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Lukyanchenko, E. A. "Human Capital: Moral and Ethical Aspects." MGIMO Review of International Relations, no. 3(30) (June 28, 2013): 142–43. http://dx.doi.org/10.24833/2071-8160-2013-3-30-142-143.
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Sychev, A. A., E. V. Zaytseva, and P. S. Tolkachev. "MORAL-ETHICAL ASPECTS OF THE DIGITAL ECONOMY." Vestnik Universiteta, no. 1 (March 23, 2020): 36–42. http://dx.doi.org/10.26425/1816-4277-2020-1-36-42.
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At the present stage, the digital (information) economy is playing an increasingly important role in the world economy and national economies. Using rapid exchange of information benefits allows economic agents at all levels (from ordinary consumers to large corporations and state bodies, regulating economic relations) to make more accurate decisions in various economic issues. It is obvious, that the creation of the Russian information system will be able to increase the efficiency of our national economy (including the objectives of its state regulation) and at the same time raise the level of the country’s security. However, the effective use of the digital economy does not only depend on the level of development of the technical base of the information system. Only the moral state of society can send the information received for the benefit of all its members.
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Parent, Bea. "Moral, ethical, and legal aspects of infection control." American Journal of Infection Control 13, no. 6 (December 1985): 278–80. http://dx.doi.org/10.1016/0196-6553(85)90030-6.
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Rostotskaya, Marianna Albertovna. "Moral Aspects of Russian PreRevolutionary Cinema." Journal of Flm Arts and Film Studies 3, no. 4 (December 15, 2011): 8–17. http://dx.doi.org/10.17816/vgik348-17.
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Yevgeniy Bauer was an outstanding exponent of the refined mass culture that began to penetrate into spiritual life at the beginning of the 20th century. The article investigates the moral conflicts and patterns that lay behind Bauer’s films and reflected the ethical guidelines of the mass audience in Pre-Revolutionary Russia
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Hunt, Geoffrey. "Moral Crisis, Professionals and Ethical Education." Nursing Ethics 4, no. 1 (January 1997): 29–38. http://dx.doi.org/10.1177/096973309700400104.
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Western civilization has probably reached an impasse, expressed as a crisis on all fronts: economic, technological, environmental and political. This is experienced on the cultural level as a moral crisis or an ethical deficit. Somehow, the means we have always assumed as being adequate to the task of achieving human welfare, health and peace, are failing us. Have we lost sight of the primacy of human ends? Governments still push for economic growth and technological advances, but many are now asking: economic growth for what, technology for what? Health care and nursing are caught up in the same inversion of human priorities. Professionals, such as nurses and midwives, need to take on social responsibilities and a collective civic voice, and play their part in a moral regeneration of society. This involves carrying civic rights and duties into the workplace.
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Corley, Mary C., Ptlene Minick, R. K. Elswick, and Mary Jacobs. "Nurse Moral Distress and Ethical Work Environment." Nursing Ethics 12, no. 4 (July 2005): 381–90. http://dx.doi.org/10.1191/0969733005ne809oa.
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This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity.
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Fida, Roberta, Carlo Tramontano, Marinella Paciello, Mari Kangasniemi, Alessandro Sili, Andrea Bobbio, and Claudio Barbaranelli. "Nurse moral disengagement." Nursing Ethics 23, no. 5 (August 2016): 547–64. http://dx.doi.org/10.1177/0969733015574924.
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Background: Ethics is a founding component of the nursing profession; however, nurses sometimes find it difficult to constantly adhere to the required ethical standards. There is limited knowledge about the factors that cause a committed nurse to violate standards; moral disengagement, originally developed by Bandura, is an essential variable to consider. Research objectives: This study aimed at developing and validating a nursing moral disengagement scale and investigated how moral disengagement is associated with counterproductive and citizenship behaviour at work. Research design: The research comprised a qualitative study and a quantitative study, combining a cross-validation approach and a structural equation model. Participants and research context: A total of 60 Italian nurses (63% female) involved in clinical work and enrolled as students in a postgraduate master’s programme took part in the qualitative study. In 2012, the researchers recruited 434 nurses (76% female) from different Italian hospitals using a convenience sampling method to take part in the quantitative study. Ethical considerations: All the organisations involved and the university gave ethical approval; all respondents participated on a voluntary basis and did not receive any form of compensation. Findings: The nursing moral disengagement scale comprised a total of 22 items. Results attested the mono-dimensionality of the scale and its good psychometric properties. In addition, results highlighted a significant association between moral disengagement and both counterproductive and citizenship behaviours. Discussion: Results showed that nurses sometimes resort to moral disengagement in their daily practice, bypassing moral and ethical codes that would normally prevent them from enacting behaviours that violate their norms and protocols. Conclusion: The nursing moral disengagement scale can complement personnel monitoring and assessment procedures already in place and provide additional information to nursing management for designing interventions aimed at increasing compliance with ethical codes by improving the quality of the nurses’ work environment.
