Despite achieving broad acceptance of the moral case for treating animals fairly, the animal rights movement has reached an impasse concerning legal rights for animals. Zoopolis proposes a new approach to addressing this failure: integrating animal interests into human society via political institutions and practices. Zoopolis’s central theory that humans owe animals citizenship rights in a shared human-animal society, but that acceptance of responsibilities by animals also is required, has merit for the advancement of animal rights discourse. But its anthropocentric (...) approach, which itself exerts power over animals, necessitating suppression and policing of animals’ natural behavior, is problematic. (shrink)

The renowned Nobel Prize-winning scientist's elegant and concise explanation of the fundamental ideas in biology and their uses today. Hailed by Philip Pullman as "a great communicator" who is also "as distinguished a scientist as there could be," Paul Nurse writes with delight at life's richness and a sense of the urgent role of biology in our time. With What Is Life? he delivers a brief but powerful work of popular science in the vein of Carlo Rovelli's Seven Brief Lessons (...) in Physics. Nurse takes readers on a wondrous journey through five fundamental biological ideas-the Cell, the Gene, Evolution by Natural Selection, Life as Chemistry, and Life as Information-introducing the scientists who made the most important advances and taking us into his own lab to give us a sense of the thrill of scientific discovery. In a final chapter, Nurse addresses biology's most pressing ethical issues (including gene-editing, genetic testing, and genetically modified crops), and he concludes with a stirring encomium to biology's role in tackling infectious disease. (shrink)

Research question and aimClinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020,...

Although the need to theorize ethics within the complexities of nursing practice has been identified within the nursing literature, to date the link between ethics epistemology and specific nursing actions has received limited attention. In particular, little exploration has been carried out to examine how nurses ‘know’ what is ethical and the knowledge they draw upon to inform their nursing actions within the complexities of their everyday practice. This study describes a participatory inquiry project that focused on developing and articulating (...) an epistemology of ethics while in the midst of everyday nursing work. Epistemological and methodological insights are discussed in light of the challenges nurses face in contemporary healthcare contexts. (shrink)

The system of asylum seeker detention in Australia is one in which those seeking refuge are stripped of many of their rights, including the right to health. This presents serious ethical problems for healthcare providers working within this system. In this article we describe asylum seeker detention and analyse the role of nurses. We discuss how far an “ethics of care” and witnessing the suffering of asylum seekers can serve to improve their situation and improve ethical nursing practice.

Background:As caring in times of pandemics becomes extremely stressful, the volume and intensity of nursing work witness significant increase. Ethical practices are therefore even more important for nurses and nurse leaders during this special period.Research aim:The aim was to explore the relationship between ethical nurse leaders and nurses’ task mastery and ostracism, and to examine the mediating role of relational identification in this relationship during pandemics.Research design:Based on social exchange theory, this study tests a theoretical model proposing that ethical nurse (...) leaders can increase nurses’ task mastery and reduce their ostracism by improving their relational identification with leaders during pandemics.Participants and research context:A multilevel and multi-wave field study using data from 172 nurses from 45 departments of two comprehensive hospitals was performed from April to August 2020 to test proposed hypotheses.Ethical considerations:We received formal approvals from the ethical committee of the hospital where we conducted this study before the data collection.Results:Ethical nurse leaders can indeed increase nurses’ task mastery and reduce their ostracism during the pandemic period; furthermore, nurses’ identification with their leaders mediates these relationships. We find that ethical leadership plays an even more important role in improving nurses’ task mastery and reducing their ostracism that may be facilitated by pandemics this special time. Nurses will become more identified with their leaders when they are treated by ethical ways.Discussion:The study tries to advance our understanding of the important role of ethical leadership in nurse management literature and provide useful suggestions for healthcare institutions, nurse leaders, and nurses during pandemics.Conclusion:Theoretical contributions and practical implications of our findings are discussed. Specifically, we suggest that healthcare institutions cultivate ethical nurse leaders to facilitate nurses’ relational identification, which in turn will positively influence work outcomes. (shrink)

Concepts and Cases in Nursing Ethics is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an (...) added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation. (shrink)

This book takes a wider approach to ethics, looking at several different dimensions and discussing these themes in a manner suitable for either reflective ...

