and (3) how disturbed the NLs were by the issues. Dillman's Total Design Method (1978) for mailed surveys guided the study design. Data analysis was performed on 470 questionnaires from New England RNs in nursing leadership roles. The most frequently experienced ethics and human rights issues during the previous 12 months were (1) protecting patient right and human dignity; (2) respecting or not respecting informed consent to treatment; (3) use or nonuse of physical or chemical restraints; (4) providing care with possible risks to the RN's health; (5) following or not following advance directives; and (6) staffing patterns that limit patient access to nursing care. The most disturbing ethics and human rights issues experienced by the NLs were staffing patterns that limited patient access to nursing care, prolonging the dying process with inappropriate measures, working with unethical, incompetent, or impaired colleagues, implementing managed care policies that threaten quality of care, not considering quality of the patient's life, and caring for patients and families who are uninformed or misinformed about treatment, prognosis, or medical alternatives. Nearly 39% of the NLs reported experiencing ethics and human rights issues one to four times a week or more, and more than 90% handled their most recent ethics issue by discussing it with nursing peers. Study findings have implications for ethics education and resource support for nurses in leadership roles, and for further research on how NLs handle ethics and human rights issues in the workplace.
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Factors influencing emergency nurses' ethical problems during the outbreak of MERS-CoV.
Choi, Jeong-Sil; Kim, Ji-Soo
2018-05-01
Whenever there has been a worldwide contagious disease outbreak, there have been reports of infection and death of healthcare workers. Particularly because emergency nurses have contact with patients on the front line, they experience ethical problems in nursing while struggling with infectious diseases in an unfavorable environment. The objective of this study was to explore emergency nurses' ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome-coronavirus in Korea. For this cross-sectional study, a questionnaire survey was conducted with emergency nurses working in six hospitals selected through convenience sampling from the hospitals designated for Middle East respiratory syndrome-coronavirus patients in the capital area. Data were collected from 169 emergency nurses in Korea during August 2015. Ethical considerations: This research was approved by the Institutional Review Board of G University in Korea. The findings of this study suggest that during the Middle East respiratory syndrome-coronavirus outbreak, emergency nurses experienced ethical problems tied to a mind-set of avoiding patients. Three factors were found to influence emergency nurses' ethical problems (in order of influence): cognition of social stigmatization, level of agreement with infection control measures, and perceived risk. Through this study, we obtained information on emergency nurses' ethical problems during the Middle East respiratory syndrome-coronavirus outbreak and identified the factors that influence them. As found in this study, nurses' ethical problems were influenced most by cognitions of social stigmatization. Accordingly, to support nurses confidently care for people during future health disasters, it is most urgent to promote appropriate public consciousness that encourages healthcare workers.
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Ethical principles of informed consent: exploring nurses' dual role of care provider and researcher.
Judkins-Cohn, Tanya M; Kielwasser-Withrow, Kiersten; Owen, Melissa; Ward, Jessica
2014-01-01
This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher-participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association's code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher. Copyright 2014, SLACK Incorporated.
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Nursing students' understanding of factors influencing ethical sensitivity: A qualitative study.
Borhani, Fariba; Abbaszadeh, Abbas; Mohsenpour, Mohaddeseh
2013-07-01
Ethical sensitivity is considered as a component of professional competency of nurses. Its effects on improvement of nurses' ethical performance and the therapeutic relationship between nurses and patients have been reported. However, very limited studies have evaluated ethical sensitivity. Since no previous Iranian research has been conducted in this regard, the present study aimed to review nursing students' understanding of effective factors on ethical sensitivity. This qualitative study was performed in Kerman, Iran, during 2009. It used semi-structured individual interviews with eight MSc nursing students to assess their viewpoints. It also included two focus groups. Purposive sampling was continued until data saturation. Data were analyzed using manifest content analysis. The students' understanding of factors influencing ethical sensitivity were summarized in five main themes including individual and spiritual characteristics, education, mutual understanding, internal and external controls, and experience of an immoral act. The findings of this study create a unique framework for sensitization of nurses in professional performance. The application of these factors in human resource management is reinforcement of positive aspects and decrease in negative aspects, in education can use for educational objectives setting, and in research can designing studies based on this framework and making related tools. It is noteworthy that presented classification was influenced by students themselves and mentioned to a kind of learning activity by them.
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Generational differences in work ethic among 3 generations of registered nurses.
Jobe, Laura L
2014-05-01
The purpose of this study was to understand if differences in dimensions of work ethic exist among 3 generations of nurses working in an inpatient setting at an acute care facility. Generational differences are linked with increased turnover, with work ethic frequently cited as an important difference. The quantitative, quasi-experimental cross-sectional study recruited inpatient registered nurses from 2 teaching hospitals in a southern US metropolitan area to complete the Multidimensional Work Ethic Profile online. The 285 completed surveys indicated that similarities exist among the 3 generations, with statistically significant differences only in leisure, hard work, and delay of gratification dimensions. Understanding differences in work ethic dimensions could lead to strategies for improving the generational conflict. These results also lead to the conclusion that work ethic differences may not be the cause of the generational conflict among nurses.
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A social-ecological framework: A model for addressing ethical practice in nursing.
Davidson, Patricia; Rushton, Cynda Hylton; Kurtz, Melissa; Wise, Brian; Jackson, Debra; Beaman, Adam; Broome, Marion
2018-03-01
To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice. Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers. Conceptual framework development. A comprehensive literature review was undertaken using the social-ecological framework as an organising construct. This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic. Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research. Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can
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Knowles, Amy J. B.
2014-01-01
Ethics is an integral component of the nursing profession. This phenomenological study aimed to describe how baccalaureate nursing students experience learning ethics both in the classroom and clinical setting. The interviews in this study were conducted with eight second semester senior nursing students. Four themes emerged from analyses of the…
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Nurse prescribing ethics and medical marketing.
Adams, J
This article suggests that nurse prescribers require an awareness of key concepts in ethics, such as deontology and utilitarianism to reflect on current debates and contribute to them. The principles of biomedical ethics have also been influential in the development of professional codes of conduct. Attention is drawn to the importance of the Association of the British Pharmaceutical Industry's code of practice for the pharmaceutical industry in regulating marketing aimed at prescribers.
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Transparency in nursing leadership: a chosen ethic.
Milton, Constance L
2009-01-01
The concept of transparency has been viewed as an essential leadership attribute or element in healthcare organizational structures and processes. While viewed as something that is desired and valued, there is a lack of nursing disciplinary literature that defines the concept and its possible meanings. This column provides a beginning definition of transparency from the humanbecoming nursing theoretical perspective and launches a discussion with potential ethical implications for leadership in nursing practice and education.
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Culture, context and community: ethical considerations for global nursing research.
Harrowing, J N; Mill, J; Spiers, J; Kulig, J; Kipp, W
2010-03-01
High-quality research is essential for the generation of scientific nursing knowledge and the achievement of the Millennium Development Goals. However, the incorporation of Western bioethical principles in the study design may not be suitable, sufficient or relevant to participants in low-income countries and may indeed be harmful and disrespectful. Before engaging in global health studies, nurses must consider carefully the cultural and social context and values of the proposed setting in order to situate the research within the appropriate ethical framework. The purpose of this paper was to examine the ethical principles and considerations that guide health research conducted in international settings using the example of a qualitative study of Ugandan nurses and nurse-midwives by a Canadian researcher. The application of Western bioethical principles with their emphasis on autonomy fails to acknowledge the importance of relevant contextual aspects in the conduct of global research. Because ethics is concerned with how people interact and live together, it is essential that studies conducted across borders be respectful of, and congruent with, the values and needs of the community in which it occurs. The use of a communitarian ethical framework will allow nurse scientists to contribute to the elimination of inequities between those who enjoy prosperity and good health, and those who do not.
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Udod, Sonia A; Racine, Louise
2017-12-01
To draw on the findings of a grounded theory study aimed at exploring how power is exercised in nurse-manager relationships in the hospital setting, this paper examines the empirical and pragmatic adequacy of grounded theory as a methodology to advance the concept of empowerment in the area of nursing leadership and management. The evidence on staff nurse empowerment has highlighted the magnitude of individual and organisational outcomes, but has not fully explicated the micro-level processes underlying how power is exercised, shared or created within the nurse-manager relationship. Although grounded theory is a widely adopted nursing research methodology, it remains less used in nursing leadership because of the dominance of quantitative approaches to research. Grounded theory methodology provides the empirical and pragmatic relevance to inform nursing practice and policy. Grounded theory is a relevant qualitative approach to use in leadership research as it provides a fine and detailed analysis of the process underlying complexity and bureaucracy. Discursive paper. A critical examination of the empirical and pragmatic relevance of grounded theory by (Corbin & Strauss, , ) as a method for analysing and solving problems in nurses' practice is provided. This paper provides evidence to support the empirical and pragmatic adequacy of grounded theory methodology. Although the application of the ontological, epistemological and methodological assumptions of grounded theory is challenging, this methodology is useful to address real-life problems in nursing practice by developing theoretical explanations of nurse empowerment, or lack thereof, in the workplace. Grounded theory represents a relevant methodology to inform nursing leadership research. Grounded theory is anchored in the reality of practice. The strength of grounded theory is to provide results that can be readily applied to clinical practice and policy as they arise from problems that affect practice and that
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Nursing informatics, ethics and decisions: implications for translational research
DEFF Research Database (Denmark)
Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Dowie, Jack
Nursing informatics, ethics and decisions: implications for translational research Objective: To introduce, in the multi-disciplinary contexts of clinical decision making and policy formation, a theory-based decision-analytic framework for the transparent forward translation of research......-calculation with evidence-based ratings for option performance on those criteria to produce a preference-sensitive assessment or opinion. Results: The first example shows the framework connecting nursing informatics and nursing ethics in the clinical context of a nurse’s decision to disclose or not disclose information......, satisfaction, Quality of Life), organization-related (staff and work environment, internal and external communication and relationships) and economics-related (start-up costs, financial implications and externalities)). Conclusion: Web-based decision support can provide nursing with a template, technique...
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Ethical values in nurse education perceived by students and educators.
Boozaripour, Mahsa; Abbaszadeh, Abbas; Shahriari, Mohsen; Borhani, Fariba
2018-03-01
Education is considered the first function and mission of the university, and observing educational ethics guarantees the health of the teaching-learning process in the university. The aim of this study was to explore ethical values in nursing education from the perspective of Iranian nursing students and educators. This qualitative study was conducted using the Thematic Content Analyses method. The data were collected from seven semi-structured individual interviews and three focus group discussions from July to November 2015. Participants and research context: The participants were faculty educators of nursing and nursing students in Tehran, capital of Iran, who were selected through purposive sampling. They were recruited gradually. Sampling was continued until data saturation when no new codes were extracted. Ethical committee: This study was conducted after obtaining the approval of Shahid Beheshti University of Medical Sciences Ethics Committee, and informed consent were ensured before conducting the research. The principles of voluntariness, confidentiality, and anonymity were respected during the research process. Seven major themes emerged: human dignity, constructive human relations, educational justice, competency enhancement, excellence view, wisdom, and commitment and accountability. The results of this study indicated that although many of the values, as universal values, were similar to those of other countries-which can be a reflection of the globalization process in the nursing profession and the presence of humanistic and spiritual approaches at the roots of the discipline, some differences could be found in the content of values due to factors such as the people's beliefs, culture, and religion. Iranian nursing students and educators revealed a unique and culture-based set of ethical values.
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12-hour shifts: an ethical dilemma for the nurse executive.
Lorenz, Susan G
2008-06-01
Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue.
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The practice of nursing research: getting ready for 'ethics' and the matter of character.
Sellman, Derek
2016-03-01
Few would argue with the idea that nursing research should be conducted ethically yet obtaining ethical approval is considered by many to have become unnecessarily burdensome. This brief article investigates the idea that there might be a relationship between the level of perceived burdensomeness of the research ethics application process on the one hand and the character of the nurse-researcher on the other. Given that nurses are required to be other-regarding, a nurse who undertakes research primarily for self-regarding reasons would seem to be acting in ways inconsistent with the aims of nursing as set out in nursing codes. It is suggested that the self-regarding nurse-researcher may find the ethics application process more burdensome than the other-regarding nurse-researcher who, it is further suggested, is engaged with nursing research as a practice in the technical sense in which that term has been developed by the philosopher Alasdair MacIntyre. © 2015 John Wiley & Sons Ltd.
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Ethics and Reverence for the Discipline of Nursing.
Milton, Constance L
2017-01-01
Healthcare disciplines, including nursing, are emerging sciences that contain discipline-specific theories that guide the activities of research, practice, and education. The term nursing science calls forth meaning that has long been accepted and referred to as the extant nursing theories undergirded with philosophy of science. Recent writings dispute the purposes and future usage of nursing theoretical frameworks in the science of nursing. The author of this article proposes new thinking about the importance of reverence and ethical implications for the future of formal inquiry in nursing science.
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Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan
2017-01-01
In the nursing profession, leadership plays a significant role in creating motivation and thus enabling nurses to provide high quality care. Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere, offer ethical guidance, and ensure the occupational satisfaction of personnel through prioritizing moralities. However, some issues prevent the implementation of this type of leadership by nursing leaders. The aim of this study was to identify and describe some problems and obstacles in ethical leadership faced by nursing leaders, and to help them achieve more accurate information and broader perspective in this field. The present study was conducted using a qualitative approach and content analysis. A total of 14 nursing managers and educators were selected purposefully, and deep and semi-structured interviews were conducted with them. Content analysis was performed using an inductive approach. Three main categories were obtained after data analysis: ethical, cultural and managerial problems. "Ethical problems" pertain to doubt in ethical actions, ethical conflicts and ethical distress; "cultural problems" include organizational and social culture; and "managerial problems" are connected to organizational and staff-related issues. Nursing leaders put forth various aspects of the problems associated with ethical leadership in the clinical setting. This style of leadership could be promoted by developing suitable programs and providing clear-cut strategies for removing the current obstacles and correcting the organizational structure. This can lead to ethical improvement in nursing leaders and subsequently the nurses.
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Hotel-type nursing and ethical dilemmas due to business interests
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Vesna Zupančič
2015-09-01
Full Text Available Introduction: In the age of neoliberalism, there are differences in the implementation of nursing activities due to business interests being integrated into nurse-patient relationships. An example of this is hotel-type nursing, which involves fulfilling patients’ needs by charging for nursing services (or by charging an additional fee for extra services. Whether this constitutes a contemporary nursing development or a danger is an important question. This paper explores an approach to resolving ethical dilemmas, which often emerge when the interests of businesses, nurses, and patients are integrated, as contemporary nursing is implemented according to community care principles.Methods: In a case study of nurses’ activities conducted in June 2013 and 2014 in three different institutions, the methods of observation and interviews were used. The collected data were analyzed using Strengths, Weaknesses, Opportunities, and Threats (SWOT methodology, and then verified and updated with a power diagram qualitative interpretation and the Decide, Establish, Consider, Identify, Develop, and Implement (DECIDE decision-making model.Results: Based on my study of hotel-type nursing, an approach to resolving ethical dilemmas which arise with the integration of business interests into nurse-patient relationships is explained.Discussion: Hotel-type nursing involves an adaptation by nurses to a change in their relationship with the patient. This adaptation must ensure that the nurse’s professionalism is recognized as being significantly more beneficial to the patient than a reduction of the nurse’s role to one of simply fulfilling a patient’s wishes.Conclusion: Hotel-type nursing can be advantageous in the development of contemporary nursing if nurses adhere to high ethical standards and practice self-control.
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Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.
Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin
2018-02-01
To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting
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College’s role in ethical promotion of nursing
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A Kalateh Sadati
2014-01-01
Full Text Available Introduction: Because teaching code of ethics to nurses has been considered the gold standard for many nursing colleges and universities, the main goal of this article was to evaluate the effect of college of nursing in changing the attitude of nursing students to professional ethics. Method: The study was performed as sectional-descriptional on 60 students first year (first and second semester and 60 last year students (seventh and eight semester of nursing college of Fatemeh Zahra Shiraz university which were selected randomly. Data was gathered using a questionnaire including general level, patient rights, and endvour for professional improvement. Frequency, mean value, and t-test was used for data analyzing. Data were analyzed using Spss software (P≤0.05. Results: 79 (% 65.8 of students were female and 41 (%32.4 of them were male .the average age was 21±1.7, there was not any significant difference between the viewpoints of both groups for professional behavior in general level (P=0.65, patients right (P=0.07, and professional improvement (P=0.43.
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Research across the disciplines: a road map for quality criteria in empirical ethics research.
Mertz, Marcel; Inthorn, Julia; Renz, Günter; Rothenberger, Lillian Geza; Salloch, Sabine; Schildmann, Jan; Wöhlke, Sabine; Schicktanz, Silke
2014-03-01
Research in the field of Empirical Ethics (EE) uses a broad variety of empirical methodologies, such as surveys, interviews and observation, developed in disciplines such as sociology, anthropology, and psychology. Whereas these empirical disciplines see themselves as purely descriptive, EE also aims at normative reflection. Currently there is literature about the quality of empirical research in ethics, but little or no reflection on specific methodological aspects that must be considered when conducting interdisciplinary empirical ethics. Furthermore, poor methodology in an EE study results in misleading ethical analyses, evaluations or recommendations. This not only deprives the study of scientific and social value, but also risks ethical misjudgement. While empirical and normative-ethical research projects have quality criteria in their own right, we focus on the specific quality criteria for EE research. We develop a tentative list of quality criteria--a "road map"--tailored to interdisciplinary research in EE, to guide assessments of research quality. These quality criteria fall into the categories of primary research question, theoretical framework and methods, relevance, interdisciplinary research practice and research ethics and scientific ethos. EE research is an important and innovative development in bioethics. However, a lack of standards has led to concerns about and even rejection of EE by various scholars. Our suggested orientation list of criteria, presented in the form of reflective questions, cannot be considered definitive, but serves as a tool to provoke systematic reflection during the planning and composition of an EE research study. These criteria need to be tested in different EE research settings and further refined.
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Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil.
Ramos, Flávia Regina Souza; Brehmer, Laura Cavalcanti de Farias; Vargas, Mara Ambrosina; Trombetta, Ana Paula; Silveira, Luciana Ramos; Drago, Laila
2015-06-01
Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students' personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Nursing students' experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students' decision-making processes - realisation, reflection and intervention. The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems. © The Author(s) 2014.
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Berggren, Ingela; Severinsson, Elisabeth
2003-03-01
The aim of the study was to explore the decision-making style and ethical approach of nurse supervisors by focusing on their priorities and interventions in the supervision process. Clinical supervision promotes ethical awareness and behaviour in the nursing profession. A focus group comprised of four clinical nurse supervisors with considerable experience was studied using qualitative hermeneutic content analysis. The essence of the nurse supervisors' decision-making style is deliberations and priorities. The nurse supervisors' willingness, preparedness, knowledge and awareness constitute and form their way of creating a relationship. The nurse supervisors' ethical approach focused on patient situations and ethical principles. The core components of nursing supervision interventions, as demonstrated in supervision sessions, are: guilt, reconciliation, integrity, responsibility, conscience and challenge. The nurse supervisors' interventions involved sharing knowledge and values with the supervisees and recognizing them as nurses and human beings. Nurse supervisors frequently reflected upon the ethical principle of autonomy and the concept and substance of integrity. The nurse supervisors used an ethical approach that focused on caring situations in order to enhance the provision of patient care. They acted as role models, shared nursing knowledge and ethical codes, and focused on patient related situations. This type of decision-making can strengthen the supervisees' professional identity. The clinical nurse supervisors in the study were experienced and used evaluation decisions as their form of clinical decision-making activity. The findings underline the need for further research and greater knowledge in order to improve the understanding of the ethical approach to supervision.
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Critical thinking by nurses on ethical issues like the termination of pregnancies.
Botes, A
2000-09-01
This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decision-making. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169). Registered nurses were selected purposively (Creswell, 1994:15). 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34) and Strauss and Corbin (1990). The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990). The measures of Lincoln and Guba (1985) and Morse (1994) related to secondary data analysis were employed to ensure trustworthiness. Based on these
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Critical thinking by nurses on ethical issues like the termination of pregnancies
Directory of Open Access Journals (Sweden)
A. Botes
2000-09-01
Full Text Available This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decisionmaking. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169. Registered nurses were selected purposively (Creswell, 1994:15. 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34 and Strauss and Corbin (1990. The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990. The measures of Lincoln and Guba (1985 and Morse (1994 related to secondary data analysis were employed to ensure trustworthiness. Based
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The ideas of nurses about the reflection of ethic education in their professional life
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Şenay Gül
2016-12-01
Full Text Available INTRODUCTION[|]This research was prepared as a qualitative study for the contribution to the ethics education studied during nursery education and reflections on nurses' practices by researching nurse's experiences.[¤]METHODS[|]In this study, data were obtained by focus group discussion method used in qualitative research. This study was completed during December 2015 – January 2016 with nurses working at University Hospitals', Training and Research Hospitals', Local Hospitals' Internal Medicine, Surgery and Intensive Care Unit Departments. Inclusion Criteria was obtained in ethics class during education and at least 1 year experience. 21 nurses included in this study. Participants were divided into 3 groups and focus group interview was made. The obtained data were analyzed by thematic analysis method.[¤]RESULTS[|]Participant nurses remarked that in general they cannot remember the knowledge which they learned during ethical classes but case debates are more memorable. Nurses expressed that the most ethical problems are related to ethical principles, malpractice, lack of professional boundaries, managerial problems, systemic problems. They claimed that in most cases there is a contradiction between their learnings and situations that they encounter in clinics and they stated that they are insufficient to represent ethical behavior due to factors like work load, supply and personal deficiency, inadequate professional definition. Nurses stated that ethical education is important but practical education is more efficient than theory and education should be continuous.[¤]DISCUSSION AND CONCLUSION[|]As a result, nurses declared that ethical education is important but it should be continuous; they cannot reflect their knowledge on their practical life due to many factors that they encounter on the clinics. In this manner, ethical education at the nursery university program should be clinical oriented, multi-disciplinary and continuous after the
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Forensic nursing and the palliative approach to care: an empirical nursing ethics analysis.
Wright, David Kenneth; Vanderspank-Wright, Brandi; Holmes, Dave; Skinner, Elise
2017-08-02
A movement is underway to promote a palliative approach to care in all contexts where people age and live with life-limiting conditions, including psychiatric settings. Forensic psychiatry nursing-a subfield of mental health nursing- focuses on individuals who are in conflict with the criminal justice system. We know little about the values of nurses working in forensic psychiatry, and how these values might influence a palliative approach to care for frail and aging patients. Interviews with four nurses working on one of two forensic units of a university-affiliated mental health hospital in an urban area of eastern Canada. Three specific values were found to guide forensic nurses in their care of aging patients that are commensurate with a palliative approach: hope, inclusivity, and quality of life. When we started this project, we wondered whether the culture of forensic nursing practice was antithetical to the values of a palliative approach. Instead, we found several parallels between forensic nurses' moral identities and palliative philosophy. These findings have implications for how we think about the palliative approach in contexts not typically associated with palliative care, but in which patients will increasingly age and die.
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Ethical issues of prison nursing: A qualitative study in Northern Italy.
Sasso, Loredana; Delogu, Barbara; Carrozzino, Roberto; Aleo, Giuseppe; Bagnasco, Annamaria
2018-05-01
Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues. 'How do correctional nurses describe their working experience in prisons? What issues emerged?' This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data. Participants and research context: Our sample included 31 correctional nurses in seven prisons in Northern Italy. Ethical considerations: The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses' employer. Formal consent was obtained from all the nurses who volunteered to participate in this study. Five themes emerged from the focus groups: (1) prisoners' healthcare needs, (2) negotiation between custody and care, (3) satisfaction of working in prisons, (4) obstacles to quality care and (5) safety. 'Manipulation' was a transversal theme that emerged from all the focus groups. The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care. In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress.
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Nursing under the influence: a relational ethics perspective.
Kunyk, Diane; Austin, Wendy
2012-05-01
When nurses have active and untreated addictions, patient safety may be compromised and nurse-health endangered. Genuine responses are required to fulfil nurses' moral obligations to their patients as well as to their nurse-colleagues. Guided by core elements of relational ethics, the influences of nursing organizational responses along with the practice environment in shaping the situation are contemplated. This approach identifies the importance of consistency with nursing values, acknowledges nurses interdependence, and addresses the role of nursing organization as moral agent. By examining the relational space, the tension between what appears to be opposing moral responsibilities may be healed. Ongoing discourse to identify authentic actions for the professional practice issue of nursing under the influence is called upon.
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Pariseau-Legault, Pierre; Lallier, Melisa
2016-07-01
Advanced practice nurses are working in a highly interdisciplinary and political context. Such situations can influence the deliberative and ethical decision-making processes in which they are also involved. This can subsequently compromise their abilities to protect their moral integrity, to find innovative and nondualistic solutions to complex ethical problems, and to collaborate with other health professionals. The authors constructed a training program inspired by discourse and narrative ethics. The objective pursued was to develop advanced practice nurses' moral integrity, highlight the ethical component of their clinical judgement, and foster the development of their deliberative competencies. The pedagogical process proposed exposes how an ethical curriculum adapted to the context in which advanced practice nurses evolve can address power relationships inherent in ethical decision making. The authors suggest that this pedagogical approach has the potential to optimize the consolidation of ethical, reflective, and deliberative competencies among advanced practice nurses. [J Nurs Educ. 2016;55(7):399-402.]. Copyright 2016, SLACK Incorporated.
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Virtue-based Approaches to Professional Ethics: a Plea for More Rigorous Use of Empirical Science
Directory of Open Access Journals (Sweden)
Georg Spielthenner
2017-08-01
Full Text Available Until recently, the method of professional ethics has been largely principle-based. But the failure of this approach to take into sufficient account the character of professionals has led to a revival of virtue ethics. The kind of professional virtue ethics that I am concerned with in this paper is teleological in that it relates the virtues of a profession to the ends of this profession. My aim is to show how empirical research can (in addition to philosophical inquiry be used to develop virtue-based accounts of professional ethics, and that such empirically well-informed approaches are more convincing than traditional kinds of professional virtue ethics. The paper is divided into four sections. In the first, I outline the structure of a teleological approach to virtue ethics. In Section 2, I show that empirical research can play an essential role in professional ethics by emphasizing the difference between conceptual and empirical matters. Section 3 demonstrates the relevance of virtues in professional life; and the last section is concerned with some meta-ethical issues that are raised by a teleological account of professional virtues.
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Zydziunaite, V; Suominen, T
2014-09-21
Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.
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Towards a viable and just global nursing ethics.
Crigger, Nancy J
2008-01-01
Globalization, an outgrowth of technology, while informing us about people throughout the world, also raises our awareness of the extreme economic and social disparities that exist among nations. As part of a global discipline, nurses are vitally interested in reducing and eliminating disparities so that better health is achieved for all people. Recent literature in nursing encourages our discipline to engage more actively with social justice issues. Justice in health care is a major commitment of nursing; thus questions in the larger sphere of globalization, justice and ethics, are our discipline's questions also. Global justice, or fairness, is not an issue for some groups or institutions, but a deeper human rights issue that is a responsibility for everyone. What can we do to help reduce or eliminate the social and economic disparities that are so evident? What kind of ethical milieu is needed to address the threat that globalization imposes on justice and fairness? This article enriches the conceptualization of globalization by investigating recent work by Schweiker and Twiss. In addition, I discuss five qualities or characteristics that will facilitate the development of a viable and just global ethic. A global ethic guides all people in their response to human rights and poverty. Technology and business, two major forces in globalization that are generally considered beneficial, are critiqued as barriers to social justice and the common good.
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Research across the disciplines: a road map for quality criteria in empirical ethics research
2014-01-01
Background Research in the field of Empirical Ethics (EE) uses a broad variety of empirical methodologies, such as surveys, interviews and observation, developed in disciplines such as sociology, anthropology, and psychology. Whereas these empirical disciplines see themselves as purely descriptive, EE also aims at normative reflection. Currently there is literature about the quality of empirical research in ethics, but little or no reflection on specific methodological aspects that must be considered when conducting interdisciplinary empirical ethics. Furthermore, poor methodology in an EE study results in misleading ethical analyses, evaluations or recommendations. This not only deprives the study of scientific and social value, but also risks ethical misjudgement. Discussion While empirical and normative-ethical research projects have quality criteria in their own right, we focus on the specific quality criteria for EE research. We develop a tentative list of quality criteria – a “road map” – tailored to interdisciplinary research in EE, to guide assessments of research quality. These quality criteria fall into the categories of primary research question, theoretical framework and methods, relevance, interdisciplinary research practice and research ethics and scientific ethos. Summary EE research is an important and innovative development in bioethics. However, a lack of standards has led to concerns about and even rejection of EE by various scholars. Our suggested orientation list of criteria, presented in the form of reflective questions, cannot be considered definitive, but serves as a tool to provoke systematic reflection during the planning and composition of an EE research study. These criteria need to be tested in different EE research settings and further refined. PMID:24580847
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[Reflection around the code of ethics for nurses].
Depoire, Nathalie
2017-09-01
The code of ethics for nurses highlights the values, principles and obligations which characterise our profession. It also emphasises the conditions required to enable nurses to perform their professional practice with the autonomy granted to them by the Public Health Code. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
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Technology and its ethics in nursing and caring journals: An integrative literature review.
Korhonen, Eila-Sisko; Nordman, Tina; Eriksson, Katie
2015-08-01
Over the past 20 years, the impact of technology has increased significantly in health care. The diversity of technology is growing and its knowledge scattered. The concept of technology is ambiguous in caring and nursing sciences and its ethics remains unidentified. To find evidence on how the concept of technology and its ethics are defined in caring and nursing sciences and practice. The purpose of this study is to describe and summarize the concept of technology and its ethics in the past nursing and caring literature. The integrative literature review of the past nursing and caring literature. The data were collected from caring and nursing journal articles from 2000 to 2013 focusing on technology and its ethics.The results were summarized and themed. Technology as a concept has three implications. First, technology is devices and products, including ICT and advanced, simple and assistive technology. Second, technology refers to a process consisting of methods for helping people. Third, technology as a service indicates the production of care by technology. The ethics of technology has not been established as a guiding principle. Some studies excluded ethical reflection completely. Many studies discussed the ethics of technology as benefits such as improved communication and symptoms management, and the simple use of e-health services whilst others remained critical presenting ethical problems such as unwillingness and the inability to use technology, or conflicts with human aspects or questions of inequality. In conclusion, this study indicates that technology as a concept is described diversely. The relation between technology and ethics is not a truism. Despite some evidence, more is needed to promote ethical care when using technology. © The Author(s) 2014.
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Ethical Issues in Maternal and Child Health Nursing: Challenges ...
African Journals Online (AJOL)
2016-06-28
Jun 28, 2016 ... and neonatal nurses, face ethical issues possibly because of their ... Aim: To identify the ethical issues related to maternal and child care, the challenges faced by ...... Lucas V.A. The business of women's health care. In: E.T. ...
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Nursing students' experiences of ethical issues in clinical practice: A New Zealand study.
Sinclair, J; Papps, E; Marshall, B
2016-03-01
Nursing students experience ethical problems in clinical practice in a different way from registered nurses. In order to develop ethical reasoning and competence in nursing students, nurse educators must recognise the unique issues students face. This research described the occurrence of ethical issues in clinical practice for 373 undergraduate nursing students who responded to a national questionnaire investigating the frequency of pre-determined ethical issues and the corresponding level of distress. Over two thirds of respondents experienced breaches of a patient's right to confidentiality, privacy, dignity or respect and 87% experienced unsafe working conditions. The most distressing issues were those that compromised patient safety, including unsafe healthcare practices, working conditions and suspected abuse or neglect. Themes that emerged from an open-ended question included lack of support and supervision, bullying and end of life issues. This research found the frequency at which ethical issues are experienced was highest in year three participants. However, the overall distress levels were lower for the majority of issues for those participants in the later part of their degree. Recommendations from this research include developing ethics education around the main concerns that students face in order to enhance students' understanding, resilience and ability to respond appropriately. Copyright © 2016 Elsevier Ltd. All rights reserved.
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The Ethics of Qualitative Nursing Research.
Robley, Lois R.
1995-01-01
Ethical issues in qualitative nursing research include the following: what to study, which participants, what methods, how to achieve informed consent, when to terminate interviews and when to probe, when treatment should supersede research, and what and how to document in case studies. (SK)
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Ancient Ethical Practices of Dualism and Ethical Implications for Future Paradigms in Nursing.
Milton, Constance L
2016-07-01
Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing. © The Author(s) 2016.