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Sharma, Amit. "Ethical and Moral Aspects of Informed Consent: General Considerations." Journal of Research in Medical Education & Ethics 1, no. 1 (2011): 11. http://dx.doi.org/10.5958/j.2231-671x.1.1.005.
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Victoria, Dmitrieva, and Lyutikova Elena. "Moral and Ethical Conceptions of Entrepreneurs: Cross-cultural Aspects." Procedia - Social and Behavioral Sciences 86 (October 2013): 318–22. http://dx.doi.org/10.1016/j.sbspro.2013.08.571.
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Gazzard, B. G. "AIDS a Moral Issue -- Ethical, Legal and Social Aspects." Journal of Medical Ethics 18, no. 1 (March 1, 1992): 51–52. http://dx.doi.org/10.1136/jme.18.1.51-a.
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Miller, Brandi Simpson. "The Moral and Ethical Aspects of Gold Coast Foodways." Gastronomica 19, no. 1 (2019): 111–12. http://dx.doi.org/10.1525/gfc.2019.19.1.111.
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Amantova-Salmane, Liene. "ETHICAL ASPECTS OF REGIONAL ECONOMY." Latgale National Economy Research 1, no. 3 (June 23, 2011): 18. http://dx.doi.org/10.17770/lner2011vol1.3.1803.
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In the beginning of economic history, economics as a social science was closely related to ethics and had a moral dimension. The works of Aristotle and Adam Smith show that the science of economics has evolved taking into consideration the ethical stand. However, during the twentieth century, ethics was not considered in the economic analysis, but this situation transformed and ethics became a part of economics. Removing ethics from economics also removes social responsibility and critical awareness. This research analyzes the ethical aspects of regional economy. Regional economy has an ethical dimension because its main goal is to reduce the disparities between regions. There is carried out a brief reference to the relationship between ethics and economy. In the following article there are analysed ethical aspects of regional policy.
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Abou Hashish, Ebtsam Aly, and Nadia Hassan Ali Awad. "Relationship between ethical ideology and moral judgment: Academic nurse educators’ perception." Nursing Ethics 26, no. 3 (September 11, 2017): 845–58. http://dx.doi.org/10.1177/0969733017722825.
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Background: 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. Purpose: This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. Methods: 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. Findings: 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 < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between 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. Discussion: The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Conclusion: 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 competencies.
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Oelhafen, Stephan, Settimio Monteverde, and Eva Cignacco. "Exploring moral problems and moral competences in midwifery: A qualitative study." Nursing Ethics 26, no. 5 (March 27, 2018): 1373–86. http://dx.doi.org/10.1177/0969733018761174.
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Background: Most undergraduate midwifery curricula comprise ethics courses to strengthen the moral competences of future midwives. By contrast, surprisingly little is known about the specific moral competences considered to be relevant for midwifery practice. Describing these competences not only depends on generic assumptions about the moral nature of midwifery practice but also reflects which issues practitioners themselves classify as moral. Objective: The goal of this study was to gain insight into the ethical issues midwives encounter in their daily work, the key competences and resources they consider indispensable to understand and deal with them, and to assess phenomena linked to moral distress. Methods: We conducted individual semi-structured interviews with eight midwives and two other health professionals, varying in terms of years of experience and work setting. Interview transcripts were analyzed in an interdisciplinary research group, following thematic analysis. Ethical considerations: This study was not subject to approval according to the Swiss Law on Research with Humans. Participants were informed about the study goals and gave written informed consent prior to participation. Results: External constraints limiting the midwife’s and the patient’s autonomy and resulting interpersonal conflicts were found to be the most relevant ethical issues encountered in clinical practice and were most often associated with moral distress. These conflicts often arise in the context of medical interventions midwives consider as not appropriate and situations in which less experienced midwives in particular observe a lack of both interprofessional communication and trust in their professional competence. Ethical issues related to late abortions or prenatal diagnostics and selective abortions were also frequently addressed, but many midwives involved had learned to cope with them. Discussion: In the light of the ethical issues and factors contributing to phenomena of moral distress, an empirically grounded profile of moral competences is drafted. Curricular implications in the light of possible adaptations within undergraduate midwifery education are critically discussed.
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Kulju, Kati, Minna Stolt, Riitta Suhonen, and Helena Leino-Kilpi. "Ethical competence." Nursing Ethics 23, no. 4 (February 9, 2015): 401–12. http://dx.doi.org/10.1177/0969733014567025.
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Background: Exploring the concept of ethical competence in the context of healthcare is essential as it pertains to better quality of care. The concept still lacks a comprehensive definition covering the aspects of ethical expertise, ethical knowledge and action of a health professional. Objective: This article aims to report an analysis of the concept of ethical competence. Method: A modified strategy suggested by Walker and Avant was used to analyse the concept. Results: As a result, the concept of ethical competence can be defined in terms of character strength, ethical awareness, moral judgement skills and willingness to do good. Virtuous professional, experience of a professional, human communication, ethical knowledge and supporting surroundings in the organisation can be seen as prerequisites for ethical competence. Ethical competence results in the best possible solutions for the patient, reduced moral distress at work and development and democratisation of society. Conclusion: The results of the analysis establish a basis for an instrument to evaluate health professionals’ ethical competence. It will guide educators, as well as managers in healthcare, to support the development of ethical conduct in healthcare.