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

_A portion of the revenue from this book’s sales will be donated to Doctors Without Borders to assist the humanitarian work of nurses, doctors, and other health care providers in the fight against COVID-19 and beyond._ _Concepts and Cases in Nursing Ethics_ is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with (...) reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation, as well as ethical issues relating to COVID-19. (shrink)

Concepts and Cases in Nursing Ethics maps the ethical landscape of contemporary nursing. The book is the product of a collaboration between philosopher-ethicist Michael Yeo, nurse-ethicist Anne Moorhouse, and six representatives of various areas of professional nursing. It thus combines philosophical and ethical analysis with nursing knowledge and experience in a manner that is both understandable and relevant. The book is organized around six main concepts in nursing ethics: beneficence, autonomy, confidentiality, truth-telling, justice, and integrity. A chapter is devoted to (...) the elucidation of each of these concepts. In each chapter, historical background and conceptual analysis are supplemented by case studies that exemplify issues and show how the concept applies in nursing practice. In this new edition, the materials in each chapter have been updated to reflect recent developments in nursing and more generally in health care. In addition, a totally new chapter on ethical theory has been added. Complete with bibliographies and study questions for further analysis of cases, this book is ideally suited for textbook use. It will help both practitioners and students to deal better with the clinical problems and issues that are encountered in the field. However, it's simple prose and clear exposition of complex issues will make Concepts and Cases in Nursing Ethics attractive to anyone concerned about health care. (shrink)

Nursing staff of many specialities are taking on and developing their roles in new and advanced practice areas. Patients will be offered new services from highly skilled advanced nurse practitioners. Such nurses need guidance, direction and information to assist them in their new roles. This book will offer insight and guidance on a variety of issues that are likely to be encountered by the Nurse Practitioner in everyday practice.

It was reported in 2006 that a regime of ‘supervised self harm’ had been implemented at St George’s Hospital, Stafford. This involves patients with a history of self-harming behaviour being offered both emotional and practical support to enable them to do so. This support can extend to the provision of knives or razors to enable them to self-harm while they are being supervised by a nurse. This article discusses, and evaluates from an ethical perspective, three competing responses to self-harming behaviours: (...) to prevent it; to allow it; and to make provision for supervised self-harm. It is argued that of these three options the prevention strategy is the least plausible. A tentative conclusion is offered in support of supervised self-harm. (shrink)

Increased technological and pharmacological interventions in patient care when patient outcomes are uncertain have been linked to the escalation in moral and ethical dilemmas experienced by health care providers in acute care settings. Health care research has shown that facilities that are able to attract and retain nursing staff in a competitive environment and provide high quality care have the capacity for nurses to process and resolve moral and ethical dilemmas. This article reports on the findings of a systematic review (...) of the empirical literature (1980 — February 2007) on the effects of unresolved moral distress and poor ethical climate on nurse turnover. Articles were sought to answer the review question: Does unresolved moral distress and a poor organizational ethical climate increase nurse turnover? Nine articles met the criteria of the review process. Although the prevailing sentiment was that poor ethical climate and moral distress caused staff turnover, definitive answers to the review question remain elusive because there are limited data that confidently support this statement. (shrink)

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

Ethics in nursing: continuity and change -- Cultural issues, methods and approaches to nursing ethics -- Nursing ethics: what do we mean by 'ethics'? -- Becoming a nurse and member of the profession -- Power and responsibility in nursing practice and management -- Professional responsibility and accountability in nursing -- Classical areas of controversy in nursing and biomedical ethics -- Direct responsibility in nurse/patient relationships -- Conflicting demands in nursing groups of patients -- Ethics in healthcare management: research, evaluation and (...) performance management -- The political ethics of healthcare: health policies and resource allocation -- Corporate ethics in healthcare: strategic planning and ethical policy development -- Making moral decisions and being able to justify our actions -- The relevance of moral theory: justifying our ethical policies. (shrink)

