Nursing Ethics最新文献

{"title":"What are optimal strategies for teaching nursing ethics?","authors":"Ann Gallagher","doi":"10.1177/09697330251354835","DOIUrl":"https://doi.org/10.1177/09697330251354835","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251354835"},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334313","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":"How paediatric nurses frame the ethics of non-disclosure directives.","authors":"Mandy Mervat El Ali, Jenny O'Neill, Lynn Gillam","doi":"10.1177/09697330251350383","DOIUrl":"https://doi.org/10.1177/09697330251350383","url":null,"abstract":"<p><p>BackgroundNurses caring for hospitalised children can be told not to disclose information to the patient. Such non-disclosure directives in adult care pose recognised ethical problems, as they impinge on a patient's autonomy and right to their own information, and have been discussed widely in the literature, from a physician's perspective. Despite the ethical implications, there is less discussion of the ethics of withholding information from children. Nurses are well positioned to advocate for the rights of a child while considering their best interests; hence, nurses' thinking about the ethics of non-disclosure directives is valuable.AimThe aim of this study was to explore the experiences and attitudes of nurses with truth-telling to seriously ill children, specifically how nurses frame and think about the ethical challenges when given a directive not to tell the truth to a child.DesignAn interpretive phenomenological approach was employed for this research, with data collected by semi-structured interviews.Participant PopulationTwenty-six nurses in Australia who had cared for children hospitalised with a serious illness in the previous 5 years.Ethical ConsiderationsEthics approval was granted by the University of Melbourne's Human Research Ethics Committee (37283A). Informed consent was acquired from all participants.FindingsFour themes encompass the views nurse-participants expressed about the ethics of a non-disclosure directive: (i) Lying is wrong, (ii) Children should know, (iii) It's hard for us when the child doesn't know, but (iv) It's not our place to tell. Nurse-participants described how a non-disclosure directive affected how they cared for their patients.ConclusionsNurse-participants believed they should be honest and articulated ethical reasons why children should be told the truth about their medical condition, but did not feel they were able to initiate this. It is recommended that nurses are supported in these ethically challenging situations and included in decision-making about how to respond when parents direct that information be withheld from their child.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251350383"},"PeriodicalIF":2.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295227","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":"Hospital ethical climate mediates moral sensitivity and ethical decision-making ability.","authors":"Fan Xu, Hongjuan Wang, Siyuan Tang, Mei Sun","doi":"10.1177/09697330251350387","DOIUrl":"https://doi.org/10.1177/09697330251350387","url":null,"abstract":"<p><p>BackgroundEthical decision-making ability is critical for senior nursing interns in addressing complex clinical dilemmas. However, the mediating role of hospital ethical climate in the relationship between moral sensitivity and ethical decision-making remains unexamined. This gap limits evidence-based strategies for enhancing interns' ethical decision-making and the delivery of high-quality care.Research AimsTo examine the mediating role of hospital ethical climate in the relationship between moral sensitivity and ethical decision-making among senior nursing interns, and to determine the relationship among these three variables.Research DesignThe study is a cross-sectional correlational design.Participants and Research ContextBetween August 2023 and January 2024, 1096 senior nursing interns from 44 universities across seven Chinese regions participated. The general information questionnaire, Judgement About Nursing Decision scale, Chinese Moral Sensitivity Questionnaire-Revised Version, and Hospital Ethical Climate Survey were distributed online. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation analysis.Ethical ConsiderationsThis study was approved by the Ethical Review Board of Xiangya School of Nursing, Central South University (No. E2023125).FindingsA total of 935 valid questionnaires were collected, with a response rate of 85.3%. Participants demonstrated moderate levels in ethical decision-making ability (276.41 ± 18.51), moral sensitivity (42.01 ± 7.61), and perceived hospital ethical climate (102.17 ± 14.63). There were significant positive correlations between each pair of these three variables (r = 0.248-0.474, <i>p</i> < 0.05). Moral sensitivity was associated with hospital ethical climate and ethical decision-making; hospital ethical climate mediated the relationship between moral sensitivity and ethical decision-making (β = 0.252-0.580, <i>p</i> < 0.05).DiscussionsComparing our findings with international research, this study highlights the influence of hospital ethical climate and moral sensitivity on ethical decision-making, emphasizing the mediating role of ethical climate and its implications.ConclusionsHospital ethical climate played a mediating role between moral sensitivity and ethical decision-making among senior nursing interns. Interventions targeting both are recommended to enhance ethical decision-making ability. Future research should explore specific measures for this population.