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Atabay, Gülem, Burcu Güneri Çangarli, and Şebnem Penbek. "Impact of ethical climate on moral distress revisited." Nursing Ethics 22, no. 1 (August 7, 2014): 103–16. http://dx.doi.org/10.1177/0969733014542674.
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Background: 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. Objectives: 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. Research design: An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Participants and research context: Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical considerations: Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Findings: 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. Discussion: 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. Conclusion: 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 conditions.
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Kulju, Kati, Riitta Suhonen, and Helena Leino-Kilpi. "Ethical problems and moral sensitivity in physiotherapy." Nursing Ethics 20, no. 5 (January 17, 2013): 568–77. http://dx.doi.org/10.1177/0969733012468462.
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This study identified and described ethical problems encountered by physiotherapists in their practice and physiotherapists’ moral sensitivity in ethical situations. A questionnaire-based survey was constructed to identify ethical problems, and the Moral Sensitivity Questionnaire Revised version was used to measure moral sensitivity. Physiotherapists (n = 116) working in public health services responded to the questionnaire. Based on the results, most of the physiotherapists encounter ethical problems weekly. They concern mainly financial considerations, equality and justice, professionalism, unethical conduct of physiotherapists or other professions and patients’ self-determination. The dimension of moral strength was emphasised in physiotherapists’ self-evaluations of their moral sensitivity. As a conclusion, ethical problems do occur not only at individual level but also at organisational and society level. Physiotherapists seem to have moral strength for speaking on behalf of the patient. Scarce resources make them feel insufficient but much could still be done to provide quality care in co-operation with other health-care professionals.
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Browman, HI, and AB Skiftesvik. "Moral, ethical and scientific aspects of welfare in aquatic organisms." Diseases of Aquatic Organisms 75 (May 4, 2007): 85. http://dx.doi.org/10.3354/dao075085.
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Tyuvina, N. A., and A. O. Nikolaevskaya. "Assisted reproductive technologies: psychoneurological, moral-ethical, and socio-cultural aspects." Neurology, Neuropsychiatry, Psychosomatics 12, no. 5 (October 25, 2020): 104–10. http://dx.doi.org/10.14412/2074-2711-2020-5-104-110.
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The paper provides a definition of sexual and reproductive health and infertility and also reflects modern ideas about ways to overcome infertility using assisted reproductive technologies, such as in vitro fertilization (IVF) and surrogacy. It shows the specificity of the impact of an IVF procedure on the mental health of a potential mother. The features of the neonatal health status, as well as neuropsychiatric disorders in babies born using the IVF procedure are described. The authors present two types of surrogacy (traditional and gestational ones) and the features of their use in different countries according to governmental legislative regulation, socioeconomic and religious factors, and cultural traditions in society. They unveil the features of a psychological relationship between the mother (surrogate and presumed one) and the fetus. The consequences of surrogacy for a surrogate mother, genetic parents, and a child himself/herself are noted to be little studied. It is shown that the development of assisted reproductive technologies (IVF and surrogacy), on the one hand, helps fight infertility and, on the other hand, entails a number of problems (moral and ethical, legal, cultural and religious, socioeconomic, and neuropsychiatric ones) that need to be solved in order to prevent psychological, neurological, and mental abnormalities in all the participants (a surrogate mother, an unborn child, and potential parents) in the assisted reproductive process:
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Ganz, Freda D., Nurit Wagner, and Orly Toren. "Nurse middle manager ethical dilemmas and moral distress." Nursing Ethics 22, no. 1 (January 29, 2014): 43–51. http://dx.doi.org/10.1177/0969733013515490.
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Background: 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. Objective: To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. Methods: 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. Results: Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Conclusion: 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.
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Ohnishi, Kayoko, Kazuyo Kitaoka, Jun Nakahara, Maritta Välimäki, Raija Kontio, and Minna Anttila. "Impact of moral sensitivity on moral distress among psychiatric nurses." Nursing Ethics 26, no. 5 (March 1, 2018): 1473–83. http://dx.doi.org/10.1177/0969733017751264.
