Nursing Ethics最新文献

{"title":"Ethical challenges nurses faced during the COVID-19 pandemic: Scoping review.","authors":"Ebin Arries-Kleyenstuber, Bernadette Dierck de Casterlé, Kathryn Kynoch, Mary-Anne Ramis, Riitta Suhonen, Carla Ventura, Georgina Morley","doi":"10.1177/09697330251339417","DOIUrl":"https://doi.org/10.1177/09697330251339417","url":null,"abstract":"<p><p>Nurses encountered a myriad of ethical challenges during the height of the COVID-19 pandemic, such as allocation of scarce resources, the need to balance duty of care with safety of self as well as visitation restrictions. The impact of these challenges on the nursing workforce requires investigation. The aim of this review was to scope and describe the reported literature on ethical challenges faced by nurses during the COVID-19 pandemic, including contextual characteristics and strategies reported to address these challenges. The review was conducted in accordance with JBI methods for scoping reviews and reported using PRISMA-ScR guidance. A published protocol guided conduct of the review. The following databases were searched for eligible studies from November 2019 to January 2023: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions were applied. Studies were reviewed for inclusion by two independent reviewers, and a data extraction form was developed to extract data relevant to the review questions. Results were analyzed and presented according to the concepts of interest, using tables, figures, and supporting narrative synthesis. After searching the databases, 2150 citations were retrieved with 47 studies included in the review. Studies represented 23 countries across five continents. Most of the studies used qualitative designs. Ethical challenges were described in several ways, often without appealing to common ethics language or terms. Few studies reported on strategies to address the specific challenges, which may reflect the dynamic nature of the pandemic. The scoping review highlights the complex and, at times, overwhelming impact of ethical challenges faced by nurses across the globe during the COVID-19 pandemic. Findings from the review can be used as a basis for further research to explore, develop, and implement strategies to address ethical challenges faced by nurses during future public health crises.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339417"},"PeriodicalIF":2.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role and purpose of editorials: Past, present and future.","authors":"Ann Gallagher, Paul Snelling","doi":"10.1177/09697330251339731","DOIUrl":"https://doi.org/10.1177/09697330251339731","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339731"},"PeriodicalIF":2.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral and ethical challenges: Media influence on maternal trust in neonatal care.","authors":"Halil Ibrahim Tasdemir, Dilek Kocabas, Emine Efe","doi":"10.1177/09697330251339065","DOIUrl":"https://doi.org/10.1177/09697330251339065","url":null,"abstract":"<p><p>BackgroundMedia narratives about healthcare scandals can profoundly influence public trust in medical institutions and professionals. In neonatal care, where trust in healthcare providers is crucial for parental decision-making, negative media portrayals may create ethical challenges by fostering fear and skepticism. The erosion of trust in neonatal nurses and healthcare institutions may seriously affect maternal decision-making and neonatal health outcomes.AimTo explore the ethical implications of media narratives on maternal trust in neonatal care. Specifically, it investigates how media portrayals of neonatal care scandals impact expectant mothers' perceptions of neonatal professionals, their emotional responses, and their healthcare choices.Research designA qualitative research design was employed using semi-structured interviews. Thematic analysis, following Braun and Clarke's framework, was used to analyze the data.Participants and research contextThe study included 22 expectant mothers in their third trimester who had been exposed to media coverage of neonatal care scandals in Turkey.Ethical considerationsEthical approval was obtained from the University Research Ethics Committee. Participants provided written informed consent, ensuring voluntary participation and anonymity.ResultsFour major themes emerged: (1) erosion of trust in neonatal nurses and institutions, leading to skepticism and emotional distress; (2) the emotional impact of media narratives, including fear, anxiety, and defensive decision-making regarding neonatal care choices; (3) perceived quality of care, highlighting concerns over the differences between public and private NICUs and resource allocation; and (4) the need for ethical reforms, including transparency, independent oversight, and media accountability to restore trust.ConclusionsMedia narratives significantly shape maternal perceptions of neonatal care, raising critical ethical concerns about trust and accountability. The findings highlight the need for systemic reforms to ensure ethical transparency, responsible media reporting, and enhanced communication between healthcare providers and the public. Addressing these ethical challenges is essential for fostering trust in neonatal nursing and ensuring equitable, high-quality care for newborns.