Nursing Ethics is a comprehensive, well-written text that provides pre-licensure nursing students with an understanding of ethical issues in the current healthcare climate and underscores the many ways in which ethics affects all levels of nursing care. Divided into three sections - Foundational Theories, Concepts and Professional Issues; Moving into Ethics Across the Lifespan; and Ethics Related to Special Issues - the current edition seamlessly aligns with the cornerstones of the nursing curriculum, providing a solid ethical foundation for pre-licensure nursing (...) students and making it a perfect fit for almost any course. (shrink)

Background: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.Aims: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.Design: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.Findings: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.Discussion: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 ethical dilemmas and to engage with political and organisational macro- and micro-decision-making.Conclusion:Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas. (shrink)

This volume provides a critical introduction to contemporary attempts to base nursing ethics on a feminine 'ethics of care'.

With the increasing use of technology in nursing, how nurses perform practice care has changed, inevitably leading to ethical concerns that differ from original ethical norms in nursing. Studies have focused on ethical issues in health informatics from clinicians’ or patients’ perspectives, while nurses’ perspective is needed. This paper conducts a theoretical study on ethical predicaments that arise in nursing informatics from nurses’ perspectives. Why and how these predicaments emerge are elaborated. Also, this paper offers countermeasures in realistic contexts from (...) technique, education, and leadership aspects. Collaborations between governments, administrators, educators, technicians, and nurses are needed to step out of these predicaments. (shrink)

Written by a nurse and a philosopher, Ethics in Nursing blends the concrete detail of recurring problems in nursing practice with the perspectives, methods, and resources of philosophical ethics. It stresses the aspects of the nurses role and relations with others -- physicians, patients, administrators, other nurses -- that give ethical problems in nursing their special focus. Among the issues addressed are deception, parentalism, confidentiality, conscientious refusal, nurse autonomy, compromise, and personal responsibility for institutional and public policy. The third edition (...) has been enlarged with new cases and case discussions related to AIDS and an additional chapter on the expanding scope of nursing ethics as it addresses issues related to scarce resources, cost containment, justice, and the possibilities of health care rationing. (shrink)

Background:Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care.Objective:The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care.Design and participants:Qualitative individual interviews were performed with 10 nurse (...) managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data.Ethical considerations:The Norwegian Centre for Research Data granted permission for this study.Findings:The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees.Discussion:The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care.Conclusions:Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means. (shrink)

BackgroundEthical care provided by nurses to earthquake victims is one of the main subjects in nursing profession.ObjectivesGiven the information gap in this field, the present study is an attempt to explore the nurses’ experience of ethical care provided to victims of an earthquake.Research design and methodA hermeneutic phenomenological study was performed. The participants were 16 nurses involved in providing care to the injured in Kermanshah earthquake, Iran. They were selected using purposeful sampling, and in-depth and semi-structured interviews were carried out. (...) The transcribed interviews were analyzed based on the hermeneutic approach using the analysis method proposed by Diekelmann et al.Ethical considerationsThe study was approved by the Research Council and Ethics Committee of Urmia University of Medical Sciences, Iran.FindingsData analyses revealed four themes and 10 sub-themes that illustrated nurses’ experience of ethical care during earthquake. The themes were (1) Respecting humanistic values (sacrifice, stepping beyond task description, and voluntary work), (2) Commitment to ethics (honesty, confidentiality, and trustworthiness), (3) Respecting dignity of victims (respecting cultural values, maintaining privacy, having humanistic perspective, and effective communication), and (4) Spiritual support (helping patients to do religious rituals Psychological support).ConclusionThe results showed the nurses’ experience with providing care to earthquake victims. The findings underlined ethics and ethical values in providing nursing care during disasters. It is suggested that special courses on the importance of nursing ethics in critical situations be incorporated into nursing curriculums and in-service educations. (shrink)

Background: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.Objectives: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.Methods: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.Findings: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.Conclusions:The review highlighted a need for improved ethics education for care-providers. (shrink)