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Background: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress. Objectives: To examine the impact of moral sensitivity on moral distress among psychiatric nurses, and affirm the hypothesis that nurses with higher moral sensitivity will suffer moral distress more than nurses with less moral sensitivity in two different samples. Ethical consideration: The study obtained ethical approval from the Research Ethics Committee of the Faculty of Medicine at Mie University (# 1111, 20.4.2010), and by the Turku University Ethics Board (29.5.2012). Permissions to undertake the study was obtained from the in two hospital districts and in one city (§ 48/4.10.2012, § 63/4.9.2012, 51/2012 27.8.2012). Informed consent was not formally obtained, because the questionnaire was anonymously reported by the participants who volunteered to answer. The participants responded voluntarily and anonymously. Methods: An anonymous questionnaire containing the Revised Moral Sensitivity Questionnaire and the Moral Distress Scale for Psychiatric nurses was conducted to 997 nurses in 12 hospitals in Japan, and 974 nurses in 10 hospitals in Finland after obtaining of approval by research ethics committees. Data were analyzed using a multi-group structural equation model analysis. Findings: A set of analyses imply that the association of moral sensitivity with moral distress is significant and similar between Japan and Finland, whereas the factor structures of moral sensitivity and moral distress may be partially different. Discussion: The result of this study may indicate that nurses with high moral sensitivity can sense and identify moral problems, but not resolve them. Therefore, supporting nurses to solve ethical problems, not benumbing them, can be important for better nursing care and prevention of nurses’ resignation. Conclusion: Moral sensitivity and moral distress were positively correlated among psychiatric nurses in both Japan and Finland, although the participating nurses from the two countries were different in qualification, age, and cultural background. Nurses with high moral sensitivity suffer from moral distress.
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Deschenes, Sadie, and Diane Kunyk. "Situating moral distress within relational ethics." Nursing Ethics 27, no. 3 (December 5, 2019): 767–77. http://dx.doi.org/10.1177/0969733019884621.
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Nurses may, and often do, experience moral distress in their careers. This is related to the complicated work environment and the complex nature of ethical situations in everyday nursing practice. The outcomes of moral distress may include psychological and physical symptoms, reduced job satisfaction and even inadequate or inappropriate nursing care. Moral distress can also impact retention of nurses. Although research has grown considerably over the past few decades, there is still a great deal about this topic that we do not know including how to deal well with moral distress. A critical key step is to develop a deeper understanding of relational practice as it pertains to moral distress. In this article, exploration of the experience of moral distress among nurses is guided by the key elements of relational ethics. This ethical approach was chosen because it recognizes that ethical practice is situated in relationships and it acknowledges the importance of the broader environment on influencing ethical action. The findings from this theoretical exploration will provide a theoretical foundation upon which to advance our knowledge about moral distress.
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Asgari, Sharareh, Vida Shafipour, Zohreh Taraghi, and Jamshid Yazdani-Charati. "Relationship between moral distress and ethical climate with job satisfaction in nurses." Nursing Ethics 26, no. 2 (July 18, 2017): 346–56. http://dx.doi.org/10.1177/0969733017712083.
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Background: Moral distress and ethical climate are important issues in the workplace that appear to affect people’s quality of work life. Objectives: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. Materials and methods: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling. Data were collected using a demographic questionnaire, the Moral Distress Scale–Revised, the Olson’s Hospital Ethical Climate Survey, and the Brayfield and Rothe Job Satisfaction index. Ethical considerations: The research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences and the Medical Deputy of the Social Security Organization. Findings: The mean scores obtained by the critical care nurses for moral distress, ethical climate, and job satisfaction were 87.02 ± 44.56, 3.51 ± 0.53, and 62.64 ± 9.39, respectively. Although no significant relationships were observed between moral distress and job satisfaction, the relationship between ethical climate and job satisfaction was statistically significant (p < 0.05). Conclusion: Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.
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Pauly, Bernadette, Colleen Varcoe, Janet Storch, and Lorelei Newton. "Registered Nurses’ Perceptions of Moral Distress and Ethical Climate." Nursing Ethics 16, no. 5 (August 11, 2009): 561–73. http://dx.doi.org/10.1177/0969733009106649.
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Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients.
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Schluter, Jessica, Sarah Winch, Kerri Holzhauser, and Amanda Henderson. "Nurses' Moral Sensitivity and Hospital Ethical Climate: a Literature Review." Nursing Ethics 15, no. 3 (May 2008): 304–21. http://dx.doi.org/10.1177/0969733007088357.
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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.
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Lützén, Kim, Tammy Blom, Béatrice Ewalds-Kvist, and Sarah Winch. "Moral stress, moral climate and moral sensitivity among psychiatric professionals." Nursing Ethics 17, no. 2 (February 25, 2010): 213–24. http://dx.doi.org/10.1177/0969733009351951.
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The aim of the present study was to investigate the association between work-related moral stress, moral climate and moral sensitivity in mental health nursing. By means of the three scales Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire and Work-Related Moral Stress, 49 participants’ experiences were assessed. The results of linear regression analysis indicated that moral stress was determined to a degree by the work place’s moral climate as well as by two aspects of the mental health staff’s moral sensitivity. The nurses’ experience of ‘moral burden’ or ‘moral support’ increased or decreased their experience of moral stress. Their work-related moral stress was determined by the job-associated moral climate and two aspects of moral sensitivity. Our findings showed an association between three concepts: moral sensitivity, moral climate and moral stress. Despite being a small study, the findings seem relevant for future research leading to theory development and conceptual clarity. We suggest that more attention be given to methodological issues and developing designs that allow for comparative research in other disciplines, as well as in-depth knowledge of moral agency.
