Nursing Ethics最新文献

{"title":"Assessment of ethical sensitivity in nursing students: Tools, trends, and implications.","authors":"Yaning Lyu, Xifeng Liang, Jing Li, Cheng Chi","doi":"10.1177/09697330241295375","DOIUrl":"10.1177/09697330241295375","url":null,"abstract":"<p><p>BackgroundRapid advances in medical technology, changing healthcare policies, and increasing patient diversity have exacerbated the ethical challenges. As nursing students are an integral part of the future nursing workforce, ethical sensitivity has a critical impact on their future careers.PurposeThis study aims to promote research in related fields by systematically reviewing the origin and development of the concept of ethical sensitivity in nursing students, comparing currently available tools for assessing ethical sensitivity in nursing students, and exploring their applicability and reliability.MethodsA literature review method was used in this study. A literature search was conducted for assessment tools published between 1995 and 2024. A total of six articles focusing on assessment tools they developed to measure ethical or moral sensitivity were included and analyzed.ResultsOur analysis revealed significant variations in the reliability and applicability of these assessment tools, particularly when used in diverse cultural settings. The study also identified a need for localized modifications of these tools to ensure their accuracy and relevance in different regions.ConclusionThe findings provide valuable guidance for nursing educators in selecting appropriate assessment tools and offer a foundation for developing new tools that are more contextually relevant. This study contributes to the advancement of ethical sensitivity education for nursing students worldwide, ultimately enhancing patient care and professional development.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1240-1252"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511701","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":"Stimulating ambulance specialist nurse students' ethical reflections by high-fidelity simulation.","authors":"Jonas Wihlborg, Ulf Andersson, Anders Sterner, Lars Sandman, Anna Kängström, Gabriella N Boysen","doi":"10.1177/09697330241291162","DOIUrl":"10.1177/09697330241291162","url":null,"abstract":"<p><p><b>Introduction:</b> Ethical competence in professional practice can be considered essential among nurses and nurses in ambulance care encounter ethical dilemmas frequently. To enhance ethical competence among students in the ambulance specialist nursing program, high-fidelity simulation scenarios including ethical dilemmas were introduced as a learning activity. <b>Research aim:</b> The research aim was to investigate the usefulness of high-fidelity simulation in ambulance specialist nurse education to teach ethical reasoning when caring for children. <b>Research design:</b> This study was conducted as a qualitative interview study, complemented with observations and using field notes and qualitative interviews for data collection. Data was analysed using deductive qualitative content analysis based on a care ethical model. <b>Participants and research context:</b> Participants (<i>n</i> = 35) were recruited from an ambulance nurse educational program at a Swedish university. Data was collected after the students took part in two high-fidelity simulations involving children in an ambulance care setting. <b>Ethical considerations:</b> The study has been vetted and approved by the ethical council at the University of Borås, Sweden. The study follows the Helsinki Declaration's advice on ethical principles. <b>Results:</b> The results showed that most of the students expressed some form of ethical reasoning during the simulation sessions, which were elaborated and reflected upon during the debriefing part of the sessions. The simulation design seemed to have a great impact on the outcome of the student's ethical reasoning, where increased immersion led to deeper emotional engagement among the students which increased awareness of their personal preconceptions. <b>Conclusions:</b> This study aimed to investigate whether high-fidelity simulations could be useful to stimulate ethical reflections and contribute to increased ethical competence among students. In conclusion, a well-designed high-fidelity simulation can be useful as an educational tool to learn and enhance ethical competence among specialist ambulance nursing students.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1197-1209"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479130","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":"Nursing professions' distinctive ethical standards: Exploring a code of ethics.","authors":"Gila Yakov, Inbal Halevi Hochwald, Tsuriel Rashi, S Shachaf, Y Sela, O Halperin","doi":"10.1177/09697330241277986","DOIUrl":"10.1177/09697330241277986","url":null,"abstract":"<p><p>This article presents an examination of the ethical code of nursing in Israel, focusing on the nurse-patient, nurse-colleague, and nurse-professional leadership relationships. This article offers for the first English translation of the Israel Nursing Association's Code of Ethics to facilitate international scholarly discussion, and to critique this Code through the lens of Asa Kasher's philosophical test, thereby examining its completeness and practical utility. As it stands today, the code lacks clarification of the professional ethical uniqueness of nursing. To address this gap, the article adopts a philosophical approach using Kasher's test named the Three Components of the Practical Ideal to distill the distinctive ethical obligations imposed on nursing professionals. The article highlights the importance of professionalism in nursing, encompassing expertise, autonomy, and recognition, as emphasized in the Code of Ethics. However, the current code does not explicitly delineate the unique requirements specific to nursing. Thus, the article proposes the integration of these explicit requirements into the Code of Ethics through collaborative efforts. Furthermore, it emphasizes the crucial role of nursing education and training programs in fostering professional identity formation based on the strengthening of the commitment to relevant ethical principles. The article contributes to the advancement of nursing ethics by providing a comprehensive framework for understanding and implementing proper ethical conduct within the nursing profession.