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  1. Ethical issues experienced by healthcare workers in nursing homes.Deborah H. L. Preshaw, Kevin Brazil, Dorry McLaughlin & Andrea Frolic - 2016 - Nursing Ethics 23 (5):490-506.
    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 (...)
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  • Ethical competence.Kati Kulju, Minna Stolt, Riitta Suhonen & Helena Leino-Kilpi - 2016 - Nursing Ethics 23 (4):401-412.
    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 (...)
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  • Implicit and Explicit Clinical Ethics Support in The Netherlands: A Mixed Methods Overview Study. [REVIEW]Linda Dauwerse, Froukje Weidema, Tineke Abma, Bert Molewijk & Guy Widdershoven - 2014 - HEC Forum 26 (2):95-109.
    Internationally, the prevalence of clinical ethics support (CES) in health care has increased over the years. Previous research on CES focused primarily on ethics committees and ethics consultation, mostly within the context of hospital care. The purpose of this article is to investigate the prevalence of different kinds of CES in various Dutch health care domains, including hospital care, mental health care, elderly care and care for people with an intellectual disability. A mixed methods design was used including two survey (...)
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  • Ethical Reasoning and Moral Distress in Social Care Among Long-Term Care Staff.Michelle Greason - 2020 - Journal of Bioethical Inquiry 17 (2):283-295.
    There are studies on the normative ethical frameworks used by long-term care staff and studies proposing how staff should reason, but few studies explore how staff actually reason. This study reports on the ethical reasoning process and experiences of moral distress of long-term care staff in the provision of social care. Seven interdisciplinary focus groups were conducted with twenty front-line staff. Staff typically did not have difficulty determining the ethical decision and/or action; however, they frequently experience moral distress. To manage (...)
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  • Developing organisational ethics in palliative care.Lars Sandman, Ulla Molander & Inger Benkel - 2017 - Nursing Ethics 24 (2):138-150.
    Background: Palliative carers constantly face ethical problems. There is lack of organised support for the carers to handle these ethical problems in a consistent way. Within organisational ethics, we find models for moral deliberation and for developing organisational culture; however, they are not combined in a structured way to support carers’ everyday work. Research objective: The aim of this study was to describe ethical problems faced by palliative carers and develop an adapted organisational set of values to support the handling (...)
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  • Everyday Ethics in the Care of Elderly People.Ingrid Ågren Bolmsjö, Lars Sandman & Edith Andersson - 2006 - Nursing Ethics 13 (3):249-263.
    This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...)
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  • The role of guidelines in ethical competence-building: perceptions among research nurses and physicians.Anna T. HÖGlund, Stefan Eriksson & Gert Helgesson - 2010 - Clinical Ethics 5 (2):95-102.
    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 (...)
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  • Dignity of older people in a nursing home: Narratives of care providers.Rita Jakobsen & Venke Sørlie - 2010 - Nursing Ethics 17 (3):289-300.
    The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in (...)
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  • “Here's My Dilemma”. Moral Case Deliberation as a Platform for Discussing Everyday Ethics in Elderly Care.S. Dam, T. A. Abma, M. J. M. Kardol & G. A. M. Widdershoven - 2012 - Health Care Analysis 20 (3):250-267.
    Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...)
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  • Matching values to technology: a value sensitive design approach to identify values and use cases of an assistive system for people with dementia in institutional care.Stefan J. Teipel, Antonia Kowe, Doreen Görß & Stefanie Köhler - 2022 - Ethics and Information Technology 24 (3):1-17.
    The number of people with dementia is increasing worldwide. At the same time, family and professional caregivers’ resources are limited. A promising approach to relieve these carers’ burden and assist people with dementia is assistive technology. In order to be useful and accepted, such technologies need to respect the values and needs of their intended users. We applied the value sensitive design approach to identify values and needs of patients with dementia and family and professional caregivers in respect to assistive (...)
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  • Ethical competence in DNR decisions –a qualitative study of Swedish physicians and nurses working in hematology and oncology care.Mona Pettersson, Mariann Hedström & Anna T. Höglund - 2018 - BMC Medical Ethics 19 (1):63.
    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 (...)
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  • Relatives’ participation in everyday care in special care units for persons with dementia.Ann Karin Helgesen, Elsy Athlin & Maria Larsson - 2015 - Nursing Ethics 22 (4):404-416.
    Background: Research concerning relatives’ participation in the everyday care related to persons living in special care units for persons with dementia is limited. Research questions: To examine relatives’ participation in their near one’s everyday care, the level of burden experienced and important factors for participation, in this special context. Design: The study had a cross-sectional design, and data collection was carried out by means of a study-specific questionnaire. Participants and context: A total of 233 relatives from 23 different special care (...)