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Zhang, Na, Mingfang Li, Zhenxing Gong, and Dingxin Xu. "Effects of ethical leadership on nurses’ service behaviors." Nursing Ethics 26, no. 6 (August 5, 2018): 1861–72. http://dx.doi.org/10.1177/0969733018787220.
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Background: Nurses’ service behaviors have critical implications for hospitals. However, few studies had adequate ethical considerations of service behaviors and accounted for how organizational or individual antecedents can induce nurses to engage in service behaviors. In addition, they mainly focused on the one side of role-prescribed or extra-role service behavior. Objective: This study aims to explore the chained mediation effect of ethical climate and moral sensitivity on the relationship between organizational ethical leadership and nurses’ service behaviors and to examine the relationship, from a comparative view, of the role-prescribed service behavior and extra-role service behavior. Methods: In all, 476 nurses from three tertiary hospitals were investigated with the Ethical Leadership Scale, Ethical Climate Scale, Moral Sensitivity Questionnaire and Service Behavior Questionnaire. Structural equation modeling was adopted to analyze the data. SPSS and Mplus statistical software was used in the data analysis. Ethical considerations: Approval was obtained from the Ethics Committee at School of Nursing, Hebei Medical University. Data privacy and confidentiality were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection. Results: The effects of ethical leadership on nurses’ service behaviors are mediated by two variables in turn: ethical climate and nurses’ moral sensitivity. Ethical climate and moral sensitivity partially mediated the relationship between ethical leadership and nurses’ role-prescribed service behavior and fully mediated the relationship between ethical leadership and nurses’ extra-role service behavior. Conclusion: Organizational ethical leadership positively affected ethical climate, which positively affected nurses’ moral sensitivity and affected both their role-prescribed service behavior and extra-role service behavior.
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Kälvemark Sporrong, Sofia, Bengt Arnetz, Mats G. Hansson, Peter Westerholm, and Anna T. Höglund. "Developing Ethical Competence in Health Care Organizations." Nursing Ethics 14, no. 6 (November 2007): 825–37. http://dx.doi.org/10.1177/0969733007082142.
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Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.
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Ventovaara, Päivi, Margareta af Sandeberg, Janne Räsänen, and Pernilla Pergert. "Ethical climate and moral distress in paediatric oncology nursing." Nursing Ethics 28, no. 6 (March 11, 2021): 1061–72. http://dx.doi.org/10.1177/0969733021994169.
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Background: Ethical climate and moral distress have been shown to affect nurses’ ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses’ perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. Ethical considerations: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. Results: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. Discussion: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. Conclusion: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.
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Kolodko, G. "Ethical Aspects of Business, Economy and Politics." Voprosy Ekonomiki, no. 11 (November 20, 2007): 44–54. http://dx.doi.org/10.32609/0042-8736-2007-11-44-54.
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Despite the main attention being given within the economic activity to the issues of efficiency and competitiveness, one shouldn’t oversee the ethical aspects of business and economic policy. Quite important are also the matters of truth and false in economic research. Several phenomena and processes - subsidies, dumping, weapons trading, fiscal system and policy - do have also their moral dimension, not just the economic one. Hence, the issues of ethics should be considered and discussed in a wider context. From this perspective there is still a lot to be done, especially in the countries with weak market institutions and relatively lower quality of market culture, including post-socialist countries in transition to market system.
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Norvoll, Reidun, and Reidar Pedersen. "Patients’ moral views on coercion in mental healthcare." Nursing Ethics 25, no. 6 (October 27, 2016): 796–807. http://dx.doi.org/10.1177/0969733016674768.
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Background: Coercion in mental healthcare has led to ethical debate on its nature and use. However, few studies have explicitly explored patients’ moral evaluations of coercion. Aim: The purpose of this study is to increase understanding of patients’ moral views and considerations regarding coercion. Research design: Semi-structured focus-group and individual interviews were conducted and data were analysed through a thematic content analysis. Participants and research context: A total of 24 adult participants with various mental health problems and experiences with coercion were interviewed in 2012–2013 in three regions of Norway. Ethical considerations: Ethical approval and permissions were obtained according to required procedures. Informed consent and confidentiality were also secured. Findings: Ethical considerations regarding coercion included seven main themes: the need for alternative perspectives and solutions, the existence of a danger or harm to oneself or others, the problem of paternalism, the problem of discrimination and stigma, the need for proportionality, the importance of the content and consequences of coercion and concerns about way that coercion is carried out in practice. Discussion: The participants’ views and considerations are in line with previous research and reflect the range of normative arguments commonly encountered in ethical and legal debates. The study accentuates the significance of institutional factors and alternative voluntary treatment opportunities, as well as the legal and ethical principles of proportionality and purposefulness, in moral evaluations of coercion. Conclusion: Broader perspectives on coercion are required to comprehend its ethical challenges and derive possible solutions to these from a patient perspective.
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Миславская and N. Mislavskaya. "Historical Aspects of Ancient Greek Ethics in Accounting." Auditor 2, no. 10 (October 25, 2016): 18–24. http://dx.doi.org/10.12737/22270.