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251350387"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295226","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":"Rethinking end-of-life decisions through the ethics of care.","authors":"Meta Krajnc, Erika Zelko, Urh Groselj","doi":"10.1177/09697330251350388","DOIUrl":"https://doi.org/10.1177/09697330251350388","url":null,"abstract":"<p><p>Although principles-based approaches have long been a cornerstone of bioethics and remain well-suited to many aspects of medical ethics, their reliance on deductive reasoning and emphasis on individualistic interpretations of autonomy often fall short in addressing the nuanced complexities of end-of-life (EOL) issues. The Ethics of Care (EoC) provides a comprehensive anthropological and ethical framework that is well-suited for EOL decision-making, including treatment limitations. This article explores the application of EoC to EOL care, proposing that decisions should prioritize care, compassion, relational networks, and context-sensitive judgements rather than the deduction of abstract principles. The inherent tension between EoC as a theoretical framework and its strong orientation toward concrete, relational practice is also discussed. While EoC cannot provide prescriptive steps, it offers valuable insights to complement traditional approaches to ethics. Following it, we propose eight practical guides for improving EOL decision-making. They represent an interpretation of EoC's core elements, interpreted for the specific challenges of treatment limitation. The practical guides are as follows: (1) building a trusting relationship with the patient, (2) identification of the patient's needs and values, (3) respect for the patient's relational part of autonomy, (4) identifying good treatment for the patient, (5) recognition of HCP's own inclinations and interests, (6) weighing different responsibilities, (7) shared decision-making towards best care, and (8) ensuring continuity of care and openness to change. Integrating the EoC perspective into clinical practice can enhance healthcare professionals' ability to navigate the ethical challenges at the EOL.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251350388"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295228","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 nurse practitioner ethicist: Distinct from a nurse ethicist?","authors":"Jesse Michael Kay","doi":"10.1177/09697330251350386","DOIUrl":"https://doi.org/10.1177/09697330251350386","url":null,"abstract":"<p><p>Ethics has been central to the nursing profession. Challenges in patient care have arisen through advances in medicine through science and technology. These advances have led to patients being sustained in ethically difficult situations. Nurses have uniquely witnessed both the suffering of patients and rendered care for extended periods of time at the bedside. Through these caring relationships nurses have developed expertise in advocating for their patients. Many nurses have also returned to graduate school to develop their nursing science and ethical reasoning. Recently, the field of nursing has developed the role of the nurse ethicist. Nurse ethicists often also work as clinical ethics consultants. Additionally, nursing has advanced to include nurse practitioners as advanced practice nurses. Nurse practitioners have also obtained additional education in ethical reasoning and are working in roles similar to nurse ethicists and clinical ethicists. Given the science and nature of the nurse practitioner there may be unique facets to nurse practitioners who are ethicists. To date there are no proposals for nurse practitioner ethicists. Let this be the first proposal addressing the distinctions of the nurse practitioner ethicist.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251350386"},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259227","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 competence in nursing: A theoretical definition.","authors":"Sigridur Halldorsdottir, Hulda S Bryngeirsdottir","doi":"10.1177/09697330251346437","DOIUrl":"https://doi.org/10.1177/09697330251346437","url":null,"abstract":"<p><p>BackgroundEthical competence in nursing is essential. However, a theoretical definition of ethical competence in nursing and the critical components of ethical competence appear to be absent, resulting in a lack of convergence on the core content to be taught on ethical competence in nursing education.Aim and research questionsThis study aimed to answer the following questions: What are the essential components of ethical competence in nursing? What is their definition in terms of nursing? What is the theoretical definition of ethical competence in nursing?MethodWalker and Avant's concept synthesis.ResultsEthical competence in nursing consists of 12 essential components, defined and grouped into three main themes: (1) Ethical knowledge and understanding; having knowledge and understanding of the main theories of theoretical and practical ethics and the principal codes of ethics in nursing; (2) Personal