Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

This article presents the works of great Polish philosopher, Mieczysław Albert Krąpiec, whose creative output can be applied to professional nursing practice. Krąpiec's philosophical heritage is extensive and encompasses many philosophical fields: metaphysics, philosophical anthropology, philosophy of law, philosophy of culture, philosophy of politics and philosophy of language. Krąpiec created an original philosophical synthesis characterized by a realistic approach. In this paper, I present only one of several original philosophical concepts developed by Krąpiec: the theory of the person based on (...) seven essential characteristics, that is the ability for cognition, love, freedom, religion, legal subjectivity, completeness and dignity. I attempt to show how these personal characteristics correspond to various patient needs. I argue that the qualitative deficit of any personal characteristics indicated by Krąpiec corresponds to a patient's real need that must be satisfied. I also stress that the skilful diagnosing of all—not only selected—qualitative deficits of characteristics can be defined as holistic care in the nursing profession. (shrink)

A case study provides the basis for consideration of the purpose of business ethics teaching, the importance of reflection and the evaluation of ethics teaching. The way in which personal reflection and an increased capacity for ethical action can be encouraged and openly identified as aims of the course is discussed. The paper considers changes in the design and delivery of the international management ethics and values course taught at the University of South Australia as part of the undergraduate management (...) degree in Australia, Singapore and Hong Kong. As a result of student and teaching staff responses, and course evaluations, the course design, teaching and assessment has moved steadily toward an aim which explicitly refers to behaviour, without losing the significant conceptual base. Ways in which opportunities can be provided to enhance the development of a reflective capability are considered, including narrative, role models, ethical reflection, journal‐keeping and practice. The changes required a change in assessment practice. The difficulties of assessing intention and commitment to ethical action, whether in an individual course or across the curriculum, are discussed. (shrink)

A case study provides the basis for consideration of the purpose of business ethics teaching, the importance of reflection and the evaluation of ethics teaching. The way in which personal reflection and an increased capacity for ethical action can be encouraged and openly identified as aims of the course is discussed. The paper considers changes in the design and delivery of the international management ethics and values course taught at the University of South Australia as part of the undergraduate management (...) degree in Australia, Singapore and Hong Kong. As a result of student and teaching staff responses, and course evaluations, the course design, teaching and assessment has moved steadily toward an aim which explicitly refers to behaviour, without losing the significant conceptual base. Ways in which opportunities can be provided to enhance the development of a reflective capability are considered, including narrative, role models, ethical reflection, journal-keeping and practice. The changes required a change in assessment practice. The difficulties of assessing intention and commitment to ethical action, whether in an individual course or across the curriculum, are discussed. (shrink)

The aim of the present study was to describe and explore the perception of ethical guidelines and their role in ethical competence-building among Swedish physicians and research nurses. Twelve informants were interviewed in depth. The results demonstrated that the informants had a critical attitude towards ethical guidelines and claimed to make little use of them in practical moral judgements. Ethical competence was seen primarily as character-building, related to virtues such as being empathic, honest and loyal to patients. Ethical competence was (...) assumed to be learned through good examples, role models and practical experience, while ethical guidelines were not perceived as valuable in this process. In order to improve the staff's familiarity with and the usability of ethical guidelines, the workplace needs to provide opportunities for ethical dialogues. In such discussions, argumentation can improve, virtues can be developed and guidelines can be usefully invoked. (shrink)

Bioethics education has remarkably grown across the globe in the last few decades. The data of the UNESCO Global Ethics Observatory proves that bioethics education is a global phenomenon with various bioethics institutions, teaching programs, and academicians. However, this situation does not mean that bioethics education has reached a stable and flawless level. Especially, the effectiveness of bioethics programs or their quality assessment is a major area that should be analyzed through more academic works. For filling that gap, this article (...) aims to formulate a general framework to address the quality standards and indicators in bioethics education. The article adapts Donabedian’s three approaches—structure, process, and outcome— as three levels to measure quality in bioethics education. The proposed model considers the indicators the ultimate quantifiable points by creating a sequential classification as the three levels, main categories, standards, and indicators, which means that it applies an inductive approach following a path from the indicators to the standards, from the standards to the main categories, and from the main categories to the levels in order to reach a conclusion about the effectiveness of each level. (shrink)

