BackgroundHealthcare professionals use the ethics of justice and care to construct moral reasoning. These ethics are conflicting in nature; different value systems and orders of justice and care are applied to the cause of actual moral conflict. We aim to clarify the structure and factors of healthcare professionals’ moral conflicts through the lens of justice and care to obtain suggestions for conflict resolutions.MethodSemi-structured interviews about experiences of moral conflict were conducted with Japanese nurses recruited using the snowball sampling method. Interviews (...) were conducted based on the real-life moral conflict and choice interview. Interviews were recorded and transcribed verbatim, then analyzed based on the interpretive method of data analysis. Verbatim transcripts were read four times, first to get an overall sense of the conflict, then to understand the person’s thoughts and actions that explain the conflict, and third and fourth to identify perspectives of justice and care, respectively. Each moral perspective was classified into categories according to Chally’s taxonomy.ResultsAmong 31 responses, 2 that did not mention moral conflict were excluded, leaving 29 responses that were analyzed. These responses were classified into six cases with conflict between both justice and care perspectives or within one perspective, and into two cases without conflict between perspectives. The “rules” category of justice and the “welfare of others” category of care were included in many cases of conflict between two perspectives, and they frequently occurred in each perspective.ConclusionsThe nurses in this study suggest that they make moral judgments based on moral values that are intertwined with justice and care perspectives complex manner.Organizational, professional, and patient-related factors influenced conflicts between justice and care. Additionally, multiple overlapping loyalties created conflicts within justice perspectives, and multifaceted aspects of care-provider’s responsibility and patient need created conflicts within care. Decision-making biased towards one perspective can be distorted. It is important to consider ethical issues from both perspectives to resolve conflicts, especially the effective use of the ethics of care is recommended. (shrink)

Die Pflegeausbildung weist die Besonderheit auf, dass die berufliche Bildung an unterschiedlichen Lernorten erfolgt. Die jeweils beteiligten Lernorte beeinflussen und fördern die Entwicklung der Ethikkompetenzen der angehenden Pflegfachpersonen – lernortspezifisch als auch lernortübergreifend – in unterschiedlicher Weise. Diese besonderen strukturellen Gegebenheiten des Lehrens und Lernens wirken sich sowohl auf die Ausgestaltung der Ethikbildung als auch auf die Förderung der Ethikkompetenzentwicklung im Ausbildungsverlauf aus.Die Ausführungen leitet die folgende Frage: Welche spezifischen pädagogischen und didaktischen Anforderungen, aber auch welche bildungsrelevanten Rahmungen ergeben sich (...) angesichts der unterschiedlichen Lernorte für die Ethikbildung und die Ethikkompetenzentwicklung zukünftiger Pflegefachpersonen?Der Beitrag unterstreicht die Relevanz einer systematischen, methodisch reflektierten und lernortabgestimmten Ethikbildung im Bereich der Pflegeausbildung wie auch die Relevanz der bewussten Einbindung ethischer Reflexionsräume in die Prozesse der Ethikkompetenzentwicklung an den jeweiligen Lernorten. Die Besonderheiten der Ethikbildung erschließen sich hierbei aus den pflegeberuflichen Anforderungen an das professionelle Pflegehandeln und aus den Erfahrungen der Lernenden an den unterschiedlichen Lernorten im Verlauf der Pflegeausbildung. (shrink)