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339065"},"PeriodicalIF":2.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress among nurse leaders: A conceptual framework.","authors":"Preston H Miller","doi":"10.1177/09697330251339420","DOIUrl":"https://doi.org/10.1177/09697330251339420","url":null,"abstract":"<p><p>Moral distress among nurses has been well examined within the literature since the concept's introduction in 1984. Moral distress occurs when constraints result in an individual being unable to act or compelled to act against their professional moral obligations, resulting in a sense of complicity and wrongdoing. Extensive research has explored the experience and consequences of moral distress, particularly among bedside nurses. Despite an abundance of articles regarding moral distress in nursing, few examine the concept among nurse leaders. Leadership roles within nursing can be at the patient care, unit, middle, and executive levels. Existing evidence suggests that nurse leaders experience moral distress similarly to other nursing populations; however, their leadership roles introduce unique challenges and experiences. The purpose of this paper is to present a framework for understanding moral distress among nurse leaders grounded in existing theory and evidence. The Moral Distress Theory, Crescendo Effect, and Ecological Systems Theory served as theoretical frameworks. The conceptual framework was developed from 2022 to 2024 following literature review, empirical (qualitative) validation, and content expert review and validation (<i>n</i> = 5). The Conceptual Framework of Moral Distress Among Nurse Leaders consists of four primary elements: (1) <i>nurse leaders as moral agents within a moral ecology</i>, (2) <i>antecedents of moral distress among nurse leaders</i>, (3) <i>physiological</i>, <i>psychological</i>, <i>and emotional effects of moral distress among nurse leaders</i>, and (4) <i>responsive action(s)</i> versus <i>inaction</i>. This proposed conceptual framework may serve as a foundational understanding of moral distress experienced by nurse leaders and a guide for future moral distress research among nurse leaders.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339420"},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of healthcare professionals and patients regarding patient privacy in ICU.","authors":"Yimei Zhang, Qiulan Hu, Yu Wang, Qinglan Li, Min Zhou, Jingran Yang, Jiafei Lu, Ruijie YangLan, Fang Ma","doi":"10.1177/09697330251339419","DOIUrl":"https://doi.org/10.1177/09697330251339419","url":null,"abstract":"<p><p>BackgroundIntensive care is essential for critically ill patients who experience loss of personal identity and restricted physical and emotional expression. However, patient privacy in Intensive Care Units (ICUs) remains inadequately protected, with both patients and healthcare professionals (HCPs) reporting breaches. Cultural backgrounds and individual perspectives of patients and HCPs significantly shape their views on privacy. In China, discourse on ICU patient privacy is still in its early stages.Research aimThis study aims to explore the experiences of HCPs and patients regarding the patient privacy in ICU under the Chinese background.Research designA qualitative study was conducted using purposive sampling methods for semi-structured, face-to-face, in-depth interviews, followed by thematic analysis to identify key themes.Participants and research contextSix focus-group interviews (with a total of 33 nurses) were conducted, while seven doctors and 10 patients were interviewed individually from March to July 2024 at a tertiary hospital in China.Ethical considerationsThis study was approved by the hospital's Ethics Committee (reference number: 2024-L-158). Informed consent was obtained from all participants, and data confidentiality was ensured through anonymization and encrypted storage.FindingsFour themes were identified: (1) the coexistence of consensus and disagreement regarding privacy scope; (2) the paradoxical perception of privacy protection; (3) conflicting responses to privacy violation and (4) much has been done, but more is needed.ConclusionsMinimizing exposure of ICU patients' private areas and protecting their information are essential to safeguarding privacy. Education and training in bioethics can enhance HCPs' sensitivity to ethical issues and improve practices regarding privacy protection. Teaching resilience and stress management can help mitigate psychological distress associated with privacy violations in ICU patients. Additionally, promoting HCPs' privacy awareness, limiting visits by opposite-sex family members, and enhancing HCPs' empathy are key strategies in this context.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339419"},"PeriodicalIF":2.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing advocacy and activism: A critical analysis of regulatory documents.","authors":"Lydia Mainey, Sarah Richardson, Ryan Essex, Jessica Dillard-Wright","doi":"10.1177/09697330241299525","DOIUrl":"10.1177/09697330241299525","url":null,"abstract":"<p><p><b>Background:</b> Advocacy and activism are dynamic terms representing a spectrum of political action, aiming to achieve social or political change. The extent to which nursing advocacy and activism are legitimate nursing roles has been debated for around 50 years. Nursing regulatory documents, such as codes of conduct and professional standards, may provide direction to nurses on how they should act in the context of advocacy and activism.