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Care as a matter of courage: vulnerability, suffering and ethical formation in nursing care
DEFF Research Database (Denmark)
Thorup, Charlotte Brun; Rundqvist, Ewa; Roberts, Christel
2012-01-01
, it also demonstrates that the nurse's personal and professional life experiences of vulnerability and suffering influence ethical formation. Vulnerability and suffering have proven to be sensitive issues for nurses, like a sore point that either serve as an eye-opener or cause the development of blind......Scand J Caring Sci; 2011 Care as a matter of courage: vulnerability, suffering and ethical formation in nursing care The aim of the study was to explore nurses' experience of how their own vulnerability and suffering influence their ethical formation and their capacity to provide professional care...... when they are confronted with the patient's vulnerability and suffering. Care is shaped in the meeting between human beings. Professional care is informed by the patient's appeal for help as it is expressed in the meeting. Ethical formation is understood as a personal ethical and existential process...
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Grace, Pamela J; Robinson, Ellen M; Jurchak, Martha; Zollfrank, Angelika A; Lee, Susan M
2014-12-01
The experience of unaddressed moral distress can lead to nurse attrition and/or distancing from patients, compromising patient care. Nurses who are confident in their ethical decision making abilities and moral agency have the antidote to moral distress for themselves and their colleagues and can act as local or institutional ethics resources. We describe a grant-funded model education program designed to increase ethics competence throughout the institution.
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Filipova, Anna A
2011-01-01
This study investigates ethical climates in government, nonprofit, and for-profit nursing homes and determines their similarities and differences. Surveys were collected from 656 (21.4%) licensed nurses who worked in 100 skilled nursing facilities in one Midwestern state. Shared law and code and caring ethical climates were identified across the 3 sector nursing homes. Those climates were also polarized. Important implications were drawn for consideration of ethical perceptions of each sector during negotiations and contract management.
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Cameron, Miriam E.; And Others
1993-01-01
Twenty-five persons with acquired immunodeficiency syndrome (AIDS) described and validated 100 ethical problems that are experienced by people with AIDS from 3 levels of ethical inquiry: descriptive ethics, normative ethics, and metaethics. Findings suggest strategies for improving nursing ethics education. (JOW)
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Transplant tourism and organ trafficking: Ethical implications for the nursing profession.
Corfee, Floraidh Ar
2016-11-01
Organ availability for transplantation has become an increasingly complex and difficult question in health economics and ethical practice. Advances in technology have seen prolonged life expectancy, and the global push for organs creates an ever-expanding gap between supply and demand, and a significant cost in bridging that gap. This article will examine the ethical implications for the nursing profession in regard to the procurement of organs from an impoverished seller's market, also known as 'Transplant Tourism'. This ethical dilemma concerns itself with resource allocation, informed consent and the concepts of egalitarianism and libertarianism. Transplant Tourism is an unacceptable trespass against human dignity and rights from both a nursing and collective viewpoint. Currently, the Australian Nursing and Midwifery Council, the Royal college of Nursing Australia, The Royal College of Nursing (UK) and the American Nurses Association do not have position statements on transplant tourism, and this diminishes us as a force for change. It diminishes our role as advocates for the most marginalised in our world to have access to care and to choice and excludes us from a very contemporary real debate about the mismatch of organ demand and supply in our own communities. As a profession, we must have a voice in health policy and human rights, and according to our Code of Ethics in Australia and around the world, act to promote and protect the fundamental human right to healthcare and dignity. © The Author(s) 2015.
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Ethical conflicts reported by Certified Nephrology Nurses (CNNs) practicing in dialysis settings.
Redman, B K; Hill, M N; Fry, S T
1997-02-01
The purpose of the investigators was to describe and classify ethical conflicts experienced by Certified Nephrology Nurses (CNNs) practicing in dialysis settings in four eastern states and the District of Columbia, and to explore associated demographic, educational, and practice setting factors associated with these ethical conflicts. A descriptive survey design was used. All members of the American Nephrology Nurses Association (ANNA) who were CNNs working in Maryland, Virginia, and the District of Columbia, and a random sample of those in New York State and Pennsylvania were contacted. Those CNNs working in dialysis settings were asked to complete the Demographic Data Form and the Moral Conflict Questionnaire developed by Fry (1990). Eighty-eight met inclusion criteria, agreed to participate, and described ethical conflicts. By far the most common practice context for the described ethical conflicts were decisions about discontinuation or initiation of dialysis (69%). Participants were clear about the moral problem and ethical principles involved. Participants reported being involved in serious ethical conflicts about patient care. Since two-thirds were not resolved, further research should investigate whether existing mechanisms in practice settings for resolution of ethical conflicts are not working or are not being used by nurses.
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Nurse Activism in the newborn intensive care unit: actions in response to an ethical dilemma.
Settle, Peggy Doyle
2014-03-01
Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance.
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Narrative ethics in nursing for persons with intellectual disabilities.
Meininger, Herman P
2005-04-01
Both in The Netherlands and in Britain, practices of 'life story work' have emerged in nursing for persons with intellectual disabilities. The narrative approach to care and support may at the same time be considered as an attempt to compensate for the 'disabled authorship' of many persons with intellectual disabilities and as a sign of controversy with standard practices of diagnosis and treatment that tend to neglect the personal identities of both clients and care givers, their particular historical and relational contexts and their spiritual needs. This paper argues that narrative ethics not only offers an appropriate moral framework for practices of life story work, but that these practices are a narrative ethics in action. Starting with an account of the concept of 'life story work' as it has been introduced in nursing practices in the field of intellectual disability, the paper explains its relationship with key characteristics of narrative ethics. The teleological dimension in narrative ethics and in practices of life story work sparks off a dialectic process of understanding of the client and self-understanding of the care giver. It also invites a respect for life in its openness toward the future and presupposes an openness toward other possible versions of the life narrative. The phenomenological and hermeneutic-interpretative methodologies in narrative ethics aim at a 'sudden moment of intimacy' in relationships of nurses and clients. The 'epiphany' of this essential moment of recognition, insight and engagement cannot, however, be brought about by methodology.
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Teaching civility to undergraduate nursing students using a virtue ethics-based curriculum.
Russell, Martha Joan
2014-06-01
As professionals, nurses are expected to engage in respectful relationships with clients, other health care professionals, and each other. Regulatory bodies set standards and codes of ethics for professional behavior in nursing that clearly communicate expectations for civility. However, the wealth of literature on incivility in the profession indicates that nurses often fall short of meeting these standards in their interactions with other nurses. Currently, few effective strategies exist for nurse educators to teach civility to nursing students and prepare them to engage in healthy relationships with their colleagues. This article argues for the use of virtue ethics as a philosophical framework for teaching civility to undergraduate nursing students. The pedagogical strategies proposed may help students contribute to the development of healthy workplaces. Copyright 2014, SLACK Incorporated.
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Discourses of social justice: examining the ethics of democratic professionalism in nursing.
Thompson, Janice L
2014-01-01
This essay provides a critical exploration of discourses of social justice in nursing. It examines commitments to social justice in the work of international nursing scholars and in professional codes of ethics in international nursing organizations. The analysis touches on salient conversations in philosophy, relating these ways of knowing to social justice as an ethical pattern in nursing practice. On the basis of this analysis, the discussion explores questions of professional formation in nursing, noticing when commitments to social justice are taken up or evaded in different models of professionalism. In concluding comments, implications of democratic professionalism are explored for professional formation in nursing, arguing for teaching, learning, and knowledge projects that contribute to social justice in our democracy.
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The Ethics of Big Data and Nursing Science.
Milton, Constance L
2017-10-01
Big data is a scientific, social, and technological trend referring to the process and size of datasets available for analysis. Ethical implications arise as healthcare disciplines, including nursing, struggle over questions of informed consent, privacy, ownership of data, and its possible use in epistemology. The author offers straight-thinking possibilities for the use of big data in nursing science.
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Directory of Open Access Journals (Sweden)
Elahe Ramezanzade Tabriz
2017-03-01
Full Text Available Abstract Background and Objectives: Study of clinical competence in nursing helps determine the quality of health care delivered to patients. Given the priority of observance of principles over caretaking and necessity of spirituality existence at the core of health care provision, this study was conducted to investigate clinical competence and its relationship with professional ethics and spiritual health in nurses. Methods: In this cross-sectional, descriptive, and correlational study, 281 nurses were enrolled by consensus sampling. Sampling was conducted from February, 2016 till June, 2016. The data were gathered by a demographics questionnaire, a self-assessment scale of clinical competence, a nursing ethics questionnaire, and a spiritual health questionnaire, and analyzed by descriptive statistics and t-test, Pearson's correlation coefficient, ANOVA, and linear regression analysis in SPSS 21. Results: The total scores for self-assessment scale of nurses' clinical competence, professional ethics, and spiritual health were moderate. In the light of the results of Spearman's correlation coefficient, there was a significant and positive correlation between clinical competence and spiritual health. Moreover, a significant positive correlation was observed between professional ethics and spiritual health but there was no correlation between professional ethics and clinical competence. Conclusion: Managers' and personnel's Knowledge about the level of nurses clinical competence, professional ethics, and spiritual health in teaching health care centers provides valuable information to develop in-service and efficacious education programs and ultimately to improve the quality of nursing services.
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A Pragmatic Approach to the Application of the Code of Ethics in Nursing Education.
Tinnon, Elizabeth; Masters, Kathleen; Butts, Janie
The code of ethics for nurses was written for nurses in all settings. However, the language focuses primarily on the nurse in context of the patient relationship, which may make it difficult for nurse educators to internalize the code to inform practice. The purpose of this article is to explore the code of ethics, establish that it can be used to guide nurse educators' practice, and provide a pragmatic approach to application of the provisions.
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Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Dizer, Berna; Gümüş, Fatma; Koyuncu, Rukiye
2014-01-01
Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.
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The metaethics of nursing codes of ethics and conduct.
Snelling, Paul C
2016-10-01
Nursing codes of ethics and conduct are features of professional practice across the world, and in the UK, the regulator has recently consulted on and published a new code. Initially part of a professionalising agenda, nursing codes have recently come to represent a managerialist and disciplinary agenda and nursing can no longer be regarded as a self-regulating profession. This paper argues that codes of ethics and codes of conduct are significantly different in form and function similar to the difference between ethics and law in everyday life. Some codes successfully integrate these two functions within the same document, while others, principally the UK Code, conflate them resulting in an ambiguous document unable to fulfil its functions effectively. The paper analyses the differences between ethical-codes and conduct-codes by discussing titles, authorship, level, scope for disagreement, consequences of transgression, language and finally and possibly most importantly agent-centeredness. It is argued that conduct-codes cannot require nurses to be compassionate because compassion involves an emotional response. The concept of kindness provides a plausible alternative for conduct-codes as it is possible to understand it solely in terms of acts. But if kindness is required in conduct-codes, investigation and possible censure follows from its absence. Using examples it is argued that there are at last five possible accounts of the absence of kindness. As well as being potentially problematic for disciplinary panels, difficulty in understanding the features of blameworthy absence of kindness may challenge UK nurses who, following a recently introduced revalidation procedure, are required to reflect on their practice in relation to The Code. It is concluded that closer attention to metaethical concerns by code writers will better support the functions of their issuing organisations. © 2016 John Wiley & Sons Ltd.
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Nurses' ethical reasoning in cases of physical restraint in acute elderly care: a qualitative study.
Goethals, Sabine; Dierckx de Casterlé, Bernadette; Gastmans, Chris
2013-11-01
In their practice, nurses make daily decisions that are ethically informed. An ethical decision is the result of a complex reasoning process based on knowledge and experience and driven by ethical values. Especially in acute elderly care and more specifically decisions concerning the use of physical restraint require a thoughtful deliberation of the different values at stake. Qualitative evidence concerning nurses' decision-making in cases of physical restraint provided important insights in the complexity of decision-making as a trajectory. However a nuanced and refined understanding of the reasoning process in terms of ethical values is still lacking. A qualitative interview design, inspired by the Grounded Theory approach, was carried out to explore nurses' reasoning process in terms of ethical values. We interviewed 21 acute geriatric nurses from 12 hospitals in different regions in Flanders, Belgium in the period October 2009-April 2011. The Qualitative Analysis Guide of Leuven was used to analyse interview data. Nurses' decision-making is characterized as an ethical deliberation process where different values are identified and where the process of balancing these values forms the essence of ethical deliberation. Ethical decision-making in cases of physical restraint implies that nurses have to choose which values receive priority in the process, which entails that not all values can be respected to the same degree. As a result, decision making can be experienced as difficult, even as a dilemma. Driven by the overwhelming goal of protecting physical integrity, nurses took into account the values of dignity and justice more implicitly and less dominantly.
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Spirituality: the basis for nurses' ethics.
Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa; Lourenço, Maria Regina; de Godoy, Simone; Rodriguez, Eliana Llapa
2004-01-01
A social crisis in both the labor and ecological systems constitutes a problem that requires the formulation of a new ethics for humanity. The social crisis is a result of the organizational model used by modern societies in the production of wealth and its unequal distribution. This intense inequality in wealth distribution contributes to a schism between populations. On one side an opulent and privileged society exists, and on the other a poor and downtrodden humanity. This crisis in the labor system stems from automated production methods, which devalue man's work and exclude him from contemporary society. The ecological crisis emerges from the dominance with which men have subjugated the Earth and its resources. Man has not acknowledged Earth's permutations and, therefore, has not taken the necessary caution of such changeability nor respected its effects. Such crises affect all populations and cry out for attention. Contemporary societies demand solutions to these questions. Nursing is a part and parcel of this yearning. In this setting, the nurse should be able to offer collaboration and solidarity with a project of creating a world ethos based on a minimum consensus amongst humans. Understanding and believing that spirituality is invaluable in this process, the authors of this work aim at addressing it as an essential dimension for nurses' ethics.
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[Ethical problems experienced by nurses in primary health care: integrative literature review].
Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida
2015-03-01
The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.
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Ethical and Moral Courage is Distress among Professional Nurses: A Workplace Issue.
Brown, Geraldine
2015-01-01
Ethics and moral issues do impact the manner in which professional nurses perform their major duties. Moral distress often conflict with an ethical appropriate course of action that is known, but cannot be implemented. This distress has been associated with job dissatisfaction, burnout, early retirement, withdrawal from the moral dimensions of direct patient care, and others just leaving the profession altogether. In the workplace, institutions must make an assertive effort in providing resources and addressing situations that cause personal anxiety and depression that adversely affects total patient care. The American Association of Critical Care Nurses (AACN) has addressed ethical issues and moral distress in practices that support nurses with moral courage, when encountering ethical conflicts. Ask, Affirm, Assess and Act are the 4 A's that AACN believes should be a part of an organization's strategic plan to create a healthy workplace environment.
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Nurse leaders' perceptions of the ethical recruitment of study subjects in clinical research.
Nurmi, Sanna-Maria; Pietilä, Anna-Maija; Kangasniemi, Mari; Halkoaho, Arja
2015-11-01
The aim of this study was to describe nurse leaders' perceptions of ethical recruitment in clinical research. Nurse leaders are expected to get involved in clinical research, but there are few studies that focus on their role, particularly the ethical issues. Qualitative data were collected from ten nurse leaders using thematic one-to-one interviews and analysed with content analysis. Nurse leaders considered clinical research at their workplace in relation to the key issues that enabled ethical recruitment of study subjects in clinical research. These were: early information and collaboration for incorporating clinical research in everyday work, an opportune and peaceful recruitment moment and positive research culture. Getting involved in clinical research is part of the nurse leader's professional responsibility in current health care. They have an essential role to play in ensuring that recruitment is ethical and that the dignity of study subjects is maintained. The duty of nurse leaders is to maintain good contact with other collaborators and to ensure good conditions for implementing clinical research at their site. This requires a comprehensive understanding of the overall situation on their wards. Implementing clinical research requires careful planning, together with educating, supporting and motivating nursing staff. © 2014 John Wiley & Sons Ltd.
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[Student nurses and the code of ethics].
Trolliet, Julie
2017-09-01
Student nurses, just like all practising professionals, are expected to be aware of and to respect the code of ethics governing their profession. Since the publication of this code, actions to raise awareness of it and explain it to all the relevant players have been put in place. The French National Federation of Student Nurses decided to survey future professionals regarding this new text. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
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[Promoting the code of ethics for nurses].
Chamboredon, Patrick; Lecointre, Brigitte
2017-09-01
The publication of the code of ethics for nurses requires the French National Order of Nurses' structures to undertake initiatives with the aim of promoting it as well as implementing the public service missions which have now been attributed to the Order. Each regional and departmental body has its role to play in raising awareness of this code and its application in the field. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
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Musa, Maizura binti; Harun-Or-Rashid, M D; Sakamoto, Junichi
2011-11-16
Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning.
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Ethical Dilemmas in Teaching and Nursing: The Israeli Case
Shapira-Lishchinsky, Orly
2010-01-01
This article explores a cross-occupational approach for dealing with ethical dilemmas by comparing teaching and nursing. Findings indicate more shared patterns of ethical dilemmas (such as caring for needs for others versus following formal codes) than dilemmas specific to teaching (e.g., advancing universal values versus advancing knowledge) or…
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Factors affecting professional ethics in nursing practice in Iran: a qualitative study.
Dehghani, Ali; Mosalanejad, Leili; Dehghan-Nayeri, Nahid
2015-09-09
Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.
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Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan
2017-01-01
In the nursing profession, leadership plays a significant role in creating motivation and thus enabling nurses to provide high quality care. Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere, offer ethical guidance, and ensure the occupational satisfaction of personnel through prioritizing moralities. However, some issues prevent the implementation of this type of leadership by nursing leaders. The aim of this study was ...
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Equality as a central concept of nursing ethics: a systematic literature review.
Kangasniemi, Mari
2010-12-01
Equality is a central concept in the Western way of thinking and in health care. In ethics research within nursing science, equality is a key concept but the meaning of its contents is more or less presumptive. The purpose of this study was to define the concept of equality as a value of nursing ethics research. Data were collected through systematic literature review and analysed using deductive and inductive content analysis. Equality has been studied as a concept and in relation to ethical theories. In nursing ethics, research on equality on theoretical and functional level is presented. These levels consist of dimensions, i.e. themes, that equality is related to. The dimensions of the theoretical level are the equality of being, i.e. universal human value, and distributive equality, i.e. equal opportunities, circumstances and results. The dimensions of functional equality included themes such as critique of distributive equality, context, difference, power and care. Critique is aimed at incompatibility of theoretical level with practice. Context raises questions of each nursing situation in relation to equality. Variation within context is closely related to differences involving parties to nursing, and it is a starting point to questions of equality. Power is understood as comprising knowledge, skills and authority that create differences and questions of equality between nurses and patients and nurses and other professionals or students. Nursing as care always includes relationship between two or more persons and needs to be inspected from the point of view of equality. The concept of equality has been complex to achieve in practice. The dimensions of the levels of equality defined in this study provide an opportunity to reach a better understanding of equality in nursing ethics. There is still a great demand for more research on the concept of equality. © 2010 The Author. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.
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[The ethical concerns of the private practice nurse].
Pivot, Annie
2015-12-01
Ethics, by its definition, is a philosophical discipline which enables human beings to behave, to act and to be, in the best way possible, between themselves and towards their environment. In private nursing practice, the ethical dimension is based on personal reflection which enables each individual to adapt their attitude in order to act for the best. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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Reitinger, Elisabeth; Heimerl, Katharina
2014-06-01
The development of palliative care in nursing homes in German-speaking countries has gained in importance within the past 15-20 years. Ethical and gender issues are core aspects of a palliative care culture and should therefore be better understood. The aim of this study was to highlight insights regarding ethical and gender issues, based on the experiences of professionals in nursing homes. A 2-year participatory action research study was performed in collaboration with three nursing homes in Austria. The article focusses on 10 group discussions with interdisciplinary professional teams that were conducted to generate ethical narratives. Thematic and narrative analysis was undertaken both individually and within the interdisciplinary research team. Findings and interpretations were validated with practitioners and researchers. A total of 36 narratives were collected and summarised within eight themes concerning the theoretical journey of a nursing home resident with relatives from entry into the house until death. The most burdensome ethical dilemmas are not the ones around death and dying but rather those relating to small-scale everyday work/life issues. Sharing experiences and feelings in ethical discussions provides relief. Emotions are important facilitators of insight into ethical dilemmas. Gender issues can be observed in care situations as well as in the organisational structure of nursing homes. Opportunities to share experiences and perspectives around ethical questions in interdisciplinary group discussions help professionals to better understand difficult issues and find appropriate ways of managing them. There is a need for communication structures such as facilitated ethical discussions that enable nursing home staff to reflect their everyday decisions. Expression of emotions should be encouraged in ethical decision-making processes in nursing homes. Gender-sensitive reflection supports the development of palliative care as organisational culture.
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Ethical issues in maternal and child health nursing: challenges ...
African Journals Online (AJOL)
Methods: This is a literature review on ethical issues in maternal and child health nursing, challenges faced by maternal and child health nurses and strategies for decision making. Literatures related to the topic was gathered from pertinent literature, completed research works and published articles retrieved from searches ...
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Ethical problems experienced by nurses in primary health care: integrative literature review
Directory of Open Access Journals (Sweden)
Carlise Rigon Dalla Nora
Full Text Available The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.
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Virtue ethics: an approach to moral dilemmas in nursing.
Arries, E
2005-08-01
Nurses are increasingly confronted with situations of moral difficulty, such as not to feed terminally ill patients, whistle blowing, or participation in termination of pregnancy. Most of these moral dilemmas are often analyzed using the principle-based approach which applies the four moral principles of justice, autonomy, beneficence, and non-malificence. In some instances, consequentialism is considered, but these frameworks have their limitations. Their limitations has to do with a consideration for the interpersonal nature of clinical nursing practice on the one hand, and is not always clear on how to judge which consequences are best on the other hand. When principles are in conflict it is not always easy to decide which principle should dominate. Furthermore, these frameworks do not take into account the importance of the interpersonal and emotional element of human experience. On the contrary, decision-making about moral issues in healthcare demands that nurses exercise rational control over emotions. This clearly focuses the attention on the nurse as moral agent and in particular their character. In this article I argue that virtue ethics as an approach, which focus of the character of a person, might provide a more holistic analysis of moral dilemmas in nursing and might facilitate more flexible and creative solutions when combined with other theories of moral decision-making. Advancing this argument, firstly, I provide the central features of virtue ethics. Secondly I describe a story in which a moral dilemma is evident. Lastly I apply virtue ethics as an approach to this moral dilemma and in particular focusing on the virtues inherent in the nurse as moral agent in the story.
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Virtue ethics: an approach to moral dilemmas in nursing
Directory of Open Access Journals (Sweden)
E Arries
2005-09-01
Full Text Available Nurses are increasingly confronted with situations of moral difficulty, such as not to feed terminally ill patients, whistle blowing, or participation in termination of pregnancy. Most of these moral dilemmas are often analyzed using the principle-based approach which applies the four moral principles of justice, autonomy, beneficence, and nonmalificence. In some instances, consequentialism is considered, but these frameworks have their limitations. Their limitations has to do with a consideration for the interpersonal nature of clinical nursing practice on the one hand, and is not always clear on how to judge which consequences are best on the other hand. When principles are in conflict it is not always easy to decide which principle should dominate. Furthermore, these frameworks do not take into account the importance of the interpersonal and emotional element of human experience. On the contrary, decision making about moral issues in healthcare demands that nurses exercise rational control over emotions. This clearly focuses the attention on the nurse as moral agent and in particular their character. In this article I argue that virtue ethics as an approach, which focus of the character of a person, might provide a more holistic analysis of moral dilemmas in nursing and might facilitate more flexible and creative solutions when combined with other theories of moral decision-making. Advancing this argument, firstly, I provide the central features of virtue ethics. Secondly I describe a story in which a moral dilemma is evident. Lastly I apply virtue ethics as an approach to this moral dilemma and in particular focusing on the virtues inherent in the nurse as moral agent in the story.
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Debunking Confabulation: Emotions and the Significance of Empirical Psychology for Kantian Ethics
Kleingeld, Pauline; Cohen, Alix
2014-01-01
It is frequently argued that research findings in empirical moral psychology spell trouble for Kantian ethics. Sometimes the charge is merely that Kantianism is mistaken about the role of emotions in human action, but it has also been argued that empirical moral psychology ‘debunks’ Kantian ethics as the product of precisely the emotion-driven processes it fails to acknowledge. In this essay I argue for a negative and a positive thesis. The negative thesis is that the ‘debunking’ argument aga...
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The metaphor of nurse as guest with ethical implications for nursing and healthcare.
Milton, Constance L
2005-10-01
Current healthcare advertising and customer relations terminology acknowledge that healthcare providers, including nurses, are to act as hosts for persons who enter into healthcare agencies and institutions. Indeed, much has been written aligning nursing and other healthcare services with consumer-oriented roles of the hospitality service industry commonly associated with hotels and restaurants. From a human becoming perspective, this article discusses possible ethical, administrative, and practice implications of nurses acting as guests entering into the lives of those we serve.
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The impact of ethical climate types on nurses' behaviors in Bosnia and Herzegovina.
Dinc, M Sait; Huric, Alma
2017-12-01
The performance of nurses has become vital in hospitals. Some studies have suggested that nurses' perceptions of the ethical climate in their hospitals are related to higher job satisfaction and organizational commitment and in turn lessen the issue of nursing shortage. (1) The ethical climate types "caring," "independent," "law and code," and "rules" have a significant positive impact on overall job satisfaction. (2) The ethical climate types and overall job satisfaction have significant positive influences on normative and affective and significant negative influences on continuance commitment. The study uses path analysis to understand which types of ethical climate impact overall job satisfaction. It also tries to find the effect of different types of ethical climate and overall job satisfaction on the components of organizational commitment. The relationships between variables were evaluated using factor analysis, reliability, descriptive statistics, correlations, and regression in this study. Participants and research context: A total of 171 useful questionnaires were collected from nurses working in public and private hospitals in Bosnia and Herzegovina. Ethical considerations: Formal research approval was obtained from the administration of each study hospital. Questionnaires with a cover letter were mailed to the hospitals that agreed to participate in the study. In the cover letter, the researchers explained the study purpose, encouraged nurses' voluntary participation, and guaranteed the anonymity of participants. In the first path analyses, "rules" and "caring" climates significantly and positively affected overall job satisfaction. In the second one, while overall job satisfaction and "rules" climate significantly influenced normative commitment, "caring" climate and overall job satisfaction significantly affected affective commitment. The findings of the study have been convenient with the literature. Public and private hospitals can enhance overall
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Chao, S-Y; Chang, Y-C; Yang, S C; Clark, M J
2017-08-01
Ethical competence, which is reflected in the ability to detect ethical challenges in clinical situations and engage in deliberate thinking on ethical actions, is one of the core competencies of nursing practice. The purpose of this study was to develop and implement an interactive situational e-learning system, integrating nursing ethical decisions into a nursing ethics course, and to evaluate the effects of this course on student nurses' ethical decision-making competence. The project was designed to be carried out in two phases. In the first phase, an interactive situated e-learning system was developed and integrated into the nursing ethics course. The second phase involved implementing the course and evaluating its effects in a quasi-experimental study. The course intervention was designed for 2h per week over one semester (18weeks). A total of 100 two-year technical college nursing students in their second year of the program participated in the study, with 51 in the experimental group and 49 in the control group. After completing the course, the students in the experimental group showed significant improvement in nursing ethical decision-making competence, including skills in "raising questions," "recognizing differences," "comparing differences," "self-dialogue," "taking action," and "identifying the implications of decisions made," compared to their performance prior to the class. After controlling for factors influencing learning effects, students in the experimental group showed superiority to those in the control group in the competency of "recognizing differences." The students in the experimental group reported that the course pushed them to search for and collect information needed to resolve the ethical dilemma. The interactive situational e-learning system developed by our project was helpful in developing the students' competence in ethical reasoning. The e-learning system and the situational teaching materials used in this study may be applicable
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The ethical dimension of nursing care rationing: A thematic synthesis of qualitative studies.
Vryonides, Stavros; Papastavrou, Evridiki; Charalambous, Andreas; Andreou, Panayiota; Merkouris, Anastasios
2015-12-01
In the face of scarcity, nurses may inevitably delay or omit some nursing interventions and give priority to others. This increases the risk of adverse patient outcomes and threatens safety, quality, and dignity in care. However, it is not clear if there is an ethical element in nursing care rationing and how nurses experience the phenomenon in its ethical perspective. The purpose was to synthesize studies that relate care rationing with the ethical perspectives of nursing, and find the deeper, moral meaning of this phenomenon. A systematic review and thematic synthesis of qualitative studies was used. Searching was based on guidelines suggested by Joana Brigs Institute, while the synthesis has drawn from the methodology described. Primary studies were sought from nine electronic databases and manual searches. The explicitness of reporting was assed using consolidated criteria for reporting qualitative research. Nine studies involving 167 nurse participants were included. Synthesis resulted in 35 preliminary themes, 14 descriptive themes, and four analytical themes (professional challenges and moral dilemmas, dominating considerations, perception of a moral role, and experiences of the ethical effects of rationing). Discussion of relationships between themes revealed a new thematic framework. Every effort has been taken, for the thoroughness in searching and retrieving the primary studies of this synthesis, and in order for them to be treated accurately, fairly and honestly and without intentional misinterpretations of their findings. Within limitations of scarcity, nurses face moral challenges and their decisions may jeopardize professional values, leading to role conflict, feelings of guilt, distress and difficulty in fulfilling a morally acceptable role. However, more research is needed to support certain relationships. Related literature is limited. The few studies found highlighted the essence of justice, equality in care and in values when prioritizing care
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Applying language technology to nursing documents: pros and cons with a focus on ethics.
Suominen, Hanna; Lehtikunnas, Tuija; Back, Barbro; Karsten, Helena; Salakoski, Tapio; Salanterä, Sanna
2007-10-01
The present study discusses ethics in building and using applications based on natural language processing in electronic nursing documentation. Specifically, we first focus on the question of how patient confidentiality can be ensured in developing language technology for the nursing documentation domain. Then, we identify and theoretically analyze the ethical outcomes which arise when using natural language processing to support clinical judgement and decision-making. In total, we put forward and justify 10 claims related to ethics in applying language technology to nursing documents. A review of recent scientific articles related to ethics in electronic patient records or in the utilization of large databases was conducted. Then, the results were compared with ethical guidelines for nurses and the Finnish legislation covering health care and processing of personal data. Finally, the practical experiences of the authors in applying the methods of natural language processing to nursing documents were appended. Patient records supplemented with natural language processing capabilities may help nurses give better, more efficient and more individualized care for their patients. In addition, language technology may facilitate patients' possibility to receive truthful information about their health and improve the nature of narratives. Because of these benefits, research about the use of language technology in narratives should be encouraged. In contrast, privacy-sensitive health care documentation brings specific ethical concerns and difficulties to the natural language processing of nursing documents. Therefore, when developing natural language processing tools, patient confidentiality must be ensured. While using the tools, health care personnel should always be responsible for the clinical judgement and decision-making. One should also consider that the use of language technology in nursing narratives may threaten patients' rights by using documentation collected
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Directory of Open Access Journals (Sweden)
Goona Fathi
2014-07-01
Full Text Available Background: Ethical leadership appeared as a new approach in the leadership perspective and provided the ground for promoting individual and organizational efficiency by giving priorities to ethics in organizations. In this regard, the present study was conducted with the aim of modeling the relations of ethical leadership and clinical governance with psychological empowerment among nurses of public hospitals in Kermanshah in 2014. Methods: the research method was descriptive survey. The study sample consisted of all nurses (n=550 working in public hospitals of Kermanshah University of Medical Science for whom 163 nurses were selected using simple random sampling. The tools for data collection were ethical leadership, clinical governance and psychology empowerment questionnaires whose validity and reliability were confirmed. The structural equation modeling was used to analyze the data. Results: The results showed a significant relationship between ethical leadership and clinical governance (P<0.01 and psychological empowerment (P<0.01. Moreover, there was a significant correlation between clinical governance and psychological empowerment (P<0.05. Based on the results of the research, ethical leadership directly and through clinical governance affected the nurses’ psychological empowerment (P<0.05. Conclusion: reliance on ethics and ethical leadership in hospitals, in addition to providing the space and ground for improving the effectiveness of clinical governance approach, can promote the feeling of psychological empowerment in nurses. Accordingly, the ethical issues are required to be taken into consideration in hospitals.
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Ethics and the politics of advancing nursing knowledge.
Milton, Constance L
2015-04-01
The politics of academia involve intricate human relationships that are political in nature as nurse leaders and scholars struggle to advance nursing science with complex leading-following situations. This article begins a dialogue of considering potential meanings for what it means to be political within competing interest groups in academia, and within the discipline of nursing. What is most important in the struggle for identity and what possibilities surface when potential competing interests in academia collide? The ethical tenets of humanbecoming and the leading-following model are used to illustrate issues surrounding academic integrity and possibilities for the advancement of nursing scholarship in future generations. © The Author(s) 2015.
