Nursing Ethics最新文献

{"title":"A human right to assisted dying? Autonomy, dignity, and exceptions to the right to life.","authors":"Jon Wittrock","doi":"10.1177/09697330251328655","DOIUrl":"https://doi.org/10.1177/09697330251328655","url":null,"abstract":"<p><p>Debates on assisted dying remain controversial and call out for conceptual clarification. What is the moral basis for assessing competing arguments, and what is the best way to frame these arguments in terms of actual and potential human rights? This article aims to investigate whether autonomy alone suffices as a moral source for human rights and whether, on this basis, there should be a positive human right to assisted dying, and a negative human right to assist others in dying. Drawing upon discussions in political theory, medical ethics, and human rights scholarship, the article develops an account of autonomy as multidimensional and subject to trade-offs. Autonomy is divided into the dimensions of liberty, opportunity, capacity, and authenticity. Furthermore, there is a common intuition that human beings ought to be endowed with a domain of core autonomy that must never be compromised in any trade-off. This analytical framework is used to map conflicts and trade-offs concerning assisted dying. By way of conclusion, it is argued that autonomy suffices to describe what human rights protect, but not why they do so. Furthermore, it is argued that the terminology of rights used in debates on assisted dying risks misrepresenting what the debate is actually about, and that the debate should be framed in terms of the right to health and exceptions to the right to life, rather than general rights related to assisted dying. Thus, assisted dying should be seen as an extreme option, where death is not the end, but the means, and ought to be considered alongside other means, as a last resort, already in the legislative process.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328655"},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812844","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 relationship between compassion competence, satisfaction, and professional commitment levels.","authors":"Ayşe Eminoğlu, Sebahat Kuşlu, Hatice Serap Koçak","doi":"10.1177/09697330251326236","DOIUrl":"https://doi.org/10.1177/09697330251326236","url":null,"abstract":"<p><p>BackgroundThe compassionate presentation of caregiving skills, which constitute the building block of nursing care, directly affects the quality of health services. It is extremely important for the future of the nursing profession to develop compassion competence and satisfaction in students who are candidates for the nursing profession and to reveal their level of commitment to the profession.Research aimThis study examined the correlation between compassion competence, compassion satisfaction, and professional commitment levels of nursing students.Research designThe study was conducted as a descriptive-correlational research.Participants and research contextThe study was conducted between 01.05.2023 and 01.10.2024 with nursing students continuing their education in the Nursing Department of state universities in Gaziantep. The research sample consisted of 280 nursing students. A convenience sampling method was used in this study. Nursing students who met the inclusion criteria and voluntarily agreed to participate were included in the sample. Personal Information Form, Compassion Competence Scale, Compassion Satisfaction Scale, and Nursing Professional Commitment Scale were used as data collection tools. SPSS package program, t-test, ANOVA, and Pearson correlation analyses were used to analyze the data.Ethical considerationsEthical approval for the study was received from the Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki.ResultsNursing students' total score on the Compassion Competence Scale was 3.86 ± 0.04. The mean total score of the Compassion Satisfaction Scale was 50.37 ± 0.58. It was determined that the mean total score of the Nursing Professional Commitment Scale was 72.98 ± 0.77. A weak, positive, statistically significant relationship was found between compassion competence and professional commitment (r: 0.288, <i>p</i> < .05). A moderate, positive, statistically significant relationship was found between compassion satisfaction and professional commitment (r: 0.403, <i>p</i> < .05).ConclusionA positive correlation was found between compassion competence, compassion satisfaction, and professional commitment among nursing students. It is recommended to increase studies on developing empathy, compassion, and emotional resilience skills in nursing education programs. In addition, these findings emphasize that a compassion-oriented approach should be adopted to improve quality in the nursing profession.