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The paper attempts to prove the relationship of ethical public perceptions and degree of development of the
accounting system. The basic moral principles of ancient Greece and their impact on the approaches to accounting are
analyzed; proposals for the necessary changes in modern ethical standards in their professional activities accountant are
reasoned.
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Hermsen, Maaike, and Marjolein van der Donk. "Nurses' Moral Problems in Dialisys." Nursing Ethics 16, no. 2 (March 2009): 184–91. http://dx.doi.org/10.1177/0969733008100078.
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This article gives an overview of the moral problems experienced and described by nurses working in a dialysis unit in the Netherlands. The nurses raised a wide variety of issues that they considered were moral problems, which were grouped into seven topics. A selection of cases are described, one of which is analysed using the Nijmegen method of ethical case deliberation. This method facilitates practical approaches to the different types of moral problems encountered. The argument is made that, owing to their specific moral position and responsibility, nurses' contribution to ethical reflection in ward discussions should be valued more. All caregivers involved are indispensable in developing a basis for well-reasoned decisions when deliberating about moral problems.
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Kucukkelepce, Gulhan Erkus, Leyla Dinc, and Melih Elcin. "Effects of using standardized patients on nursing students’ moral skills." Nursing Ethics 27, no. 7 (July 30, 2020): 1587–602. http://dx.doi.org/10.1177/0969733020935954.
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Background: Nurses and nursing students increasingly confront ethical problems in clinical practice. Moral sensitivity, moral reasoning, and ethical decision-making are therefore important skills throughout the nursing profession. Innovative teaching methods as part of the ethics training of nursing students help them acquire these fundamental skills. Aim: This study investigated the effects and potential benefits of using standardized patients in ethics education on nursing baccalaureate students’ moral sensitivity, moral reasoning, and ethical decision-making by comparing this method with in-class case analyses. Research design: This is a quasi-experimental study. Participants and research context: The sample comprised 89 students in Hacettepe University’s Faculty of Nursing. Following lectures describing the theoretical components of ethics, students were randomly assigned to two working groups, one using standardized patients and the other using in-class case analyses. Data were collected using the Moral Sensitivity Questionnaire, Rest’s Defining Issues Test, and the Nursing Dilemma Test. All data were analysed using IBM SPSS Statistics Version 23. Ethical considerations: Ethical approval and official permission were obtained. All participating students completed informed consent forms. Findings: According to the results, the moral sensitivity of students in the standardized patient group significantly improved over time compared to those in the case analysis group, while the mean scores of students in both groups for moral reasoning and ethical decision-making were not statistically significant. Conclusion: Based on our results, we recommend the use of both standardized patients and case analysis as appropriate teaching methods in ethics education.
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Prentovic, Risto. "Ethical aspects of hunting tourism in Serbia." Zbornik Matice srpske za drustvene nauke, no. 144 (2013): 523–38. http://dx.doi.org/10.2298/zmsdn1344523p.
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The aim of this paper is to examine contemporary moral controversies about hunting tourism in Serbia in the context of defined value orientations and norms of ethics of hunting tourism, as a branch of applied ethics. On the one hand, this paper summarizes conceptual definitions and specificities of hunting tourism, as a special form of tourism, and the crucial value postulates derived from the assumptions of the concept of sustainable development and biodiversity conservation, and philosophical, theological and legal settings of man?s attitude towards animals and their welfare, as well as the standard code of hunting ethics and issues of business ethics in hunting tourism, on the other. The paper also cites some examples of ethically problematic phenomena in modern hunting tourism in Serbia and offers possible solutions to overcome them.
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Krawczyk, Rosemary M. "Teaching Ethics: Effect on Moral Development." Nursing Ethics 4, no. 1 (January 1997): 57–65. http://dx.doi.org/10.1177/096973309700400107.
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The purpose of this study was to determine the development of moral judgement in first-year and senior baccalaureate nursing students. These students were enrolled in three separate nursing programmes, each of which differed significantly in ethical content. The sample totalled 180 students enrolled in three New England programmes. Programme A included an ethics course taught by a professor of ethics. Programme B integrated ethical issues into all nursing theory courses. Programme C did not include ethical content in theory courses. The design was of a developmental cross-sectional study. The dependent variable was the development of moral judgement, as measured by Rest’s Defining Issues Test. The independent variable was the amount of ethics taught in the nursing programmes and the level of academic education. The senior nursing students from programme A scored significantly higher than the other senior groups on the Defining Issues Test. The conclusion is that an ethics course with group participation and a decision-making element significantly facilitated nursing students’ development of moral judgement.
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Martinson, Ryan. "Moral and Ethical Aspects of Autonomous Vehicles and Mobility ( breakout presentation )." Journal of Transport & Health 7 (December 2017): S65. http://dx.doi.org/10.1016/j.jth.2017.11.106.
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NACASATO, Rayssa Pereira, Rafael Aiello BOMFIM, and Alessandro Diogo DE-CARLI. "Ethical and moral development: aspects relating to professional training in Dentistry." RGO - Revista Gaúcha de Odontologia 64, no. 1 (March 2016): 43–49. http://dx.doi.org/10.1590/1981-863720160001000063056.