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Vynckier, Tine; Gastmans, Chris; Cannaerts, Nancy; de Casterlé, Bernadette Dierckx
2015-05-01
The effectiveness of ethics education continues to be disputed. No studies exist on how nursing students perceive the effectiveness of nursing ethics education in Flanders, Belgium. To develop a valid and reliable instrument, named the 'Students' Perceived Effectiveness of Ethics Education Scale' (SPEEES), to measure students' perceptions of the effectiveness of ethics education, and to conduct a pilot study in Flemish nursing students to investigate the perceived efficacy of nursing ethics education in Flanders. Content validity, comprehensibility and usability of the SPEEES were assessed. Reliability was assessed by means of a quantitative descriptive non-experimental pilot study. 86 third-year baccalaureate nursing students of two purposefully selected university colleges answered the SPEEES. Formal approval was given by the ethics committee. Informed consent was obtained and anonymity was ensured for both colleges and their participating students. The scale content validity index/Ave scores for the subscales were 1.00, 1.00 and 0.86. The comprehensibility and user-friendliness were favourable. Cronbach's alpha was 0.94 for general effectiveness, 0.89 for teaching methods and 0.85 for ethical content. Students perceived 'case study', 'lecture' and 'instructional dialogue' to be effective teaching methods and 'general ethical concepts' to contain effective content. 'Reflecting critically on their own values' was mentioned as the only ethical competence that, was promoted by the ethics courses. The study revealed rather large differences between both schools in students' perceptions of the contribution of ethics education to other ethical competences. The study revealed that according to the students, ethics courses failed to meet some basic objectives of ethics education. Although the SPEEES proved to be a valid and reliable measure, the pilot study suggests that there is still space for improvement and a need for larger scale research. Additional insights will
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Final Narrative Report on Nursing Ethics at Delta College.
Pfeiffer, Raymond S.
This four-part report describes a project undertaken by Delta College to implement two required bioethics courses for nursing students: an introductory course in ethical theories and an advanced course in applications of these theories in nursing. After Part I relates how funding for the project was secured and used, Part II delineates the…
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Mental disorder ethics: theory and empirical investigation
Eastman, N; Starling, B
2006-01-01
Mental disorders and their care present unusual problems within biomedical ethics. The disorders themselves invite an ethical critique, as does society's attitude to them; researching the diagnosis and treatment of mental disorders also presents special ethical issues. The current high profile of mental disorder ethics, emphasised by recent political and legal developments, makes this a field of research that is not only important but also highly topical. For these reasons, the Wellcome Trust's biomedical ethics programme convened a meeting, “Investigating Ethics and Mental Disorders”, in order to review some current research, and to stimulate topics and methods of future research in the field. The meeting was attended by policy makers, regulators, research funders, and researchers, including social scientists, psychiatrists, psychologists, lawyers, philosophers, criminologists, and others. As well as aiming to inspire a stronger research endeavour, the meeting also sought to stimulate an improved understanding of the methods and interactions that can contribute to “empirical ethics” generally. This paper reports on the meeting by describing contributions from individual speakers and discussion sections of the meeting. At the end we describe and discuss the conclusions of the meeting. As a result, the text is referenced less than would normally be expected in a review. Also, in summarising contributions from named presenters at the meeting it is possible that we have created inaccuracies; however, the definitive version of each paper, as provided directly by the presenter, is available at http://www.wellcome.ac.uk/doc.WTX025116.html. PMID:16446414
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Jurchak, Martha; Grace, Pamela J; Lee, Susan M; Willis, Danny G; Zollfrank, Angelika A; Robinson, Ellen M
2017-07-01
Nurses face complex ethical issues in practice and have to determine appropriate actions. An inability to conceptualize or follow a preferred course of action can give rise to moral uncertainty or moral distress. Both moral uncertainty and moral distress are problematic for nurses and their patients. A program designed to increase nurse confidence in moral decision making, the clinical ethics residency for nurses (CERN), was offered selectively to nurses affiliated with two academic medical centers. This is a report of the analysis of their application essays. Over a 3-year period, 67 application essays were analyzed using conventional content analysis. Applicants comprised one third advanced practice nurses (APNs) and two thirds staff nurses. They were asked to describe their reasons for interest in the CERN and how they would apply the knowledge gained. For conventional content analyses, no theoretical presumptions are used; rather, codes are identified from the data in an iterative manner and eventually collapsed into themes. Initially, broad themes were identified by the CERN team. Subsequently, in-depth and recursive readings were completed by a subset of three members, resulting in refinement of themes and subthemes. The overarching theme identified was "developing abilities to navigate through the 'grey zones' in complex environments." Three subthemes were: (a) nurses encountering patients who are chronically critically ill, culturally diverse, and presenting with complex circumstances; (b) nurses desiring enhanced ethics knowledge and skills to improve quality of care, understand different perspectives, and act as a resource for others; and (c) nurses supporting and facilitating patient-centered ethical decision making. Findings are consistent with those appearing in the international literature but provide a more cohesive and comprehensive account than previously, and hold promise for the development of educational and policy strategies to address moral
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The Construction Of Ethical Competence In The Perception Of Primary Care Nurses
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Rafaela Schaefer
2014-04-01
Full Text Available The study intended to understand the perception of nurses of Primary Care Services about the construction of ethical competence on their formation and practices. This is a qualitative study, with an interpretative phenomenological approach and interviews with ten nurses of the community health services of Porto Alegre, RS. The results showed that the interviewed professionals had already experienced situations with ethical conflicts and knew what ethical competence means. The central themes point out three fundamental issues in the construction of the ethical competence: personal values, education and practice. Taking into account that ethical competence is in permanent construction, the study shows the importance to promote organizational and educational activities in a transversal manner, as a tool to cope the moral stress and contribute in improving the quality of care in the primary health attention.
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Abou Hashish, Ebtsam Aly
2017-03-01
Healthcare organizations are now challenged to retain nurses' generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses' dedication, commitment, satisfaction, and loyalty to their organization. This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses' organizational commitment, job satisfaction, and turnover intention. A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent to participate in the research before data collection. The result revealed positive significant correlations between nurses' perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses' turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention
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Nursing intellectual capital theory: operationalization and empirical validation of concepts.
Covell, Christine L; Sidani, Souraya
2013-08-01
To present the operationalization of concepts in the nursing intellectual capital theory and the results of a methodological study aimed at empirically validating the concepts. The nursing intellectual capital theory proposes that the stocks of nursing knowledge in an organization are embedded in two concepts, nursing human capital and nursing structural capital. The theory also proposes that two concepts in the work environment, nurse staffing and employer support for nursing continuing professional development, influence nursing human capital. A cross-sectional design. A systematic three-step process was used to operationalize the concepts of the theory. In 2008, data were collected for 147 inpatient units from administrative departments and unit managers in 6 Canadian hospitals. Exploratory factor analyses were conducted to determine if the indicator variables accurately reflect their respective concepts. The proposed indicator variables collectively measured the nurse staffing concept. Three indicators were retained to construct nursing human capital: clinical expertise and experience concept. The nursing structural capital and employer support for nursing continuing professional development concepts were not validated empirically. The nurse staffing and the nursing human capital: clinical expertise and experience concepts will be brought forward for further model testing. Refinement for some of the indicator variables of the concepts is indicated. Additional research is required with different sources of data to confirm the findings. © 2012 Blackwell Publishing Ltd.
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“Values That Vanish into Thin Air”: Nurses' Experience of Ethical Values in Their Daily Work
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Gro Bentzen
2013-01-01
Full Text Available The objective of this study was to examine how nurses experience ethical values as they are expressed in daily practice in a Norwegian hospital. A growing focus in Western healthcare on effectiveness, production, and retrenchment has an influence on professional nursing standards and nursing values. Lack of resources and subsequent ethically difficult prioritizations imply a strain on nurses. This study is qualitative. Data collection was carried out by conducting 4 focus group interviews. The data was analyzed using content analysis. The results are presented in two main themes: (1 values and reflection are important for the nurses; (2 time pressure and nursing frustrations in daily work. The results demonstrate that nurses believe the ethical values to be of crucial importance for the quality of nursing; however, the ethical values are often repressed in daily practice. This results in feeling of frustration, fatigue, and guilty conscience for the nurses. There is a need for changes in the system which could contribute to the development of a caring culture that would take care of both patients and nurses. In an endeavour to reach this goal, one could apply caritative leadership theory, which is grounded on the caritas motive, human love, and mercy.
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Occupational and environmental health nursing: ethics and professionalism.
Rogers, Bonnie
2012-04-01
This article provides an overview of ethical issues related to the practice of occupational and environmental health nursing and possible strategies for resolution. Also, professionalism related to professional growth and advancing the specialty is discussed. Copyright 2012, SLACK Incorporated.
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White, Janine; Phakoe, Maureen; Rispel, Laetitia C
2015-01-01
A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. The study explored hospital nurses' perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses' Pledge of Service; and their views on contemporary ethical practice. Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA(®) 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients' rights as opposed to nurses' rights and 32% agreeing with a statement that they would take part in strike action to improve nurses' salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses' responses to open-ended questions. Continuing education in ethics and addressing health system deficiencies will enhance nurses' professional development and their ethical decision-making and practice.
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[Subjective glance in ethics and attitudes in psychiatric nursing].
Schädle-Deininger, Hilde
2014-07-01
Patients with psychiatric problems have the right to receive qualified and humane psychiatric nursing. To meet these requirements nurses should reflect on their daily practice and whether they support clients in respect of autonomy, empowerment and recovery or only meet the requirements of the institution and well-worn routines. The Code of Ethics for Nurses (International Council of Nurses [ICN] and the four principles of Beauchamp and Childress [respect of autonomy, nonmaleficence, beneficence and justice]) help nurses to decide in their daily work on the narrow line between autonomy and treating the patient like a child. Emphasis is laid on the nurses' duty to influence the political development in health services. © Georg Thieme Verlag KG Stuttgart · New York.
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[Code of ethics for nurses and territory hospital group].
Danan, Jane-Laure; Giraud-Rochon, François
2017-09-01
The publication of the decree relating to the code of ethics for nurses means that the State is producing a text for all nursing professionals, whatever their sector or their mode of practice. However, faced with the standardisation of nursing procedures, the production of a new standard by a government is not a neutral issue. On the one hand, it could constitute a reinforcement of the professional credibility of this corporation; on the other this text becomes enforceable on all nurses and employers. Within a territory hospital group, this reflection must form part of nursing and managerial practices and the relationships with the hospital administration. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
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Business ethics and economic growth: An empirical analysis for Turkish economy
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Ekrem Erdem
2015-12-01
Full Text Available Purpose – The roots of the science of modern economics are originated from the ideas of Adam Smith who is not a pure economist but a moralist-philosopher. Basic concepts in the Wealth of Nations which is perceived as the hand book of economics depend on the arguments that Adam Smith suggests in his Theory of Moral Sentiments. In this theory, business ethics as a part of the Law of Sympathy appears as one of the factors that provide the invisible hand to operate properly. In light of this property, it is possible to assume business ethics as one of the components of the market mechanism. In this context, this study aims to analyse the link between business ethics and economic growth in the Turkish economy. Design/methodology/approach – The study employs bounced cheques and protested bonds for representing the degradation of business ethics and tries to show how this degradation affects economic growth in the Turkish economy for the period 1988-2013. Findings – Either illustrative or empirical results show that business ethics is an important determinant of economic growth in the Turkish economy and damaging it negatively effects the growth rate of the economy. Research limitations/implications – One of the most restrictive things conducting the present empirical analysis is the lack of various and longer data sets. Using different indicators in terms of business ethics with longer time span will definitely increase the reliability of the study. However, in the current form, results imply a policy that is capable of limiting the failures of business ethics may boost the Turkish economy up. Originality/value – The results tend to support the close link between business ethics and economic growth.
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Falcó-Pegueroles, Anna; Lluch-Canut, Teresa; Guàrdia-Olmos, Joan
2013-06-01
Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables 'frequency' and 'degree of conflict'. In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable 'exposure to conflict', as well as considering six 'types of ethical conflict'. An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach's alpha was used to evaluate the instrument's reliability. All analyses were performed using the statistical software PASW v19. Cronbach's alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model
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Zirak M
2012-09-01
Full Text Available Background and Objectives: Nurses in their daily practice need acceptable level of ethical development. There is few literature about ethical development of Iranian nurses. The aims of present study are to determine the level ethical development in nurses and its related factors.Methods: This descriptive-correlational study conducted in 2010. The study sample consisted of 269 nurses working in three training-treatment hospitals affiliated to Tabriz University of Medical Sciences. These nurses selected by census sampling method. For assessing the ethical development of nurses, nursing dilemma test was used. This questionnaire was designed based on Kohlbergs’ theory of ethical development and assessed ethical development in pre-convetional, conventional and post-convetional levels. The data analysis was done by descriptive and inferential statistics. Results: Forty four nurses (16.3% were in pre-conventional level, 86 nurses (31.8% were in conventional level, 116 nurses (43.1% were in post-conventional level, and 23 nurses (8.5% were in clinical consideration level. There was negative significant correlation between ethical development of nurses with their job experience. Conclusion: In spite of this fact that near half of nurses are at postconventional level, but still a significant number of them are at lower levels of ethical development. These findings indicate that nursing managers should pay more attention to ethical development of nurses.
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The Japanese value of harmony and nursing ethics.
Konishi, Emiko; Yahiro, Michiko; Nakajima, Naoko; Ono, Miki
2009-09-01
Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses' perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses' harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for all. Because of the unique link between harmony and the location of interaction, the ideal 'workplace harmony' threatened some nurses' professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged.
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The relationship between ethical climate at work and job satisfaction among nurses in Tehran.
Joolaee, Soodabeh; Jalili, Hamid Reza; Rafii, Forough; Hajibabaee, Fatemeh; Haghani, Hamid
2013-01-01
This study aimed to provide an understanding of the relationship between the ethical climate at the workplace and job satisfaction among nurses. 210 nurses working in selected wards in the Tehran University of Medical Sciences were asked to fill out questionnaires on their work environment and level of job satisfaction. The data collection tools included a questionnaire to obtain demographic data, the Olson moral climate questionnaire and Minnesota job satisfaction questionnaire. The data were analysed using SPSS software version 14. We found a significant positive relationship between the ethical climate and the level of job satisfaction among the nurses. Among the demographic variables, the working shift, income level and type of duties allocated had a significant relationship with job satisfaction. Hospital managements should pay attention to the factors influencing job motivation among nurses, including the ethical climate of the work environment.
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The development of ethical guidelines for nurses' collegiality using the Delphi method.
Kangasniemi, Mari; Arala, Katariina; Becker, Eve; Suutarla, Anna; Haapa, Toni; Korhonen, Anne
2017-08-01
Nurses' collegiality is topical because patient care is complicated, requiring shared knowledge and working methods. Nurses' collaboration has been supported by a number of different working models, but there has been less focus on ethics. This study aimed to develop nurses' collegiality guidelines using the Delphi method. Two online panels of Finnish experts, with 35 and 40 members, used the four-step Delphi method in December 2013 and January 2014. They reformulated the items of nurses' collegiality identified by the literature and rated based on validity and importance. Content analysis and descriptive statistical methods were used to analyze the data, and the nurses' collegiality guidelines were formulated. Ethical considerations: Organizational approval was received, and an informed consent was obtained from all participants. Information about the voluntary nature of participation was provided. During the first Delphi panel round, a number of items were reformulated and added, resulting in 32 reformulated items. As a result of the second round, 8 of the 32 items scored an agreement rate of more than 75%, with the most rated item being collegiality means that professionals respect each other. The item with second highest rating was collegiality has a common objective: what is best for patients, followed by the third highest which was professional ethics is the basis of collegiality. Nurses' collegiality and its content are well recognized in clinical practice but seldom studied. Collegiality can be supported by guidelines, and nurses working in clinical practice, together with teachers and managers, have shared responsibilities to support and develop it. More research in different nursing environments is needed to improve understanding of the content and practice of nursing collegiality.
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'Working behind the scenes'. An ethical view of mental health nursing and first-episode psychosis.
Moe, Cathrine; Kvig, Erling I; Brinchmann, Beate; Brinchmann, Berit S
2013-08-01
The aim of this study was to explore and reflect upon mental health nursing and first-episode psychosis. Seven multidisciplinary focus group interviews were conducted, and data analysis was influenced by a grounded theory approach. The core category was found to be a process named 'working behind the scenes'. It is presented along with three subcategories: 'keeping the patient in mind', 'invisible care' and 'invisible network contact'. Findings are illuminated with the ethical principles of respect for autonomy and paternalism. Nursing care is dynamic, and clinical work moves along continuums between autonomy and paternalism and between ethical reflective and non-reflective practice. 'Working behind the scenes' is considered to be in a paternalistic area, containing an ethical reflection. Treating and caring for individuals experiencing first-episode psychosis demands an ethical awareness and great vigilance by nurses. The study is a contribution to reflection upon everyday nursing practice, and the conclusion concerns the importance of making invisible work visible.
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Ethical issues experienced by intensive care unit nurses in everyday practice.
Fernandes, Maria I D; Moreira, Isabel M P B
2013-02-01
This research aims to identify the ethical issues perceived by intensive care nurses in their everyday practice. It also aims to understand why these situations were considered an ethical issue and what interventions/strategies have been or are expected to be developed so as to minimize them. Data were collected using a semi-structured interview with 15 nurses working at polyvalent intensive care units in 4 Portuguese hospitals, who were selected by the homogenization of multiple samples. The qualitative content analysis identified end-of-life decisions, privacy, interaction, team work, and health-care access as emerging ethical issues. Personal, team, and institutional aspects emerge as reasons behind the experience of these issues. Personal and team resources are used in and for solving these issues. Moral development and training are the most significant strategies.
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Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area
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Ethelwynn L. Stellenberg
2014-06-01
Full Text Available Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise. Objectives: The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment. Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5% was drawn from all nurses and caregivers (N = 2990 working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables. Results: Results included (95% of respondents provided safe and committed care to their patients, (99% loved to care for their patients and (93% believed in the Nurses’ Pledge of Service. Fifty percent (50% of the respondents indicated verbal abuse from patients and only (59% experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient.
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Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area
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Ethelwynn L. Stellenberg
2014-02-01
Full Text Available Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise.Objectives: The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment.Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5% was drawn from all nurses and caregivers (N = 2990 working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables.Results: Results included (95% of respondents provided safe and committed care to their patients, (99% loved to care for their patients and (93% believed in the Nurses’ Pledge of Service. Fifty percent (50% of the respondents indicated verbal abuse from patients and only (59% experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse.Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient.
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Brown, Nancy C; McGee, Summer Johnson
2014-12-01
One of the challenges of modern healthcare ethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcare ethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcare ethics practice is critical. Because healthcare ethics is endowed with many boundaries which often delineate concerns about professional expertise and authority, epistemological reflection on the relationship between theory and practice points toward the social context as relevant to the conceptualization of boundaries. The skills of social scientists may prove helpful to provide data and insights into the conceptualization and navigation of clinical ethics qua profession. Empirical ethics research, which combines empirical description (usually social scientific) with normative-ethical analysis and reflection, is a way forward as we engage and reflect upon issues which have implications for practice standards and professionalization of the role. This requires cooperative engagement of the descriptive and normative disciplines to explore our understandings of boundaries in healthcare ethics practice. This will contribute to the ongoing reflection not only as we envision the professional role but to ensure that it is enacted in practice.
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[The Positionality of Caring Action: Small Group Dialogue in a Course on Nursing Ethics].
Chiang, Hsien-Hsien
2016-12-01
The content of nursing-ethics education has typically focused on the external standards of caring behavior and neglected the relationship between the ethical attitudes and internal experiences of caregivers. To explore the embodied experience in order to define the positionality of caring action, which is necessary to enrich the content of nursing ethics through small-group-learning-based dialogue. The researcher, as a participant observer, teaches a course on nursing ethics. Reflective analysis was used to analyze the data from the process of small group learning, a reflective group of faculty members, and 30 reflective journals submitted by 10 students. The results identified three items that were related to the positionality of caring action: the attitudes of belief, including the choice to belief and deep understanding; articulating the value system, including exploring affectivity and positionality; and cultivating the self through self-dialogues and dialogues with others. The attitudes of belief promote trust in interpersonal relationships. Articulating the value system deepens the meaning of caring. Cultivating the self may facilitate the ethical self.
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ETHICS AND DEONTOLOGY OF MEDICAL EDUCATION AND NURSES IN PORTUGUAL
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Clara Costa Oliveira
2012-07-01
Full Text Available This article discusses deontological issues of health care professions in relation to their ethical foundation. We present four models of teaching ethics and deontology in doctors’ training and the results of a PhD research on the teaching of these subjects in nurses’ training in Portugal. Given the importance of bioethics in deontological training of health care professions, we present a comparative analysis of. bioethical principles enunciated by Beauchamp and Childress (1979, related to ‘ethics of justice’, and Kemp’s(2000 proposal, associated to an ‘ethics of care’. Given the ambiguity of these bioethical expressions, we focus on the analysis of its contents and the need to discuss the fundamentals of ethical training of doctors and nurses in relation to the ethical theories they are derived from. Utilitarian ethics, duty ethics, virtue ethics, when the analysis of bioethics’ fundaments is not trained, the duty of caring of suffering can be put at risk.
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Alves, Débora Cristina Ignácio; Evora, Yolanda Dora Martinez
2002-01-01
This qualitative work was developed according to Bardin's method of content analysis. It aimed at finding out the perceptions of nurses that are members of a Hospital Infection Control Commission about ethical issues that are inherent to their professional practice as well as understanding the clinical nurses opinion regarding the professional practice of the nurses that are members of the Hospital Infection Control Commission, considering the ethical aspects. In order to achieve an ethical, efficient and effective professional practice, there is a need for governmental changes and professional recognition through autonomy, respect and exclusivity in the Service of Hospital Infection Control, as well as improvements regarding information, the care provided to the patient and professional secret. The predominance of bureaucratic activities and team work were mentioned by the clinical nurses as differentiating factors of the activities performed by nurses that are members of the Commission.
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Will Nursing Continue as the Most Trusted Profession? An Ethical Overview.
Milton, Constance L
2018-01-01
Trust-mistrust is a paradoxical rhythm found in all healthcare disciplines. The discipline of nursing has traditionally been regarded as the most trusted. What are the ethical obligations for professional nurses in establishing community relationships of trust according to societal needs and desires? Specifically, the author seeks to conceptualize and discern potential implications for fiduciary trust and the future of nursing as a healthcare discipline.
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Hadjistavropoulos, Thomas; Malloy, David C; Douaud, Patrick; Smythe, William E
2002-09-01
The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.
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Examination of ethical practice in nursing continuing education using the Husted model.
Steckler, J
1998-01-01
Beliefs about human nature, adult education, adult learners, and moral commitment are at the heart of the educator-learner agreement. In continuing nursing education, it is the point where professional values, morals, and ethical principles meet. Using Husteds' bioethical decision-making model, the values, beliefs, and actions within the educator-learning agreement are identified and organized by the bioethical standards. By relating the bioethical standards to practice, continuing nurse educators can find their own basis for practice and work toward attaining a consistent professional ethical orientation.
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The ethical component of professional competence in nursing: an analysis.
Paganini, Maria Cristina; Yoshikawa Egry, Emiko
2011-07-01
The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice.
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Aydan, Seda; Kaya, Sidika
2018-01-01
Objectives: To reveal the effect of perception of ethical climate by nurses and secretaries and their level of organizational trust on their whistleblowing intention. Methods: Nurses and secretaries working in a University Hospital in Ankara, Turkey, were enrolled in the study conducted in 2016. Responses were received from 369 nurses and secretaries working at Clinics and Polyclinics. Path analysis, investigation of structural equation models used while multi-regression analysis was also applied. Results: According to the regression model, ethical climate dimensions, profession, gender, and work place had significant impact on the whistleblowing intention. According to Path analysis, ethical climate had direct impact of 69% on whistleblowing intention. It was seen that organizational trust had an indirect impact of 27% on the whistleblowing score when ethical climate had a moderator role. Conclusion: In order to promote whistleblowing in organizations, it is important to keep the ethical climate perception of employees and the level of their organizational trust at high levels. PMID:29805421
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Aydan, Seda; Kaya, Sidika
2018-01-01
To reveal the effect of perception of ethical climate by nurses and secretaries and their level of organizational trust on their whistleblowing intention. Nurses and secretaries working in a University Hospital in Ankara, Turkey, were enrolled in the study conducted in 2016. Responses were received from 369 nurses and secretaries working at Clinics and Polyclinics. Path analysis, investigation of structural equation models used while multi-regression analysis was also applied. According to the regression model, ethical climate dimensions, profession, gender, and work place had significant impact on the whistleblowing intention. According to Path analysis, ethical climate had direct impact of 69% on whistleblowing intention. It was seen that organizational trust had an indirect impact of 27% on the whistleblowing score when ethical climate had a moderator role. In order to promote whistleblowing in organizations, it is important to keep the ethical climate perception of employees and the level of their organizational trust at high levels.
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Developing nursing ethical competences online versus in the traditional classroom.
Trobec, Irena; Starcic, Andreja Istenic
2015-05-01
The development of society and science, especially medical science, gives rise to new moral and ethical challenges in healthcare. In order to respond to the contemporary challenges that require autonomous decision-making in different work contexts, a pedagogical experiment was conducted to identify the readiness and responsiveness of current organisation of nursing higher education in Slovenia. It compared the successfulness of active learning methods online (experimental group) and in the traditional classroom (control group) and their impact on the ethical competences of nursing students. The hypothesis set in the experiment, hypothesis 1 (the experimental group will be successful and will have good achievements in comprehension and application of ethical principles) was confirmed based on pre-tests and post-tests. The hypothesis tested by the questionnaire, hypothesis 2 (according to the students, the active learning methods online in the experimental group have a positive impact on the development of ethical competences) was confirmed. The pedagogical experiment was supported by a multiple-case study that enabled the in-depth analysis of the students' attitudes towards the active learning methods in both settings. The study included Slovenian first-year nursing students (N = 211) of all the enrolled students (N = 225) at the University of Ljubljana and University of Primorska in the academic year 2010/2011. Before the study ethical permission was obtained from the managements of both participating faculties. The students were given all the necessary information of the experiment before the tutorials. No significant difference was found between the two learning settings and both had a positive impact upon learning. The results of the content analysis show that the students' active engagement with the active learning methods in the group enables the development of ethical competences and the related communicative competences, interpersonal skills, collaboration
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Moral distress: a review of the argument-based nursing ethics literature.
McCarthy, Joan; Gastmans, Chris
2015-02-01
The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers' Index and Socindex. A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. We found that like the empirical literature, most authors in this review draw on Jameton's original definition and describe moral distress in psychological-emotional-physiological terms. They also agree that moral distress is linked to the presence of some kind of constraint on nurses' moral agency, and that it is best understood as a two-staged process that can intensify over time. There is also consensus that moral distress has an important normative meaning, although different views concerning the normative meaning of moral distress are expressed. Finally, the authors generally agree that moral distress arises from a number of different sources and that it (mostly) affects negatively on nurses' personal and professional lives and, ultimately, harms patients. However, despite this consensus, many authors take issue with the way in which moral distress is conceptualized and operationalized. Moreover, while some worry that identifying nurses as a group of health professionals whose voices are ignored or marginalized might disempower nurses and encourage them to avoid their moral responsibilities, others take situations involving moral distress as indicative of more fundamental, structural inequities at the heart of contemporary healthcare provision. We conclude that research on moral distress in nursing is timely and important because it highlights the specifically moral labour of nurses. However, we suggest that significant concerns about the conceptual fuzziness and
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[The code of ethics for nurses, history and perspectives].
de Kerguenec, Yann
2017-09-01
The French decree of 25 November 2016 relating to the code of ethics for nurses reinforces the principles guiding their missions and the corresponding responsibilities. It is the fruit of a collaboration between nurses from all backgrounds heavily involved in the Order. Imbued with the nursing spirit, reflecting the sensitivities and concerns of professionals, it is a unique project and, in every regard, quite remarkable, as it has been produced by a profession which is often reluctant to put pen to paper to express its vision of health. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
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A new prescription for empirical ethics research in pharmacy: a critical review of the literature
Cooper, R J; Bissell, P; Wingfield, J
2007-01-01
Empirical ethics research is increasingly valued in bioethics and healthcare more generally, but there remain as yet under-researched areas such as pharmacy, despite the increasingly visible attempts by the profession to embrace additional roles beyond the supply of medicines. A descriptive and critical review of the extant empirical pharmacy ethics literature is provided here. A chronological change from quantitative to qualitative approaches is highlighted in this review, as well as differi...
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Powers, B A
2001-01-01
The concept of everyday ethics was used to emphasize the moral basis of ordinary issues of daily living affecting quality of life for nursing home residents with dementia. To critically examine ethical issues of daily living affecting nursing home residents with dementia and to construct a descriptive taxonomy inductively derived from ethnographic fieldwork data. Combined anthropological methods of participant observation and in-depth interviewing were used in the natural setting of a 147-bed, voluntary, not-for-profit nursing home. Experiences of 30 residents, their family members, and nursing home staff were explored. In addition, the records of 10 ethics committee cases involving residents with dementia further enlarged the database. The taxonomy of everyday ethical issues includes the following four domains: (a) learning the limits of intervention; (b) tempering the culture of surveillance and restraint; (c) preserving the integrity of the individual; and (d) defining community norms and values. Each is representative of constellations of concerns that are grounded in the cultural and moral environment of the nursing home. Results highlight the challenges of recognizing the ethical in the ordinary, and of resolving everyday issues in ways that enhance quality of life for residents with dementia and those (family and staff) who care for them.
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Principle-based ethics and nurses' attitudes towards artificial feeding.
Day, L; Drought, T; Davis, A J
1995-02-01
Nurses often institute artificial feeding for patients who would otherwise starve. Recently, the courts in the United States have favoured withholding or withdrawing feedings from patients who currently refuse or previously gave some indication they would refuse artificial nutrition and hydration. This paper investigates under what circumstances nurses feel justified in withholding artificial nutrition and hydration. Structured interviews were conducted with 40 cancer care nurses from two sites, and 40 dementia care nurses from two sites. The interviews were based on two vignettes, one involving an alert patient with terminal cancer, the other a patient suffering end-stage Alzheimer's dementia, and were analysed for themes coinciding with principles of deontological ethics. Investigators found that autonomy, beneficence and non-maleficence most often guided nurses' decisions to withhold or implement artificial feeding.
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Mauno, Saija; Ruokolainen, Mervi; Kinnunen, Ulla; De Bloom, Jessica
2016-05-01
The study examined whether three resources, that is, compassion, transformational leadership and work ethic feasibility, buffer against the negative effects of emotional labour on work engagement. Emotional labour is a common job stressor among nurses, but little is known about whether certain personal and work resources buffer against it in relation to work engagement. Revealing buffers of emotional labour would help organizations to design tailored interventions. Cross-sectional online survey conducted in 2014. Participants were 3466 Finnish nurses. Hypotheses were tested via hierarchical moderated regression analyses. Higher emotional labour related to lower engagement. Two interaction effects were found. First, work ethic feasibility buffered against emotional labour: the nurses who perceived work ethic feasibility as high in a situation of high emotional labour, scored higher on engagement compared with those nurses who in this stress situation perceived work ethic feasibility to be low. Second, high compassion was detrimental to engagement in the presence of high emotional labour. Transformational leadership did not act as a buffer but showed a positive relationship with engagement. Work ethic feasibility (being able to work according to high ethical standards) is an important resource in nursing as it protects an employee against the negative effects of emotional labour and as it also directly promotes engagement. However, compassion may not always be beneficial in nursing, especially if co-occurring with high job stress. Transformational leadership has potential to improve engagement in nursing although it may not operate as a stress buffer. © 2016 John Wiley & Sons Ltd.
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PREDICTORS OF ETHICAL JUDGMENTS IN THE ROMANIAN AUDIT PROFESSION: AN EMPIRICAL INVESTIGATION
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Alina Beattrice Vladu
2013-12-01
Full Text Available This paper explores empirically six potential predictors of ethical judgments in the audit profession. Those potential predictors are assessed in the literature under the aegis of inconsistency in terms of their impact on ethical behaviour. In this paper, their impact was investigated using auditors as respondents. In this respect: age, gender, education, work experience, religiosity and deontological versus teleological evaluations were used to examine whether they have the potential to influence the ethical behaviour. The findings from the survey cannot conclusively indicate that all the items above influence the ethical behaviour of auditors. In this respect, education, work experience, deontological and teleological evaluations are found as predictors of ethical judgments. On the other side age, gender or religiosity are not found to be relevant in ethical decision making process. Further research is also approached.
