This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, compassion, sympathetic joy, (...) equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand. (shrink)

This article derives from a doctoral thesis in which a particular discourse was used as a ‘paradigm case’. From this discourse an ethic set within a South African culture arose. Using many cultural ‘voices’ to aid the understanding of this narrative, the ethic shows that one can build on both a ‘justice’ and a ‘care’ ethic. With further development based on African culture one can take the ethic of care deeper and reveal ‘layers of understanding’. Care, together with compassion, forms (...) the foundation of morality. Nursing ethics has followed particular western moral philosophers. Often nursing ethics has been taught along the lines of Kohlberg’s theory of morality, with its emphasis on rules, rights, duties and general obligations. These principles were universalistic, masculine and noncontextual. However, there is a new ethical movement among Thomist philosophers along the lines to be expounded in this article. Nurses such as Benner, Bevis, Dunlop, Fry and Gadow - to name but a few - have welcomed the concept of an ‘ethic of care’. Gilligan’s work gave a feminist view and situated ethics in the everyday aspects of responsiveness, responsibility, context and concern. Shutte’s search for a ‘philosophy for Africa’ has resulted in finding similarities in Setiloane and in Senghor with those of Thomist philosophers. Using this African philosophy and a research participant’s narrative, an African ethic evolves out of the African proverb: ‘A person is a person through other persons’, or its alternative rendering: ‘I am because we are: we are because I am.’ This hermeneutic narrative reveals ‘the way affect imbues activity with ethical meaning’ within the context of a black nursing sister in a rural South African hospital. It expands upon the above proverb and incorporates the South African constitutional idea of ‘Ubuntu’ (compassion and justice or humanness). (shrink)

This article reports findings of a hermeneutic phenomenological study that explored the clinical learning experience for Malawian undergraduate student nurses. The study revealed issues that touch on both nursing education and practice, but the article mainly reports the practice issues. The findings reveal the emotions that healthcare workers in Malawi encounter as a consequence of practising in resource-poor settings. Furthermore, there is severe nursing shortage in most clinical settings in Malawi, and this adversely affects the performance of nurses because of (...) the excess workload it imposes on them. The results of the study also illustrate loss of professional pride among some of the nurses, and the article argues that such a demeanour is a consequence of burnout. However, despite these problems, the study also reveals that there are some nurses who have maintained their passion to care. (shrink)

Student nurses are confronted by many ethical challenges in clinical practice. The aim of the study was to explore Malawian students’ experiences of ethical problems during their clinical placement. A phenomenological hermeneutic design comprising interviews and qualitative content analysis was used. Ten students were interviewed. Three main themes emerged: 1) Conflict between patient rights and the guardians’ presence in the hospital; 2) Conflict between violation of professional values and patient rights caused by unethical behaviour; and 3) Conflict between moral awareness (...) and the ideal course of action. The students had difficulties ensuring patient rights and acting in accordance with western norms and values which are not always appropriate in the Malawian context. The students require role models who demonstrate professional attitudes towards patients’ rights and values. There is a need to create pedagogical strategies in which a caring attitude and ethical reflection can be learned and cultivated in clinical practice. (shrink)