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  • Ethical challenges.Rita Jakobsen & Venke Sørlie - 2016 - Nursing Ethics 23 (6):636-645.
    Introduction: To meet and take care of people with dementia implicate professional and moral challenges for caregivers. Using force happens daily. However, staff also encounter challenges with the management in the units. Managing the caretaking function is also significant in how caretakers experience working in dementia care. Purpose: The purpose of this study is to explore the caregiver’s experiences with ethical challenges in dementia care settings and the significance of professional leadership in this context. Method: The design is qualitative, and (...)
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  • Organizing moral case deliberation Experiences in two Dutch nursing homes.Sandra S. Van der Dam, Tineke T. A. Abma, Bert A. C. Molewijk, Tinie M. J. M. Kardol, Jos Jmga Schols & Guy G. A. M. Widdershoven - 2011 - Nursing Ethics 18 (3):327-340.
    Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...)
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  • Need for ethics support in healthcare institutions: views of Dutch board members and ethics support staff.L. Dauwerse, T. Abma, B. Molewijk & G. Widdershoven - 2011 - Journal of Medical Ethics 37 (8):456-460.
    Next SectionObjective The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. Methods This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Findings Most respondents see a (...)
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  • Contrasts in older persons’ experiences and significant others’ perceptions of existential loneliness.Helena Larsson, Anna-Karin Edberg, Ingrid Bolmsjö & Margareta Rämgård - 2019 - Nursing Ethics 26 (6):1623-1637.
    Background: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the (...)
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  • “Here’s My Dilemma”. Moral Case Deliberation as a Platform for Discussing Everyday Ethics in Elderly Care.S. van der Dam, T. A. Abma, M. J. M. Kardol & G. A. M. Widdershoven - 2012 - Health Care Analysis 20 (3):250-267.
    Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...)
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  • Prevention of Unethical Actions in Nursing Homes.Eva Merethe Solum, Åshild Slettebø & Solveig Hauge - 2008 - Nursing Ethics 15 (4):536-548.
    Ethical problems regularly arise during daily care in nursing homes. These include violation of patients' right to autonomy and to be treated with respect. The aim of this study was to investigate how caregivers emphasize daily dialogue and mutual reflection to reach moral alternatives in daily care. The data were collected by participant observation and interviews with seven caregivers in a Norwegian nursing home. A number of ethical problems linked to 10 patients were disclosed. Moral problems were revealed as the (...)
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  • Goals of Clinical Ethics Support: Perceptions of Dutch Healthcare Institutions. [REVIEW]L. Dauwerse, T. A. Abma, B. Molewijk & G. Widdershoven - 2013 - Health Care Analysis 21 (4):323-337.
    In previous literature, ethicists mention several goals of Clinical Ethics Support (CES). It is unknown what key persons in healthcare institutions see as main–—and sub-goals of CES. This article presents the goals of CES as perceived by board members and members of ethics support staff. This is part of a Dutch national research using a mixed methods design with questionnaires, focus groups and interviews. Quantitative and qualitative data were analyzed and combined in an iterative process. Four main clusters of goals (...)
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  • A systematic review of ethical and legal issues in elder care.Nertila Podgorica, Magdalena Flatscher-Thöni, Daniela Deufert, Uwe Siebert & Michael Ganner - 2021 - Nursing Ethics 28 (6):895-910.
    Background: Ethical and legal issues are increasingly being reported by health caregivers; however, little is known about the nature of these issues in geriatric care. These issues can improve work and care conditions in healthcare, and consequently, the health and welfare of older people. Aim: This literature review aims to identify research focusing on ethical and legal issues in geriatric care, in order to give nurses and other health care workers an overview of existing grievances and possible solutions to take (...)
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  • Ethics support in institutional elderly care: a review of the literature. [REVIEW]Sandra van der Dam, Bert Molewijk, Guy A. M. Widdershoven & Tineke A. Abma - 2014 - Journal of Medical Ethics 40 (9):625-631.
    Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases . Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: ‘institutional bodies’ ; ‘frameworks’ ; ‘educational programmes and moral case deliberation’; and ‘written (...)
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  • Morality in the mundane: Specific needs for ethics support in elderly care.Linda Dauwerse, Sandra van der Dam & Tineke Abma - 2012 - Nursing Ethics 19 (1):91-103.
    Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly care. The findings of two surveys, two focus groups and 17 interviews demonstrate that the availability of ethics support is limited. There is a need for ethics support, albeit not unconditionally. Advice-based forms of ethics support (...)