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Roediger, Jeanette
A project was undertaken to research and acquire the instructional sources needed for a course in ethics for community college associate degree nursing students and to develop such a course. Addressed in the individual units of the course were the following topics: bioethics and ethical decision making, basic ethical concepts and principles,…
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[The legal framework of the code of ethics for nurses].
Doutriaux, Yves
2017-09-01
As with all professions with its own order, nurses now have a code of ethics written by the Order's elected leaders. These leaders oversee its application for the benefit of patients and professionals, notably when a complaint is made. The code reconciles the interests of patients and public health care with the competition law. The numerous innovations which it has introduced are beneficial to nurses employed in the public and private sectors as well as freelance nurses. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
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Crock, Elizabeth
2009-10-01
In recent years, nurses have increasingly become recipients of pharmaceutical company gifts, funding and sponsorship. There has been little discussion in the nursing literature, however, of the ethical and professional implications of nurses' acceptance of such sponsorship. This article examines ethical issues related to the issue of nurses' accepting benefits from pharmaceutical companies (and other commercial enterprises). It aims to encourage nurses to look critically at the implications of accepting such gifts/sponsorship, or to enter any form of relationship with commercial companies within the health sector, and to stimulate further discussion of this issue within the profession.
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Monahan, Torin; Fisher, Jill A
2010-10-01
The aim of this study was to assess empirically the social and ethical risks associated with implantable radio-frequency identification (RFID) devices. Qualitative research included observational studies in twenty-three U.S. hospitals that have implemented new patient identification systems and eighty semi-structured interviews about the social and ethical implications of new patient identification systems, including RFID implants. The study identified three primary social and ethical risks associated with RFID implants: (i) unfair prioritization of patients based on their participation in the system, (ii) diminished trust of patients by care providers, and (iii) endangerment of patients who misunderstand the capabilities of the systems. RFID implants may aggravate inequalities in access to care without any clear health benefits. This research underscores the importance of critically evaluating new healthcare technologies from the perspective of both normative ethics and empirical ethics.
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Ethical and Epistemic Dilemmas in Empirically-Engaged Philosophy of Education
Newman, Anne; Glass, Ronald David
2015-01-01
This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of…
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Van Niekerk, Leesa Micole; Martin, Frances
2002-01-01
A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…
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An intercultural nursing perspective on autonomy.
Hanssen, Ingrid
2004-01-01
This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients' possibly harmful choices is discussed, the focus is on 'forced' autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively participate neither in the treatment offered nor in making choices regarding that treatment. Nurses' demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person's autonomy is also respect for the person, one's respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second-order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why.
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Palliative sedation in nursing anesthesia.
Wolf, Michael T
2013-04-01
Palliative sedation is a technique of providing a sedative for end-of-life care to patients with intractable pain. The literature discusses the techniques and use of palliative sedation. Numerous articles have been written regarding the issues surrounding its use, but no literature has discussed the prescription or administration of palliative sedation by a nurse anesthetist. By understanding the concept and ethics involved in its use and providing nursing care that is theory based, the author argues that the involvement of nursing anesthesia is appropriate and within the scope of practice. Few other healthcare disciplines can provide the patient care and empirical knowledge that is imperative in the care of the dying patient. This article discusses the concept and ethics of palliative sedation and presents a case of providing palliative sedation to a terminally ill patient by an experienced nurse anesthetist. Palliative sedation should be understood, embraced, and utilized as an area of expertise suited for nursing anesthesia.
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Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António M; Carvalho, Ana Sofia
2014-02-01
Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units (ICUs). A quantitative, multicentre, correlational study was conducted among 300 professionals. The most crucial ethical decisions made by professionals working in ICU were related to communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments (p=0.032), to withhold treatments (p=0.002) and to proceed to terminal sedation (p=0.005). This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses (6%), it was the physicians (34%) who more keenly felt the need to proceed to ethical decisions in ICU. Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout.
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Ramos, Flávia Regina Souza; de Pires, Denise Elvira Pires; Brehmer, Laura Cavalcanti de Farias; Gelbcke, Francine Lima; Schmoeller, Soraia Dornelles; Lorenzetti, Jorge
2013-10-01
From a scenario of political and technological changes in work and health education, the purpose of this study was to understand the ethics discourse in nurses' education process in Brazilian nursing schools. A research was performed with a qualitative approach, characterized as a case study, involving six schools of a region in the south of Brazil. The data were collected by focal groups involving 50 teachers. The results were organized in three categories: (1) experience and motivation to teach ethics and bioethics, (2) indicators of change identified in global and local contexts and (3) challenges in the education of ethics, values and related themes. The teachers have highlighted complex elements related to scientific, educational and professional contexts, and pointed out the need for a critical perspective on the professional scenario and on their own situations as nurses and educators. The analyzed discourse brings to light the topic of ethics, seen as peculiar to the present day and in intimate connection with the daily routine of clinical, pedagogical and political professional practices. The findings suggest that the reflections on nurses' ethics education should not be limited to discussing content and pedagogical strategies but should be extended to include a commitment to the adoption of values in professional practice and to the process of the construction of a professional identity. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Indhraratana, Apinya; Kaemkate, Wannee
2012-01-01
The aim of this paper is to develop a reliable and valid tool to assess ethical decision-making ability of nursing students using rubrics. A proposed ethical decision making process, from reviewing related literature was used as a framework for developing the rubrics. Participants included purposive sample of 86 nursing students from the Royal…
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Park, Mihyun; Kjervik, Diane; Crandell, Jamie; Oermann, Marilyn H
2012-07-01
This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students.
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Skela-Savič, Brigita; Kiger, Alice
2015-10-01
Providing adequate training for mentors, fostering a positive mentorship culture and establishing the necessary operational procedures for ensuring mentorship quality are the keys to effective clinical mentoring of nursing students. The purpose of the research was to explain different dimensions of clinical mentors' professional development and their capability of developing ethical values in nursing students. A non-experimental quantitative research design was employed. Data were collected by means of a questionnaire administered to the population of clinical mentors (N=143). The total number of questions was 36. Descriptive statistics were used, and bivariate analysis, factor analysis, correlation analysis and linear regression analysis were performed. The professional development of clinical nurse mentors was explained (R(2)=0.256) by career advancement (p=0.000), research and learning (p=0.024) and having a career development plan (p=0.043). Increased professional self-confidence (R(2)=0.188) was explained by career advancement (p=0.000) and the time engaged in record keeping (p=0.028). Responsibility for the development of ethical values in nursing students (R(2)=0.145) was explained by the respondents' level of education (p=0.020) and research and learning (p=0.024). Applying ethical principles and norms into practice (R(2)=0.212) was explained by self-assessed knowledge in ethics (p=0.037) and research and learning (p=0.044). Clinical nurse mentors tended to lack a career development plan, had low work time spent on research and insufficiently participated in education and training activities, which turned out to be significant explanatory factors of their professional development and their capability of developing ethical values in nursing students. The research showed that nursing and higher education managers often failed to assume responsibility for the professional development of clinical nurse mentors. Copyright © 2015 Elsevier Ltd. All rights
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Moral deliberation and nursing ethics cases: elements of a methodological proposal.
Schneider, Dulcinéia Ghizoni; Ramos, Flávia Regina Souza
2012-11-01
A qualitative study with an exploratory, descriptive and documentary design that was conducted with the objective of identifying the elements to constitute a method for the analysis of accusations of and proceedings for professional ethics infringements. The method is based on underlying elements identified inductively during analysis of professional ethics hearings judged by and filed in the archives of the Regional Nursing Board of Santa Catarina, Brazil, between 1999 and 2007. The strategies developed were based on the results of an analysis of the findings of fact (occurrences/infractions, causes and outcomes) contained in the records of 128 professional ethics hearings and on the structural elements (statements, rules and practices) identified in five example professional ethics cases. The strategies suggested for evaluating accusations of ethics infringements and the procedures involved in deliberating on ethics hearings constitute a generic proposal that will require adaptation to the context of specific professional ethics accusations.
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Moral courage in nursing: A concept analysis.
Numminen, Olivia; Repo, Hanna; Leino-Kilpi, Helena
2017-12-01
Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one's moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. This article is an analysis of the concept of moral courage in nursing. Rodgers' evolutionary method of concept analysis provided the framework to conduct the analysis. The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher's Index. The following key words were used: "moral" OR "ethical" AND "courage" OR "strength" AND "nurs*" with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice.
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Internet research and ethics: transformative issues in nursing education research.
Mahon, Pamela Young
2014-01-01
As practice in the educational and clinical settings seeks to be evidence based, faculty are increasingly required to conduct research and publish the results to advance the science of our profession. The purpose of this article is to discuss transformative research ethics because Internet use is an increasing component of current research studies. How nurse educators can engage in research-utilizing methodologies inclusive of technology while adhering to ethical standards developed before the advance of the Internet is reviewed. Recommendations are cited to address the new questions that arise at institutional review board meetings resulting from potential ethical implications of using students or research participants in cyber space. © 2014.
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Kangasniemi, Mari; Haho, Annu
2012-12-01
The aim of this study is to describe the idea pattern of nursing ethics in the textbook written by the Swedish nurse Estrid Rodhe (1911). The purpose is to increase understanding of the ideas in early written history of nursing ethics by using the method of history of ideas. A theoretical premise, but also a fascinating factor in this study, is that the ethics of one profession is always contextual in relation to current period. The historical context of Rodhe's time was a time of difficult societal circumstances in Europe. Nurses' work was demanding, but a distinctive feature was enthusiasm to develop nursing. Discussion of the moral issues of nursing was intense, and the characteristics of a good nurse consisted of being as altruistic and unselfish woman. Based on our analysis, the inner essence of Rodhe's idea pattern consists of human love. It is reflected in her ideas of calling-based altruism, virtuous woman as a personal reason for being a nurse and nurses' ethical duty to implementation and subservience. Rodhe's thinking reflects the conventions of her time. The role of personal moral characteristics of nurses was highlighted and not viewed as separable from the professional. Her textbook represented nursing knowledge of ethics written by a nurse and making her a pioneer of the early written history of nursing in general. Understanding the past helps us comprehend current issues in nursing and makes visible cultural values that form the basis for today and tomorrow. It also provides a possibility to observe the same fundamental features in spite of temporal distance. Here, the history of ideas is a beneficial and fruitful method to increase our understanding of nursing ethics. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.
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[Bioethical Approach for Nursing Research -Focused on the Use of Research Ethics Committees].
Jeong, Ihn Sook
2015-06-01
This paper was written to introduce methods of using the research ethics committee (RES) from requesting the initial review to reporting the close-out for nursing researchers. General ethical principles were described by reviewing the 'Bioethics and Safety Act' and other related guidelines, and constructing some questions and answers. The results were composed of three parts; definition of RES, steps in using RES, and archiving. The 7 steps for using RES were; identifying whether the study needed to be reviewed, by the RES identifying whether the study could be exempted, requesting the initial review after preparing documents, requesting the re-review, requesting an amendment review, requesting a continuing review and reporting the close-out. Nursing researchers need to receive RES approval before starting nursing research involving human subjects. Nursing researchers are urged to use the steps reported in this paper to receive RES approval easily and quickly.
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Imaginative ethics--bringing ethical praxis into sharper relief.
Hansson, Mats G
2002-01-01
The empirical basis for this article is three years of experience with ethical rounds at Uppsala University Hospital. Three standard approaches of ethical reasoning are examined as potential explanations of what actually occurs during the ethical rounds. For reasons given, these are not found to be satisfying explanations. An approach called "imaginative ethics", is suggested as a more satisfactory account of this kind of ethical reasoning. The participants in the ethical rounds seem to draw on a kind of moral competence based on personal life experience and professional competence and experience. By listening to other perspectives and other experiences related to one particular patient story, the participants imagine alternative horizons of moral experience and explore a multitude of values related to clinical practice that might be at stake. In his systematic treatment of aesthetics in the Critique of Judgement, Kant made use of an operation of thought that, if applied to ethics, will enable us to be more sensitive to the particulars of each moral situation. Based on this reading of Kant, an account of imaginative ethics is developed in order to bring the ethical praxis of doctors and nurses into sharper relief. The Hebraic and the Hellenic traditions of imagination are used in order to illuminate some of the experiences of ethical rounds. In conclusion, it is argued that imaginative ethics and principle-based ethics should be seen as complementary in order to endow a moral discourse with ethical authority. Kantian ethics will do the job if it is remembered that Kant suggested only a modest, negative role of principle-based deliberation.
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Educating for ethical leadership.
Gallagher, Ann; Tschudin, Verena
2010-04-01
In this article we consider the nature of ethical leadership in nursing. An appreciation of the basis of such leadership requires an understanding of responsibility and of key intellectual and ethical qualities or virtues. We examine some of the educational and practice strategies to promote ethical leadership. We argue that there are different levels of ethical leadership. All members of the nursing workforce are ethical leaders in so far as they demonstrate a commitment to ethical practice in their everyday work and act as ethical role models for others. Nurse managers are responsible for influencing their team and for acting as arbiters between organisational and professional values. Nurse educators are role models and ethical leaders as they ensure that the explicit and hidden curriculum demonstrate a commitment to professional values. Nurses who assume political roles have an obligation to lead on ethical agenda compatible with the values of nursing.
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Nurses serving on clinical ethics committees: A qualitative exploration of a competency profile
dr. Bart Cusveller
2014-01-01
The competency profile underlying higher nursing education in the Netherlands states that bachelor-prepared nurses are expected to be able to participate in ethics committees. What knowledge, skills and attitudes are involved in this participation is unclear. In five consecutive years, groups of two
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Ethical concerns of nursing reviewers: an international survey.
Broome, Marion; Dougherty, Molly C; Freda, Margaret C; Kearney, Margaret H; Baggs, Judith G
2010-11-01
Editors of scientific literature rely heavily on peer reviewers to evaluate the integrity of research conduct and validity of findings in manuscript submissions. The purpose of this study was to describe the ethical concerns of reviewers of nursing journals. This descriptive cross-sectional study was an anonymous online survey. The findings reported here were part of a larger investigation of experiences of reviewers. Fifty-two editors of nursing journals (six outside the USA) agreed to invite their review panels to participate. A 69-item forced-choice and open-ended survey developed by the authors based on the literature was pilot tested with 18 reviewers before being entered into SurveyMonkey(TM). A total of 1675 reviewers responded with useable surveys. Six questions elicited responses about ethical issues, such as conflict of interest, protection of human research participants, plagiarism, duplicate publication, misrepresentation of data and 'other'. The reviewers indicated whether they had experienced such a concern and notified the editor, and how satisfied they were with the outcome. They provided specific examples. Approximately 20% of the reviewers had experienced various ethical dilemmas. Although the majority reported their concerns to the editor, not all did so, and not all were satisfied with the outcomes. The most commonly reported concern perceived was inadequate protection of human participants. The least common was plagiarism, but this was most often reported to the editor and least often led to a satisfactory outcome. Qualitative responses at the end of the survey indicate this lack of satisfaction was most commonly related to feedback provided on resolution by the editor. The findings from this study suggest several areas that editors should note, including follow up with reviewers when they identify ethical concerns about a manuscript.
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Approaching Ethical Reasoning in Nursing Research through a Communitarian Perspective.
Dresden, Elissa; McElmurry, Beverly J.; McCreary, Linda L.
2003-01-01
Case studies depict dilemmas in nursing research involving protection of community rights and community informed consent. Outlines research guidelines derived from communitarian ethical frameworks that consider beneficence, justice, and respect for autonomy in the context of community. (Contains 58 references.) (SK)
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Negative workplace behaviours: an ethical dilemma for nurse managers.
Lindy, Cheryl; Schaefer, Florence
2010-04-01
To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.
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Gilligan's different voice: a perspective for nursing.
Cooper, M C
1989-01-01
This article proposes that Carol Gilligan's ethic of care provides for nursing a paradigm for moral deliberation that demonstrates compatibility with nursing's historical and philosophical traditions of relational caring and furnishes empirical support for the value of caring as a moral activity. The appropriateness of Gilligan's theory for nursing is further illustrated by an elucidation of the similarities between Gilligan's theory and nurse theorist Jean Watson's claims that caring constitutes both a necessary and a fundamental component of nursing. It is argued that Gilligan's theory of moral deliberation more faithfully reflects the nursing experience than Kohlberg's contractual, Kantian theory, which currently dominates the nursing literature.
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Ethical and cultural striving: Lived experiences of minority nurses in dementia care.
Egede-Nissen, Veslemøy; Sellevold, Gerd Sylvi; Jakobsen, Rita; Sørlie, Venke
2017-09-01
Nursing workforce in Western European health institutions has become more diverse because of immigration and recruitment from Asian, African, and East-European countries. Minority healthcare providers may experience communication problems in interaction with patients and coworkers, and they are likely to experience conflict or uncertainty when confronted with different cultural traditions and values. Persons with dementia are a vulnerable group, and the consequences of their illness challenge the ability to understand and express oneself verbally. The large number of minority healthcare providers in nursing homes underlines the importance to obtain better knowledge about this group's experiences with the care challenges in dementia care units. Can you tell about any challenges in the experiences in the encounter with persons suffering from dementia? Participants and research context: Five minority healthcare providers in a nursing home, in a dementia unit. All guidelines for research ethic were followed. Ethical consideration: The participants were informed that participation was voluntary, and they were guarantied anonymity. We used a qualitative method, conducting individual interviews, using a narrative approach. In the analysis, we applied a phenomenological-hermeneutical method, developed for researching life experiences. One theme and four subthemes: striving to understand the quality of care for persons with dementia. The subthemes: sensitivity to understand the patients' verbal and nonverbal expressions. To understand gratefulness, understand the patient as an adult and autonomous person, and understand the patient as a patient in a nursing home. Challenges comprise both ethical and cultural striving to understand persons with dementia. To care for persons with dementia in an unfamiliar context may be understood as a striving for acting ethically, when at the same time striving to adapt and acculturate to new cultural norms, in order to practice good
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Prock, Valencia N., Ed.; And Others
A variety of ethical issues confronting the nursing profession are examined in these proceedings. The following papers are presented: (1) "Ethics: Care & Conflict," by Leah Curtin; (2) "The Interface of Politics and Ethics in Nursing," by Mila Aroskar; (3) "Pluralistic Ethical Decision-Making," by Rita Payton; (4)…
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Directory of Open Access Journals (Sweden)
Tatiana González-Noguera
2018-01-01
Full Text Available The central interest of this document is to reflect on the ethical responsibility of the nursing educator in the promotion of the health and quality of life of university students, taking into account that nursing is considered a profession that benefits the people which has a close relationship with. To promote a good health in students is a task that implies ethical duties for society, institutions of higher education, of health and essentially for nursing. A nursing professsional is indispensable to produce changes in the lifestyles of the students through the rights and ethical duties that emanate from dignity and that is essential in the education of the youngest. As university educators we must accept the responsibility of promoting healthy lifestyles that protect the health of students and therefore the quality of life of them as future integral professionals.
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Ethics and quality care in nursing homes: Relatives' experiences.
Jakobsen, Rita; Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Sørlie, Venke
2017-01-01
A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients' relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words. The aim of the study is to investigate relatives of persons with dementia's experiences with quality care in nursing homes. The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological-hermeneutical method for the study of lived experiences. Participants and research context: Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included. Ethical considerations: The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study. Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives' experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives
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Legal, ethical and professional aspects of duty of care for nurses.
Dowie, Iwan
2017-12-13
Duty of care is a fundamental aspect of nursing, and many nurses consider this to be an important part of their professional duties as a nurse. However, the legal underpinnings of duty of care are often overlooked, and, as such, nurses may be unsure about when to act if they encounter emergency situations or serious incidents, especially when they are off duty. This article examines the legal, ethical and professional aspects of duty of care, what these mean for nurses in practice, and how duty of care is intrinsically linked with standards of care and negligence. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
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[Nursing between ethic and aesthetic. Profession described by media].
Gradellini, Cinzia; Idamou, Sara; Lusetti, Simona
2013-01-01
Nurse's role, according to the media, does not fit the role and evolution that nursing had in these last years: nursing remains unknown to public. Objective of research is to define how nurse's image is described by media. analysis of two newspapers, at national and local level with respect to articles about nurses, taking into account numbers of articles, position, topic (malpractice, frauds/crimes, job/economical cuts, praise). A second part of research has been focused on online newspapers, by using key words. Analysis of television medical dramas about presence of nurse, competences, relationship with physician/patient, social elements, context of work (acute or chronic), impact on patients welfare, and eventually ethical-deontological aspects has been carried out. on three hundred articles related health context, thirty-nine talk about nurse; five of those are in first page. 39% of articles regards frauds/crimes, 19% job/economical cuts, 15% malpractice. With respect to online articles, 66% concerns frauds/crimes. In medical dramas there is small attention to nurse who has generic competence as well as other health professional but doctor. The nurse character is played only by women. a low level of professionalism comes out both from newspaper and television. A specific professional identity is often absent furthermore nurses are relegated to a role of weakness in work and private circumstance.
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Fowler, Marsha D
How does and should the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, with foundations from the late 1800s, impact today's nursing practice? How can the Code help you? The earlier 2001 Code was revised and became effective January 2015. The nine provisions received modest revision, as did the corresponding interpretive statements. However, Provisions 8 and 9 and their interpretive statements received more substantial revision. This article explains the Code and summarizes the 2015 revisions, considering points of particular interest for nurses of faith.
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Parandavar, Nehleh; Rahmanian, Afifeh; Badiyepeymaie Jahromi, Zohreh
2015-07-31
Commitment to ethics usually results in nurses' better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses' professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses' self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses' self-concept, which can boost their commitment to ethics, be given more consideration.
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Gastmans, Chris; Lemiengre, Joke; de Casterlé, Bernadette Dierckx
2006-10-01
To describe whether and how Catholic hospitals and nursing homes in Belgium (Flanders) have developed written ethics policies on euthanasia and communicated these policies to their employees, patients, and patient's relatives. A cross-sectional mail survey of general directors of Catholic hospitals and nursing homes in Belgium (Flanders). Of the 298 targeted institutions, 81% of hospitals and 62% of nursing homes returned complete questionnaires. A high percentage of Catholic hospitals (79%) and a moderate percentage of nursing homes (30%) had written ethics policies on euthanasia. Both caregivers and healthcare administrators were involved in the development and approval of these policies. Physicians and nurses were best informed about the policies. More than half of the nursing homes (57%) took the initiative to inform both residents and relatives about the policies, while only one hospital did so. The high prevalence of written ethics policies on euthanasia in Flemish Catholic hospitals may reflect the concern of healthcare administrators to maintain the quality of care for patients requesting euthanasia. However, the true contribution of these policies to quality end-of-life care and to supporting caregivers remains unknown and needs further research. Legislation and centrally developed guidelines might influence healthcare institutions to develop ethics policies.
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Ethics, economics, and the erosion of physician authority: a leadership role for nurses.
Rambur, B
1998-06-01
The emergence of managed care raises new concerns about the ethics of health care financing and its impact on service delivery. The current outcry, however, fails to recognize that American health care financing has presented serious ethical dilemmas for at least 50 years. What follows is a historic overview of American health care financing, contrasted with current challenges. The intersection between ethics, economics, professionalism, and public authority is explicated, with a critical leader/advocate role for nurses presented.
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Workplace Incivility in Nursing: A Literature Review Through the Lens of Ethics and Spirituality.
Phillips, Gwenda Smith; MacKusick, Carol Isaac; Whichello, Ramona
A literature review was conducted to evaluate existing knowledge of incivility in the nursing workplace through the lens of nursing ethics and spirituality. Study articles presented a consistent theme of improved organizational commitment and job satisfaction when spirituality was injected into the workplace. It seems plausible to suggest a positive correlation between spirituality and more civil environments in nursing workplaces.
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Davison, Colleen M; Kahwa, Eulalia; Atkinson, Uki; Hepburn-Brown, Cerese; Aiken, Joyette; Dawkins, Pauline; Rae, Tania; Edwards, Nancy; Roelofs, Susan; MacFarlane, Denise
2013-02-01
As part of a multinational program of research, we undertook a community-based participatory research project in Jamaica to strengthen nurses' engagement in HIV and AIDS policy. Three leadership hubs were purposefully convened and included small groups of people (6-10) from diverse HIV and AIDS stakeholder groups in Jamaica: frontline nurses and nurse managers in primary and secondary care settings; researchers; health care decision makers; and other community members. People living with HIV or AIDS were among the hub members. Using a relational public health ethics framework, we outline some of the ethical challenges and opportunities experienced by the research team and the leadership hubs. Data included research assistant field notes and hub progress reports. Emerging ethical concerns were associated with relational personhood, social justice, relational autonomy, relational solidarity, and sustainability of the hub activities.
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Noh, Yoon Goo; Jung, Myun Sook
2016-12-01
The purpose of this study was to analyze the paths of influence that a hospital's ethical climate exerts on nurses' organizational commitment and organizational citizenship behavior, with supervisor trust as the mediating factor, and verify compatibility of the models in hospital nurses. The sample consisted of 374 nurses recruited from four hospitals in 3 cities in Korea. The measurements included the Ethical Climate Questionnaire, Supervisor Trust Questionnaire, Organizational Commitment Questionnaire and Organizational Citizenship Behavior Questionnaire. Ethical Climate Questionnaire consisted of 6 factors; benevolence, personal morality, company rules and procedures, laws and professional codes, self-interest and efficiency. Data were analysed using SPSS version 18.0 and AMOS version 18.0. Supervisor trust was explained by benevolence and self-interest (29.8%). Organizational commitment was explained by benevolence, supervisor trust, personal morality, and rules and procedures (40.4%). Organizational citizenship behavior was explained by supervisor trust, laws and codes, and benevolence (21.8%). Findings indicate that managers need to develop a positive hospital ethical climate in order to improve nurses' trust in supervisors, organizational commitment and organizational citizenship behavior.
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Moving life science ethics debates beyond national borders: some empirical observations.
Bezuidenhout, Louise
2014-06-01
The life sciences are increasingly being called on to produce "socially robust" knowledge that honors the social contract between science and society. This has resulted in the emergence of a number of "broad social issues" that reflect the ethical tensions in these social contracts. These issues are framed in a variety of ways around the world, evidenced by differences in regulations addressing them. It is important to question whether these variations are simply regulatory variations or in fact reflect a contextual approach to ethics that brings into question the existence of a system of "global scientific ethics". Nonetheless, within ethics education for scientists these broad social issues are often presented using this scheme of global ethics due to legacies of science ethics pedagogy. This paper suggests this may present barriers to fostering international discourse between communities of scientists, and may cause difficulties in harmonizing (and transporting) national regulations for the governance of these issues. Reinterpreting these variations according to how the content of ethical principles is attributed by communities is proposed as crucial for developing a robust international discourse. To illustrate this, the paper offers some empirical fieldwork data that considers how the concept of dual-use (as a broad social issue) was discussed within African and UK laboratories. Demonstrating that African scientists reshaped the concept of dual-use according to their own research environmental pressures and ascribed alternative content to the principles that underpin it, suggests that the limitations of a "global scientific ethics" system for these issues cannot be ignored.
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The art and learning patterns of knowing in nursing
Directory of Open Access Journals (Sweden)
Cristina Lavareda Baixinho
2014-12-01
Full Text Available Objective To identify the perception of the students about the use of art as a pedagogical strategy in learning the patterns of knowing in nursing; to identify the dimensions of each pattern valued in the analysis of pieces of art. Method Descriptive mixed study. Data collection used a questionnaire applied to 31 nursing students. Results In the analysis of the students’ discourse, it was explicit that empirical knowledge includes scientific knowledge, tradition and nature of care. The aesthetic knowledge implies expressiveness, subjectivity and sensitivity. Self-knowledge, experience, reflective attitude and relationships with others are the subcategories of personal knowledge and the moral and ethics support ethical knowledge. Conclusion It is possible to learn patterns of knowledge through art, especially the aesthetic, ethical and personal. It is necessary to investigate further pedagogical strategies that contribute to the learning patterns of nursing knowledge.
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Blended learning in ethics education: a survey of nursing students.
Hsu, Li-Ling
2011-05-01
Nurses are experiencing new ethical issues as a result of global developments and changes in health care. With health care becoming increasingly sophisticated, and countries facing challenges of graying population, ethical issues involved in health care are bound to expand in quantity and in depth. Blended learning rather as a combination of multiple delivery media designed to promote meaningful learning. Specifically, this study was focused on two questions: (1) the students' satisfaction and attitudes as members of a scenario-based learning process in a blended learning environment; (2) the relationship between students' satisfaction ratings of nursing ethics course and their attitudes in the blended learning environment. In total, 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were invited to participate in this study. A cross-sectional survey design was adopted in this study. The participants were asked to fill out two Likert-scale questionnaire surveys: CAAS (Case Analysis Attitude Scale), and BLSS (Blended Learning Satisfaction Scale). The results showed what students felt about their blended learning experiences - mostly items ranged from 3.27-3.76 (the highest score is 5). Another self-assessment of scenario analysis instrument revealed the mean scores ranged from 2.87-4.19. Nearly 57.8% of the participants rated the course 'extremely helpful' or 'very helpful.' This study showed statistically significant correlations (r=0.43) between students' satisfaction with blended learning and case analysis attitudes. In addition, results testified to a potential of the blended learning model proposed in this study to bridge the gap between students and instructors and the one between students and their peers, which are typical of blended learning, and to create meaningful learning by employing blended pedagogical consideration in the course design. The use of scenario instruction enables students to develop critical
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Virtue-based Approaches to Professional Ethics: a Plea for More Rigorous Use of Empirical Science
Georg Spielthenner
2017-01-01
Until recently, the method of professional ethics has been largely principle-based. But the failure of this approach to take into sufficient account the character of professionals has led to a revival of virtue ethics. The kind of professional virtue ethics that I am concerned with in this paper is teleological in that it relates the virtues of a profession to the ends of this profession. My aim is to show how empirical research can (in addition to philosophical inquiry) be used to develop vi...
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d'Amore, Maurizia; Peroni, Antonia
2008-01-01
In 2006, 279 nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service. The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation : this confirmed one of the aspects of the study : poor levels of motivation and sense of belonging can be correlated to insufficient ethical information in local health organizations. The main working needs that emerged among the nurses of this hospital regarded economical retribution (90%), security and success (88%) , belonging (86%) and self-satisfaction (77%): the need for power was relatively low (40%). The strong points of the study were : the strong involvement of nurses, the value of the information gathered regarding working motivation, sense of belong to a nursing organization , working needs , ethical information in health environments, organization according to targets. The limits of the study were: limited number of nurses in outsourcing at the time of the study (12%), impossibility of comparing the results with data prior to the outsourcing choices made by the hospital in question.
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Institute of Scientific and Technical Information of China (English)
陈英
2011-01-01
目的 提高急诊科护士的伦理决策能力.方法 通过伦理决策过程,由护理团体对以往在急诊救治中的护理困境作出最佳伦理决策.结果使护士知晓伦理相关的理论,掌握应对护理实践中的护理伦理困惑的方法,提高护理伦理决策能力.结论 通过应用团体伦理决策法,培养和提高急诊科护士的伦理决策能力,有效地减少了护患医疗纠纷.%Objective: To increase the ethical decision - making capacity of nurses of emergency department. Method: Optimal ethical decisions are made by nursing group s discussion of the experience gathered from past ethical predicaments in emergency nursing. Result; Nurses are equipped with relevant ethical theories, measures of coping with possible ethical predicaments in future nursing practice, and increased capacity of nursing ethical decision - making. Conclusion: The ethical decision - making capacity of nurses of emergency department has been cultivated and increased by the approach of group ethical decision - making, resulting in a decrease in medical disputes between nurses and doctors.
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我国护理伦理学教育现状及原因分析%Current Status and Analysis on Nursing Ethics Education in China
Institute of Scientific and Technical Information of China (English)
伍永慧; 施雁
2012-01-01
目前,我国护理伦理学教育存在护生护理伦理学教育内容偏离临床实践需求,护理伦理学知识水平及应用程度较低,临床护士缺乏护理伦理学再教育的问题,其原因在于护理伦理学课程定位不明确,任课教师临床实践经验缺乏,重护理伦理学理论教学轻实践,部分医院尚未认识到护理伦理学的指导作用.对此,建议提升护理伦理学课程地位、注重培养护生决策能力、提高任课教师知识经验积累、合理制定护理伦理学再教育方案.%At present, some problems exist in the nursing ethics education such as the nursing ethics education content deviates the clinical practice needs, nursing ethics knowledge levels and application level is relatively low, clinical nurses lack of re - education of nursing ethics. The reasons are that the nursing ethics course orientation is unclear, the clinical practice experience of the teachers is insufficient, pay too much attention on the nursing ethics theory but not practice, the guidance role of nursing ethics is not accepted in some hospitals. This paper proposed that promoting the nursing ethics course status, paying attention to the cultivation of decision - making ability, improving nursing experience of teachers, establishing a reasonable nursing ethics re - education scheme.