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ABSTRACT Objective: To assess the progression of a public university's dental students through stages of moral development during the course. Methods: A cross-sectional study with 115 students (from the 1st to the 7th semester), to whom the "Opiniões sobre problemas sociais" test, adapted and translated to the Portuguese language, was applied. Results: The collected answers were charted according to the test manual's guidelines and data were analyzed by the GraphPad Prism software 6.0 and STATA v.13. Principal morality score values, expressed as a P value (%), were 40.26%; 39.32%; 36.45% and 36.27% for the 1st, 3rd, 5th and 7th semesters, respectively, with no statistically significant difference between the groups (ANOVA, p = 0.52). Conclusion: Students' degrees of morality did not vary significantly among the semesters compared, indicating the need for a reorientation of teaching-learning practices that takes the potential of transformative learning into account.
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Gluchman, Vasil. "Pious Aspects in the Ethical and Moral Views of Matthias Bel." History of European Ideas 39, no. 6 (July 4, 2013): 776–90. http://dx.doi.org/10.1080/01916599.2013.816540.
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Yaremin, B. I., S. Yu Pushkin, A. S. Navasardyan, A. A. Selyutin, K. K. Gubarev, and V. E. Alexandrova. "Moral and ethical aspects of organ donation for transplantation – catechism project." Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH), no. 1 (April 13, 2021): 97–108. http://dx.doi.org/10.20340/vmi-rvz.2021.1.tx.3.
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The moral and ethical aspects of organ donation for transplantation constitute a new section of the doctor's activity. The correct and motivated awareness of the answers to the main questions that may arise from members of the public, patients, members of their families, medical personnel, undoubtedly, is within the competence of the doctor. This work is devoted to the analysis of existing approaches to answering the main questions arising around the activity of preserving the organs of the deceased for transplantation. The work was done in the format of a catechism, questions and the answers offered to them. Answers are given as one of the options.
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Linder, G. Fletcher, Allison J. Ames, William J. Hawk, Lori K. Pyle, Keston H. Fulcher, and Christian E. Early. "Teaching Ethical Reasoning." Teaching Ethics 19, no. 2 (2019): 147–70. http://dx.doi.org/10.5840/tej202081174.
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This article presents evidence supporting the claim that ethical reasoning is a skill that can be taught and assessed. We propose a working definition of ethical reasoning as 1) the ability to identify, analyze, and weigh moral aspects of a particular situation, and 2) to make decisions that are informed and warranted by the moral investigation. The evidence consists of a description of an ethical reasoning education program—Ethical Reasoning in Action (ERiA)—designed to increase ethical reasoning skills in a variety of situations and areas of life. ERiA is housed at a public, major comprehensive U.S. university—James Madison University—and assessment of the program focuses on interventions delivered prior to and during orientation for incoming first-year students. Findings indicate that the interventions measurably enhance the ability of undergraduate students to reason ethically. ERiA’s competency-targeted program and positive student learning outcomes offers a promising model for higher education ethics programs seeking to connect classroom learning in ethics to decision-making in everyday life.
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Numminen, Olivia, Hanna Repo, and Helena Leino-Kilpi. "Moral courage in nursing: A concept analysis." Nursing Ethics 24, no. 8 (March 22, 2016): 878–91. http://dx.doi.org/10.1177/0969733016634155.
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Background: 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. Objective: This article is an analysis of the concept of moral courage in nursing. Design: Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis. Data sources: 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. Results: 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. Discussion and conclusion: 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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Tuvesson, Hanna, and Kim Lützén. "Demographic factors associated with moral sensitivity among nursing students." Nursing Ethics 24, no. 7 (January 28, 2016): 847–55. http://dx.doi.org/10.1177/0969733015626602.
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Background: 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. Objectives: 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. Research design: 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. Findings: 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. Discussion and conclusion: 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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Miller, Franklin G. "Research Ethics and Misguided Moral Intuition." Journal of Law, Medicine & Ethics 32, no. 1 (2004): 111–16. http://dx.doi.org/10.1111/j.1748-720x.2004.tb00455.x.
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The term therapeutic misconception was coined by Paul Appelbaum and his colleagues to describe the tendency of patients enrolled in clinical trials to confuse research participation with the personal clinical attention characteristic of medical care. It has not been recognized that an analogous therapeutic misconception pervades ethical thinking about clinical research with patient-subjects. Investigators and bioethicists often judge the ethics of clinical research based on ethical standards appropriate to the physician-patient relationship in therapeutic medicine. This ethical approach to clinical research constitutes a misconception because it fails to appreciate the ethically significant differences between clinical research and clinical care.In this article I argue that the assumption that the ethical principles governing the practice of therapeutic medicine should also apply to clinical research with patient- subjects produces incoherence in research ethics and erroneous guidance concerning certain controversial research designs.