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  • Maintenance of Patients' Integrity in Long-Term Institutional Care.Sari Teeri, Maritta Välimäki, Jouko Katajisto & Helena Leino-Kilpi - 2008 - Nursing Ethics 15 (4):523-535.
    This study aimed to describe and compare the views of nurses and older patients' relatives on factors restricting the maintenance of patient integrity in long-term care. The purposive sample comprised 222 nurses and 213 relatives of older patients in four Finnish long-term care institutions. The data were collected using a self-developed questionnaire addressing five sets of factors relating to patients, relatives, nurses, the organization and society. The maintenance of patient integrity was restricted by: (1) social factors, including lack of respect (...)
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  • Quality care for persons experiencing dementia: The significance of relational ethics.Gerd S. Sellevold, Veslemøy Egede-Nissen, Rita Jakobsen & Venke Sørlie - 2013 - Nursing Ethics (3):0969733012462050.
    The degree of success in creating quality care for people suffering from dementia is limited despite extensive research. This article describes Healthcare providers’ experience with the ethical challenges and possibilities in the relationship with patients suffering from dementia and its impact on quality care. The material is based on qualitative, in-depth individual narrative interviews with 12 professional Healthcare providers from two different nursing homes. The transcribed interview texts were subjected to a phenomenological–hermeneutical interpretation. To provide quality care to patients with (...)
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  • Ethical Dilemmas and Ethical Competence in the Daily Work of Research Nurses.A. T. Höglund, G. Helgesson & S. Eriksson - 2010 - Health Care Analysis 18 (3):239-251.
    In spite of the growing interest in nursing ethics, few studies have focused on ethical dilemmas experienced by nurses working with clinical studies as ‘research nurses’. The aim of the present study was to describe and explore ethical dilemmas that Swedish research nurses experience in their day-to-day work. In a qualitative study a purposeful sample of six research nurses from five wards of differing disciplines in four Swedish hospitals was interviewed. The analysis displayed several examples of ethical dilemmas, primarily tensions (...)
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  • Quality care for persons experiencing dementia.Gerd S. Sellevold, Veslemøy Egede-Nissen, Rita Jakobsen & Venke Sørlie - 2013 - Nursing Ethics 20 (3):263-272.
    The degree of success in creating quality care for people suffering from dementia is limited despite extensive research. This article describes healthcare providers’ experience with the ethical challenges and possibilities in the relationship with patients suffering from dementia and its impact on quality care. The material is based on qualitative, in-depth individual narrative interviews with 12 professional healthcare providers from two different nursing homes. The transcribed interview texts were subjected to a phenomenological–hermeneutical interpretation. To provide quality care to patients with (...)
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  • Applicants' success in the ethics entrance exam: A cross-sectional study.Jonna Vierula, Tiina Karihtala, Niina Ervaala, Kati Naamanka, Elina Haavisto & Kirsi Talman - 2024 - Nursing Ethics 31 (5):818-832.
    Background Student selection is the first step in recruiting future social and healthcare professionals. Ethically competent professionals are needed in social and healthcare. It is important to select applicants who have the best possible abilities to develop their ethical competence in the future. Values-based recruitment has been used to inform the recruitment and selection of higher education applicants. However, objective and valid tests in student selection are needed. Aim To assess social and healthcare applicants’ success and related factors in the (...)
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  • Inspectors’ ethical challenges in health care regulation: a pilot study.W. Seekles, G. Widdershoven, P. Robben, G. van Dalfsen & B. Molewijk - 2017 - Medicine, Health Care and Philosophy 20 (3):311-320.
    There is an increasing body of research on what kind of ethical challenges health care professionals experience regarding the quality of care. In the Netherlands the Dutch Health Care Inspectorate is responsible for monitoring and regulating the quality of health care. No research exists on what kind of ethical challenges inspectors experience during the regulation process itself. In a pilot study we used moral case deliberation as method in order to reflect upon inspectors’ ethical challenges. The objective of this paper (...)
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  • How to respond to resistiveness towards assistive technologies among persons with dementia.Anders Nordgren - 2018 - Medicine, Health Care and Philosophy 21 (3):411-421.
    It is a common experience among care professionals that persons with dementia often say ‘no’ to conventional caring measures such as taking medication, eating or having a shower. This tendency to say ‘no’ may also concern the use of assistive technologies such as fall detectors, mobile safety alarms, Internet for social contact and robots. This paper provides practical recommendations for care professionals in home health care and social care about how to respond to such resistiveness towards assistive technologies. Apart from (...)
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