ethical qualities; having ethical awareness and ethical self-awareness, ethical sensitivity, ethical perception, and ethical judgement. (3) Ethical ability and courage to perform; capable of moral reasoning, ethical reflection, and ethical decision-making, having moral courage and demonstrating ethical action and behaviour. The theoretical definition is thus: Nurses considered ethically competent have knowledge and understanding of the main ethical principles in nursing and possess personal ethical qualities, that is, ethical self-awareness, ethical awareness, ethical sensitivity, ethical perception, and ethical judgment as well as having the ethical ability and the courage to perform ethically, that is, capable of moral reasoning, ethical reflection, ethical decision-making, having moral courage, they demonstrate ethical action, and ethically responsible conduct.ConclusionsThis study is essential to nursing as a discipline and profession. The findings provide a theoretical definition of ethical competence in nursing and the qualities characterising ethically competent nurses, which can be of great value in clinical practice, nursing education, leadership, and nursing research and theory development.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251346437"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259226","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":"Family Systems Care ‒ Expert consensus on ethics behind committed practice.","authors":"Corina Sgier, Margrit Hilpertshauser, Mirjam Mezger, Melanie Werren","doi":"10.1177/09697330251339060","DOIUrl":"https://doi.org/10.1177/09697330251339060","url":null,"abstract":"<p><p>BackgroundEthically challenging situations often arise in interactions between healthcare professionals (HCPs) and families. Although the Calgary models offer guidance for practical work and are beneficial in various challenging situations, explicit awareness and recognition of the ethical concepts and theories underlying Family Systems Care (FSC) is generally lacking.Method - Research aimThis study examined the basis of FSC in virtue ethics, deontology, and teleology.Research designUtilizing a qualitative design, an expert consensus was conducted through two focus group interviews, a Delphi group, and an expert panel.Participants and research contextThe expert consensus consisted of 23 professionals in FSC from various specialities, including nurses (<i>n</i> = 18), midwives (<i>n</i> = 4), and a general practitioner, who explored ethical considerations in clinical practice.Ethical considerationsThe research project was conducted in accordance with the ethical principles of participants' informed consent and the Declaration of Helsinki.FindingsParticipants recognized the significance of classical virtues such as faith, fortitude, hope, and caritas in FSC. They emphasized that these virtues not only guide HCPs in their practice but also empower families to rediscover their strengths amid suffering. Additionally, the integration of deontological principles and teleological perspectives highlighted the importance of balancing individual and collective well-being, and fostering compassionate relationships while navigating ethical complexities in therapeutic conversations.ConclusionThis study highlights the importance of virtue ethics, deontology, and teleology in guiding HCPs' moral reasoning within FSC. Participants emphasized respect and appreciation as essential values for maintaining trust with families during ethical challenges. By integrating ethical theories into practice, HCPs can navigate complex situations effectively, fostering compassionate and dignified care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339060"},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250560","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 culture and climate in nursing: A bibliometric review.","authors":"Hossein Imani, Mehran Badin Dahesh, Niloofar Hashemi","doi":"10.1177/09697330251339415","DOIUrl":"https://doi.org/10.1177/09697330251339415","url":null,"abstract":"<p><p>Ethical culture and climate are key factors that shape the quality of nursing care in healthcare settings. Together, these constructs provide a framework for tackling moral dilemmas and supporting nurses as they navigate ethical challenges in patient care. Despite progress in understanding these concepts, systemic issues remain. The increasing number of studies on this topic in recent years highlights the importance of issues related to ethical culture and climate in healthcare settings. The present study employs a bibliometric method to analyze and examine 251 documents published in the Web of Science database, aiming to provide a comprehensive review of the literature and science mapping of the field of ethical culture. It also seeks to identify historical and contemporary research streams and analyze the evolutionary trends in this domain. The results indicate that two historical research streams in the field of ethical culture have evolved into four contemporary streams, with topics such as ethical leadership, professional ethics, and resilience gaining increased significance. We have also identified and introduced the most influential authors, documents, and sources in the field of ethical culture. Finally, the study examines potential future research directions in this domain. Recommendations include strengthening ethical leadership, using reflective practices such as ethics rounds, and encouraging cross-cultural research to address diverse healthcare environments. By addressing moral distress and improving organizational support, healthcare facilities can retain nurses, enhance patient care, and advance ethical nursing practices.