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Switch to: Citations
References in:
Whistle-blowers – morally courageous actors in health care?
Nursing Ethics 29 (6):1415-1429 (2022)
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Background: Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. Objective: This article is an analysis (...) |
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Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation (...) |
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Background: Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage. Objectives: The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors. Research design: In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ (...) |
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Background: Nurses’ ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses’ ethical competence is needed. Research questions: This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses’ and nurse leaders’ ethical competence, perceptions of support for nurses’ ethical competence at the organisational and individual levels and background factors associated with this support. Research design: (...) |
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Background: Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students. Aim/objective: The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students. Research design: The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of (...) |
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Scholars have shown renewed interest in the construct of courage. Recent studies have explored its theoretical underpinnings and measurement. Yet courage is generally discussed in its broad form to include physical, psychological, and moral features. To understand a more practical form of moral courage, research is needed to uncover how ethical challenges are effectively managed in organizational settings. We argue that professional moral courage (PMC) is a managerial competency. To describe it and derive items for scale development, we studied managers (...) |
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Background: The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Discussion: Some researchers suggest that a closer examination of how socio-political structures influence healthcare (...) |
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Background: Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses’ socio-demographic factors. Objective: To describe nurses’ self-assessed level of moral courage and its association with their socio-demographic factors. Research design: Quantitative descriptive cross-sectional study. The data were collected with Nurses’ Moral Courage Scale and analyzed statistically. Participants and research context: A total of 482 registered nurses from a major university hospital in Southern Finland (...) |
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Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the ‘therapeutic’ or ‘helping’ nurse–patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories (...) |
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Background: Moral courage is one of the most fundamental virtues in the nursing profession, however, little attention has been paid to it. As a result, no exact and clear definition of moral courage has ever been accessible. Objective: This study is carried out for the purposes of defining and clarifying its concept in the nursing profession. Methods: This study used a hybrid model of concept analysis comprising three phases, namely, a theoretical phase, field work phase, and a final analysis phase. (...) |
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Background: Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career. Aim: To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries. Research design: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, (...) |
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This study uses a rational ethical decision-making framework to examine the influence of moral intensity (potential harm and social pressure) on whistleblowing intention and behaviour using organisational commitment as a moderator. A scenario was developed, and an online questionnaire was used to conduct an empirical analysis on the responses of 533 participants. The mean age and years of work experience of the respondents were 31 and 8.2 years, respectively. The results show, first, that while moral intensity is correlated with whistleblowing (...) |
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The notion of virtue in general, and courage in particular, has had a hard time integrating itself into the everyday lexicon of bioethics. Following the lead of enlightenment moral philosophy, which concentrates on the theory of right action as opposed to the ancient Greeks' emphasis on the development of good character, bioethics, with some notable exceptions, has tended to relegate consideration of the virtues to the sidelines of moral argument. Recently, however, there have been calls for the necessity of “moral (...) |
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In view of recent studies that identified certain interest groups as potential whistleblowers, we propose an integrative conceptual framework to examine whistleblower behavior by whistleblower type. The framework, dubbed the whistleblowing triangle, is modeled on the fraud triangle and is comprised of three factors that condition the act of whistleblowing: pressure, opportunity, and rationalization. For a rich examination, we use a qualitative research framework to analyze 11 whistleblowing cases of corporate financial statement fraud in Canada that were publicly denounced between (...) |
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The factors preventing registered nurses from failing students in practice are multifaceted and have attracted much debate over recent years. However, writers rarely focus on what is needed to fail an incompetent pre-registration nursing student in their final placement. This hermeneutic study explored the mentor experience of failing a pre-registration nursing student in their final placement. A total of 19 mentors were recruited from 7 different healthcare organisations in both inner city and rural locations in the southeast of England. Participants (...) |
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The incidence of moral distress, compromised moral integrity, and leaving nursing is highest among nurses new to the profession. Understanding perceptions of moral integrity may assist in developing strategies to reduce distress and promote workforce retention. The purpose of this study was to determine how newly graduated baccalaureate prepared nurses perceive moral integrity and how prepared they feel to manage challenges to it. The design was qualitative descriptive using a confidential short answer online survey. Data were analyzed using conventional content (...) |
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Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers’ agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical “coalfaces”.Virtue ethics, emphasising techniques promoting an agent’s character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we (...) |
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Conflicts between the ethical values of an organisation and the ethical values of the employees of that organisation can often lead to conflict. When the ethical values of the employee are considerably higher than those of the organisation the potential for catastrophic results is enormous. In recent years several high profile cases have exposed organisations with ethical weaknesses. Academic medical institutions have exhibited such weaknesses and when exposed their employees have almost invariably been vindicated by objective inquiry. The mechanisms that (...) |
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Research on whistle-blowing has been hampered by a lack of a sound theoretical base. In this paper, we draw upon existing theories of motivation and power relationships to propose a model of the whistle-blowing process. This model focuses on decisions made by organization members who believe they have evidence of organizational wrongdoing, and the reactions of organization authorities. Based on a review of the sparse empirical literature, we suggest variables that may affect both the members' decisions and the organization's responses. |
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This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after (...) |
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This article reports a study exploring the meaning of the complex phenomenon of moral responsibility in nursing practice. Each of three focus groups with a total of 14 student nurses were conducted twice to gather their views on moral responsibility in nursing practice. The data were analysed by qualitative thematic content analysis. Moral responsibility was interpreted as a relational way of being, which involved guidance by one’s inner compass composed of ideals, values and knowledge that translate into a striving to (...) |
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The growing body of whistleblowing literature includes many studies that have attempted to identify the individual level antecedents of whistleblowing behavior. However, cross-cultural differences in perceptions of the ethicality of whistleblowing affect the judgment of whistleblowing intention. This study ascertains how Chinese managers/professionals decide to blow the whistle in terms of their locus of control and subjective judgment regarding the intention of whistleblowing. Hypotheses that are derived from these speculations are tested with data on Chinese managers and professionals. Statistical analysis (...) |
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Neither the corporate view of whistle blowers as tattle-tales and traitors, nor the more sympathethic understanding of them as tragic heroes battling corrupt or abused systems captures what is at stake in whistle blowing at its most distinctive. The courage, determination and sacrifice of the most ardent whistle blowers suggests that they only begin to be appreciated when they are seen as the saints of secular culture. Although some whistle blowers may be attempting to deflect attention from their own deficiencies (...) |
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