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251326236"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755544","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":"Gaslighting of Inpatients-A threat to nursing care and a violation of relational autonomy.","authors":"Gabay Gillie, Yaarit Bokek-Cohen","doi":"10.1177/09697330251331194","DOIUrl":"https://doi.org/10.1177/09697330251331194","url":null,"abstract":"<p><p>Background Medical gaslighting refers to the mistreatment that patients experience following interactions with clinicians when their medical complaints and suffering are discounted, doubted, questioned, second-guessed, or denied, resulting in self-doubts of patients and psychological ramifications. This research focuses on the ethical aspects of medical gaslighting among hospitalized patients by nurses.Research QuestionWhat are the nursing care and nursing ethics perspectives concerning medical gaslighting? Research DesignA narrative review.Research MethodInterpretation of two narrative interviews with each participant through the lenses of nursing ethics.Participants14 hospitalized patients, males and females, ages 30-81, from the majority group in the population.ContextLengthy hospitalizations.Ethical considerationsEthical approval was granted; all participants signed an informed consent form for participation and publication.FindingsPatient experiences demonstrate medical gaslighting by nurses, violating relational autonomy and resulting in delayed care.DiscussionMedical gaslighting contradicts ethics of care, the professional values of nursing, and patient-centered care constituting obstacles to respectful patient-nurse relationships and to relational autonomy.ConclusionsMedical gaslighting is a profoundly concerning ethical phenomenon that adversely affects patient well-being and trust in nursing as a significant profession in a just society.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251331194"},"PeriodicalIF":2.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744335","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":"Ethical analysis of community-based dementia screening for unhoused older adults.","authors":"Alisa Squires, Diana M Bowman, Heather M Ross","doi":"10.1177/09697330251328672","DOIUrl":"https://doi.org/10.1177/09697330251328672","url":null,"abstract":"<p><p>Screening for dementia and mild cognitive impairment (MCI) in community-based settings helps connect vulnerable older adults to medical and social support services promoting well-being. Referencing a universal screening program for unhoused older adults seeking emergency shelter services as a case example, this paper calls attention to alignment of programmatic features with the four principles of biomedical ethics, beneficence, nonmaleficence, autonomy, and justice. Regarding beneficence, homeless services workers gain insight into clients' needs and can facilitate engagement with resources to aid in their successful exiting of homelessness. Using assessment findings to promote safety in shelter environments incorporates nonmaleficence. Concerning autonomy, by choosing to share screening results with healthcare providers and other human service stakeholders such as public safety officials and social service professionals, older adults are empowered to take charge of their care. Justice is embodied by the ability to influence policy changes related to homelessness prevention and equitable distribution of health resources.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328672"},"PeriodicalIF":2.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674854","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 implicit ethical values in nurse educator stories.","authors":"Destiny R Brady, Susan Hunter Revell","doi":"10.1177/09697330251328638","DOIUrl":"https://doi.org/10.1177/09697330251328638","url":null,"abstract":"<p><p>BackgroundStorytelling is a frequent practice within nursing education. Stories are thought to be helpful for student learning, engagement, professional role development, and transmission of ethical values. Despite its common use, little is known about the stories told by nurse educators and the implicit ethical values within those stories.AimsTo describe the reasons nurse educators tell stories to undergraduate students and examine implicit ethical values within these stories.Research designA qualitative descriptive study with Rubin and Rubin's responsive interviewing method. Interview transcripts and written stories were analyzed thematically with constant comparison.Participants and research contextParticipants included 15 nurse educators, primarily from the northeastern United States.Ethical considerationsInstitutional Review Board (IRB) approval for protection of human subjects was received prior to conducting the study. Informed consent was obtained from all participants.FindingsNurse educators use storytelling to help students understand what it means to be a nurse, to improve student learning, because we are all human, and because the art and science of nursing requires storytelling. Ethical values from these stories were organized into the following themes: <i>advocacy</i>, <i>nurse attributes</i>, <i>importance of the nurse-patient relationship</i>, and <i>reflection</i>.ConclusionsFindings suggest that that storytelling in nursing education is used for role development and communicating ethical values. Additional studies are needed to determine the effectiveness of storytelling and how it can be used to improve nursing practice.