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Directory of Open Access Journals (Sweden)
Гадиля Гизатуллаевна Корноухова
2012-06-01
Full Text Available The article considers the confessional and ethical base of the Muslim entrepreneurship in the Russian Empire in the late 19th - early 20th centuries. The author analyzes the differentiation of the value-institutional system of the broad public on the one hand, and that of entrepreneurs - on the other hand. Whereas the former adhered to the national and ethical values of the traditional culture, the latter - to religious and moral values based on Islam and developed by the Russian Empire reformers of that period.
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Nagington, Maurice; Walshe, Catherine; Luker, Karen A
2016-03-01
Quality of care is a prominent discourse in modern health-care and has previously been conceptualised in terms of ethics. In addition, the role of knowledge has been suggested as being particularly influential with regard to the nurse-patient-carer relationship. However, to date, no analyses have examined how knowledge (as an ethical concept) impinges on quality of care. Qualitative semi-structured interviews were conducted with 26 patients with palliative and supportive care needs receiving district nursing care and thirteen of their lay carers. Poststructural discourse analysis techniques were utilised to take an ethical perspective on the current way in which quality of care is assessed and produced in health-care. It is argued that if quality of care is to be achieved, patients and carers need to be able to redistribute and redevelop the knowledge of their services in a collaborative way that goes beyond the current ways of working. Theoretical works and extant research are then used to produce tentative suggestions about how this may be achieved. © 2015 The Authors Nursing Inquiry Published by John Wiley & Sons Ltd.
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[Contribution to an ethics of care--masculinities and gender in the nursing profession].
Roy, Bernard; Holmes, Dave; Chouinard, Vincent
2011-12-01
Today, the nursing profession is almost exclusively associated to women while men seem to desert this field in which they were, before the nineteenth century, very present. This paper offers a critical look and reflects on the presence of men in nursing. The critical perspective of "genderization" as well as the "ethics of care" constitutes the cornerstone of the reflection developed in this paper. Prejudices against men in the field of nursing are also highlighted, which attest that the future of men in this profession is still not assured. From that point of view, the "degenderization" of nursing and the valorization of men in the history of nursing as well as in the current practice of nursing are presented as potential ways forward.
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Ethical decision making in clinical practice.
Fowler, M D
1989-12-01
Contemporary nursing ethics education focuses on the use of an analytical model of ethical decision making for both its process and its content. Perhaps this is the case because it bears some resemblance to the nursing process, which is taught in a similar fashion. Thus, a deductivist method of ethical decision making fits within the same general schema of the hypotheticodeductive method of decision making that is taught for nursing diagnosis. Ethics requires that nurses respect persons, inform patients and secure their consent, not inflict harm, preserve the patient's quality of life, prevent harm and remove harmful conditions, do good for patients, and minimize risk to themselves. These are among the norms of obligation that guide ethical analysis and judgment in nursing practice and are the substance of the analytical model of ethical decision making. Nursing's ethics has established high ideals and strong demands for nurses. These are demands which nurses have met and ideals which have often been realized. Whatever the strength of our science, nursing is an inherently moral endeavor and is only as strong as its commitment to its ethical obligations and values. Between the grinding edges of the forces that affect it, nursing must establish its priorities among the aspects of its environment that it attempts to control. Ethics must be chief among those priorities.
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Delayed clarification: information, clarification and ethical decisions in critical care in Norway.
Bunch, E H
2000-12-01
Following the analysis of about 150 hours of field observation on a critical care unit in Norway a theory was generated to explain the actual ethical decision-making process. This was grounded in the empirical reality of physicians, nurses and family. The core theme in this study was a delayed clarification in assessing the prognosis of accident victims with neurosurgical traumas. The physicians, nurses and family had to wait for the clinical picture to clarify, during which time there was an exchange and emergence of information. Exchanging information, a subprocess to delayed clarification, involved a continuous flow of collecting and dispersing information about the clinical status of the patient. The nurses engaged in two useful strategies: grading information to family when the patient prognosis was poor, and providing grieving strategies for themselves, colleagues and family members. The core variable, delayed clarification has three dimensions: clinical, psychological and ethical. The nurses participated in the decision-making process to discontinue treatment as passive participants, they did not engage in collegial deliberations with the physicians. Ethical dilemmas were end of life questions, resource allocations, and questions of justice and organ transplants.
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Nursing Students' Use of Electronic and Social Media: Law, Ethics, and E-Professionalism.
Westrick, Susan J
2016-01-01
This article discusses the promotion of professionalism in nursing students with regard to the use of electronic and social media. Misuse of social media can lead to disciplinary actions and program dismissal for students and to legal actions and lawsuits for nursing programs. Programs are concemed about breaches of patient confidentiality and release of private or inappropriate information that jeopardizes clinical placements and relationships. The American Nurses Association Code of Ethics and National Council of State Boards of Nursing social media guidelines provide a foundation for promoting e-professionalism in students. Recent law cases involving students who were dismissed from nursing programs due to social media misuse are analyzed. Schools need policies that clearly establish expectations and the consequences of misuse of social media platforms. Lessons learned from the legal cases presented provide further guidance for both nursing students and nursing programs.
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Moving Life Science Ethics Debates Beyond National Borders: Some Empirical Observations
Bezuidenhout, Louise
2016-01-01
The life sciences are increasingly being called on to produce “socially robust” knowledge that honors the social contract between science and society. This has resulted in the emergence of a number of “broad social issues” that reflect the ethical tensions in these social contracts. These issues are framed in a variety of ways around the world, evidenced by differences in regulations addressing them. It is important to question whether these variations are simply regulatory variations or in fact reflect a contextual approach to ethics that brings into question the existence of a system of “global scientific ethics”. Nonetheless, within ethics education for scientists these broad social issues are often presented using this scheme of global ethics due to legacies of science ethics pedagogy. This paper suggests this may present barriers to fostering international discourse between communities of scientists, and may cause difficulties in harmonizing (and transporting) national regulations for the governance of these issues. Reinterpreting these variations according to how the content of ethical principles is attributed by communities is proposed as crucial for developing a robust international discourse. To illustrate this, the paper offers some empirical fieldwork data that considers how the concept of dual-use (as a broad social issue) was discussed within African and UK laboratories. Demonstrating that African scientists reshaped the concept of dual-use according to their own research environmental pressures and ascribed alternative content to the principles that underpin it, suggests that the limitations of a “global scientific ethics” system for these issues cannot be ignored. PMID:24046220
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Park, Dong Won; Moon, Jae Young; Ku, Eun Yong; Kim, Sun Jong; Koo, Young-Mo; Kim, Ock-Joo; Lee, Soon Haeng; Jo, Min-Woo; Lim, Chae-Man; Armstrong, John David; Koh, Younsuck
2015-04-01
This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behaviorrelated issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-oflife (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behaviorrelated issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
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Rubinstein, Dorit; Tabak, Nili
2012-03-01
This research was designed to assess nurses' perceptions, knowledge, attitudes and intentions in relation to nurse participation in Healthcare Ethics Committees (HECs). A convenience sample of 87 nurses from five Israeli hospitals completed a self-administered questionnaire, whose data were then analyzed by quantitative statistics. The main findings were that large percentages of nurses were totally ignorant of the existence and functioning of the HEC in their workplaces. Nurses in managerial roles were (a) much more knowledgeable on these matters than staff nurses and (b) regarded more positively the idea that nurses had an obligation to sit on such committees. Workplace role and rank in the organizational hierarchy had a stronger impact on nurse attitudes to HEC work than level of education. Overall, nurse willingness to sit on an HEC and to take special training in preparation for such a role were high.
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The rise of empirical research in medical ethics: a MacIntyrean critique and proposal.
Lawrence, Ryan E; Curlin, Farr A
2011-04-01
Hume's is/ought distinction has long limited the role of empirical research in ethics, saying that data about what something is cannot yield conclusions about the way things ought to be. However, interest in empirical research in ethics has been growing despite this countervailing principle. We attribute some of this increased interest to a conceptual breakdown of the is/ought distinction. MacIntyre, in reviewing the history of the is/ought distinction, argues that is and ought are not strictly separate realms but exist in a close relationship that is clarified by adopting a teleological orientation. We propose that, instead of recovering a teleological orientation, society tends to generate its own goals via democratic methods like those described by Rousseau or adopt agnosticism about teleology such as described by Richard Rorty. In both latter scenarios, the distinction between is and ought is obscured, and the role for empirical research grows, but for controversial reasons. MacIntyre warns that the is/ought distinction should remain, but reminds ethicists to make careful arguments about when and why it is legitimate to move from is to ought.
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Directory of Open Access Journals (Sweden)
NG Mtshali
2001-09-01
Full Text Available A comparative descriptive study was conducted to establish whether the Comprehensive Basic Nursing Course (CBNC is able to develop students ethically, and how educational preparation from two different programmes (basic degree and basic diploma influence their ethical development. This study was conducted because of the concerns on the escalating number of litigations instituted against nurses. Several studies have indicated that some of these litigations are as a result of the growing complexity of the health care system and the society’s increasing awareness of their human rights. Some studies have shown that nurses are failing to make principled and ethically sound decisions because they are inadequately prepared to handle ethical issues in an ethically responsible manner. A purposively selected sample of third and fourth year students from both programmes was used. Data was collected from both groups through the use of questionnaires. The findings revealed that the students are developing ethically in a CBNC but the level of ethical development is influenced by their educational preparation, teaching approaches and strategies used, clinical environment, hospital bureaucracy, rules and policies.
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[Acute care nurses’ ethical reasoning: a thematic analysis].
Barandun Schäfer, Ursi; Ulrich, Anja; Meyer-Zehnder, Barbara; Frei, Irena Anna
2015-12-01
In the day-to-day course of nursing, ethical issues are being openly articulated to a growing extent. However, nurses only rarely systematically address these issues. This subject was explored in interviews with professionals who have a particular focus on ethics. Gain input for further developing the skills of nursing staff in ethical reasoning. In two focus groups and four individual interviews, we questioned 14 professionals, including nine nurses, who have a special interest in ethics. Nurses find it ethically problematic when the wishes of patients are not respected or something is forced on them, creating the impression that the care being given is exacerbating rather than alleviating the patient’s suffering. These problematic aspects are often overlooked because the consequences of the action in question are not immediately apparent. Ethical issues in nursing are often addressed in informal, non-systematic discussions among nursing staff. Nurses actively and confidently engage in discussions on treatment goals, and the teamwork with doctors is usually experienced as being based on mutual respect and partnership. The inherent hierarchical role differences between nursing and medical staff nevertheless manifest in ethical issues. Through the practical application of ethical reasoning in day-to-day nursing, structured discussions of the ethical aspects of cases and dedicated further education, nurses should learn to better recognise ethical issues in nursing and effectively analyse them and find solutions.
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Ethics in perioperative practice--patient advocacy.
Schroeter, Kathryn
2002-05-01
Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this second of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the third provision statement, which addresses nurses' position as patient advocates.
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Krautscheid, Lorretta C
2017-01-01
Despite the inclusion of ethics education in the formal curriculum, students felt ill-prepared to manage ethical issues and protect patients' health and well-being. Nursing students reported knowing what should be done to promote optimal patient care; however, they also reported an inability to act on their convictions due to fear of reprisal, powerlessness, and low confidence. Bloom's Taxonomy guided the development and implementation of experiential-applied ethics education via microethical dilemmas embedded in existing high-fidelity simulation (HFS) scenarios. Students were unaware that ethical dilemmas would be presented, replicating complex and spontaneous practice environments. Students reported that the educational strategy was powerful, increasing ethical decision-making confidence, empowering effective advocacy, and building courage to overcome fears and defend ethical practice. Simulation extends ethics education beyond the cognitive domain, ensuring the purposeful integration of affective and psychomotor learning, which promotes congruence between knowing what to do and acting on one's convictions. [J Nurs Educ. 2017;56(1):55-58.]. Copyright 2017, SLACK Incorporated.
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[The nursing role and ethical dimension of end of life care].
Daydé, Marie-Claude
2016-02-01
Supporting people in situations of precarity at the end of life is often fraught with complex problems, where one form of vulnerability amplifies another. This complexity requires interdisciplinary support, around the nursing care, to reflect together on the meaning of the action taken in an ethical approach. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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Patient participation: causing moral stress in psychiatric nursing?
Jansen, Trine-Lise; Hanssen, Ingrid
2017-06-01
The aim of this study was to explore psychiatric nurses' experiences and perspectives regarding patient participation. Patient participation is an ambiguous, complex and poorly defined concept with practical/clinical, organisational, legal and ethical aspects, some of which in psychiatric units may cause ethical predicaments and moral stress in nurses, for instance when moral caring acts are thwarted by constraints. An explorative quantitative pilot study was conducted at a psychiatric subacute unit through three focus group interviews with a total of nine participants. A thematic analytic approach was chosen. Preliminary empirical findings were discussed with participants before the final data analysis. Ethical research guidelines were followed. Patient participation is a difficult ideal to realise because of vagueness of aim and content. What was regarded as patient participation differed. Some interviewees held that patients may have a say within the framework of restraints while others saw patient participation as superficial. The interviewees describe themselves as patient's spokespersons and contributing to patients participating in their treatment as a great responsibility. They felt squeezed between their ethical values and the 'system'. They found themselves in a negotiator role trying to collaborate with both the doctors and the patients. Privatisation of a political ideal makes nurses vulnerable to burn out and moral distress. Nurses have a particular ethical responsibility towards vulnerable patients, and may themselves be vulnerable when caught in situations where their professional and moral values are threatened. Unclear concepts make for unclear division of responsibility. Patient participation is often a neglected value in current psychiatric treatment philosophy. When healthcare workers' ethical sensibilities are compromised, this may result in moral stress. © 2016 Nordic College of Caring Science.
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Research ethics in dissertations: ethical issues and complexity of reasoning.
Kjellström, S; Ross, S N; Fridlund, B
2010-07-01
Conducting ethically sound research is a fundamental principle of scientific inquiry. Recent research has indicated that ethical concerns are insufficiently dealt with in dissertations. To examine which research ethical topics were addressed and how these were presented in terms of complexity of reasoning in Swedish nurses' dissertations. Analyses of ethical content and complexity of ethical reasoning were performed on 64 Swedish nurses' PhD dissertations dated 2007. A total of seven ethical topics were identified: ethical approval (94% of the dissertations), information and informed consent (86%), confidentiality (67%), ethical aspects of methods (61%), use of ethical principles and regulations (39%), rationale for the study (20%) and fair participant selection (14%). Four of those of topics were most frequently addressed: the majority of dissertations (72%) included 3-5 issues. While many ethical concerns, by their nature, involve systematic concepts or metasystematic principles, ethical reasoning scored predominantly at lesser levels of complexity: abstract (6% of the dissertations), formal (84%) and systematic (10%). Research ethics are inadequately covered in most dissertations by nurses in Sweden. Important ethical concerns are missing, and the complexity of reasoning on ethical principles, motives and implications is insufficient. This is partly due to traditions and norms that discount ethical concerns but is probably also a reflection of the ability of PhD students and supervisors to handle complexity in general. It is suggested that the importance of ethical considerations should be emphasised in graduate and post-graduate studies and that individuals with capacity to deal with systematic and metasystematic concepts are recruited to senior research positions.
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Unresolved pain in children: a relational ethics perspective.
Olmstead, Deborah L; Scott, Shannon D; Austin, Wendy J
2010-11-01
It is considered the right of children to have their pain managed effectively. Yet, despite extensive research findings, policy guidelines and practice standard recommendations for the optimal management of paediatric pain, clinical practices remain inadequate. Empirical evidence definitively shows that unrelieved pain in children has only harmful consequences, with no benefits. Contributing factors identified in this undermanaged pain include the significant role of nurses. Nursing attitudes and beliefs about children's pain experiences, the relationships nurses share with children who are suffering, and knowledge deficits in pain management practices are all shown to impact unresolved pain in children. In this article, a relational ethics perspective is used to explore the need for nurses to engage in authentic relationships with children who are experiencing pain, and to use evidence-based practices to manage that pain in order for this indefensible suffering of children to end.
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Schwerdt, R
2005-08-01
The intraprofessional discourse about economical aspects in nursing from an ethical point of view has not taken place yet. To cope with the increasing restriction of resources, some preconditions have to be met: It is necessary to communicate issues in rationalizing and rationing in nursing openly. Person-oriented criteria in the nursing process indicate a high level of competence and user-oriented quality in nursing care. But nursing professionals do not decide in favor or against resources to perform this task on a high or poor quality level. Democratic decision-making on providing nursing services depends on a continuous societal discourse about allocation criteria.
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Nursing ethics: what lies ahead? The case of Bulgaria.
Popova, S
1996-03-01
In Bulgaria, we are sharing a transition to a civic society and a market economy, which means transferring to new parameters of our culture. Many old customs based on coercion, obedience and unacceptable interference are gradually dying out, and new principles tend to shape the way we live our collective lives. These include the ethics of partnership, which tend to create an assertion of individual rights and an affirmation of free will and autonomy, and within which the individual is protected in the pursuit of personal judgements. It is remarkable, however, that we have so much difficulty in talking about and identifying the most beneficial approaches for the achievement of the new design of our society. In this paper, I propose to illustrate the current crisis in nursing ethics with information mainly from Bulgaria. However, I think that the problems and trends in the other Eastern European countries are similar.
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Ethical dilemma and moral distress: proposed new NANDA diagnoses.
Kopala, Beverly; Burkhart, Lisa
2005-01-01
To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.
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Undergraduate healthcare ethics education, moral resilience, and the role of ethical theories.
Monteverde, Settimio
2014-06-01
This article combines foundational and empirical aspects of healthcare education and develops a framework for teaching ethical theories inspired by pragmatist learning theory and recent work on the concept of moral resilience. It describes an exemplary implementation and presents data from student evaluation. After a pilot implementation in a regular ethics module, the feasibility and acceptance of the novel framework by students were evaluated. In addition to the regular online module evaluation, specific questions referring to the teaching of ethical theories were added using simple (yes/no) and Likert rating answer formats. At the Bern University of Applied Sciences, a total of 93 students from 2 parallel sub-cohorts of the bachelor's program in nursing science were sent the online survey link after having been exposed to the same modular contents. A total of 62% of all students participated in the survey. The survey was voluntary and anonymous. Students were free to write their name and additional comments. Students consider ethical theories-as taught within the proposed framework-as practically applicable, useful, and transferable into practice. Teaching ethical theories within the proposed framework overcomes the shortcomings described by current research. Students do not consider the mutually exclusive character of ethical theories as an insurmountable problem. The proposed framework is likely to promote the effectiveness of healthcare ethics education. Inspired by pragmatist learning theory, it enables students to consider ethical theories as educative playgrounds that help them to "frame" and "name" the ethical issues they encounter in daily practice, which is seen as an expression of moral resilience. Since it does not advocate a single ethical theory, but is open to the diversity of traditions that shape ethical thinking, it promotes a culturally sensitive, ethically reflected healthcare practice. © The Author(s) 2013.
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The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing
Hassmiller, Susan; Bilazarian, Ani
2018-01-01
OBJECTIVE The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. METHODS A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. RESULTS Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. CONCLUSION Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement. PMID:29470381
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The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing.
Hassmiller, Susan; Bilazarian, Ani
2018-04-01
The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement.
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DEFF Research Database (Denmark)
Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth
2016-01-01
to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner...... on data collection. Design Discussion paper that draws on data from three phenomenological studies. Data sources Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews...... with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. Implication for nursing The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may...
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Kadivar, Maliheh; Mosayebi, Ziba; Asghari, Fariba; Zarrini, Pari
2015-01-01
The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians' and nurses' perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients' rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients' rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals.
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A synthesis of the literature on Asian nurses' work experiences in the United States.
Lin, Li-Chen
2009-01-01
Nursing shortages in the United States have underscored the need for foreign nurse recruitment. The major population of foreign nurse recruits has long been Asian. When employing foreign nurses, fair employment practices and quality of care must be ensured; however, few empirical studies were found on this topic. Thus, the purpose of this article is to synthesize the extant literature about Asian nurses' work experiences in and adaptation to the U.S. health care system. The author searched four major bibliographic databases, as well as the ProQuest Dissertation and Thesis Database and analyzed eight empirical studies based on four predetermined inclusion criteria. The major themes identified in the selected scholarly works were: (a) overcoming language barriers, (b) dealing with discrimination, (c) adopting U.S. nursing practices, (d) adjusting to U.S. social customs, (e) becoming accustomed to U.S. culture, and (f) reconciling work ethics. Additional research studies, using both quantitative and qualitative approaches, are necessary to gain in-depth knowledge related to this phenomenon.
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The Role of Empirical Research in Bioethics
Kon, Alexander A.
2010-01-01
There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. PMID:19998120
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Cohen-Mansfield, Jiska; Regier, Natalie G.; Peyser, Hedy; Stanton, Joshua
2009-01-01
Purpose: This is a pilot study that provides a description of the values older persons report in ethical wills and their reasoning for the values they chose, and compares the values in ethical wills of seniors and students. Nursing home residents rarely get the opportunity or venue to discuss these topics and the ethical will enables them to have…
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Global Voyeurism or Sustainable Ethical Practice?
Finn, Cris; Coast, Mary Jo
This is a conceptual article exploring global voyeurism and service, overlaying ethical considerations in service within the profession of forensic nursing. Key elements considered include examining and reflecting on personal motivations, benefits, and consequences of service when viewed through an ethical perspective. Through this article we seek to examine the relationships between poverty tourism and service, while better supporting individual forensic nurses in their quest to align their actions with the ethical and practice comportment standards within the profession of nursing service globally. We include definition of terms, including professional identity, ethics and social justice, poverty tourism and voyeurism, global and professional service, cultural humility, partnerships, and trusting relationships. We conclude with implications, and considerations for forensic nursing.
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Early indicators and risk factors for ethical issues in clinical practice.
Pavlish, Carol; Brown-Saltzman, Katherine; Hersh, Mary; Shirk, Marilyn; Nudelman, Olga
2011-03-01
Nurses in all clinical settings encounter ethical issues that frequently lead to moral distress. This critical incident study explored nurses' descriptions of ethically difficult situations to identify risk factors and early indicators of ethical conflicts. Employing the critical incident technique, researchers developed a questionnaire that collected information on ethically difficult situations, their risk factors and early indicators, nurse actions, and situational outcomes. Two nurse researchers independently analyzed and categorized data using a constant comparison technique. Most of the ethically difficult situations pertained to end-of-life care for children and adults. Conflicts in interpersonal relationships were prevalent. Nurses were especially moved by patient and family suffering and concerned about patient vulnerability, harm-benefit ratio, and patient autonomy. Researchers discovered risk factor categories for patients, families, healthcare providers, and health systems. Additionally, researchers found subcategories in six major categories of early indicators: signs of conflict, patient suffering, nurse distress, ethics violation, unrealistic expectations, and poor communication. Nurses are keenly aware of pertinent risk factors and early indicators of unfolding ethical conflicts. Many nurses reported feeling powerless in the face of ethical conflict. Research that develops interventions to strengthen nurses' voices in ethically difficult situation is warranted. Nurses are in a key position to identify patient situations with a high risk for ethical conflict. Initiating early ethics consultation and interventions can alter the course of pending conflicts and diminish the potential for patient and family suffering and nurses' moral distress. © 2011 Sigma Theta Tau International.
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Eklund, Kerri
2016-01-01
The Guide to the Code of Ethics for Nurses is an excellent guideline for all nurses regardless of their area of practice. I greatly enjoyed reading the revisions in place within the 2015 edition and refreshing my nursing conscience. I plan to always keep my Guide to the Code of Ethics for Nurses near in order to keep my moral compass from veering off the path of quality care.
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Opportunity to discuss ethical issues during clinical learning experience.
Palese, Alvisa; Gonella, Silvia; Destrebecq, Anne; Mansutti, Irene; Terzoni, Stefano; Morsanutto, Michela; Altini, Pietro; Bevilacqua, Anita; Brugnolli, Anna; Canzan, Federica; Ponte, Adriana Dal; De Biasio, Laura; Fascì, Adriana; Grosso, Silvia; Mantovan, Franco; Marognolli, Oliva; Nicotera, Raffaela; Randon, Giulia; Tollini, Morena; Saiani, Luisa; Grassetti, Luca; Dimonte, Valerio
2018-01-01
Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much'). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues
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Noddings's caring ethics theory applied in a paediatric setting.
Lundqvist, Anita; Nilstun, Tore
2009-04-01
Since the 1990s, numerous studies on the relationship between parents and their children have been reported on in the literature and implemented as a philosophy of care in most paediatric units. The purpose of this article is to understand the process of nurses' care for children in a paediatric setting by using Noddings's caring ethics theory. Noddings's theory is in part described from a theoretical perspective outlining the basic idea of the theory followed by a critique of her work. Important conceptions in her theory are natural caring (reception, relation, engrossment, motivational displacement, reciprocity) and ethical caring (physical self, ethical self, and ethical ideal). As a nurse one holds a duty of care to patients and, in exercising this duty, the nurse must be able to develop a relationship with the patient including giving the patient total authenticity in a 'feeling with' the patient. Noddings's theory is analysed and described in three examples from the paediatrics. In the first example, the nurse cared for the patient in natural caring while in the second situation, the nurse strived for the ethical caring of the patient. In the third example, the nurse rejected the impulse to care and deliberately turned her back to ethics and abandoned her ethical caring. According to the Noddings's theory, caring for the patient enables the nurse to obtain ethical insights from the specific type of nursing care which forms an important contribution to an overall increase of an ethical consciousness in the nurse.
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American Nurses Association Nursing World
... Standards Nursing Quality Ethics / Genetics & Genomics Code of Ethics Workplace Safety / Safe Patient Handling Needlestick Prevention Environmental Health Policy & Advocacy / Take Action Position Statements Member ...
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The development and psychometric validation of the Ethical Awareness Scale.
Milliken, Aimee; Ludlow, Larry; DeSanto-Madeya, Susan; Grace, Pamela
2018-04-19
To develop and psychometrically assess the Ethical Awareness Scale using Rasch measurement principles and a Rasch item response theory model. Critical care nurses must be equipped to provide good (ethical) patient care. This requires ethical awareness, which involves recognizing the ethical implications of all nursing actions. Ethical awareness is imperative in successfully addressing patient needs. Evidence suggests that the ethical import of everyday issues may often go unnoticed by nurses in practice. Assessing nurses' ethical awareness is a necessary first step in preparing nurses to identify and manage ethical issues in the highly dynamic critical care environment. A cross-sectional design was used in two phases of instrument development. Using Rasch principles, an item bank representing nursing actions was developed (33 items). Content validity testing was performed. Eighteen items were selected for face validity testing. Two rounds of operational testing were performed with critical care nurses in Boston between February-April 2017. A Rasch analysis suggests sufficient item invariance across samples and sufficient construct validity. The analysis further demonstrates a progression of items uniformly along a hierarchical continuum; items that match respondent ability levels; response categories that are sufficiently used; and adequate internal consistency. Mean ethical awareness scores were in the low/moderate range. The results suggest the Ethical Awareness Scale is a psychometrically sound, reliable and valid measure of ethical awareness in critical care nurses. © 2018 John Wiley & Sons Ltd.
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Empirical Moral Philosophy and Teacher Education
Schjetne, Espen; Afdal, Hilde Wågsås; Anker, Trine; Johannesen, Nina; Afdal, Geir
2016-01-01
In this paper, we explore the possible contributions of empirical moral philosophy to professional ethics in teacher education. We argue that it is both possible and desirable to connect knowledge of how teachers empirically do and understand professional ethics with normative theories of teachers' professional ethics. Our argument is made in…
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Evaluating a Web-based Graduate Level Nursing Ethics Course: Thumbs Up or Thumbs Down?
McAlpine, Heather; Lockerbie, Linda; Ramsay, Deyanne; Beaman, Sue
2002-01-01
Student and teacher opinions were obtained regarding a Web-based ethics course for nursing graduate students. Both groups had positive views of online discussions; critical and reflective thinking was enhanced; technical difficulties were overcome with the help of expert support services; compressed time frame was a drawback; and ways to enhance…
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De Vries, Kay; Plaskota, Marek
2017-04-01
Palliative sedation is a method of symptom management frequently used in hospices to treat uncontrolled symptoms at the end of life. There is a substantial body of literature on this subject; however, there has been little research into the experiences of hospice nurses when administering palliative sedation in an attempt to manage the terminal restlessness experienced by cancer patients. Semistructured interviews were conducted with a purposive sample of seven hospice nurses who had cared for at least one patient who had undergone palliative sedation within the past year in a hospice in the south of England in the United Kingdom. A phenomenological approach and Colaizzi's stages of analysis were employed to develop themes from the data. Facilitating a "peaceful death" was the primary goal of the nurses, where through the administration of palliative sedation they sought to enable and support patients to be "comfortable," "relaxed," and "calm" at the terminal stage of their illness. Ethical dilemmas related to decision making were a factor in achieving this. These were: medication decisions, "juggling the drugs," "causing the death," sedating young people, the family "requesting" sedation, and believing that hospice is a place where death is hastened. Hospice nurses in the U.K. frequently encounter ethical and emotional dilemmas when administering palliative sedation. Making such decisions about using palliative sedation causes general discomfort for them. Undertaking this aspect of care requires confidence and competence on the part of nurses, and working within a supportive hospice team is of fundamental importance in supporting this practice.
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Philanthropic dilemmas and the nurse administrator role.
Klein, Tracy
2014-01-01
Nurse administrators are in a position to encounter ethical dilemmas when evaluating philanthropic proposals. Nurses may have little formal training in ethics, or they may be most experienced with ethical frameworks that apply primarily to clinical patient encounters. Gifts of goods, services, education, or other benefits to nurses may create ethical dilemmas. Philanthropic ethics and potential dilemmas are discussed in nonnursing professions such as medicine and nonprofit administration but rarely explored in the nursing administration context. Nurse administrators in a position to evaluate generous offers of philanthropy should identify key components to fully assess the ethics of their receipt. A survey of several resources is done to provide nurse administrators with the foundation to develop policies related to philanthropy if they are absent, preferably in advance of the offer. Recommendations for assessment and evaluation of philanthropic proposals are provided to aid nurse administrators in their synthesis and application of ethical principles from multiple sources.
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Directory of Open Access Journals (Sweden)
Mukul Chopra
2013-07-01
Full Text Available Background: Recent raise in litigation againsthealthcare practitioners is definitely an issueof immediate concern and may reflect an in-crease in unethical practices by them. Profes-sional relations between physicians and nursesmay have differences with respect to their atti-tudes towards patient-care. Aim and Objec-tives: To assess the knowledge of, and attitudesto healthcare ethics among north Indian physi-cians and nurses. Material and Methods: Thepresent cross sectional study was carried outamong 298 physicians and 107 nurses of threemedical colleges of northern India in the monthof July-August 2011 using pretested self ad-ministered questionnaire. Data analysis wasdone using SPSS version 20. Result and Con-clusion: There was a statistically significantdifference between the opinion of physiciansand nurses with respect to adherence to confi-dentiality, paternalistic attitude of doctors (doc-tors should do their best for the patient irre-spective of the patients opinion, informingclose relatives of a patients for consent proce-dures. The study highlighted gaps in the knowl-edge about practical aspects of health care eth-ics among physicians and nurses which theyencounter in day to day practice at workplace.Measures of workplace education like sensiti-zation workshops, CMEs, conferences onhealth care ethics would assist in bridging thisgap to a certain extent.