The purpose of this article is to report what can be learned about nurses’ ethical conflicts by the systematic analysis of methodologically similar studies. Five studies were identified and analysed for: (1) the character of ethical conflicts experienced; (2) similarities and differences in how the conflicts were experienced and how they were resolved; and (3) ethical conflict themes underlying four specialty areas of nursing practice (diabetes education, paediatric nurse practitioner, rehabilitation and nephrology). The predominant character of the ethical conflicts was (...) disagreement with the quality of medical care given to patients. A significant number of ethical conflicts were experienced as ‘moral distress’, the resolution of which was variable, depending on the specialty area of practice. Ethical conflict themes underlying the specialty areas included: differences in the definition of adequacy of care among professionals, the institution and society; differences in the philosophical orientations of nurses, physicians and other health professionals involved in patient care; a lack of respect for the knowledge and expertise of nurses in specialty practice; and difficulty in carrying out the nurse’s advocacy role for patients. (shrink)

The aim of this study was to identify the ethical problems that nurse managers encounter in their work and the role of codes of ethics in the solutions to these difficulties. The data were collected using a structured questionnaire and analysed statistically. The target sample included all nurse managers in 21 specialized health care or primary health care organizations in two hospital districts in Finland (N = 501; response rate 41%). The most common ethical problems concerned resource allocation as well (...) as providing and developing high quality care. This was the case in different managerial positions as well as in types of organization. Professional codes of ethics were used more often for problems related to patients’ care compared with issues of resource allocation. Nurse managers at middle or strategic management levels used codes of ethics more often than those in charge of a ward. More research is required to investigate ethical decision making in nursing management, especially with regard to problem solving. In addition, new guidelines and continuing education in ethics are important for management personnel. (shrink)

Background The COVID-19 pandemic has forced rapid and widespread change to standards of patient care and nursing practice, inevitably leading to unprecedented shifts in the moral conditions of nursing work. Less is known about how these challenges have affected nurses’ capacity to meet their ethical responsibilities and what has helped to sustain their efforts to continue to care. Research objectives 1) To explore nurses’ experiences of striving to fulfill their ethical responsibilities of care during the COVID-19 pandemic and 2) to (...) explore what has fostered nurses’ capacity to fulfill these responsibilities. Research Design A generic qualitative approach was used incorporating concepts coming from fundamental features of care. Participants Twenty-four Canadian Registered Nurses from a variety of practice settings were interviewed. Ethical Considerations After receiving ethics approval, signed informed consent was obtained before participants were interviewed. Findings Four themes were identified. 1) Challenges providing good care in response to sudden changes in practice. 2) Tensions in juggling the responsibility to prevent COVID-19 infections with other competing moral responsibilities. 3) Supports to foster nurses’ capacity to meet their caring responsibilities. 4) The preservation of nurses’ moral identity through expressions of gratitude and health improvement. Discussion Infection control measures and priorities set in response to the pandemic made at distant population and organizational levels impacted nurses who continued to try to meet the ideals of care in close proximity to patients and their families. Despite the challenges that nurses encountered, the care they received themselves enabled them to continue to care for others. Nurses benefited most from the moral communities they had with their colleagues and occasionally nurse leaders, especially when they were supported in a face-to-face manner. Conclusion: Moral community can only be sustained if nurses are afforded the working conditions that make it possible for them to support each other. (shrink)

BackgroundProfessional ethics is the regulation and discipline of nurses’ daily nursing work. Nurses often encounter various ethical challenges and problems in their clinical work, but there are fe...

The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing’s past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as ‘other’. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the nursing profession. First of (...) all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession’s past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today. (shrink)

Three clinical cases of very ill neonates exemplifying extreme ethical situations for nurses are interpreted through Arendt's concepts of life and natality, and Agamben's critique of bare life. Agamben's notions of form-of-life, as the inseparability of zoe/bios, and testimony are offered as the potential foundation of nursing ethics.

