This study reports the results of a study of Swedish psychiatrists’ responses to moral statements related to decision making in the psychiatric context. Use was made of the Moral Sensitivity Questionnaire, a modified instrument previously constructed from a theory of moral sensitivity. This Likert-type scale contains 30 items constructed from the following categories: interpersonal orientation, structuring moral meaning, benevolence, modifying autonomy, experiencing moral conflict, and trust in medical knowledge and principles of care. The purpose was to identify possible differences in (...) responses rather than to evaluate right or wrong responses. The analysis is based on 754 completed questionnaires. The results of the study showed some significant differences in the item and category levels; for example, male psychiatrists experienced more conflicts than female psychiatrists and agreed to a greater extent that medical knowledge was most important in deciding what was best for the patient. The results also showed that more female than male psychiatrists thought that the relationship with the patient was most important in psychiatric practice. (shrink)

The purpose of this study was to describe the extent to which nurses perceive the ethical dimensions of clinical practice situations involving patients, families and health care professionals. Using the composite theory of basic moral principles and the professional standard of care established by legal custom as a framework, situations involving ethical dilemmas were gleaned from the nursing literature. They were reviewed for content validity, clarity and representativeness in a two-stage process by expert panels. The situations were presented in a (...) written format to a convenience sample of nurses (n = 125), who were primarily staff nurses (65.6%). Respondents' judgements about whether the main issue of each situation concerned ethics ranged from a low of 0.8% to a high of 40%. From analyses of the categories into which the majority of subjects placed each situation, it was concluded that these nurses generally perceived ethics as the main issue in situations that directly involve patients' autonomy. Analysis yielded unanticipated findings about the themes in ethical situations to which nurses in practice may respond. (shrink)

Nurses are often caught in the middle of what appear to be intractable moral conflicts. For such times, the function and limits of moral compromise need to be explored. Compromise is compatible with moral integrity if a number of conditions are met. Among these are the sharing of a moral language, mutual respect on the part of those who differ, acknowledgement of factual and moral complexities, and recognition of limits to compromise. Nurses are in a position uniquely suited to leadership (...) in fostering an environment that makes compromise with integrity possible. Keywords: compromise, integrity, nursing ethics CiteULike Connotea Del.icio.us What's this? (shrink)

: Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this contribution is to develop a fundamental ethical view on nursing care considered as moral practice. Three main components are analyzed more deeply--i.e., the caring relationship, caring behavior as the integration of virtue and expert activity, and "good care" as the ultimate goal (...) of nursing practice. For the development of this philosophical-ethical interpretation of nursing, we have mainly drawn on the pioneering work of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. We will also show that the European philosophical background offers some original ideas for this endeavor. (shrink)

Should nurses have their own ethics to match specific problems met in their daily routines? How do nurses act in a society that is changing from a 'monocultural' to an 'intercultural' structure? What are the ethical consequences of these changes for their many tasks? How can the ethical aspects be taught to nurses? This article describes the current status of nursing ethics in the curriculum taught in schools of higher education for nurses in The Netherlands. Aspects of the debate on (...) nursing ethics are outlined and ideas about its future as a subject and discipline in nurse education are offered. Est-ce que le personnel infirmier doit avoir son éthique à soi pour faire face aux problèmes spécifiques dans la routine journalière? Et comment les infirmiers/ères se comportent-ils dans une société qui est en train de changer de la 'monoculture' en 'interculture'? Quels sont les conséquences éthiques de leur tâches? Comment peuvent ces aspets éthiques être enseignés aux infirmiers/ères? Cet article parle de l'état courant de l'éthique infirmier dans l'enseignement dans les écoles de l'education supérieure pour infirmiers/ères en Hollande. En plus, il donne une esquisse de la discussion sur l'éthique infirmier et donne quelques idées pour le futur de l'éthique infirmier comme sujet et discipline en soi dans l'éducation des infirmiers/ères. Sollte das Pflegepersonal seine eigene Ethik haben um den spezifischen Problemen seiner täglichen Routine gewachsen zu sein? Wie soll das Pflegepersonal in einer Gesellschaft handeln, die im Wechsel ist von einer 'Monokultur' zu einer 'Interkultur'? Was sind die ethischen Konsequenzen ihres handeln? Wie können diese ethischen Aspekte dem Pflegepersonal gelehrt werden? Dieser Artikel beschreibt den gegenwärtigen Zustand der Krankenpflege-Ethik im Lehrplan der Schulen für Höhere Ausbildung für Pflegepersonal in Holland. Er gibt auch einen Umriss über die Debatte über Krankenpflege-Ethik und formuliert einige Ideen für die Zukunft der Krankenpflege- Ethik als ein Thema und eine Disziplin in der Ausbildung des Pflegepersonals. (shrink)

This paper examines the ‘justice’ and ‘care’ orientations in ethical theory as characterized in Carol Gilligan's research on moral development and the philosophical work it has inspired. Focus is placed on challenges to the justice orientation – in particular, to the construal of impartiality as the mark of the moral point of view, to the conception of moral judgment as essentially principle-driven and dispassionate, and to models of moral responsibility emphasizing norms of formal equality and reciprocity. Suggestions are made about (...) the implications of these challenges, and of the care orientation in ethics, for the ethical theory taught, the issues addressed, and the skills and sensitivities encouraged through bioethical education. Keywords: bioethical education, ethics of care, impartiality, moral judgment, moral psychology CiteULike Connotea Del.icio.us What's this? (shrink)

Because moral perception plays an essential role in guiding morally responsible behaviour, agents have a responsibility to develop their capacities in this area. There are several strategies agents can (and should) pursue in order to improve their skills at moral perception. I appeal to insights derived from the work of feminist epistomologists and philosophers of science to argue that feminist approaches to multiculturalism are particularly valuable tools for improving moral perception.

The current interest in and discussion of virtue ethics suggests that this approach to moral decisionmaking has several distinct advantages as applied to ethical issues in healthcare delivery. For the most part, calls to incorporate the virtues of the healthcare provider in discussions of these issues have sought to supplement rather than totally replace traditional ethical theories, such as the utilitarian focus on maximizing the best overall consequences and the Kantian concern to act on the duty of respect for persons. (...) Including virtue-based ethics in such discussions allows for a more eclectic view of what should be considered in resolving difficult moral problems. As many critics of the purely principle-based approach have noted, real moral dilemmas are usually quite messy and are not easily susceptible to satisfactory resolution solely on the basis of abstract moral theories or principles. (shrink)

This paper suggests that a consideration of health care practice is a necessary step in gaining insight into the appropriate composition of an ethics course for students in the health care professional. Health care practice, if it responds to the needs of society, is dynamic in nature. In the current climate of change in the health service, the author sug gests that the nursing profession needs to become more proactive in analysing and attempting to determine the future shape of nursing. (...) To protect patient care the nursing profession needs to have its eyes open to the ethical dimensions of changes in role and practice. The author argues that, in attempting to ensure that the education to which nursing students are exposed is of relevance, it is necessary to introduce an element of the ideal into the ethics component of their professional education. From early on in their profes sional development students should be aware of the scope and standards of practice, and the type of role enactment to which the profession requires them to aspire. (shrink)

Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an (...) emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics. (shrink)