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328638"},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664870","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":"Palliative nurses' experiences of alleviating suffering and preserving dignity.","authors":"Erika Storm, Elisabeth Bergdahl, Oscar Tranvåg, Yulia Korzhina, Cecilia Linnanen, Heidi Blomqvist, Jessica Hemberg","doi":"10.1177/09697330251326235","DOIUrl":"https://doi.org/10.1177/09697330251326235","url":null,"abstract":"<p><p>BackgroundMost patients in need of palliative care remain in their homes, thus great focus should be placed on the creation of functional palliative homecare. Suffering through an often multifaceted illness and contemplating one's death can contribute to the loss of one's sense of dignity, and the preservation of patient dignity is a major challenge for health professionals worldwide.AimThe aim of the study was to explore and describe nurses' experiences of caring qualities alleviating suffering and preserving the dignity of patients in need of palliative homecare.Research designA qualitative exploratory study. In-depth semi-structured interviews as data collection method, and the qualitative content analysis of Graneheim and Lundman for data analysis. The theoretical perspective was based on Eriksson's caritative caring theory.Participants and research contextA total of nine nurses with extensive work experience from a palliative homecare context participated in the study.Ethical considerationsThe study was conducted in accordance with the criteria set forth by the Finnish National Board on Research Integrity TENK. Research permission was granted and participants gave their written informed consent to participate in the study.FindingsOne main theme and three subthemes were found. The main theme was: Being there for the other alleviates suffering while shaping and reshaping dignity preservation in a process. The three subthemes were: (1) Being a sensitive and compassionate witness who becomes responsible, (2) Having compliance, courage, and perception in a deep presence, (3) Being calm and patient while having time for conducting skilled practical knowledge.ConclusionsCertain caring qualities are important in the dignity-preserving care of people in need of palliative homecare, and person-centeredness plays a central role in alleviating suffering. Deep and trusting caring relationships and nurses' ability to customize the care being provided are significant in alleviating patient suffering and preserving dignity.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251326235"},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671634","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":"A caring-perception model for ethical competence in virtual reality environment.","authors":"Camilla Koskinen, Anne Gunn Dovland Vassbø, Linda Estman","doi":"10.1177/09697330251328651","DOIUrl":"https://doi.org/10.1177/09697330251328651","url":null,"abstract":"<p><p>BackgroundAn ethical foundation for caring involves doing good, alleviating suffering, and treating human beings with dignity and respect. While virtual reality (VR) has primarily been used to develop clinical skills, there is limited research on its use for educating healthcare personnel in ethical competence and the use of VR grounded by ethical concepts and theories. This gap has prompted us to develop a theoretical basis grounded in enhancing the ethical competence of health professionals using VR.AimThe study aimed to develop a caring-perception model for enhancing ethical competence in VR environments for educating healthcare personnel.Method and MaterialThe development of the caring-perception model was fundamentally anchored in theoretical frameworks established by the three caring theorists Eriksson, Martinsen, and Koskinen. Hermeneutic reading was used to interpret selected texts, extracting meaningful fragments to form interpretive patterns, leading to the creation of basic elements for a theoretical model. The caring-perception model was then interpreted in the context of developing ethical competence in a VR environment.ResultsThe caring-perception model consists of six fundamental elements: \"I am here,\" \"I see and listen,\" \"I'm affected,\" \"I realize,\" \"I'm responsible,\" and a synthesis in \"ethical bearing and acting.\" The theory model serves as a robust framework aimed at enhancing healthcare personnel's ethical competence within VR environments.DiscussionVR grounded on a theoretical basis and educational model has the potential to offer unique opportunities to enhance healthcare personnel's ethical competence and to practice ethical decision-making in simulated scenarios, fostering presence, attentiveness, and ethical reflection. Despite challenges such as technical barriers and the need for substantial investment, the potential benefits of using VR for ethical training can promise improved patient outcomes and a more ethically aware healthcare workforce.