Background:Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it.Objectives:This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units.Research design:This was a descriptive cross-sectional research.Participants and research context:In total, 382 nurses working in (...) the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version).Ethical considerations:This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed.Findings:The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to “using resources despite believing in its futility,” with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of “working with incompetent staff.” The most frequently observed type of conflict was moral dilemma.Conclusion:The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment. (shrink)

This study examines the presence of ethical climates in skilled nursing facilities and identifies their antecedents (work group, job position, tenure). A cross-sectional survey design was implemented. A total of 359 facilities were selected in the Midwestern United States. Responses were received from nurses representing 100 of those facilities (28%). A total of 656 usable questionnaires were returned of the 3060 distributed (21.4% response rate). Descriptive statistics, confirmatory factor analysis, and multivariate and univariate analyses of variance were used. The results (...) confirmed the presence of five ethical climates. Significant differences between registered and licensed practical nurses with regard to egoistic and independence ethical climates were found. Furthermore, nurses in management and non-management positions differed significantly in their perceptions of caring and egoistic climates. The results suggest incongruence in value perceptions and imply that researchers and practitioners have to direct efforts towards preventing and identifying reasons behind this. (shrink)

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. (shrink)

Background To practice nursing ethics, students must first understand the ethical concepts and principles of their profession, but despite this knowledge, students face challenges in implementing ethical principles in clinical settings. The educational performance of nurse educators is critical in resolving these challenges. This study focused on the lived experiences of nurse educators. Objective To address the main concern of educators when teaching ethics to undergraduate nursing students and how they deal with it. Research Design We conducted this qualitative content (...) analysis in Iran in 2020. We used individual semi-structured interviews to collect, record, and transcribe data, as well as Graneheim and Lundman method to analyze them. Participants and research context: We used purposive sampling to select 11 nurse educators who either were currently in the position of ethics educators or had taught ethics from Iranian universities of medical sciences. Ethical considerations The present study received the code of ethics No. IR.MODARES.REC.1399.036. Participants were aware of the study’s purpose and signed a consent form to participate in the study. We considered data confidentiality and the voluntary principle in data collection. Findings Nurse educators’ main concern was how to sensitize students to ethical principles in clinical settings, so they tried to involve students in the teaching process, to repeat and practice ethical principles and concepts, simplify and simulate ethical principles and concepts, and provide opportunities for students to gain clinical experiences. Discussion To sensitize students to ethical nursing care, nurse educators try to institutionalize ethical principles using different teaching methods, including students' involvement in teaching, experiential learning through simulated situations, practice, repetition, and provision of opportunities for practice and experience. Conclusion Improving students’ cognitive ability and objectifying moral concepts and principles for students will institutionalize moral values in them that are fundamental for their moral sensitization. (shrink)

Background: In accordance with ethical guidelines for nurses, leaders for nurse services in general are responsible for facilitating professional development and ethical reflection and to use ethical guidelines as a management tool. Research describes a gap between employees’ and nurse leaders’ perceptions of priorities. Objective: The purpose of this article is to gain deeper insight into how nurses as leaders in somatic hospitals describe ethical challenges. Design and method: We conducted individual, quality interview with 10 nurse leaders, nine females and (...) one male nurse aged 34–64 years. We used a hermeneutical approach to analyse the data. Ethical considerations: The participants received oral and written information about the study. Participation in the study was voluntary, and the participants were given the opportunity to withdraw. All of them gave written consent. The Norwegian Centre for Research Data approved the research project. In addition, the head of the hospitals gave permission to conduct our study. Findings: Four main areas were identified: deficient ethical language, conflicting demands on nurse leaders regarding staff management, concerns regarding young nurses’ ethical consciousness and restricting factors on the creation of a climate of ethics. The nurse leaders experienced considerable pressure. An unexpected finding was the lack of – and even disregard for – an ethical language. Discussion and conclusion: It is crucial to recognise ethics in all types of nursing approaches and to make it explicit. Ethical language must be implemented in nursing education. It must be recognised and used in clinical practice. Recommendations: We recommend further research be conducted into how nurses understand the concept of ethics and how to incorporate ethical principles into clinical nursing and nurse leadership. (shrink)

Ethical theories -- Healthcare ethics -- Modern healthcare ethics : landmark events that shaped hospital ethics protocols -- A nurse-led ethics committee -- Common ethical challenges -- Ethics case studies.