Through narrative reflections of Jack?s story of inclusive recreational sport, the meaning of dignity in professional practice is explored. Jack?s story is one of respect, strong humiliation and embarrassment, and vulnerability. Through the lens of relational ethics, the aggression of a stranger illustrates how the lack of mutual respect, compassion and knowledge creates experiences of indignity. Jack?s story highlights how relationships can shape, constrain and enable lives. Understanding that which constitutes a dignified recreational sport context for instructors and participants opens (...) opportunities for authentic social relationships based upon respect of oneself, as well as others to emerge. Jack?s narrative further reinforces the need to create pedagogical spaces for discussions of various forms of dignity and ethical professional practice in inclusive recreational sport contexts. (shrink)

The purpose of this qualitative study was to analyse nurses’ professional dignity in their everyday working lives. We explored the factors that affect nursing professional dignity in practice that emerge in relationships with health professionals, among clinical nurses working in hospitals and in community settings in central Italy. The main themes identified were: (i) nursing professional dignity perceived as an achievement; (ii) recognition of dignity beyond professional roles. These two concepts are interconnected. This study provides insights into professional dignity in (...) nursing being perceived as an achievement linked to the intrinsic dignity of every human being. The ‘nursing professional dignity perceived as an achievement’ was perceived as having declined in different social factors. Some factors of nursing professional dignity perceived as an achievement were attained more easily in community settings. ‘Recognition of dignity beyond professional roles’ underpins the intrinsic dignity as an expression of humanity, embedded in persons regardless of any profession, and values, such as: respect, moral integrity, humility, working conscientiously and kindness. (shrink)

The Aristotelian‐Thomist philosopher holds that human intellectual knowledge is possible because of the order in the world and natural human capacities. It is the position of this paper that there is a shared human form or nature that unites all humanity as members of the same kind. Moral treatment is due to every human being because they are human, and is not based upon expression of abilities. Humans have substantial dynamic existence in the world, an existence which overflows in expressive (...) relationships. As both patient and health professional are human, human nature forms the natural foundation of health care. This paper looks towards human nature for moral guidance. The therapeutic relationship is seen as a part of the interpersonal moral space formed by human relationality, which tends towards community – in this case, the healthcare system. The therapeutic relationship is also a source of moral responsibility, as illness makes the patient vulnerable, while knowledge and nursing capacities generate in the nurse a duty to care. Nursing theory serves to connect philosophical reflection and nursing practice. Imogene King's conceptual system and theory of Goal Attainment is the theory that follows from the perspective of human person being presented. This synthesis of philosophy and theory is developed with the goal of shedding light on healthcare decisions in palliative care. The article concludes with the acknowledgement that the complexity of contextualized individual decisions requires the insight and discipline of the moral practitioner, and provides some thoughts on how education, development, and refinement transform an individual into a nurse. (shrink)

The purpose of this qualitative study was to analyse nurses’ professional dignity in their everyday working lives. We explored the factors that affect nursing professional dignity in practice that emerge in relationships with health professionals, among clinical nurses working in hospitals and in community settings in central Italy. The main themes identified were: (i) nursing professional dignity perceived as an achievement; (ii) recognition of dignity beyond professional roles. These two concepts are interconnected. This study provides insights into professional dignity in (...) nursing being perceived as an achievement linked to the intrinsic dignity of every human being. The ‘nursing professional dignity perceived as an achievement’ was perceived as having declined in different social factors. Some factors of nursing professional dignity perceived as an achievement were attained more easily in community settings. ‘Recognition of dignity beyond professional roles’ underpins the intrinsic dignity as an expression of humanity, embedded in persons regardless of any profession, and values, such as: respect, moral integrity, humility, working conscientiously and kindness. (shrink)

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. Ethical competence can be (...) developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

The health sector is facing many challenges, and there is a need to maintain the delivery of high‐quality health‐care. Issues related to equity and access to health‐care have emerged in a context of an economic recession in which the sustainability of the health system depends on everyone, including the actions and decisions of professionals. Therefore, nurses and their skills may be the answer to ethical, professional and community health management, but this recession could lead to major problems in the education (...) of nurses in daily health‐care practice. Due to the limited availability of resources, nurses are increasingly taking leadership positions, continuing to develop their critical abilities and thinking skills, and considering sciences such as deontology and ethics. The main goals of this study were to reflect on the economic recession and its impact on health‐care and to demonstrate the contribution of nursing to the sustainability of health‐care and in the promotion of individuals' dignity. The authors conclude that health‐care depends on economic redistribution and, in this context, needs to be equitable and fair. Nurses have the responsibility to develop their profession according to the underlying sciences and can therefore strategically help the healthcare system. (shrink)

The target article by Grady and colleagues (2008) is a valuable and exciting contribution to the debate about the importance of ethics education for nurses. The findings indicated that ethics educa...