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328651"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659292","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 and clinical judgment among newly graduated nurses: A meta-ethnographic literature review.","authors":"Ulla Nielsby, Susanne Dau, Henriette Bruun, Anne-Marie Søndergaard Christensen","doi":"10.1177/09697330251319373","DOIUrl":"https://doi.org/10.1177/09697330251319373","url":null,"abstract":"<p><p>The transition from nursing education to professional practice is a critical period for newly graduated nurses, marked by significant moral challenges that can lead to moral distress and impact the development and application of clinical judgment. Understanding how moral distress affects newly graduated nurses is vital to support their integration into professional roles and ensure the delivery of quality care. Newly graduated nurses may experience moral distress due to conflicts between professional values and institutional constraints, which impact their ability to exercise effective clinical judgment. The purpose of this qualitative meta-ethnographic review is to investigate the phenomenon of moral distress among newly graduated nurses and its implications for clinical judgment. The research question is: How do newly graduated nurses experience moral distress, and how does it affect their clinical judgment? Methodologically, the study is grounded in Ricoeur's three-fold mimesis, which offers a rich interpretative framework for exploring the complexities of moral distress in nursing practice. Guided by the seven steps of meta-ethnography, the analysis reveals significant variations in the conceptualization and experiences of moral distress, thus highlighting inadequacies in existing definitions. The findings from 12 qualitative studies were synthesized into an integrative model of moral challenges. This integrative model presents moral distress as a multifaceted phenomenon that intersects with clinical judgment. The integrative model of moral challenges demonstrates how institutional constraints, moral uncertainty, moral conflict and lack of moral attention can hinder newly graduated nurses' ability to exercise effective clinical judgment and deliver quality care. The integrative model of moral challenges is a crucial contribution to research on moral distress. The review reveals limited research on the way moral distress affects the clinical judgment of newly graduated nurses and highlights the importance of promoting reflective practice and moral deliberation among newly graduated nurses to strengthen their clinical judgment and professional development.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251319373"},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659297","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":"Reflections on the 20th International Pan Arab Critical Care Medicine Society Conference in Kuwait: A nursing ethics perspective.","authors":"Ali Haddad, Ann Gallagher","doi":"10.1177/09697330251327853","DOIUrl":"https://doi.org/10.1177/09697330251327853","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251327853"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651656","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 ethics of intimacy and sexuality of older adults living in nursing homes: A systematic review of argument-based literature.","authors":"Ilse Cornu, Wim Vandewiele, Chris Gastmans","doi":"10.1177/09697330251324301","DOIUrl":"https://doi.org/10.1177/09697330251324301","url":null,"abstract":"<p><p>Admission to a nursing home does not automatically blunt the desire or reduce the need for intimacy and sexuality in older residents. This ageist and ableist stereotype that older people are asexual or post-sexual negatively affects nurses and other healthcare professionals, as they are regularly faced with residents' sexual expressions. How are nurses to view and respond appropriately if a clear understanding of current ethical concepts and argumentations about intimacy and sexuality in older adults is lacking? This study aimed to document and better understand current ethical concepts and arguments about intimacy and sexuality in institutionalised older adults. We used PRISMA and Reporting of Systematic Reviews in Ethics guidelines in a systematic review of current ethical literature (2010 to 2023). Six databases were searched: PubMed, Embase, Web of Science, CINAHL, Atla, and Philosopher's Index. Inclusion criteria were (1) publication was argument-based; (2) contained ethical concepts and arguments concerning intimacy and/or sexuality in institutionalised older adults; and (3) written in English, French, German, or Dutch. Our search returned 4371 publications; of those, 29 publications met our inclusion criteria. Since all included articles appeared in peer-reviewed journals, article quality was assumed to be sufficiently good. Our use of a modified version of the Qualitative Analysis Guide of Leuven showed that two main approaches characterised discussions of intimacy and sexuality in institutionalised older adults: (1) individual-cognitive-oriented approach and (2) relational-embodied-oriented approach. The first emphasises respect for autonomy and consent, fundamental to protecting rights and dignity. The second focusses on intentional bodily capacities and the interdependent nature of being human, both crucial for the emotional well-being of the residents, even when cognitive abilities decline. We conclude that the ethical landscape on sexuality in ageing has shifted, implying that changes are warranted on how ethicists, society, and healthcare professionals view sexual expressions of older adults.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251324301"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605563","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}