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de Casterlé, Bernadette Dierckx, Mieke Grypdonck, Magda Vuylsteke-Wauters, and Piet J. Janssen. "Nursing Students’ Responses to Ethical Dilemmas in Nursing Practice." Nursing Ethics 4, no. 1 (January 1997): 12–28. http://dx.doi.org/10.1177/096973309700400103.
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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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Lee, Hsiao Lu, Shu-He Huang, and Chiu-Mieh Huang. "Evaluating the effect of three teaching strategies on student nurses’ moral sensitivity." Nursing Ethics 24, no. 6 (January 27, 2016): 732–43. http://dx.doi.org/10.1177/0969733015623095.
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Background: 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. Objectives: 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. Research design: This was a quasi-experimental study. Participants: 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. Results: 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. Conclusion: 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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Huang, Fei Fei, Qing Yang, Jie Zhang, Qing Hua Zhang, Kaveh Khoshnood, and Jing Ping Zhang. "Cross-cultural validation of the moral sensitivity questionnaire-revised Chinese version." Nursing Ethics 23, no. 7 (August 3, 2016): 784–93. http://dx.doi.org/10.1177/0969733015583183.
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Background: Ethical issues pose challenges for nurses who are increasingly caring for patients in complicated situations. Ethical sensitivity is a prerequisite for nurses to make decisions in the best interest of their patients in daily practice. Currently, there is no tool for assessing ethical sensitivity in Chinese language, and no empirical studies of ethical sensitivity among Chinese nurses. Research objectives: The study was conducted to translate the Moral Sensitivity Questionnaire–Revised Version (MSQ-R) into Chinese and establish the psychometric properties of the Moral Sensitivity Questionnaire–Revised Version into Chinese (MSQ-R-CV). Research design: This research was a methodological and descriptive study. Participants and research context: MSQ-R was translated into Chinese using Brislin’s model, and the Translation Validity Index was evaluated. MSQ-R-CV was then distributed along with a demographic questionnaire to 360 nurses working at tertiary and municipal hospitals in Changsha, China. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Findings: MSQ-R-CV achieved Cronbach’s alpha 0.82, Spearman-Brown coefficient 0.75, significant item discrimination (p < 0.001), and item-total correlation values ranging from 0.524 to 0.717. A two-factor structure was illustrated by exploratory factor analysis, and further confirmed by confirmatory factor analysis. Chinese nurses had a mean total score of 40.22 ± 7.08 on the MSQ-R-CV, and sub-scores of 23.85 ± 4.4 for moral responsibility and strength and 16.37 ± 3.75 for sense of moral burden. Discussion: The findings of this study were compared with studies from other countries to examine the structure and meaningful implications of ethical sensitivity in Chinese nurses. Conclusion: The two-factor MSQ-R-CV (moral responsibility and strength, and sense of moral burden) is a linguistically and culturally appropriate instrument for assessing ethical sensitivity among Chinese nurses.
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Horstman, Klasien, and Engeline van Rens-Leenaarts. "Beyond the Boundary Between Science and Values: re-evaluating the moral dimension of the nurse’s role in cot death prevention." Nursing Ethics 9, no. 2 (March 2002): 137–54. http://dx.doi.org/10.1191/0969733002ne494oa.
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This article combines a philosophical critique of the idea that public health nurses are primary technicians who neutrally hand over scientifically established facts on risks to the public and an empirical analysis of the actual work of public health nurses. It is argued that the relationship between facts and values in public health is complex and that, despite the introduction of several scientifically-based standards and guidelines, public health nurses are not technicians. They do moral work and experience ethical dilemmas. To get a grip on the specific character of this moral work, we distance ourselves from the idea that there are ethical dilemmas in public health nursing for which we can provide general ethical rules and principles. Instead we suggest a contextual ethical approach, in which several different kinds of consideration may be important. To illustrate this, we analysed 15 in-depth interviews with nurses involved in the prevention of cot deaths in the Netherlands. It is shown that these nurses do not neutrally pass on the epidemiological facts on the risks of prone sleeping, warm bedclothes and passive smoking, but they are the moral architects of this preventive practice. It is also shown that this moral work and the ethical dilemmas they experience cannot be characterized in terms of general ethical rules and principles. It becomes clear that the moral work of nurses differs according to the three main risks at stake: the balance between virtue, risk taking and responsibility depends on the specific context.
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Ko, Hsun-Kuei, Hui-Chen Tseng, Chi-Chun Chin, and Min-Tao Hsu. "Phronesis of nurses: A response to moral distress." Nursing Ethics 27, no. 1 (April 11, 2019): 67–76. http://dx.doi.org/10.1177/0969733019833126.
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Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress.
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Pinch, W. J. Ellenchild, and Mary E. Parsons. "Moral Orientation of Elderly Persons: considering ethical dilemmas in health care." Nursing Ethics 4, no. 5 (September 1997): 380–93. http://dx.doi.org/10.1177/096973309700400504.
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Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons ( n = 20) in order to explore and describe their moral orientation based on the paradigms of justice (Kohlberg) and care (Gilligan). The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men’s moral reasoning was dominated by caring, but justice dominated the reasoning of four women. The implications for ethical decision-making and future research are discussed.