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339415"},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200657","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":"Intergenerational views on humanoid nurse robots in general wards, obstetrics and neonatal units.","authors":"Özen İnam, Yahya Kahvecioğlu","doi":"10.1177/09697330251339416","DOIUrl":"https://doi.org/10.1177/09697330251339416","url":null,"abstract":"<p><p>BackgroundThis study explores intergenerational perspectives on the use of humanoid nurse robots in healthcare settings, recognizing the increasing relevance of robotic technologies and associated ethical, emotional, and privacy concerns.Research aimThe study aims to assess acceptance levels, concerns, and expectations regarding humanoid nurse robots among Generations X, Y, and Z.Research designA mixed-method design combining quantitative survey analysis and qualitative interviews was employed.Participants and research contextThe study was conducted in Türkiye with 45 participants: 15 from Generation X (1965-1980), 15 from Generation Y (1981-1996), and 15 from Generation Z (1997-2012). Visual scenarios depicting robotic nurse applications were used during data collection.Ethical considerationsThe research obtained ethical approval from the Maltepe University Ethics Committee with the decision number 2024/23-02, issued during the meeting held on December 12, 2024 (Meeting No: 2024/23). Informed consent was obtained from all participants, and confidentiality and voluntary participation were ensured.FindingsQuantitative findings showed that Generations Y and Z were more accepting of robots in technical tasks, whereas Generation X expressed skepticism, especially in emergency care roles. Privacy concerns were high across all groups (mean = 4.2). Qualitative interviews revealed that 75% of participants were skeptical about robots' lack of empathy and strongly opposed their use in birth and neonatal care, emphasizing that these emotionally sensitive areas require the compassionate presence and emotional intelligence of human nurses.Conclusions: Cultural and generational characteristics significantly affect the acceptance of humanoid nurse robots. Targeted education, stronger data privacy frameworks, and emotionally intelligent human-robot interaction strategies are essential for successful integration into healthcare. The study confirms the Robot Anxiety Scale's validity and reliability in the Turkish context.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339416"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200658","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 effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students: A quasi-experimental study.","authors":"Burcu Demircan, Yasemin Kıyak, Türkinaz Aştı","doi":"10.1177/09697330241287866","DOIUrl":"10.1177/09697330241287866","url":null,"abstract":"<p><p><b>Background:</b> Since the increasingly complex structure of health care services brings many ethical problems, it is important to use different instructional technologies in the ethical education of future nurses.<b>Aim:</b> The aim of this study was to determine the effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students.<b>Research design:</b> A quasi-experimental study with pretest-posttest design.<b>Participants and research context:</b> The research was conducted in the Nursing Department of a University located in Istanbul, Turkey between October 15 and November 15, 2024. The sample of the research consisted of 3rd year nursing students. Data were collected using the Descriptive Characteristics Form, the Nursing Dilemma Test, and the Instructional Material Motivation Scale for Single-Use.<b>Ethical considerations:</b> Permission was obtained from Bezmialem Vakif University Non-Interventional Ethical Research Committee and the institution where the study was conducted for the implementation of the research. Written and verbal consent was obtained from all participants in accordance with the Helsinki Declaration.<b>Findings:</b> While there was no difference between the students' Ethical Dilemma Test Principled Thinking pre-test and post-test scores, their Practical Consideration (<i>p</i> = .005) and motivation levels (<i>p</i> = .037) post-test scores were found to be higher. There was a weak but significant negative correlation between academic achievement and pre-test teaching material motivation levels (r = -0.375, <i>p</i> = .041).<b>Discussion:</b> The use of different teaching methods and techniques in ethics education in nursing is important for future nurses to find more practical solutions to the ethical problems they will encounter during patient care.<b>Conclusion:</b> The results of the study indicate that the use of video-supported role play can be effective in teaching ethics courses in nursing education.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1113-1128"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479131","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}