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Ethics and deontology of medical education and nurses in Portugual
Directory of Open Access Journals (Sweden)
Clara Costa Oliveira
2012-01-01
Full Text Available This article discusses deontological issues of health care professions in relation to their ethical foundation. We present four models of teaching ethics and deontology in doctors’ training and the results of a PhD research on the teaching of these subjects in nurses’ training in Portugal. Given the importance of bioethics in deontological training of health care professions, we present a comparative analysis of. bioethical principles enunciated by Beauchamp and Childress (1979, related to ‘ethics of justice’, and Kemp’s(2000 proposal, associated to an ‘ethics of care’. Given the ambiguity of these bioethical expressions, we focus on the analysis of its contents and the need to discuss the fundamentals of ethical training of doctors and nurses in relation to the ethical theories they are derived from. Utilitarian ethics, duty ethics, virtue ethics, when the analysis of bioethics’ fundaments is not trained, the duty of caring of suffering can be put at risk.Abstract Abordaremos a deontologia de profissões de saúde (médicos e enfermeiros, relacionando-a com os seus fundamentos éticos. Apresentamos quatro modelos de ensino da ética e deontologia na formação dos médicos, e os resultados da pesquisa de doutorado sobre o ensino dessas disciplinas na formação de enfermeiros em Portugal. Dada a importância da bioética na formação desses profissionais, explicitam-se duas orientações fundamentais neste campo: os princípios bioéticos enunciados por Beauchamp e Childress(1979, relacionados com uma ‘ética da justiça’, e a proposta de Kemp(2000, próxima de uma ‘ética do cuidado’. Dada a ambiguidade dos termos ‘ética da justiça’ e ‘ética do cuidado’, detemo-nos na análise de seu conteúdo e na necessidade de discutir os fundamentos da formação ética de médicos e enfermeiros, reportando-os às concepções éticas de que se derivam: ética utilitarista, ética do dever, ética da virtude. Indicaremos
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Directory of Open Access Journals (Sweden)
Jochen Schmidt
2014-06-01
Full Text Available Since the publication of Anscombe’s famous paper “Modern Moral Philosophy” (1958, virtue ethics has become a matter of discussion among scholars. At least four charges have been raised against virtue ethics, one of which is the charge of promoting undue enthusiasm regarding the moral fitness of human beings. This article explores the limits of virtue ethics with regard to the frailty of human virtuousness. After giving a report of the charges raised against virtue ethics from the perspective of empirical ethics, the author presents the idea of what he would like to call critical virtue ethics as seen by three Lutheran thinkers: Immanuel Kant, Friedrich Nietzsche and Martin Luther himself. He will demonstrate that the empirical contestation of virtue ethics shows a remarkable resemblance to insights found in Luther, Kant and Nietzsche. And finally, the writer draws tentative conclusions about the future of critical virtue ethics.
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The Ethical Problems of Reserach : An empirical study of ethics in research practice
Colnerud, Gunnel
2013-01-01
Most accounts of the ethical problems facing researchers across a broad spectrum of research fields come from ethicists, ethics committees and specialists committed to the study of ethics in human research. In contrast, this study reports on the ethical questions that researchers, themselves, report facing in their everyday practice. Fifty-five Swedish researchers contributed 109 examples of ethical dilemmas, conflicts and problems in research. They were all researchers at the post-doctoral l...
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[Nursing care: an ethical act].
Gruat, Florence
2015-12-01
Care means taking care, paying extreme attention to others in vulnerable situations, "helping and not hurting". Admitting that ethical care exists would require recognizing that there are also treatments which are not ethical. However, care can only be ethical. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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Research methods in nursing students' Bachelor's theses in Sweden: A descriptive study.
Johansson, Linda; Silén, Marit
2018-07-01
During the nursing programme in Sweden, students complete an independent project that allows them to receive both a professional qualification as a nurse and a Bachelor's degree. This project gives students the opportunity to develop and apply skills such as critical thinking, problem-solving and decision-making, thus preparing them for their future work. However, only a few, small-scale studies have analysed the independent project to gain more insight into how nursing students carry out this task. The aim of the present study was to describe the methods, including ethical considerations and assessment of data quality, applied in nursing students' independent Bachelor's degree projects in a Swedish context. A descriptive study with a quantitative approach. A total of 490 independent projects were analysed using descriptive statistics. Literature reviews were the predominant project form. References were often used to support the analysis method. They were not, however, always relevant to the method. This was also true of ethical considerations. When a qualitative approach was used, and data collected through interviews, the participants were typically professionals. In qualitative projects involving analysis of biographies/autobiographies or blogs participants were either persons with a disease or next of kin of a person with a disease. Although most of the projects were literature reviews, it seemed unclear to the nursing students how the data should be analysed as well as what ethical issues should be raised in relation to the method. Consequently, further research and guidance are needed. In Sweden, independent projects are not considered research and are therefore not required to undergo ethics vetting. However, it is important that they be designed so as to avoid possible research ethics problems. Asking persons about their health, which occurred in some of the empirical projects, may therefore be considered questionable. Copyright © 2018 Elsevier Ltd. All
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Williams, Izaak L
2016-01-01
Patients' admission to modern substance use disorder treatment comes with the attendant risk of being discharged from treatment-a widespread practice. This article describes the three mainstream theories of addiction that operate as a reference point for clinicians in reasoning about a decision to discharge a patient from treatment. The extant literature is reviewed to highlight the pathways that patients follow after administrative discharge. Little scientific research has been done to investigate claims and hypotheses about the therapeutic function of AD, which points to the need for empirical ethics to inform clinical addictions practice. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
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Colaco, Keith A; Courtright, Alanna; Andreychuk, Sandra; Frolic, Andrea; Cheng, Ji; Kam, April Jacqueline
2018-01-01
We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments (EDs) in order to build ethics capacity and provide a foundation for the development of an ethics education programme. This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity. Of the 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress (16%), conflict management with patients or families (16%) and resource issues (15%). Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams (42%) was the most desired method. Nurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Nicholls, Stuart G; Hayes, Tavis P; Brehaut, Jamie C; McDonald, Michael; Weijer, Charles; Saginur, Raphael; Fergusson, Dean
2015-01-01
To date there is no established consensus of assessment criteria for evaluating research ethics review. We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction. Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial--randomised or otherwise--of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review. Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review.
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Kudo, Yasushi; Hayashi, Sachiko; Yoshimura, Emiko; Shibuya, Akitaka; Aizawa, Yoshiharu
2013-05-01
Nursing students must develop their abilities to provide appropriate nursing services. They need to acquire the level of nursing knowledge to pass the national examination according to Japanese law. Moreover, even if the awareness of the rights of people who receive nursing services increases, students must not have a sense of resistance toward those rights. Therefore, we investigated the factors associated with students' motivation to pass their examination and such a sense of resistance. We produced items related to reasons students wanted to become registered nurses with reference to job satisfaction and their learning environment (e.g., teachers' manners and school events unrelated to the examination). There were 3,417 female nursing students analyzed in 29 vocational schools that allow graduation after a 3-year study period (average age, 21.93 years [standard deviation, 5.44]). Older and third-year students had a stronger motivation to pass the examination and a weaker sense of resistance to people's rights compared with younger and first- to second-year students. Students who answered a "Lack of enthusiasm for becoming a registered nurse" had a weakened motivation and a strengthened sense of resistance. Factors enhancing students' motivation to pass their examination were "Professional commitment," "Desire for companionship," and "School events unrelated to the national examination." Factors strengthening students' sense of resistance to people's rights were "Living stability" and "Social appraisal." Teachers must develop methods to teach ethics so that their students respect the rights of people who receive nursing services and to ensure that they acquire the necessary nursing knowledge.
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Directory of Open Access Journals (Sweden)
Dulcinéia Ghizoni Schneider
2011-12-01
Full Text Available Objetivo principal: analizar los elementos de sustentación de discursos ético-profesionales, a partir de un caso ejemplar de proceso ético juzgado. Metodología: Estudio cualitativo con diseño exploratorio-descriptivo y documental, teniendo como fuente procesos éticos tramitados y archivados en el Consejo Regional de Enfermería/SC (Brasil, en el período de 1999 a 2007. Resultados principales: el caso ejemplar seleccionado (responsabilidad ético-profesional es representativo de discursos profesionales presentes en procesos éticos, en sus elementos de sustentación (enunciados, reglas y prácticas, y describe las referencias usadas por los profesionales para justificar sus deliberaciones morales, o dar legitimidad a los discursos accionados en estos juicios. Conclusión principal: los elementos de sustentación de los discursos, articulados en un modelo empírico analítico, son interesantes por dar visibilidad a los diseños de procesos de deliberación moral y, también, por suministrar un diseño general de los procesos éticos en su capacidad de "hablar para" y "hablar de la" Enfermería.Main goal: analyzing the supporting elements of ethical - professional discourses, from an exemplary case of a judged ethical process. Methodology: Qualitative study with documentary, descriptive and exploratory design, having as a source the ethical procedures conducted and filed at the Regional Council of Nursing / SC (Brazil, between 1999 and 2007. Main results: the exemplary case selected (ethical - professional responsibility is representative from professional discourses that are present in ethical processes, in their supporting elements (statements, rules and practices and describes references used by practitioners to justify their moral decisions or give legitimacy to the speeches triggered in those judgments. Main conclusion: discourses' supporting elements, articulated in the analytical -empirical model, are interesting for giving visibility
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Salloch, Sabine; Vollmann, Jochen; Schildmann, Jan
2014-09-01
Empirical studies on people's moral attitudes regarding ethically challenging topics contribute greatly to research in medical ethics. However, it is not always clear in which ways this research adds to medical ethics as a normative discipline. In this article, we aim to provide a systematic account of the different ways in which attitudinal research can be used for normative reflection. In the first part, we discuss whether ethical judgements can be based on empirical work alone and we develop a sceptical position regarding this point, taking into account theoretical, methodological and pragmatic considerations. As empirical data should not be taken as a direct source for normative justification, we then delineate different ways in which attitudes research can be combined with theoretical accounts of normative justification in the second part of the article. Firstly, the combination of attitudes research with normative-ethical theories is analysed with respect to three different aspects: (a) The extent of empirical data which is needed, (b) the question of which kind of data is required and (c) the ways in which the empirical data are processed within the framework of an ethical theory. Secondly, two further functions of attitudes research are displayed which lie outside the traditional focus of ethical theories: the exploratory function of detecting and characterising new ethical problems, and the field of 'moral pragmatics'. The article concludes with a methodological outlook and suggestions for the concrete practice of attitudinal research in medical ethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Directory of Open Access Journals (Sweden)
Hamed Hosseinzadeh
2016-08-01
Full Text Available Ethics, how to live and how to behave in a professional style and in a professional environment, both individual and organizational sets. In this regard, the present study was to determine the relationship between the ethics of the profession and improve the quality of care with nurses, hospital staff empowerment from the perspective of Ayatollah Rouhani was performed. The study was a descriptive one. The population consisted of nurses Ayatollah spiritual Babylon, which uses random sampling method, 163 samples were selected and evaluated. Collection tool was a questionnaire, content validity of the questionnaire in consultation with experts confirmed the reliability of the test-retest on 10% of the total of 2-week interval was calculated, and Cronbach's alpha for the whole questionnaire 0.85respectively. To analyze the data, structural equation modeling was used. The results showed that relations professional ethics to improve the quality of care (P <0.01 and staff empowerment (P <0.01 was significant. The ability of the staff as well as improve the quality of care (P <0.05 there was a significant relationship. Based on the results of research, professional ethics directly and indirectly improve the quality of nursing care was effective (P<0.05. In general it can be said that rely on moral and ethical management, increases the effectiveness of the approach is to improve the quality of care and sense of empowerment among nurses.
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Ethical Issues in Public Health Practice in Michigan
Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.
2009-01-01
Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850
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Kim, Jane Paik; Roberts, Laura Weiss
Empirical ethics inquiry works from the notion that stakeholder perspectives are necessary for gauging the ethical acceptability of human studies and assuring that research aligns with societal expectations. Although common, studies involving different populations often entail comparisons of trends that problematize the interpretation of results. Using graphical model selection - a technique aimed at transcending limitations of conventional methods - this report presents data on the ethics of clinical research with two objectives: (1) to display the patterns of views held by ill and healthy individuals in clinical research as a test of the study's original hypothesis and (2) to introduce graphical model selection as a key analytic tool for ethics research. In this IRB-approved, NIH-funded project, data were collected from 60 mentally ill and 43 physically ill clinical research protocol volunteers, 47 healthy protocol-consented participants, and 29 healthy individuals without research protocol experience. Respondents were queried on the ethical acceptability of research involving people with mental and physical illness (i.e., cancer, HIV, depression, schizophrenia, and post-traumatic stress disorder) and non-illness related sources of vulnerability (e.g., age, class, gender, ethnicity). Using a statistical algorithm, we selected graphical models to display interrelationships among responses to questions. Both mentally and physically ill protocol volunteers revealed a high degree of connectivity among ethically-salient perspectives. Healthy participants, irrespective of research protocol experience, revealed patterns of views that were not highly connected. Between ill and healthy protocol participants, the pattern of views is vastly different. Experience with illness was tied to dense connectivity, whereas healthy individuals expressed views with sparse connections. In offering a nuanced perspective on the interrelation of ethically relevant responses, graphical
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Conflict between nursing student's personal beliefs and professional nursing values.
Pickles, David; de Lacey, Sheryl; King, Lindy
2017-01-01
Studies have established that negative perceptions of people living with HIV/AIDS exist among nursing students throughout the world, perceptions which can be detrimental to the delivery of high-quality nursing care. The purpose of this research was to explore socio-cultural influences on the perceptions of nursing students towards caring for people living with HIV/AIDS. The study was guided by stigma theory, a qualitative descriptive research approach was adopted. Data collected via semi-structured interviews were thematically analysed. Participants and research context: Participants were 21 international and Australian undergraduate nursing students enrolled in a Bachelor of Nursing programme at an Australian university. Ethical considerations: Ethical approval was granted by the Social and Behavioural Research Ethics Committee at the study university. Participation was entirely voluntary; informed consent was obtained before the study commenced; confidentiality and anonymity were assured. Three major themes were found: blame, othering and values. Complex and interrelated factors constructed participant perceptions of people living with HIV/AIDS, perceptions underscored by the prevailing culturally construed blame and othering associated with HIV/AIDS. The study found discordance between the negative personal beliefs and perceptions some nursing students have towards people living with HIV/AIDS, and the professional values expected of them as Registered Nurses. There was considerable commonality between this and previous studies on how homosexuality and illicit drug use were perceived and stigmatised, correlating with the blame directed towards people living with HIV/AIDS. These perceptions indicated some nursing students potentially risked not fulfilling the ethical and professional obligations the Registered Nurse. Nursing curriculum should be strengthened in relation to comprehending the meaning of being stigmatised by society. Educational institutions need to
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Directory of Open Access Journals (Sweden)
Stuart G Nicholls
Full Text Available To date there is no established consensus of assessment criteria for evaluating research ethics review.We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction.Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial--randomised or otherwise--of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review.Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review.
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Nicholls, Stuart G.; Hayes, Tavis P.; Brehaut, Jamie C.; McDonald, Michael; Weijer, Charles; Saginur, Raphael; Fergusson, Dean
2015-01-01
Background To date there is no established consensus of assessment criteria for evaluating research ethics review. Methods We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction. Results Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial - randomised or otherwise – of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review. Discussion Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review. PMID:26225553
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Competence for older people nursing in care and nursing homes: An integrative review.
Kiljunen, Outi; Välimäki, Tarja; Kankkunen, Päivi; Partanen, Pirjo
2017-09-01
People living in care and nursing homes are vulnerable individuals with complex needs; therefore, a wide array of nursing competence is needed to ensure their well-being. When developing the quality of care in these units, it is essential to know what type of competence is required for older people nursing. The aim of this integrative review was to identify the competence needed for older people nursing in licensed practical nurses' and registered nurses' work in care and nursing homes. Integrative literature review. We performed an integrative review using Whittemore and Knafl's method. The CINAHL, MEDLINE, PsycINFO, SocINDEX and Scopus databases were searched for studies published from 2006 to April 2016. We assessed the quality of the studies using Joanna Briggs Institute critical appraisal tools and analysed the data by applying qualitative content analysis. Ten articles were included in the review. Most of the studies focused on registered nurses' work. We identified five competence areas that are needed for older people nursing in registered nurses' work in care and nursing homes: attitudinal and ethical, interactional, evidence-based care, pedagogical, and leadership and development competence. Empirical evidence of competence requirements related to licensed practical nurses' work in these facilities was scarce. The competence required for registered nurses and licensed practical nurses should be clearly identified to support competence management in the care and nursing home context. Well-educated nursing staff are needed in care and nursing homes to provide high-quality care because comprehensive and advanced nurse competence is required to meet the needs of older people. © 2016 John Wiley & Sons Ltd.
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Mauno, Saija; Ruokolainen, Mervi; Kinnunen, Ulla; De Bloom, Jessica
Aim. The study examined whether three resources, that is, compassion, transformational leadership and work ethic feasibility, buffer against the negative effects of emotional labour on work engagement. Background. Emotional labour is a common job stressor among nurses, but little is known about
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Professional nursing values: A concept analysis.
Schmidt, Bonnie J; McArthur, Erin C
2018-01-01
The aim of this concept analysis is to clarify the meaning of professional nursing values. In a time of increasing ethical dilemmas, it is essential that nurses internalize professional values to develop and maintain a professional identity. However, nursing organizations and researchers provide different conceptions of professional nursing values, leading to a lack of clarity as to the meaning and attributes of this construct. Walker and Avant's (2011) method was used to guide an analysis of this concept. Resources published from 1973 to 2016 were identified via electronic databases and hand-searching of reference lists. A review of the literature was completed and the data were analyzed to identify uses of the concept; the defining attributes of the concept; borderline, related, contrary, and illegitimate examples; antecedents and consequences; and empirical referents. Professional nursing values were defined as important professional nursing principles of human dignity, integrity, altruism, and justice that serve as a framework for standards, professional practice, and evaluation. Further research is needed in the development and testing of professional nursing values theory, and the reassessment of values instruments. Core professional values that are articulated may help unify the profession and demonstrate the value of nursing to the public. © 2017 Wiley Periodicals, Inc.
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'Nobody tosses a dwarf!' The relation between the empirical and the normative reexamined.
Leget, Carlo; Borry, Pascal; de Vries, Raymond
2009-05-01
This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as a point of departure because it challenges the reader to look with fresh eyes upon several central bioethical themes, including human dignity, autonomy, and the protection of vulnerable people. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theoretical ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. Against efforts fully to integrate the normative and the empirical into one synthesis, we propose that the two should stand in tension and relation to one another. The approach we endorse acknowledges that a social practice can and should be judged both by the gathering of empirical data and by normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical point of view. We conclude by applying our five-stage critical applied ethics to the example of dwarf tossing.
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On the moral nature of nursing practice.
Crowden, A
1994-12-01
Until recent times many nursing authors have relied on rather narrow interpretations of selected aspects from the broader discourse of ethics and moral philosophy in their writing on ethics in nursing. As a consequence, discourse in nursing ethics has been limited in its vision and far from comprehensive in its content. This can be seen in the large number of texts and journals which discuss issues in nursing ethics. Particularly in many of the nursing textbooks up to and including the 1960s, 1970s and, to a lesser extent, the early 1980s, ethics content is commonly framed in terms of the dilemmas of practice. Moreover, overall there is a preoccupation with either deontological or teleological positions and the application of corresponding analytical frameworks consistent with the particular view taken. In most texts the preferred view is deontological, with a predominating emphasis on principle and duty. Recently in nursing ethics there has been a focus towards the deconstruction of the dominant views in ethics encompassed by the more traditional perspectives. Consequently, as in other areas of applied and theoretical ethics, there has been a re-awakening of interest in the 'virtues', and in processes which encourage the articulation of ethical dimensions of practice in ways other than applying principles, rules and formulae to situations of clinical dilemma.
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Washing the patient: dignity and aesthetic values in nursing care.
Pols, Jeannette
2013-07-01
Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic values embedded in genres of sociality that relate to differences between people. The paper explores these values by way of an empirical ethical analysis of practices of washing psychiatric patients in nursing care. Nurses legitimate the washing of reluctant patients with reference to dignity. The analysis shows the intertwinement of humanitas and dignitas that gives dignity its fundamental meaning. © 2013 John Wiley & Sons Ltd.
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DEFF Research Database (Denmark)
Vistisen, Peter; Jensen, Thessa; Poulsen, Søren Bolvig
2015-01-01
This paper addresses the challenge of attaining ethical user stances during the design process of products and services and proposes animation-based sketching as a design method, which supports elaborating and examining different ethical stances towards the user. The discussion is qualified...... by an empirical study of Responsible Research and Innovation (RRI) in a Triple Helix constellation. Using a three-week long innovation workshop, U- CrAc, involving 16 Danish companies and organisations and 142 students as empirical data, we discuss how animation-based sketching can explore not yet existing user...... dispositions, as well as create an incentive for ethical conduct in development and innovation processes. The ethical fulcrum evolves around Løgstrup’s Ethical Demand and his notion of spontaneous life manifestations. From this, three ethical stances are developed; apathy, sympathy and empathy. By exploring...
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Level of Ethics, Ethical Frustration and Accountant Discretionary Practices
Tamminen, Rauno; Leskinen, Markku
1996-01-01
In this paper it is shown with the help of a small sample that accounting is ethically loaded; that there exists ethical frustration caused by situational factors related to accounting; and that most probably the situational pressures may also change the level of ethics in the Kohlbergian sense; and that in studying accounting-related ethical problems empirically, the paper-and pencil tests and interviewing may give biased results. The accountant's model of the world is supplemented with ...
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Weisberg, Mark; Duffin, Jacalyn
1995-01-01
A program that brings together students entering demanding professions (law, medicine, and nursing) to explore issues of ethics and professionalism is described. The course uses thought-provoking stories, classroom discussion, student journals, and collaborative teaching. Lessons learned from teaching the course a number of times are also…
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Bank Ethics:An Empirical Investigation of the Banking in China
Institute of Scientific and Technical Information of China (English)
刘春红; 宋玮
2004-01-01
Business ethics is considered critical for the reputation and competitive power of banks, especially in China after WTO Entry. This study applied the theory and research on ethical practices of successful managers and ethics control mechanisms to identify the ethical climates that result in ethical behaviors in the banking. 141 employees from different banks in Shanghai, China, completed measures of all scales in the survey. The results support the theorizing of the value of well-formed business ethics in the banking in China. The correlation and structural equation analysis suggests that ethical practices of successful managers and ethics control mechanisms of banks reinforce three ethical climates of 'service', 'law and rules' and 'caring' that promote the ethical level of employees, and the independence and instrumental climate on the contrary. This study also found that there are three ethics control mechanisms most commonly used in the banking and ethics-focused reward system is believed to be a mostly effective one by the employees of banking in China.
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Mechanisms Linking Ethical Leadership to Ethical Sales Behavior.
Wu, Yu-Chi
2017-06-01
This study investigated the relationship between ethical leadership and ethical sales behavior. A total of 248 matched surveys with participant responses from insurance agents and their customers were collected. The insurance agents were asked to rate the ethical leadership of their leaders, the ethical climate in their organization, and their individual moral identity. Customers were asked to rate the perceived ethical sales behavior of the insurance agents. This empirical study utilized moderated mediation techniques to analyze the data. Results indicated that ethical climate mediated the relationship between ethical leadership and ethical sales behavior when moral identity was high, however, did not when moral identity was low. The research framework including contextual effects (i.e., ethical climate) and individual differences in moral judgment (i.e., moral identity) can provide a comprehensive picture of how ethical leadership influences ethical sales behavior. Theoretical and practical implications of these findings are also discussed.
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Applied Ethics in Nowadays Society
Tomita CIULEI
2013-01-01
This special issue is dedicated to Nowadays Applied Ethics in Society, and falls in the field of social sciences and humanities, being hosted both theoretical approaches and empirical research in various areas of applied ethics. Applied ethics analyzes of a series of morally concrete situations of social or professional practice in order to make / adopt decisions. In the field of applied ethics are integrated medical ethics, legal ethics, media ethics, professional ethics, environmental ethic...
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[A "dialogue" between the aesthetics of nursing and philosophy].
Chang, Chia-Hsiu; Chen, Chung-Hey
2012-02-01
Nursing aesthetics belong to the broader school of aesthetics, a branch of philosophy, as well as the nursing arts, an element of professional nursing. The philosophy of aesthetics recognizes the connection between an author and appreciators and identifies both substantive and abstract aesthetic experiences in interpersonal communication through the fine arts. Nursing aesthetics values the meaningful moments of patients, is sensitive to the influences of different circumstances and situations, and appreciates the unique qualities of humanness. Nursing aesthetics is emancipatory knowledge and involves empirical, ethical and personal knowing. The article is based on a search of OvidSP and Chinese Electronic Periodical Services (CEPS) database references using key words including aesthetic, aesthetics, art of nursing, or nursing aesthetics as well as a review of books related to aesthetics, knowledge construction, and nursing aesthetics. Authors determined definitions as defined by nursing experts and the applications thereof in clinical practice. This article aimed to illustrate that the ultimate concern of philosophy is "goodness" and that the foundation of caring behaviors is "love". In practice, nursing aesthetics is expressed through empathy, appreciation, inspiration and the therapeutic use of the self. Through aesthetic knowing and enhanced perceptual sensibility and reflection, nurses can transform intuitive knowing into art-acts and ultimately enhance nursing care quality.
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Demographic factors associated with moral sensitivity among nursing students.
Tuvesson, Hanna; Lützén, Kim
2017-11-01
Today's healthcare environment is often characterized by an ethically demanding work situation, and nursing students need to prepare to meet ethical challenges in their future role. Moral sensitivity is an important aspect of the ethical decision-making process, but little is known regarding nursing students' moral sensitivity and its possible development during nursing education. The aims of this study were to investigate moral sensitivity among nursing students, differences in moral sensitivity according to sample sub-group, and the relation between demographic characteristics of nursing students and moral sensitivity. A convenience sample of 299 nursing students from one university completed a questionnaire comprising questions about demographic information and the revised Moral Sensitivity Questionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models, were used to investigate the relationship between demographic characteristics and moral sensitivity. Ethical considerations: The study followed the regulations according to the Swedish Ethical Review Act and was reviewed by the Ethics Committee of South-East Sweden. The findings showed that mean scores of nursing students' moral sensitivity were found in the middle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio = 3.32), age (odds ratio = 2.09; 1.73), and parental status (odds ratio = 0.31) were of relevance to nursing students' moral sensitivity. Academic year was found to be unrelated to moral sensitivity. These demographic aspects should be considered when designing ethics education for nursing students. Future studies should continue to investigate moral sensitivity in nursing students, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity in nursing students.
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Everyday ethical problems in dementia care: a teleological model.
Bolmsjö, Ingrid Agren; Edberg, Anna-Karin; Sandman, Lars
2006-07-01
In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and nurses' ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses' everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care.
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Directory of Open Access Journals (Sweden)
Maria Adelane Alves Monteiro
2008-12-01
Full Text Available This systematic literature review used nursing studies about "ethics" published in the SCIELO database. The objective was to identify the ethical dilemmas of nursing, based on a literature review of nursing publications between 2002 and 2006. Forty publications were found, of which seventeen were selected. The analysis of the articles permitted the organization of the following categories: ethics, the health system and nursing practice; ethics and nursing teaching-learning; ethics and nursing care. We noticed that the authors attributed a multidimensional approach to ethical issues. However, we considered it necessary to pay closer attention to the ethical aspects involved in nursing practice. There is a clear need for further studies, showing new ethical dilemmas experienced by nurses, so that they can contribute to a change in attitude, with outcomes for professional practice.Se trata de una revisión sistemática de la literatura, realizada en artículos del área de la enfermería, contenidos en el banco de datos SCIELO, y que abordaron el tema "ética". El estudio tuvo como objetivo identificar los dilemas éticos de la enfermería a partir de una revisión de la literatura en publicaciones sobre esa área, en el período de 2002 a 2006. Se localizaron cuarenta publicaciones, de las cuales fueron seleccionadas diecisiete. El análisis de los artículos permitió la organización de las categorías en: ética, el sistema de salud y la práctica de enfermería, ética y la enseñanza-aprendizaje en la enfermería y, ética y el cuidado de enfermería. Se percibió que los autores realizaron, sobre las cuestiones éticas, un abordaje multidimensional, entretanto, se consideró necesario, en este estudio, dar mayor atención a los aspectos éticos que se encuentran frecuentemente en la práctica de enfermería. Quedó clara la necesidad de realizar otros estudios que pongan en evidencia nuevos dilemas éticos vivenciados por enfermeros, en el
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Moore, Linda Weaver; Rieg, Linda S
2005-01-01
Cybernetics and cyborg technologies are rapidly developing in the field of biotechnology. Such developments have yielded a wide variety of devices and prosthetics that have promoted the quality of life for many individuals with physical limitations and generally have been applauded by society and the rehabilitation field. However, such rapid developments have given rise to multiple ethical concerns. Understanding these ethical concerns and the implications they have for rehabilitation nurses is imperative. While the potential benefits of advances in technology are great for those with disabilities and chronic conditions, ethicists suggest that skepticism must be balanced with the zeal that often accompanies cutting-edge developments. As Hook notes, "We must show not a fear of technology, but a courageous control of technology, and refuse to let technology control us" (2002, p. 67).
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“Nobody tosses a dwarf!” The relation between the empirical and normative reexamined
Leget, C.; Borry, P.; De Vries, R.
2009-01-01
This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as point of departure because it challenges the reader to look upon several central bioethical themes – including human dignity, autonomy, and the protection of vulnerable people – with fresh eyes. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theorist ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. The approach we endorse acknowledges that a social practice can and should be judged by both the gathering of empirical data and by the normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical poles that, in our view, should operate as two independent focuses of the ellipse that is called bioethics. We conclude by applying our five stage critical applied ethics to the example of dwarf tossing. PMID:19338523
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Screening situations for risk of ethical conflicts: a pilot study.
Pavlish, Carol L; Hellyer, Joan Henriksen; Brown-Saltzman, Katherine; Miers, Anne G; Squire, Karina
2015-05-01
Ethical conflicts, often leading to poor teamwork and moral distress, are very challenging to patients, patients' families, and health care providers. A proactive approach to ethical conflicts may improve patient care outcomes. To examine acceptability and feasibility of an ethics screening and early intervention tool for use by nurses caring for critically ill patients. Twenty-eight nurses in 2 medical centers applied the ethics screening tool to 55 patient situations. Nurses assessed situations for risk factors and early indicators of ethical conflicts and analyzed level of risk. At study completion, nurses participated in focus group discussions about the tool's benefits and challenges. Frequency counts were performed on risk factors and early indicators of ethical conflicts. Content analysis was used on written explanations regarding high-, medium-, and low-risk situations and on focus group data. Older patients with multiple comorbid conditions and aggressive treatments were frequently assessed to be at risk for ethical conflicts. Nurses who witnessed patients' suffering and deterioration were likely to initiate the screening process. The most prominent family risk factors included unrealistic expectations and adamancy about treatment. The most prominent early indicators were signs of patients' suffering, unrealistic expectations, and providers' own moral distress. High-risk situations averaged a greater number of risk factors and early indicators than did medium- and low-risk situations. Certain risk factors featured prominently in high-risk situations. A phenomenon of shared suffering emerged from the study and signifies the importance of relational strategies such as routine family conferences and ethics consultation. ©2015 American Association of Critical-Care Nurses.
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The Evolution of American Hospital Ethics Committees: A Systematic Review.
Courtwright, Andrew; Jurchak, Martha
2016-01-01
During the 1970s and 1980s, legal precedent, governmental recommendations, and professional society guidelines drove the formation of hospital ethics committees (HECs). The Joint Commission on Accreditation of Health Care Organization's requirements in the early 1990s solidified the role of HECs as the primary mechanism to address ethical issues in patient care. Because external factors drove the rapid growth of HECs on an institution-by-institution basis, however, no initial consensus formed around the structure and function of these committees. There are now almost 40 years of empirical studies on the composition, administration, and activities of HECs in the United States. We conducted a systematic review of the available empirical literature on HECs to describe their evolution. As HECs changed over time, they increased their total number of members and percentage of members from nursing and the community. Although physicians increasingly chaired these committees, their presence as a percentage of overall members declined. The percentage of administrative members remained steady, although committees became increasingly likely to have at least one administrative member. HECs were also increasingly likely to report to an administrative body or to the board of trustees or directors rather than to the medical staff. Finally, consultation volume increased steadily over time. There has not, however, been a national survey of the composition of ethics committees, their administration, or volume of consultation in more than 10 years, despite increasing calls for professional standards and quality improvement assessments among HECs. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
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Ethical issues in the qualitative researcher--participant relationship.
Eide, Phyllis; Kahn, David
2008-03-01
Qualitative research poses ethical issues and challenges unique to the study of human beings. In developing the interpersonal relationship that is critical to qualitative research, investigator and participant engage in a dialogic process that often evokes stories and memories that are remembered and reconstituted in ways that otherwise would not occur. Ethical issues are raised when this relationship not only provides qualitative research data, but also leads to some degree of therapeutic interaction for the participant. The purpose of this article is to examine some of the controversies inherent in the researcher's dilemma when this occurs, set within the context of a nursing caring theory (Swanson), and the International Council of Nurses Code of ethics for nurses, which provides guidance on global nursing practice.
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Simulations in nursing practice: toward authentic leadership.