<b>Aim:</b> To explore what regulatory documents say about advocacy and activism, either explicitly or implicitly, and how they shape advocacy and activism.<b>Research design:</b> We used a Reflexive Qualitative Document Analysis approach with a Critical Feminist lens to analyse contemporary nursing regulatory documents from the USA, UK and Australia.<b>Ethical considerations:</b> This article has no human participants, and informed consent was not required.<b>Findings:</b> We identified eight nursing regulatory documents from the American Nurses Association, Nursing and Midwifery Council and Nursing and Midwifery Board of Australia. We constructed two major themes that reveal how nursing advocacy and activism are conceived and shaped in regulatory documents. Theme 1, <i>Ideological arena</i> describes the gendered and neoliberal subtexts influencing advocacy and activism. Theme 2, <i>A five-pointed star</i>, describes the shape of advocacy and activism in the regulatory documents.<b>Conclusions:</b> Regulatory documents from the USA, UK and Australia support diplomatic nursing advocacy and activism for people, equity, ourselves (nurses), the profession and systems change. However, more oppositional and disruptive advocacy and activism are potentially constrained by gendered and neoliberal subtexts that depoliticise nurses' roles.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"980-993"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' justifications for morally courageous acts in ethical conflicts: A narrative inquiry.","authors":"Elina Pajakoski, Helena Leino-Kilpi, Minna Stolt, Anto Čartolovni, Riitta Suhonen","doi":"10.1177/09697330241284357","DOIUrl":"10.1177/09697330241284357","url":null,"abstract":"<p><p><b>Background:</b> Moral courage is defined as the courage to act in ethical conflicts based on individual or professional values despite the personal risks involved. Nurses justify their decisions to act morally courageously as part of their ethical decision-making.<b>Objective:</b> To describe registered nurses' justifications for acting morally courageously, or not, in ethical conflicts where they needed moral courage.<b>Research design:</b> A narrative inquiry with a holistic content approach was used. Individual, in-depth interviews were conducted in January-February 2023. The data were analysed using holistic content analysis.<b>Participants and research context:</b> Fourteen registered nurses with experience in situations where they needed moral courage participated. The nurses came from the somatic, palliative, mental health, and substance abuse care fields in Finland.<b>Ethical considerations:</b> Good scientific practice was followed. Ethical approval was obtained before data collection from the university's ethics committee.<b>Findings:</b> The nurses needed moral courage in ethical conflicts with patients present and between professionals. Individual responsibility, professional ethics, and emotions were identified as bases of nurses' justifications for morally courageous acts. The justifications for acting morally courageously, or not, had individual, contextual, and organisational perspectives. Morally courageous acts included starting a discussion about the conflict with other professionals and reporting the situation in writing within one's organisation.<b>Discussion and conclusions:</b> The identified bases and perspectives of justifications illustrate the complexity of nurses' decision-making in ethical conflicts, either leading to morally courageous acts or not. These results can inform nursing practice and research in developing processes to strengthen nurses' moral courage and examining relationships between moral courage and other concepts, such as moral resilience.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"752-766"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of moral integrity in the association between moral self and moral sensitivity among nurses: A mediation model.","authors":"Vered Ne'eman-Haviv, Ayala Blau, Lani Ofri","doi":"10.1177/09697330241263994","DOIUrl":"10.1177/09697330241263994","url":null,"abstract":"<p><p><b>Aim:</b> This study aimed to investigate the relationship between moral self, moral integrity, and moral sensitivity in decision-making among nurses.<b>Background:</b> nurses face moral dilemmas almost on a daily basis. Studies have demonstrated that nurses with high moral sensitivity make thoughtful decisions and exhibit professional responsibility. The current study seeks to examine personality variables that may be related to moral sensitivity among nurses.<b>Design:</b> A cross-sectional study.<b>Ethical considerations:</b> This study was approved by the IRB of the authors University's ethics committee (number: AU-HEA-LO-20220317). Written consent was obtained from all participants.<b>Methods:</b> A structured questionnaires were administered to a sample of 187 Israeli nurses.<b>Results:</b> The degree of nurses' moral self, moral integrity and moral sensitivity was relatively high. \"Patient-centered care\" was found to be the most significant component of moral sensitivity. The next component is \"Using knowledge bases,\" followed by \"Exercising professional judgment.