This discussion paper aims to explore potential ethical and moral implications of (patient) centredness in nursing and healthcare. Healthcare is experiencing a philosophical shift from a perspective where the health professional is positioned as the expert to one that re‐centres care and service provision central to the needs and desires of the persons served. This centred approach to healthcare delivery has gained a moral authority as the right thing to do. However, little attention has been given to its moral and (...) ethical theoretical grounding and potential implications for nurses, persons served and the healthcare system. Based upon a review of academic and grey literature, centredness is proposed as a value‐laden concept in nursing inquiry. Potential moral and ethical implications of centredness on nurses/healthcare providers, persons served and the healthcare system are discussed. These challenges are then considered within the context of normative and relational ethical theories. These perspectives may offer guidance relative to how one should act in those circumstances as well as an understanding as to how interdependency and engagement with the other person(s) can help navigate the challenges of a centred care approach. Viewing centredness through an ethical theoretical lens provides a valuable discourse to nursing in efforts to expand the knowledge base and integrate centred approaches into practice and policy. (shrink)

Every day nurses are required to make ethical decisions in the course of caring for their patients. Ethics in Nursing Practice provides the background necessary to understand ethical decision making and its implications for patient care. The authors focus on the individual nurse’s responsibilities, as well as considering the wider issues affecting patients, colleagues and society as a whole. This third edition is fully updated, and takes into account recent changes in ICN position statements, WHO documents, as well as addressing (...) current issues in healthcare, such as providing for the health and care needs of refugees and asylum seekers, bioethics and the enforcement of nursing codes. (shrink)

Background: Ethical challenges are common in clinical nursing practice, and an infectious environment could put nurses under ethical challenges more easily, which may cause nurses to submit to negative emotions and psychological pressure, damaging their mental health. Purpose: To examine the ethical challenges encountered by nurses caring for patients with the novel coronavirus pneumonia and to provide nurses with suggestions and support regarding promotion of their mental health. Research design and method: A qualitative study was carried out using a qualitative (...) content analysis. The participants were 18 nurses who agreed to attend an interview and describe their own experiences of providing care to COVID-19 patients in China. They were purposively sampled, and structured, in-depth interviews were performed. Data were iteratively collected and analyzed from February to March 2020. Ethical considerations: The proposal was approved by the Research Ethics Committee of the Second Hospital of Shandong University, China. Findings: The findings revealed three main themes and 10 categories. The themes were the following: ethical challenges ; coping styles ; and impacts on career. Conclusion: Nurses faced ethical challenges on multiple fronts in caring for COVID-19 patients. The results may help nurses with more safety, ethics, and humanistic care in nursing practice. (shrink)

Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of (...) ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes. (shrink)

Background Ethical conflict is a problem with negative consequences, which can compromise the quality and ethical standards of the nursing profession and it is a source of stress for health care practitioners’, especially for nurses. Objectives The main aim of this study was to analyze Spanish critical care nurses’ level of exposure to ethical conflict and its association with sociodemographic, occupational, and COVID-19–related variables. Research Design, Participants, and Research context: This was a quantitative cross-sectional descriptive study conducted among 117 nurses (...) working in critical care units. Data collection tools were sociodemographic, occupational, and COVID-19–related questionnaires and previously validated Spanish version of Ethical Conflict in Nursing Questionnaire-Critical Care Version. Ethical Considerations We obtained permission from the Ethics Committee and participants' informed consent. Findings Data indicates a moderate level of exposure to ethical conflicts. The most frequent ethical conflicts were related to situations about "treatment and clinical procedures." The most intensity of ethical conflicts was related to situations about "treatment and clinical procedures" and "dynamics of the service and working environment." No statistical significance was identified between the socio-demographic variables and level of exposure to ethical conflicts. However, for critical care nurses working in ICU, nurses with perceived worked stress had a higher level of exposure to ethical conflicts. Likewise, critical care nurses whose family/friends were infected with COVID-19 had a higher level of exposure. Conclusions Critical care nurses experience a moderate level of exposure to ethical conflicts which is consistent with the results of previous studies. A deeper understanding of ethical conflicts in conflictive situations allows recognition of the situations that occur in everyday clinical practice, identification of the ethical conflicts, and facilitation of the nurses working in the challenging clinical situation. (shrink)

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. (shrink)