Shapira-Lishchinsky, Orly
2014-01-01
Aim This study explores nurses' ethical decision-making in team simulations in order to identify the benefits of these simulations for authentic leadership. Background While previous studies have indicated that team simulations may improve ethics in the workplace by reducing the number of errors, those studies focused mainly on clinical aspects and not on nurses' ethical experiences or on the benefits of authentic leadership. Methods Fifty nurses from 10 health institutions in central Israel participated in the study. Data about nurses' ethical experiences were collected from 10 teams. Qualitative data analysis based on Grounded Theory was applied, using the atlas.ti 5.0 software package. Findings Simulation findings suggest four main benefits that reflect the underlying components of authentic leadership: self-awareness, relational transparency, balanced information processing and internalized moral perspective. Conclusions Team-based simulation as a training tool may lead to authentic leadership among nurses. Implications for nursing management Nursing management should incorporate team simulations into nursing practice to help resolve power conflicts and to develop authentic leadership in nursing. Consequently, errors will decrease, patients' safety will increase and optimal treatment will be provided. © 2012 John Wiley & Sons Ltd.
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Influencers of ethical beliefs and the impact on moral distress and conscientious objection.
Davis, Shoni; Schrader, Vivian; Belcheir, Marcia J
2012-11-01
Considering a growing nurse shortage and the need for qualified nurses to handle increasingly complex patient care situations, how ethical beliefs are influenced and the consequences that can occur when moral conflicts of right and wrong arise need to be explored. The aim of this study was to explore influencers identified by nurses as having the most impact on the development of their ethical beliefs and whether these influencers might impact levels of moral distress and the potential for conscientious objection. Nurses whose ethical beliefs were most influenced by their religious beliefs scored higher in levels of moral distress and demonstrated greater differences in areas of conscientious objection than did nurses who developed their ethical beliefs from influencers such as family values, life and work experience, political views or the professional code of ethics.
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Cutcliffe, John R; Links, Paul S
2008-08-01
It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries is that the individual owns his/her own body. Yet given that contemporary mental healthcare policy and associated practice positions do not reflect view, this can easily lead to the scenario where a Mental Health nurse is faced with a major ethical dilemma, and the corresponding probability of moral distress. The authors also find that it is inaccurate to posit a simple positive correlation between the potential seriousness and/or extent of bodily harm and the degree of paternalistic removal of an individual's rights to personal body ownership. Lastly, the authors find that the relevant theoretical and ethical literature in this area suggests, at least for some and under certain conditions, suicide can be the right thing to do.
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Doll therapy: an intervention for nursing home residents with dementia.
Shin, Juh Hyun
2015-01-01
The use of dolls as a therapeutic intervention for nursing home residents with dementia is relatively new. The current article describes a research study implemented with nursing home residents in Korea to examine the effects of doll therapy on their mood, behavior, and social interactions. A one-group, pretest-posttest design was used to measure the impact of doll therapy on 51 residents with dementia. Linear regression demonstrated statistically significant differences in aggression, obsessive behaviors, wandering, negative verbalization, negative mood, and negative physical appearance after introduction of the doll therapy intervention. Interactions with other individuals also increased over time. Findings support the benefits of doll therapy for nursing home residents with dementia; however, further research is needed to provide more empirical evidence and explore ethical considerations in the use of doll therapy in this vulnerable population. Copyright 2015, SLACK Incorporated.
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Directory of Open Access Journals (Sweden)
J. van Hoof
2018-04-01
Full Text Available Real-time location systems (RTLS can be implemented in aged care for monitoring persons with wandering behaviour and asset management. RTLS can help retrieve personal items and assistive technologies that when lost or misplaced may have serious financial, economic and practical implications. Various ethical questions arise during the design and implementation phases of RTLS. This study investigates the perspectives of various stakeholders on ethical questions regarding the use of RTLS for asset management in nursing homes. Three focus group sessions were conducted concerning the needs and wishes of (1 care professionals; (2 residents and their relatives; and (3 researchers and representatives of small and medium-sized enterprises (SMEs. The sessions were transcribed and analysed through a process of open, axial and selective coding. Ethical perspectives concerned the design of the system, the possibilities and functionalities of tracking, monitoring in general and the user-friendliness of the system. In addition, ethical concerns were expressed about security and responsibilities. The ethical perspectives differed per focus group. Aspects of privacy, the benefit of reduced search times, trust, responsibility, security and well-being were raised. The main focus of the carers and residents was on a reduced burden and privacy, whereas the SMEs stressed the potential for improving products and services.
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Evaluating the effect of three teaching strategies on student nurses' moral sensitivity.
Lee, Hsiao Lu; Huang, Shu-He; Huang, Chiu-Mieh
2017-09-01
The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy. To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory and kinaesthetic model, three strategies were developed for determining the programme components and corresponding learning styles. This was a quasi-experimental study. A total of 234 junior-college student nurses participated in this study. All participants were aged 18-19 years. Ethical considerations: The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score. The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies ( p = .042). Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning. This strategy was consistent with the student nurses' preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge.
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Ethical sensitivity in professional practice: concept analysis.
Weaver, Kathryn; Morse, Janice; Mitcham, Carl
2008-06-01
This paper is a report of a concept analysis of ethical sensitivity. Ethical sensitivity enables nurses and other professionals to respond morally to the suffering and vulnerability of those receiving professional care and services. Because of its significance to nursing and other professional practices, ethical sensitivity deserves more focused analysis. A criteria-based method oriented toward pragmatic utility guided the analysis of 200 papers and books from the fields of nursing, medicine, psychology, dentistry, clinical ethics, theology, education, law, accounting or business, journalism, philosophy, political and social sciences and women's studies. This literature spanned 1970 to 2006 and was sorted by discipline and concept dimensions and examined for concept structure and use across various contexts. The analysis was completed in September 2007. Ethical sensitivity in professional practice develops in contexts of uncertainty, client suffering and vulnerability, and through relationships characterized by receptivity, responsiveness and courage on the part of professionals. Essential attributes of ethical sensitivity are identified as moral perception, affectivity and dividing loyalties. Outcomes include integrity preserving decision-making, comfort and well-being, learning and professional transcendence. Our findings promote ethical sensitivity as a type of practical wisdom that pursues client comfort and professional satisfaction with care delivery. The analysis and resulting model offers an inclusive view of ethical sensitivity that addresses some of the limitations with prior conceptualizations.
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The complexity of nurses' attitudes toward euthanasia: a review of the literature.
Berghs, M; Dierckx de Casterlé, B; Gastmans, C
2005-08-01
In this literature review, a picture is given of the complexity of nursing attitudes toward euthanasia. The myriad of data found in empirical literature is mostly framed within a polarised debate and inconclusive about the complex reality behind attitudes toward euthanasia. Yet, a further examination of the content as well as the context of attitudes is more revealing. The arguments for euthanasia have to do with quality of life and respect for autonomy. Arguments against euthanasia have to do with non-maleficence, sanctity of life, and the notion of the slippery slope. When the context of attitudes is examined a number of positive correlates for euthanasia such as age, nursing specialty, and religion appear. In a further analysis of nurses' comments on euthanasia, it is revealed that part of the complexity of nursing attitudes toward euthanasia arises because of the needs of nurses at the levels of clinical practice, communication, emotions, decision making, and ethics.
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Directory of Open Access Journals (Sweden)
Tina Röbel
2016-10-01
Full Text Available As an effect of marketisation, the importance of workplace learning in Germany has increased. The article follows up on the long-standing discourse around the question of how economic and pedagogical ideals interact in this context. In order to develop a theoretical framework for empirical research, three major positions of the discipline of business ethics are introduced. Business ethics in more abstract ways deals with the very same question, namely how do ideas such as profit orientation interact with other norms and values? The new perspectives show that the discourse has been hitherto based on a specific understanding of economy. In order to derive an empirical answer to the research question, the question is re-formulated as follows: Which values are inherent in the decisions taken? Consequently, it suggests using the concept of "rationalities of justification" for empirical research. The article shows how this concept can be applied by conducting a test run.
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Virtuous acts as practical medical ethics: an empirical study.
Little, Miles; Gordon, Jill; Markham, Pippa; Rychetnik, Lucie; Kerridge, Ian
2011-10-01
To examine the nature, scope and significance of virtues in the biographies of medical practitioners and to determine what kind of virtues are at play in their ethical behaviour and reflection. A case study involving 19 medical practitioners associated with the Sydney Medical School, using semi-structured narrative interviews. Narrative data were analysed using dialectical empiricism, constant comparison and iterative reformulation of research questions. Participants represented virtuous acts as centrally important in their moral assessments of both themselves and others. Acts appeared to be contextually virtuous, rather than expressions of stable character traits, and virtue was linked to acts that served to protect or enhance fundamental values attached to ontological security and human flourishing. Virtue ethics, in this sense, was the single most important ethical system for each of the participants. Virtue ethics, construed as the appraisal of acts in contexts of risk, danger or threat to foundational values, emerged as the 'natural' ethical approach for medical practitioners in this case study. Teaching medical ethics to students and graduates alike needs to accommodate the priority attached to virtuous acts. © 2011 Blackwell Publishing Ltd.
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'Best interests' in paediatric intensive care: an empirical ethics study.
Birchley, Giles; Gooberman-Hill, Rachael; Deans, Zuzana; Fraser, James; Huxtable, Richard
2017-10-01
In English paediatric practice, English law requires that parents and clinicians agree the 'best interests' of children and, if this is not possible, that the courts decide. Court intervention is rare and the concept of best interests is ambiguous. We report qualitative research exploring how the best interests standard operates in practice, particularly with decisions related to planned non-treatment. We discuss results in the light of accounts of best interests in the medical ethics literature. We conducted 39 qualitative interviews, exploring decision making in the paediatric intensive care unit, with doctors, nurses, clinical ethics committee members and parents whose children had a range of health outcomes. Interviews were audio-recorded and analysed thematically. Parents and clinicians indicated differences in their approaches to deciding the child's best interests. These were reconciled when parents responded positively to clinicians' efforts to help parents agree with the clinicians' view of the child's best interests. Notably, protracted disagreements about a child's best interests in non-treatment decisions were resolved when parents' views were affected by witnessing their child's physical deterioration. Negotiation was the norm and clinicians believed avoiding the courts was desirable. Sensitivity to the long-term interests of parents of children with life-limiting conditions is defensible but must be exercised proportionately. Current approaches emphasise negotiation but offer few alternatives when decisions are at an impasse. In such situations, the instrumental role played by a child's deterioration and avoidance of the courts risks giving insufficient weight to the child's interests. New approaches to decision making are needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Can Ethical Leaders Heal The Wounds? An Empirical Research
Directory of Open Access Journals (Sweden)
Ufuk BASAR
2015-05-01
Full Text Available Leaders form the character and the nature of the organizations. In this respect ethical leaders may be the solution for organizations in corruption and employees in trouble. For this reason we treated ethical leadership as a healer, and analyzed its effects on intention to quit along with moderation effect of perceptions of organizational politics and mediation effect of organizational identification on this interaction. To that end, data were collected from 103 sales persons, who work at an international white good producing firm, in Ankara, Turkey through questionnaire. The data were analyzed with multifarious statistical techniques. The findings affirm healing effect of ethical leadership on intention to quit. In addition, as a new discovery, moderation effect of perceptions of organizational politics on healing effect of ethical leadership was found. Finally it was discovered that organizational identification and ethical leadership predict intention to quit separately.
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Impact of ethical climate on moral distress revisited: multidimensional view.
Atabay, Gülem; Çangarli, Burcu Güneri; Penbek, Şebnem
2015-02-01
Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and Cullen's framework, and moral distress intensity among nurses in Turkish healthcare settings. An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Factor analyses showed that moral distress had three dimensions, namely, organizational constraints, misinformed and over-treated patients, and lack of time and resources, while ethical climate had four types, namely, rules, well-being of stakeholders, individualism, and organizational interests. Positive correlations were identified between certain types of ethical climate (rules, individualism, or organizational interests) and moral distress intensity. Factor distribution of the scales shows some commonalities with the findings of previous research. However, context-specific dimensions and types were also detected. No particular ethical climate type was found to have a negative correlation with moral distress. Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical
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[Precision Nursing: Individual-Based Knowledge Translation].
Chiang, Li-Chi; Yeh, Mei-Ling; Su, Sui-Lung
2016-12-01
U.S. President Obama announced a new era of precision medicine in the Precision Medicine Initiative (PMI). This initiative aims to accelerate the progress of personalized medicine in light of individual requirements for prevention and treatment in order to improve the state of individual and public health. The recent and dramatic development of large-scale biologic databases (such as the human genome sequence), powerful methods for characterizing patients (such as genomics, microbiome, diverse biomarkers, and even pharmacogenomics), and computational tools for analyzing big data are maximizing the potential benefits of precision medicine. Nursing science should follow and keep pace with this trend in order to develop empirical knowledge and expertise in the area of personalized nursing care. Nursing scientists must encourage, examine, and put into practice innovative research on precision nursing in order to provide evidence-based guidance to clinical practice. The applications in personalized precision nursing care include: explanations of personalized information such as the results of genetic testing; patient advocacy and support; anticipation of results and treatment; ongoing chronic monitoring; and support for shared decision-making throughout the disease trajectory. Further, attention must focus on the family and the ethical implications of taking a personalized approach to care. Nurses will need to embrace the paradigm shift to precision nursing and work collaboratively across disciplines to provide the optimal personalized care to patients. If realized, the full potential of precision nursing will provide the best chance for good health for all.
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Dean, Peter J.
1993-01-01
Provides a review of the key ethical theories and relevant empirical research relating to the practice of human performance technology. Topics addressed include ethics, morals, business ethics, ethics officers, empiricism versus normative ethical theory, consequentialism, utilitarianism, nonconsequentialism, Kohlberg model of cognitive moral…
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Animal ethics based on friendship
Fröding, B.; Peterson, M.B.
2011-01-01
This article discusses some aspects of animal ethics from an Aristotelian virtue ethics point of view. Because the notion of friendship (philia) is central to Aristotle's ethical theory, the focus of the article is whether humans and animals can be friends. It is argued that new empirical findings
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Healthcare professionals' perceptions of the ethical climate in paediatric cancer care.
Bartholdson, Cecilia; Sandeberg, Margareta Af; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla
2016-12-01
How well ethical concerns are handled in healthcare is influenced by the ethical climate of the workplace, which in this study is described as workplace factors that contribute to healthcare professionals' ability to identify and deal with ethical issues in order to provide the patient with ethically good care. The overall aim of the study was to describe perceptions of the paediatric hospital ethical climate among healthcare professionals who treat/care for children with cancer. Data were collected using the Hospital Ethical Climate Survey developed by Olsson as a separate section in a questionnaire. Descriptive statistics were used to analyse perceptions of the ethical climate. Participants and research context: Physicians, nurses and nurse-aides (n = 89) from three paediatric units participated in this study: haematology/oncology, chronic diseases and neurology. Ethical considerations: The study was approved by the regional ethical review board. Different perceptions of the ethical climate were rated as positive or negative/neutral. Nurses' ratings were less positive than physicians on all items. One-third of the participants perceived that they were able to practice ethically good care as they believed it should be practised. Differences in professional roles, involving more or less power and influence, might explain why physicians and nurses rated items differently. A positive perception of the possibility to practice ethically good care seems to be related to inter-professional trust and listening to guardians/parents. A negative/neutral perception of the possibility to practice ethically good care appears to be influenced by experiences of ethical conflicts as well as a lack of ethical support, for example, time for reflection and discussion. The two-thirds of participants who had a negative/neutral perception of the possibility to practice ethically good care are at risk of developing moral stress. Clinical ethics support needs to be implemented in care
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Assessing and addressing moral distress and ethical climate, part 1.
Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine
2014-01-01
There is minimal research exploring moral distress and its relationship to ethical climate among nurses working in acute care settings. Objectives of the study were to explore moral distress, moral residue, and perception of ethical climate among registered nurses working in an academic medical center and develop interventions to address study findings. A mixed-methods design was used. Two versions of Corley and colleagues' Moral Distress Scale, adult and pediatric/neonatal, were used in addition to Olson's Hospital Ethical Climate Survey. Participants were invited to respond to 2 open-ended questions. This article reports the results for those nurses working in adult acute and critical care units. The sample (N = 225) was predominantly female (80%); half held a bachelor of science in nursing or higher, were aged 30 to 49 years, and staff nurses (77.3%). The mean item score for moral distress intensity ranged from 3.79 (SD, 2.21) to 2.14 (SD, 2.42) with mean item score frequency ranging from 2.86 (SD, 1.88) to 0.23 (SD, 0.93). The mean score for total Hospital Ethical Climate Survey was 94.39 (SD, 18.3) ranging from 23 to 130. Qualitative comments described bullying, lateral violence, and retribution. Inadequate staffing and perceived incompetent coworkers were the most distressing items. Almost 22% left a previous position because of moral distress and perceived the current climate to be less ethical compared with other participants. Findings may potentially impact nurse retention and recruitment and negatively affect the quality and safety of patient care. Interventions developed focus on the individual nurse, including ethics education and coping skills, intraprofessional/interprofessional approaches, and administrative/policy strategies.
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Pépin, Jacinthe
2015-06-01
The social contribution of nurses to the health of the population is mainly defined by the knowledge supporting their actions. Conceptualization in nursing guides the production and utilisation of scientific knowledge within the discipline. The purpose of this paper is to present the recent thoughts on nursing theory and to provide some strategies to integrate them within the activities of knowledge mobilization, in practice, research, and education. When nurses are engaged in mobilizing theoretical and empirical knowledge in answering nursing practice questions and in discussing social health issues, they participate in persons, families, and communities health improvement, while affirming their disciplinary and social identity. Called to be change agents in health care systems, with other professional team members, it is important that nurses be prepared to mobilize knowledge and to engage in critical reasoning, and ethical conduct. Their social contribution will be as strong as the value they assign to nursing knowledge and their participation in producing it.
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Ethical leadership: through the eyes of employees
Kalshoven, K.
2010-01-01
Ethical leaders in organizations are important for putting formal ethics programs into practice as they are role models of appropriate behaviors. The four empirical studies included in this dissertation examined the antecedents and outcomes of ethical leader behavior. In the studies ethical
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Opposing the nuclear threat: The convergence of moral analysis and empirical data
International Nuclear Information System (INIS)
Hehir, J.B.
1986-01-01
This paper examines the concept of nuclear winter from the perspective of religious and moral values. The objective is to identify points of intersection between the empirical arguments about nuclear winter and ethical perspectives on nuclear war. The analysis moves through three steps: (1) the context of the nuclear debate; (2) the ethical and empirical contributions to the nuclear debate; and (3) implications for policy drawn from the ethical-empirical data
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Assessment of knowledge of nurses regarding bioethics.
Saini, Radha; Saini, Parvesh; Alagh, Preety
2014-01-01
Nurses involved in research, whether as a principal investigator, a study coordinator, clinical trials nurse, or as a staff nurse caring for patients who are research subjects have a responsibility to promote the ethical conduct of clinical research. Will a registered nurse be ever able to challenge and infact unearth the unscrupulous medical practices which make poor patients guinea pigs in pharmaceutical company-sponsored clinical trials? Keeping this in view an exploratory study was carried out to assess the knowledge of bioethics among MSc Nursing students studying in recognised Nursing Colleges of North India. 92 percent of MSc nursing students scored below average knowledge regarding bioethics even after studying ethics in MSc (N) 1st year and B.Sc. Nursing degree programme. This research study strongly recommends the Indian Nursing Council-the statutory licensing body of nurses in India to ensure strict compliance of all researches (at masters as well as bachelors level) in nursing education with all the principles and components of bioethics. Need of the hour is to include at least one clinical nurse in the Institutional Ethics Committee in every medical and research institution.
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Mannix, Judy; Wilkes, Lesley; Daly, John
2015-06-01
To explore how aesthetic leadership is embodied by clinical leaders in the nursing workplace. A number of different leadership styles have been developed, theorised and applied to the nursing workforce over the years. Many of these styles lack an explicit moral dimension in their identified leader attributes, due to a shift in theorising of leadership to focus on the impact of leader traits on followers. It is timely to look at aesthetic leadership, with its explicit moral dimension, as a way of improving outcomes for nurses, patients and health care organisations. Qualitative design, using conversation-style interviews with experienced registered nurses in designated clinical leadership roles. Twelve experienced registered nurses who worked in designated clinical leadership roles participated in an individual, digitally recorded, semi-structured conversation-style interview. Narrative data were transcribed and subject to thematic analysis. Three main themes emerged: 'True to their beliefs': embodying principled practice; 'Not all policies fit every patient': ethical leadership in ambiguous situations; and 'Being open to people's concerns': providing fair and just solutions. A strong moral compass shaped and guided participants' day-to-day clinical leadership activities. Participants provided a rich narrative on how aesthetic leadership is embodied in the clinical nursing setting. It was evident that their clinical leadership is shaped and guided by a strong moral compass. By incorporating into their practice an aesthetic world-view with its strong moral purpose, participants in this study have shown how aesthetic leadership can enhance the clinical nursing workplace. Nurses in the clinical setting value clinical leaders who embrace and operate with a strong moral compass. Aesthetic leadership, with its explicit strong moral purpose, offers a way of incorporating morality into clinical leadership in the nursing workplace. © 2015 John Wiley & Sons Ltd.
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Instrumental and ethical aspects of experimental research with animal models
Directory of Open Access Journals (Sweden)
Mirian Watanabe
2014-02-01
Full Text Available Experimental animal models offer possibilities of physiology knowledge, pathogenesis of disease and action of drugs that are directly related to quality nursing care. This integrative review describes the current state of the instrumental and ethical aspects of experimental research with animal models, including the main recommendations of ethics committees that focus on animal welfare and raises questions about the impact of their findings in nursing care. Data show that, in Brazil, the progress in ethics for the use of animals for scientific purposes was consolidated with Law No. 11.794/2008 establishing ethical procedures, attending health, genetic and experimental parameters. The application of ethics in handling of animals for scientific and educational purposes and obtaining consistent and quality data brings unquestionable contributions to the nurse, as they offer subsidies to relate pathophysiological mechanisms and the clinical aspect on the patient.
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Clinical research ethics in Irish healthcare: diversity, dynamism and medicalization.
LENUS (Irish Health Repository)
Condell, Sarah L
2012-11-01
Gaining ethical clearance to conduct a study is an important aspect of all research involving humans but can be time-consuming and daunting for novice researchers. This article stems from a larger ethnographic study that examined research capacity building in Irish nursing and midwifery. Data were collected over a 28-month time frame from a purposive sample of 16 nurse or midwife research fellows who were funded to undertake full-time PhDs. Gaining ethical clearance for their studies was reported as an early \\'rite of passage\\' in the category of \\'labouring the doctorate\\'. This article penetrates the complexities in Irish clinical research ethics by describing the practices these nurse and midwife researchers encountered and the experiences they had. The key issue of representation that occurred in the context of \\'medicalized\\' research ethics is further explored including its meaning for nursing or midwifery research.
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Wasserman, Jason Adam; Stevenson, Shannon Lindsey; Claxton, Cassandra; Krug, Ernest F
2015-01-01
In light of the ongoing development and implementation of core competencies in bioethics, it is important to proceed with a clear sense of how bioethics knowledge is utilized in the functioning of hospital ethics committees (HECs). Without such an understanding, we risk building a costly edifice on a foundation that is ambiguous at best. This article examines the empirical relationship between traditional paradigms of bioethics theory and actual decision making by HEC members using survey data from HEC members. The assumption underlying the standardization of qualifications and corresponding call for increased education of HEC members is that they will base imminent case decisions on inculcated knowledge. Our data suggest, however, that HEC members first decide intuitively and then look for justification, thereby highlighting the need to re-examine the pedagogical processes of ethics education in the process of standardizing and improving competencies. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
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Green, Rebecca
2011-01-01
ABSTRACT The current global economic crisis is forcing governments to consider a variety of methods to generate funds for infrastructure. In the United States, smoking-related illness and an obesity epidemic are forcing public health institutions to consider a variety of methods to influence health behaviors of entire target groups. In this paper, the author uses a public health nursing model, the Public Health Code of Ethics (Public Health Leadership Society, 2002), the American Nurses' Association (ANA) Code of Ethics (2001), and other relevant ethical theory to weigh and balance the arguments for and against the use of sin taxes. A position advocating the limited use of sin taxes is supported as a reasonable stance for the public health professional. © 2010 Wiley Periodicals, Inc.
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Crawford, Doreen; Morris, Maryke
1994-01-01
"Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...
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Baykara, Zehra Gocmen; Demir, Sevil Guler; Yaman, Sengul
2015-09-01
Moral sensitivity is a life-long cognitive ability. It is expected that nurses who work in a professional purpose at "curing human beings" should have a highly developed moral sensitivity. The general opinion is that ethics education plays a significant role in this sense to enhance the moral sensitivity in terms of nurses' professional behaviors and distinguish ethical violations. This study was conducted as intervention research for the purpose of determining the effect of the ethics training on fourth-year students of the nursing department recognizing ethical violations experienced in the hospital and developing ethical sensitivity. The study was conducted with 50 students, with 25 students each in the experiment and control groups. Students in the experiment group were provided ethics training and consultancy services. The data were collected through the data collection form, which consists of questions on the socio-demographic characteristics and ethical sensitivity of the students, Moral Sensitivity Questionnaire, and the observation form on ethical principle violations/protection in the clinic environment. The data were digitized on the computer with the SPSS for Windows 13.0 program. The data were evaluated utilizing number, percentile calculation, paired samples t-test, Wilcoxon test, and the McNemar test. The total Moral Sensitivity Questionnaire pre-test score averages of students in the experiment group were determined to be 93.88 ± 13.57, and their total post-test score averages were determined to be 89.24 ± 15.90. The total pre-test score averages of students in the control group were determined to be 91.48 ± 17.59, and their total post-test score averages were determined to be 97.72 ± 19.91. In the study, it was determined that the post-training ethical sensitivity of students in the experiment group increased; however, this was statistically not significant. Furthermore, it was determined that the number of ethical principle protection
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Ebbesen, Mette; Pedersen, Birthe D
2007-01-01
Background This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. Method This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology
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Directory of Open Access Journals (Sweden)
Ebbesen Mette
2007-10-01
Full Text Available Abstract Background This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. Method This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of
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The community health clinics as a learning context for student nurses
Directory of Open Access Journals (Sweden)
MB Makupu
2000-09-01
Full Text Available The purpose of the research study was to describe guidelines to improve the community health clinics as a learning context conducive to learning. The objectives of the study commenced by getting the perception of student nurses from a nursing college in Gauteng; community sisters from ten community health clinics in the Southern Metropolitan Local Council and college tutors from a college in Gauteng. The research design and method used, consisting of a qualitative, exploratory, descriptive and contextual approach and the design was divided into two phases. Phase one consisted of a field/empirical study and phase two of conceptualization. In all the samples follow-up focus group interviews were conducted to confirm the findings. To ensure trustworthiness, Lincoln and Guba’s model (1985 was implemented and data analysis was according to Tesch’s model (1990 in Creswell 1994:155 based on a qualitative approach. The conceptual framework discussed, indicating a body of knowledge, was based on the study and empirical findings from phase one to give clear meaning and understanding regarding the research study. The research findings were then compared with existing literature within the framework, to determine similarities and differences as literature control method. Guidelines were then formulated from phase one and two to solve the indicated problems based on the three different sample groups. Ethical consideration was maintained throughout the research study. Recommendations related to nursing education, nursing practice and nursing research were indicated accordingly.
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Common-sense ethics in administrative decision making. Part I, Preparatory steps.
Sullivan, P A; Brown, T
1991-10-01
This is Part 1 of two articles demonstrating the relevance of business ethics to nurse administrators as they confront value-laden issues such as the advantages and disadvantages of 10-12-hour scheduling patterns, understaffing, emerging registered nurse partnerships, and other administrative problems. Common-sense ethics can serve as the basis of just administrative decisions. The authors present a model of preparatory attitudes and behaviors. The steps that they propose do not guarantee success, but if implemented, they may facilitate the nurse administrator's management of diverse ethical issues.
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Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth
2016-04-01
To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.
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Moral sensitivity relating to the application of the code of ethics.
Kim, Yong-Soon; Kang, Se-Won; Ahn, Jeong-Ah
2013-06-01
This study investigated the clinical application of the 2006 Third Revised Korean Nurses' Code of Ethics and the moral sensitivity of nurses. A total of 303 clinical nurses in South Korea participated in the survey in May and June 2011. As instruments of this study, we used the 15 statements of the Korean Nurses' Code of Ethics and Korean Moral Sensitivity Questionnaire. The mean score for application was 3.77 ± 0.59 (out of 5), and the mean score for moral sensitivity was 5.14 ± 0.55 (out of 7). The correlation coefficient (r) of the application and moral sensitivity was 0.336 (p moral sensitivity also scored high on application (t = -5.018, p moral sensitivity of nurses are necessary for improving the application of the code of ethics.
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Lee, Hyejung; Kim, Anna; Meong, Anna; Seo, Minjeong
2017-10-01
The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs). We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing. Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis. Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience. To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.
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Critical Realism and Empirical Bioethics: A Methodological Exposition.
McKeown, Alex
2017-09-01
This paper shows how critical realism can be used to integrate empirical data and philosophical analysis within 'empirical bioethics'. The term empirical bioethics, whilst appearing oxymoronic, simply refers to an interdisciplinary approach to the resolution of practical ethical issues within the biological and life sciences, integrating social scientific, empirical data with philosophical analysis. It seeks to achieve a balanced form of ethical deliberation that is both logically rigorous and sensitive to context, to generate normative conclusions that are practically applicable to the problem, challenge, or dilemma. Since it incorporates both philosophical and social scientific components, empirical bioethics is a field that is consistent with the use of critical realism as a research methodology. The integration of philosophical and social scientific approaches to ethics has been beset with difficulties, not least because of the irreducibly normative, rather than descriptive, nature of ethical analysis and the contested relation between fact and value. However, given that facts about states of affairs inform potential courses of action and their consequences, there is a need to overcome these difficulties and successfully integrate data with theory. Previous approaches have been formulated to overcome obstacles in combining philosophical and social scientific perspectives in bioethical analysis; however each has shortcomings. As a mature interdisciplinary approach critical realism is well suited to empirical bioethics, although it has hitherto not been widely used. Here I show how it can be applied to this kind of research and explain how it represents an improvement on previous approaches.
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Nonrational Processes in Ethical Decision Making
Rogerson, Mark D.; Gottlieb, Michael C.; Handelsman, Mitchell M.; Knapp, Samuel; Younggren, Jeffrey
2011-01-01
Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…
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Lin, Yu-Chih; Chan, Te-Fu; Lai, Chung-Sheng; Chin, Chi-Chun; Chou, Fan-Hao; Lin, Hui-Ju
2013-09-01
Clinical ethic situations in modern multiprofessional healthcare systems may involve different healthcare professions who work together for patient care. The undergraduate interprofessional education of clinical ethics would help to incubate healthcare students' ability of interprofessional collaboration in solving ethical problems. However, the impact from an interprofessional educational model on student's attitudes and confidence of interprofessional collaboration should be carefully evaluated during the process of curricular development. This study aimed to conduct a pilot interprofessional PBL curriculum of clinical ethics and evaluate the curricular impact on interprofessional students' attitude and confidence of collaborative teamwork. Thirty-six medical and nursing students volunteered to participate in this study and were divided into three groups (medical group, nursing group, and mixed group). Tutors were recruited from the Medical School and the College of Nursing. The pilot curriculum included one lecture of clinical ethics, one PBL case study with two tutorial sessions, and one session of group discussion and feedback. A narrative story with multiple story lines and a multiperspective problem analysis tool were used in the PBL tutorials. The students' self-evaluation of learning questionnaire was used to evaluate students' learning of clinical ethics and interprofessional collaborative skills and attitude. The internal consistency of the questionnaire was measured by Cronbach α, and the criterion-related validity of the questionnaire was evaluated through associations between the dimension scores with the student group by one-way analysis of variance test (ANOVA) test and Tukey-Kramer honestly significant difference (HSD) comparison. There was significant difference among different groups in students' ability and attitudes about "interprofessional communication and collaboration" (p = 0.0184). The scores in the mixed group (37.58 ± 3.26) were higher
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Directory of Open Access Journals (Sweden)
Yu-Chih Lin
2013-09-01
Full Text Available Clinical ethic situations in modern multiprofessional healthcare systems may involve different healthcare professions who work together for patient care. The undergraduate interprofessional education of clinical ethics would help to incubate healthcare students' ability of interprofessional collaboration in solving ethical problems. However, the impact from an interprofessional educational model on student's attitudes and confidence of interprofessional collaboration should be carefully evaluated during the process of curricular development. This study aimed to conduct a pilot interprofessional PBL curriculum of clinical ethics and evaluate the curricular impact on interprofessional students' attitude and confidence of collaborative teamwork. Thirty-six medical and nursing students volunteered to participate in this study and were divided into three groups (medical group, nursing group, and mixed group. Tutors were recruited from the Medical School and the College of Nursing. The pilot curriculum included one lecture of clinical ethics, one PBL case study with two tutorial sessions, and one session of group discussion and feedback. A narrative story with multiple story lines and a multiperspective problem analysis tool were used in the PBL tutorials. The students' self-evaluation of learning questionnaire was used to evaluate students' learning of clinical ethics and interprofessional collaborative skills and attitude. The internal consistency of the questionnaire was measured by Cronbach α, and the criterion-related validity of the questionnaire was evaluated through associations between the dimension scores with the student group by one-way analysis of variance test (ANOVA test and Tukey-Kramer honestly significant difference (HSD comparison. There was significant difference among different groups in students' ability and attitudes about “interprofessional communication and collaboration” (p = 0.0184. The scores in the mixed group (37
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General and professional values of student nurses and nurse educators.