\" While the concept of patient-centered care was found to be related to the nurses' moral self, the other components were found to be related to their moral integrity. The mediation model found that moral integrity mediates and even strengthens the moral self in its connection with moral sensitivity.<b>Conclusions:</b> Understanding the role of moral self and moral integrity in explaining moral sensitivity, can contribute to achieving a desirable combination of \"the good and the right\" in nursing practice, thereby enhancing nurses' work. From a practical perspective, these findings are also relevant to nursing education. Nursing education plays a pivotal role in fostering moral and ethical decision-making in both clinical aspects and ethical moral sensitivity. Strengthening the moral self and moral integrity among nursing students can aid in making balanced and morally sensitive decisions while also building moral and ethical support systems to assist students in distressing and emergency situations.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"828-836"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical risks in robot health education: A qualitative study.","authors":"ZiQi Mei, ShengJi Jin, WeiTong Li, SuJu Zhang, XiRong Cheng, YiTing Li, Meng Wang, YuLei Song, WenJing Tu, HaiYan Yin, Qing Wang, YaMei Bai, GuiHua Xu","doi":"10.1177/09697330241270829","DOIUrl":"10.1177/09697330241270829","url":null,"abstract":"<p><p>BackgroundAs health education robots may potentially become a significant support force in nursing practice in the future, it is imperative to adhere to the European Union's concept of \"Responsible Research and Innovation\" (RRI) and deeply reflect on the ethical risks hidden in the process of intelligent robotic health education.AimThis study explores the perceptions of professional nursing professionals regarding the potential ethical risks associated with the clinical practice of intelligent robotic health education.Research designThis study adopts a descriptive phenomenological approach, employing Colaizzi's seven-step method for data analysis.Participants and research contextWe conducted semi-structured interviews with 17 nursing professionals from tertiary comprehensive hospitals in China.Ethical considerationsThis study has been approved by the Ethics Committee of the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Chinese Medicine Hospital.FindingsNursing personnel, adhering to the principles of RRI and the concept of \"person-centered\" care, have critically reflected on the potential ethical risks inherent in robotic health education. This reflection has primarily identified six themes: (a) threats to human dignity, (b) concerns about patient safety, (c) apprehensions about privacy disclosure, (d) worries about implicit burdens, (e) concerns about responsibility attribution, and (f) expectations for social support.ConclusionsThis study focuses on health education robots, which are perceived to have minimal ethical risks, and provides rich and detailed insights into the ethical risks associated with robotic health education. Even seemingly safe health education robots elicit significant concerns among professionals regarding their safety and ethics in clinical practice. As we move forward, it is essential to remain attentive to the potential negative impacts of robots and actively address them.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"913-930"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse misinformation and the digital era: Abrogating professional responsibility.","authors":"Christopher M Charles, Pamela J Grace","doi":"10.1177/09697330251317674","DOIUrl":"10.1177/09697330251317674","url":null,"abstract":"<p><p>In the current digital era, reliance on technology for communication and the gathering and dissemination of information is growing. However, the information disseminated can be misleading or false. Nurses tend to be trusted by the public, but not all information brought to the public forum is well-informed. Ill-informed discussions have resulted in harm to individuals who take such information as fact and act on it. As technology continues to evolve and fact versus fiction becomes more challenging to discern, it is critical that nurses recognize their ethical responsibility to the public in providing information for which sound evidence exists. This analysis will explore medical misinformation through concepts such as confirmation bias and the politicization of science. Also, the impact of nurses not recognizing the power and responsibility associated with using their credentials in public fora, even when the central motivator is that they believe they are helping other individuals. Using nursing goals and perspectives, we will discuss the ethical responsibility of nurses to be aware of the soundness of what they think they know. Utilizing ideas of professional responsibilities, as outlined by professional codes of ethics as well as the ethical principles of non-maleficence and veracity, we explore the problem of nurses propagating misinformation and suggest strategies to enhance nurse awareness of their ethical responsibilities for veracity and transparency regarding what is known and what is not.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"931-940"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}