Riklikiene, Olga; Karosas, Laima; Kaseliene, Snieguole
2018-03-01
The aim of this study was to explore and compare the self-reported general and professional values in undergraduate student nurses and nurse educators in Lithuania. Contemporary nursing requires strong moral motivation and clear values as nurses confront many ethical dilemas in their practice. Students acquire essential values of the nursing profession through the appropriate role modelling of their educators. Nursing students seek to become capable in providing ethical and professional patient care while their educators attempt to model desired behaviours. A national cross-sectional comparative study was carried out in March 2011. Four-hundred eight respondents participated: 316 undergraduate nursing students and 92 nurse educators. A 57-item questionnaire was delivered to nursing programs at three universities and six colleges. Permission to conduct the study was granted by The Center on Bioethics. Student nurses and their educators rated the general value of altruism equally. Educators, in comparison with students, ranked honesty and intellectualism significantly higher and more often admired truth-telling in any circumstance. Students were more likely to avoid intellectual challenges in reading and placed lower importance on academic qualifications for career advancement. The professional nursing values of honesty, intellectualism and authority were ranked significantly higher by nurse educators than student nurses. The study revealed differences in self-reported general and professional values in undergraduate student nurses and nurse educators. The values of nurse educators were not always stronger than those of students. Positive relationships between particular general and professional values in both students and educators confirmed the link between professional and personal values. © 2017 John Wiley & Sons Ltd.
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Violence against new graduated nurses in clinical settings: A qualitative study.
Ebrahimi, Hossein; Hassankhani, Hadi; Negarandeh, Reza; Jeffrey, Carol; Azizi, Azim
2017-09-01
Ethical studies in nursing are very important topics, and it is particularly crucial with vulnerable populations such as new graduated nurses. Neglecting ethical principles and violence toward graduates can lead to their occupational burnout, job dissatisfaction, and leaving the nursing profession. This study was designed with the aim of understanding the experience of Iranian experienced nurses' use of lateral and horizontal violence against new graduated nurses. This qualitative study used a conventional content analysis approach; it was conducted with 18 experienced nurses. Data were collected through unstructured and semi-structured interviews of various general hospital departments in northwest of Iran and analyzed using methods as described by Graneheim and Lundman. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. "Psychological violence," "Verbal violence," "Physical violence," and "Source of violence" were four categories extracted through data analysis. Violence behaviors are instances of workplace maltreatment that damage individual nurses, quality of care, and the ethical climate of the healthcare settings. The lateral and hierarchical violence in nursing were explained by oppressed group model. This study provided the context for identifying details of various types of workplace violence against new graduated nurses. It should be approached as a health system priority that requires specific multi-dimensional methods to manage consisting of identification, strategic planning, policymaking, prevention, education, and research.
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Torrance, C; Mansell, I; Wilson, C
2012-11-01
This study explored the views of nursing lecturers concerning the use of patients in nursing education, particularly in light of the development of additional learning opportunities such as clinical simulation. Focus group interviews involving 19 educators from one school of nursing in the United Kingdom were held. An interview schedule was developed by the study team from the findings of a focused literature review of the area. The focus groups were audio-taped and transcribed into NVivo (version 8) for analysis and identification of emergent themes. Four major categories emerged from the data analysis: clinical placement; patient consent; educator conflict; and developing competency. The themes of clinical placement and patient consent are presented in this paper. Clinical placement revealed two sub-themes: historical custom and practice and safety. Four sub-themes emerged from the theme of patient consent: informed consent; implied consent; capacity to consent; and patients' value of student involvement in their care. Educators believed that patients benefit from being cared for by well-qualified nurses and to achieve this it is necessary for patients to participate in clinical training. The predominant view seemed to be one of historical necessity; essentially, it has always been done that way so it has to continue that way. There was an awareness of the need for staff and students to consider the patient's rights and wishes, but the prevailing sentiment seemed to be that informed consent and choice were secondary to patient safety and the need to train student nurses. There is some conflict between the need for educating health professions and the Kantian view of never using the patients as a means to an end. Using patients for nursing education may be ethical as long as the patient is fully informed and involved in the decision-making process.
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When the severely ill elderly patient refuses food. Ethical reasoning among nurses.
Jansson, L; Norberg, A; Sandman, P O; Aström, G
1995-02-01
Forty registered nurses (RNs) regarded as "good and experienced" in either cancer or dementia care, were asked about their decision to feed or not feed a severely ill elderly woman (a hypothetical case). In order to compare ethical reasoning in the two groups of nurses and to illuminate what it means to RNs to face a situation where the patients can/cannot decide for themselves, a phenomenological hermeneutic approach was used for the analysis. Both groups saw themselves as the advocate for their patients but in different ways. The RNs who talked about a mentally alert patient emphasized that they encouraged their patient to speak up for herself, while the RNs who talked about a severely demented patient emphasized that they tried very hard to interpret their patient's vague and unclear communicative cues and to act as her advocate, especially in relation to physicians. Transcending experiences of dying relatives and patients as well as role models helped them to achieve their ambition of putting themselves in the patient's shoes in order to respect and understand her or his wish and/or what was best for them. The majority of RNs strongly rejected active euthanasia.
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School Counselors and Ethical Decision Making
West, Dana R.
2016-01-01
Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Ethical decision making for this study was defined as the degree to which decisions pertaining to…
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(The Ethics of) Teaching Science and Ethics: A Collaborative Proposal.
Kabasenche, William P
2014-12-01
I offer a normative argument for a collaborative approach to teaching ethical issues in the sciences. Teaching science ethics requires expertise in at least two knowledge domains-the relevant science(s) and philosophical ethics. Accomplishing the aims of ethics education, while ensuring that science ethics discussions remain grounded in the best empirical science, can generally best be done through collaboration between a scientist and an ethicist. Ethics as a discipline is in danger of being misrepresented or distorted if presented by someone who lacks appropriate disciplinary training and experience. While there are exceptions, I take philosophy to be the most appropriate disciplinary domain in which to gain training in ethics teaching. Science students, who must be prepared to engage with many science ethics issues, are poorly served if their education includes a misrepresentation of ethics or specific issues. Students are less well prepared to engage specific issues in science ethics if they lack an appreciation of the resources the discipline of ethics provides. My collaborative proposal looks at a variety of ways scientists and ethicists might collaborate in the classroom to foster good science ethics education.
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(The Ethics of Teaching Science and Ethics: A Collaborative Proposal
Directory of Open Access Journals (Sweden)
William P. Kabasenche
2014-10-01
Full Text Available I offer a normative argument for a collaborative approach to teaching ethical issues in the sciences. Teaching science ethics requires expertise in at least two knowledge domains—the relevant science(s and philosophical ethics. Accomplishing the aims of ethics education, while ensuring that science ethics discussions remain grounded in the best empirical science, can generally best be done through collaboration between a scientist and an ethicist. Ethics as a discipline is in danger of being misrepresented or distorted if presented by someone who lacks appropriate disciplinary training and experience. While there are exceptions, I take philosophy to be the most appropriate disciplinary domain in which to gain training in ethics teaching. Science students, who must be prepared to engage with many science ethics issues, are poorly served if their education includes a misrepresentation of ethics or specific issues. Students are less well prepared to engage specific issues in science ethics if they lack an appreciation of the resources the discipline of ethics provides. My collaborative proposal looks at a variety of ways scientists and ethicists might collaborate in the classroom to foster good science ethics education.
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Ethical experiential learning in medical, nursing and allied health education: A narrative review.
Grace, Sandra; Innes, Ev; Patton, Narelle; Stockhausen, Lynette
2017-04-01
Students enrolled in medical, nursing and health science programs often participate in experiential learning in their practical classes. Experiential learning includes peer physical examination and peer-assisted learning where students practise clinical skills on each other. To identify effective strategies that enable ethical experiential learning for health students during practical classes. A narrative review of the literature. Pubmed, Cinahl and Scopus databases were searched because they include most of the health education journals where relevant articles would be published. A data extraction framework was developed to extract information from the included papers. Data were entered into a fillable form in Google Docs. Findings from identified studies were extracted to a series of tables (e.g. strategies for fostering ethical conduct; facilitators and barriers to peer-assisted learning). Themes were identified from these findings through a process of line by line coding and organisation of codes into descriptive themes using a constant comparative method. Finally understandings and hypotheses of relevance to our research question were generated from the descriptive themes. A total of 35 articles were retrieved that met the inclusion criteria. A total of 13 strategies for ethical experiential learning were identified and one evaluation was reported. The most frequently reported strategies were gaining written informed consent from students, providing information about the benefits of experiential learning and what to expect in practical classes, and facilitating discussions in class about potential issues. Contexts that facilitated participation in experiential learning included allowing students to choose their own groups, making participation voluntary, and providing adequate supervision, feedback and encouragement. A total of 13 strategies for ethical experiential learning were identified in the literature. A formal process for written consent was evaluated
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Ethics Programs and Ethical Cultures: A Next Step in Unraveling their Multi-Faceted Relationship
S.P. Kaptein (Muel)
2008-01-01
textabstractThe objective of an ethics program is to improve the ethical culture of an organization. To date, empirical research treats at least one of these concepts as a one-dimensional construct. This paper demonstrates that by conceptualizing both constructs as multi-dimensional, a better
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Röbel, Tina
2016-01-01
As an effect of marketisation, the importance of workplace learning in Germany has increased. The article follows up on the long-standing discourse around the question of how economic and pedagogical ideals interact in this context. In order to develop a theoretical framework for empirical research, three major positions of the discipline of business ethics are introduced. Business ethics in more abstract ways deals with the very same question, namely how do ideas such as profit orientation i...
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Health Research Ethics: Between Ethics Codes and Culture.
Gheondea-Eladi, Alexandra
2017-10-01
This article is meant to describe and analyze some of the ethical difficulties encountered in a pilot research on treatment decisions of patients with chronic viral hepatitis C infection in Romania. It departs from an overview of the main ethics codes, and it shows that social health research on patients falls in between institutional codes of ethics. Furthermore, the article moves on to analyze so-called "important moments" of empirical research, such as the implementation of the ethical protocol, dealing with informal payments and with information on shady actions, as well as requests of information from interviewed patients and deciding when and if to breach confidentiality. In an attempt to evaluate the ad hoc solutions found in the field, the concluding remarks discuss these issues at the threshold of theory and practice.
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Being a good nurse and doing the right thing: a replication study.
Catlett, Shelia; Lovan, Sherry R
2011-01-01
This qualitative research study, a replication of a study published in 2002, investigated the qualities of a good nurse and the role ethics plays in decision making. After reviewing the limitations of the published work, the current study implemented modifications related to the research questions, sample selection, data collection, and use of software for data analysis. The original study identified seven categories that related to being a good nurse and doing the right thing. In the present study, the use of relational analysis led to the recognition of four categories: (1) personal traits and attributes; (2) technical skills and management of care; (3) work environment and co-workers; and (4) caring and caring behaviors. To understand what it means to be a good nurse and do the right thing is a complex task; however, this research adds to the small amount of empirical data that exists to describe those characteristics.
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Habits in perioperative nursing culture.
Lindwall, Lillemor; von Post, Iréne
2008-09-01
This study focuses on investigating habits in perioperative nursing culture, which are often simply accepted and not normally considered or discussed. A hermeneutical approach was chosen as the means of understanding perioperative nurses' experiences of and reflections on operating theatre culture. Focus group discussions were used to collect data, which was analysed using hermeneutical text analysis. The results revealed three main categories of habits present in perioperative nursing culture: habits that promote ethical values (by temporary friendship with patients, showing respect for each other, and spending time on reflection on ethics and caring); habits that hinder progress (by seeing the patient as a surgical case, not acknowledging colleagues, and not talking about ethics); and habits that set the cultural tone (the hidden power structure and achieving more in less time).
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Calculus formation: nurses' decision-making in abortion-related care.
McLemore, Monica R; Kools, Susan; Levi, Amy J
2015-06-01
Nurses routinely provide care to patients in ethically challenging situations. To explore the continuum between conscientious objectors and designated staff in the provision of care to women seeking abortions, the aim of this study was to thickly describe decision-making, using abortion as the clinical context to elucidate how nurses approach ethically challenging work. A purposive sample of 25 nurses who worked in abortion clinics, emergency departments, intensive care units, labor, and delivery, operating rooms, and post anesthesia care units were interviewed. Qualitative description and thematic analysis were used to identify the cognitive, emotional, and behavioral processes in nurses' decisions to care for women needing abortions. Nurses developed and used multifaceted, real-time calculi when making decisions about their participation in emergent or routine abortion care. Nurses tacked back and forth between the personal and professional and/or held multiple contradictory positions simultaneously. Nurses weighed the role and opinion of others to determine if they know how to or know why they would provide abortion care to women, particularly in the elective abortion context. The parameters of the nurse-patient relationship were complex and specific to the experiences of both the nurse and patient. Findings from this study further develop the science of ethically challenging decision-making and expand our understanding of factors that influence how nurses develop relationships to ethically challenging work. © 2015 Wiley Periodicals, Inc.
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Virtue ethics and its importance in accounting
Vuković, Milovan; Riznić, Dejan; Voza, Danijela
2015-01-01
This paper analyzes virtue ethics which, together with deontology and utilitarianism, represents one of the three traditions of normative ethics frequently applied to the area of business ethics. The main part of this paper considers various aspects of virtue ethics - the oldest ethical tradition - both from the theoretical and empirical standpoint. Virtue ethics, which focuses on character (moral) traits of an individual, is becoming an increasingly important social issue in modern society d...
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Combes, Stéphanie
2015-12-01
Ethics emerges in the interstices of deontology, in difficult situations generating internal conflicts for the caregiver, sources of anxiety and questioning. Ethics education has always played a major in nursing programs by initiating a reflection on human values. Faced with current uncertainties in the context of care, it is now based on the appropriation of a reflexive approach to the meaning of action. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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[Ethical case discussions in the intensive care unit : from testing to routine].
Meyer-Zehnder, B; Barandun Schäfer, U; Albisser Schleger, H; Reiter-Theil, S; Pargger, H
2014-06-01
The daily work of many healthcare professionals has become more complex and demanding in recent years. Apart from purely medical issues, ethical questions and problems arise quite often. Managing these problems requires ethical knowledge. Questions about the usefulness of a therapy and treatment occur especially at the end of life. So-called medical futility, a useless futile therapy, is often perceived by nurses and physicians in intensive care units who themselves often develop symptoms of depression or burnout. The clinical ethical model METAP (acronym from module, ethics, therapy decision, allocation and process) provides methods and criteria that allow the clinical team to treat and solve ethical issues according to a solution-oriented approach. The ethical decision-making of this model addresses these issues according to a series of sequential stages in the form of a so-called escalation model. When it is not possible to tackle and solve an ethical problem or dilemma in one stage, one moves to the next. The implementation of this approach in everyday practice requires the commitment of all team members in addition to certain basic conditions. In a surgical intensive care unit a fixed date in the schedule is reserved for ethical case discussions (level 3 of the escalation model). At this level a team member who has been specified according to a quarterly plan is responsible for the organization and performance of the discussion. All protocols of the 44 ethical case discussions in 41 patients between January 2011 and July 2012 were collected and summarized. A short questionnaire to all participants recorded their assessment of the benefits for the patient and the team as well as their perception of personal stress reduction. Also queried was the impact of this method on the collaboration between nurses and physicians and the ethical competence. Ethical case discussions among the care team took place regularly (44 case discussions between January 2011 and June
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Male nurses and the protection of female patient dignity.
Prideaux, Antony
Nurses need to be aware of their professional, legal and ethical responsibilities towards patients. Male nurses in particular face problems in their practice as a result of their gender and the stereotypes associated with male nurses. Such stereotypes can act as a barrier to their duty of care. This article examines the challenges associated with male nurses carrying out intimate, physical care. It discusses the ethical, legal and professional issues that male nurses should consider in relation to maintenance of patient dignity during nursing care provision, particularly in relation to female patients.
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DEFF Research Database (Denmark)
Olivares Bøgeskov, Benjamin Miguel
This paper presents the result from our research on how nurse managers use and occasionally misuse inconclusive ethical arguments to engage their personnel in current reforms. The Danish health care system has undergone a series of reforms inspired by New Public Management theories, which have......, paying special attention to the way in which ethical arguments are used in relation to engagement. Our research shows that ethical arguments are extremely common, and they are used either to elicit engagement, or to demand engagement considering the result of a duty. However, most interestingly...... it was possible for us to find recurrence of fallacious arguments of different kinds. Based on these findings, I will argue that the use of fallacious arguments in order to generate engagement is in reality an abusive use of ethics, which raises important questions. I argue that depending on the degree...
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[Ethics and laws related to human subject research].
Chiu, Hui-Ju; Lee, Ya-Ling; Chang, Su-Fen
2011-10-01
Advances in medical technology rely on human subject research to test the effects on real patients of unproven new drugs, equipment and techniques. Illegal human subject research happens occasionally and has led to subject injury and medical disputes. Familiarity with the laws and established ethics related to human subject research can minimize both injury and disputes. History is a mirror that permits reflection today on past experience. Discussing the Nuremberg Code, the Declaration of Helsinki and Belmont Report, this article describes the laws, ethics, history and news related to human subject research as well as the current definition and characteristics of human subject research. Increasing numbers of nurses serve as research nurses and participate in human subject research. The authors hope this article can increase research nurse knowledge regarding laws and ethics in order to protect human research subjects adequately.
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Samuel, Gabrielle; Cribb, Alan; Owens, John; Williams, Clare
2016-09-01
In this paper we contribute to "sociology in bioethics" and help clarify the range of ways sociological work can contribute to ethics scholarship. We do this using a case study of an innovative neurotechnology, functional magnetic resonance imaging, and its use to attempt to diagnose and communicate with severely brain-injured patients. We compare empirical data from interviews with relatives of patients who have a severe brain injury with perspectives from mainstream bioethics scholars. We use the notion of an "ethical landscape" as an analogy for the different ethical positions subjects can take-whereby a person's position relative to the landscape makes a difference to the way they experience and interact with it. We show that, in comparison to studying abstract ethics "from above" the ethical landscape, which involves universal generalizations and global judgements, studying ethics empirically "from the ground," within the ethical landscape foregrounds a more plural and differentiated picture. We argue it is important not to treat empirical ethics as secondary to abstract ethics, to treat on-the-ground perspectives as useful only insofar as they can inform ethics from above. Rather, empirical perspectives can illuminate the plural vantage points in ethical judgments, highlight the "lived" nature of ethical reasoning, and point to all ethical vantage points as being significant. This is of epistemic importance to normative ethics, since researchers who pay attention to the various positions in and trajectories through the ethical landscape are unlikely to think about ethics in terms of abstract agency-as can happen with top-down ethics-or to elide agency with the agency of policymakers. Moreover, empirical perspectives may have transformative implications for people on the ground, especially where focus on the potential harms and benefits they face brings their experiences and interests to the forefront of ethical and policy discussion.
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Mentoring overseas nurses: barriers to effective and non-discriminatory mentoring practices.
Allan, Helen
2010-09-01
In this article it is argued that there are barriers to effective and non-discriminatory practice when mentoring overseas nurses within the National Health Service (NHS) and the care home sector. These include a lack of awareness about how cultural differences affect mentoring and learning for overseas nurses during their period of supervised practice prior to registration with the UK Nursing and Midwifery Council. These barriers may demonstrate a lack of effective teaching of ethical practice in the context of cultural diversity in health care. This argument is supported by empirical data from a national study. Interviews were undertaken with 93 overseas nurses and 24 national and 13 local managers and mentors from six research sites involving UK health care employers in the NHS and independent sectors in different regions of the UK. The data collected showed that overseas nurses are discriminated against in their learning by poor mentoring practices; equally, from these data, it appears that mentors are ill-equipped by existing mentor preparation programmes to mentor overseas-trained nurses from culturally diverse backgrounds. Recommendations are made for improving mentoring programmes to address mentors' ability to facilitate learning in a culturally diverse workplace and thereby improve overseas nurses' experiences of their supervised practice.
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Cloyes, Kristin Gates
2006-01-01
Nursing literature is replete with discussions about the ethics of research interviews. These largely involve questions of method, and how careful study design and data collection technique can render studies more ethical. Analysis, the perennial black box of the research process, is rarely discussed as an ethical practice. In this paper, I introduce the idea that analysis itself is an ethical practice. Specifically, I argue that political discourse analysis of research interviews is an ethical practice. I use examples from my own research in a prison control unit to illustrate what this might look like, and what is at stake.
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Ethical implications and decision making in care education process
Directory of Open Access Journals (Sweden)
Layse Kelle Silva
2014-07-01
Full Text Available Objective. To determine ethical implications for nursing practice at the point of decision making by nursing professors in practice area. Methodology. A qualitative method was adopted, with use of semistructured interviews with sixteen nursing professors who delivered care at a teaching hospital in Salvador, Bahia, from May to June 2011. The methodological reference used was the discourse of the collective subject (DCS by Lefévre and Lefévre. Results. In response to DCSs, the following subjects appeared: "Ethics is fundamental and of vital importance in the decision making process," "searching for knowledge and research to identify problems and solutions, including alternatives and support for decisions," and "to act in the best way." Conclusion. Professors who provide education about patient care also delivered care. They have the responsibility to consider the ethical implications of decision making because they stimulate fundamental reflection and could positively influence future nursing professionals.
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S.P. Kaptein (Muel)
2007-01-01
textabstractBased on four interlocking empirical studies, this paper initially validates and refines the Corporate Ethical Virtues Model which formulates normative criteria for the ethical culture of organizations. The findings of an exploratory factor analysis provide support for the existence of
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Ethics, government and sexual health: insights from Foucault.
Winch, Sarah
2005-03-01
The work of Michel Foucault, the French philosopher who was interested in power relationships, has resonated with many nurses who seek a radically analytical view of nursing practice. The purpose of this article is to explore 'ethics' through a Foucauldian lens, in a conceptual and methodological sense. The intention is to provide a useful framework that will help researchers critically to explore aspects of nursing practice that relate to the construction of the self, morality and identity, be that nurse or patient related. The fundamentals of the research method of genealogy and the methods of ethics are reviewed. Using an example taken from the sexual health practice area, advice is given on how to structure data collection, incorporate interview data, avoid discourse determinism and measure resistance.
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Respect in forensic psychiatric nurse-patient relationships: a practical compromise.
Rose, Donald N; Peter, Elizabeth; Gallop, Ruth; Angus, Jan E; Liaschenko, Joan
2011-03-01
The context of forensic psychiatric nursing is distinct from other psychiatric settings as, it involves placement of patients in secure environments with restrictions determined by the courts. Previous literature has identified that nurses morally struggle with respecting patients who have committed heinous offences, which can lead to the patient being depersonalized and dehumanized. Although respect is fundamental to ethical nursing practice, it has not been adequately explored conceptually or empirically. As a result, little knowledge exists that identifies how nurses develop, maintain, and express respect for patients. The purpose of this study is to analyze the concept of respect systematically, from a forensic psychiatric nurse's perspective using the qualitative methodology of focused ethnography. Forensic psychiatric nurses were recruited from two medium secure forensic rehabilitation units. In the first interview, 13 registered nurses (RNs) and two registered practical nurses (RPNs) participated, and although all informants were invited to the second interview, six RNs were lost to follow-up. Despite this loss, saturation was achieved and the data were interpreted through a feminist philosophical lens. Respect was influenced by factors categorized into four themes: (1) emotive-cognitive reactions, (2) nonjudgmental approach, (3) social identity and power, and (4) context. The data from the themes indicate that forensic psychiatric nurses strike a practical compromise, in their understanding and enactment of respect in therapeutic relationships with forensic psychiatric patients. © 2011 International Association of Forensic Nurses.
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Different methods for ethical analysis in health technology assessment: an empirical study.
Saarni, Samuli I; Braunack-Mayer, Annette; Hofmann, Bjørn; van der Wilt, Gert Jan
2011-10-01
Ethical analysis can highlight important ethical issues related to implementing a technology, values inherent in the technology itself, and value-decisions underlying the health technology assessment (HTA) process. Ethical analysis is a well-acknowledged part of HTA, yet seldom included in practice. One reason for this is lack of knowledge about the properties and differences between the methods available. This study compares different methods for ethical analysis within HTA. Ethical issues related to bariatric (obesity) surgery were independently evaluated using axiological, casuist, principlist, and EUnetHTA models for ethical analysis within HTA. The methods and results are presented and compared. Despite varying theoretical underpinnings and practical approaches, the four methods identified similar themes: personal responsibility, self-infliction, discrimination, justice, public funding, and stakeholder involvement. The axiological and EUnetHTA models identified a wider range of arguments, whereas casuistry and principlism concentrated more on analyzing a narrower set of arguments deemed more important. Different methods can be successfully used for conducting ethical analysis within HTA. Although our study does not show that different methods in ethics always produce similar results, it supports the view that different methods of ethics can yield relevantly similar results. This suggests that the key conclusions of ethical analyses within HTA can be transferable between methods and countries. The systematic and transparent use of some method of ethics appears more important than the choice of the exact method.
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Qualitative assessment of a blended learning intervention in an undergraduate nursing course.
Hsu, Li-Ling
2012-12-01
Nurses are experiencing new ethical issues because of global developments and changes in the healthcare environment. Blended learning is one of the various methods used to deliver meaningful learning experiences. Well-designed, properly administered nursing ethics education is essential for nursing students to visualize the role of professional nurses. However, a literature review shows that only a few existing studies have touched on the subject of nursing student experiences with blended learning in a nursing ethics course. This study examines how undergraduate nursing students respond to a blended learning approach in a nursing ethics course and how blended learning affects the learning process. We used a qualitative research design with in-depth interviews. Participants included 28 female undergraduate nursing students who had completed the nursing ethics course. Each interview lasted 50-100 minutes. The researcher conducted all interviews in 2009. The researcher identified six major themes and 13 subthemes from the data. The six themes included (a) enhancing thinking ability, (b) improving problem-solving skills, (c) reflecting in and on practice, (d) perceiving added workload, (e) encouraging active learning, and (f) identifying the value of nursing. Participants felt that the blended learning experience was a generally positive experience. Most participants appreciated the opportunity to take a more active role in the learning process, think about issues profoundly and critically, and exercise metacognitive powers in the thinking and decision-making process. Study findings may suggest productive ideas for fine-tuning blended learning models.
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Gair, Jonathan
2013-01-01
The gastroenterology procedures environment has proven to be fertile ground for the realization of moral distress as it relates to the practice of nursing. Specifically, nurses are expected to fulfill their duty as advocates for their clients at all times and within all contexts; however, their ability to discharge this essential function has been complicated by such influential factors as sedating medications, competing ethical motivations, discordant conclusions of moral reasoning and action, as well as competing institutional factors. This article begins with a fictional case study to introduce readers to the contextual essence of the moral distress that a group of gastroenterology nurses was collectively experiencing. Subsequently, the aim of this article was to explicate how one department, with the aid of an ethics committee, negotiated a process similar to the case study to develop a pragmatic policy and identify an educational primer that encourages nurses to reexamine and value the tangible realities inherent and expected of an advocate in the dynamically complex environment that characterizes all gastroenterology procedure environments where gastroenterology nurses practice.
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Developing organisational ethics in palliative care.
Sandman, Lars; Molander, Ulla; Benkel, Inger
2017-03-01
Palliative carers constantly face ethical problems. There is lack of organised support for the carers to handle these ethical problems in a consistent way. Within organisational ethics, we find models for moral deliberation and for developing organisational culture; however, they are not combined in a structured way to support carers' everyday work. The aim of this study was to describe ethical problems faced by palliative carers and develop an adapted organisational set of values to support the handling of these problems. Ethical problems were mapped out using focus groups and content analysis. The organisational culture were developed using normative analysis and focus group methodology within a participatory action research approach. Main participants and research context: A total of 15 registered nurses and 10 assistant nurses at a palliative unit (with 19 patient beds) at a major University Hospital in Sweden. Ethical considerations: The study followed standard ethics guidelines concerning informed consent and confidentiality. We found six categories of ethical problems (with the main focus on problems relating to the patient's loved ones) and five categories of organisational obstacles. Based on these findings, we developed a set of values in three levels: a general level, an explanatory level and a level of action strategies. The ethical problems found corresponded to problems in other studies with a notable exception, the large focus on patient loved ones. The three-level set of values is a way to handle risks of formulating abstract values not providing guidance in concrete care voiced in other studies. Developing a three-level set of values adapted to the specific ethical problems in a concrete care setting is a first step towards a better handling of ethical problems.
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Directory of Open Access Journals (Sweden)
Luciane Patrícia Andreani Cabral
2015-10-01
Full Text Available AbstractOBJECTIVETo report the nurse's experience of inclusion in interdisciplinary clinical study about technological innovation, involving people with spinal cord injury.METHODDescriptive experience report. The empirical support was based on notes about perspectives and practice of clinical research, with a multi-professional nursing, physical education, physiotherapy and engineering staff.RESULTThe qualification includes the elaboration of the document for the Ethics Committee, familiarization among the members of staff and with the studied topic, and also an immersion into English. The nurse's knowledge gave support to the uptake of participants and time adequacy for data collection, preparation and assistance of the participants during the intervention and after collection. Nursing theories and processes have contributed to reveal risky diagnoses and the plan of care. It was the nurse's role to monitor the risk of overlapping methodological strictness to the human aspect. The skills for the clinical research must be the object of learning, including students in multidisciplinary researches.CONCLUSIONTo qualify the nurse for clinical research and to potentialize its caregiver essence, some changes are needed in the educational system, professional behavior, attitude and educational assistance.
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Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan
2016-01-01
The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the "frequency" and "difficulty" of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The "ethical dilemma" scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average "ethical dilemma" score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average "ethical dilemma" score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average "ethical dilemma" score in communication. Nurses reported higher "ethical dilemma" scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average "ethical dilemma" score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the
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Peter, Elizabeth; Liaschenko, Joan
2013-10-01
Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and responsibilities in situations of moral distress. We also discuss the importance of nurses creating "counterstories" of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life.
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Simulation: a new approach to teaching ethics.
Buxton, Margaret; Phillippi, Julia C; Collins, Michelle R
2015-01-01
The importance of ethical conduct in health care was acknowledged as early as the fifth century in the Hippocratic Oath and continues to be an essential element of clinical practice. Providers face ethical dilemmas that are complex and unfold over time, testing both practitioners' knowledge and communication skills. Students learning to be health care providers need to develop the knowledge and skills necessary to negotiate complex situations involving ethical conflict. Simulation has been shown to be an effective learning environment for students to learn and practice complex and overlapping skills sets. However, there is little guidance in the literature on constructing effective simulation environments to assist students in applying ethical concepts. This article describes realistic simulations with trained, standardized patients that present ethical problems to graduate-level nurse-midwifery students. Student interactions with the standardized patients were monitored by faculty and peers, and group debriefing was used to help explore students' emotions and reactions. Student feedback postsimulation was exceedingly positive. This simulation could be easily adapted for use by health care education programs to assist students in developing competency with ethics. © 2014 by the American College of Nurse-Midwives.
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Ulrich, Connie M; Zhou, Qiuping Pearl; Hanlon, Alexandra; Danis, Marion; Grady, Christine
2014-08-01
Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Ethics preparedness and confidence were significantly associated with perceived quality of care (pfactors. Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.
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Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine
2015-01-01
Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented.
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Avoid Ethical Misconduct in Manuscript Preparation.
Hicks, Rodney W; Harris, Ruth
2016-01-01
In order for nurses and other health care professionals to make important contributions to the literature, there must be an awareness of the many areas where unintentional ethical conflicts can arise. Leading ethical concerns include plagiarism, duplicate submission, authorship standards, bias, and conflicts of interest. Although many sources are available on the variety of ethical concerns, this article takes the position to identify the area of concern and describe why it is an ethical violation. Solutions are posed for resolving the conflict, including why medical librarians can help in the publishing process.