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1210-1229"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331102","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":"Nurses' adherence to ethical principles - A qualitative study.","authors":"Valery Wong, Norasyikin Hassan, Yoke Ping Wong, Sophia Yen Nee Chua, Shaliza Abdul Rahman, Mas Linda Mohamad, Siriwan Lim","doi":"10.1177/09697330241291159","DOIUrl":"10.1177/09697330241291159","url":null,"abstract":"<p><p>BackgroundNursing is regulated by a set of professional standards. Whilst many forms of ethics apply to nursing, the biomedical ethical framework is common, involving autonomy, beneficence, non-maleficence and justice. In healthcare, nurses often encounter ethical dilemmas that require them to navigate conflicting ethical principles. However, how nurses adhere to these principles in such situations is unclear.Research AimTo explore how registered nurses adhere to ethical principles when dealing with ethical dilemmas at work.Research DesignA qualitative descriptive study design.Participants and Research ContextBetween August and December 2023, 21 registered nurses were recruited from a teaching hospital through purposive sampling. Data were collected through semi-structured in-person interviews or online video conferencing. Braun and Clarke's thematic analysis approach was employed to analyse the data.Ethical ConsiderationsInterview participation was voluntary. Written consent was obtained before participation. Participants' real identities were replaced with pseudonyms. This study was approved by the SingHealth Centralised Institutional Review Board.FindingsThe data analysis developed four major themes and 15 subthemes. The four major themes are \"Addressing the dilemma,\" \"Contemplating the principles and consequences,\" \"Coordinating for well-informed, ethical decision,\" and \"Self-reflecting and finding consolation.\"ConclusionThis study explains how nurses navigate and uphold ethical principles when caring for patients to the best of their ability. Fully adhering to ethical principles can be challenging for caring for actively dying patients. Further research can expound on nurses' experiences and adherence to ethical principles in complex clinical cases.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1162-1176"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511719","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":"Axiological reflection for nursing ethics education: The missing link in understanding value conflicts.","authors":"Johanna Elise Groothuizen","doi":"10.1177/09697330241295369","DOIUrl":"10.1177/09697330241295369","url":null,"abstract":"<p><p>Texts from various areas of the world highlight the importance of moral values like compassion and integrity in healthcare. Such values are held in high esteem by healthcare organisations and are actively 'taught' within nursing ethics education to ensure their presence within the future workforce. With such an emphasis, it is easy to overlook that moral values are not the only values that people, including nurses, hold. <i>Other</i> personal values - which may or may not conflict with moral values - are simultaneously present within individuals. Therefore, moral behaviour cannot be predicted solely by the presence/absence of certain moral values. Instead, it depends on how these integrate into an individual's broader values system.Using Schwartz's axiological Theory of Basic Human Values as a framework, I argue that moral values are but one part of an individual's greater personal values spectrum, which also includes, for instance, hedonism, achievement, and power. Within this spectrum, values are ordered hierarchically, influencing behaviour based on relative priority. When a conflict arises between moral and other personal values, the prioritisation of moral values is a requirement for moral behaviour.I discuss how socialisation in suboptimal clinical practice environments can cause moral values to be deprioritised and argue that the development of practical reasoning skills is paramount to learning to balance one's values and guide decision-making. I advocate for the integration of (meta-)axiological reflection - characterised by introspection and aimed at developing a deeper understanding of one's personal values spectrum - within nursing ethics education. This involves exploring the origin, meaning, and perceived relative importance of one's different personal values. By incorporating specific reflective exercises, students can increase self-awareness/insight and enhance their ability to recognise situations where conflicts between their moral values and other personal values may occur, which is likely to benefit moral decision-making in clinical practice.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1230-1239"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511702","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 and purpose of editorials: Past, present and future.","authors":"Ann Gallagher, Paul Snelling","doi":"10.1177/09697330251339731","DOIUrl":"10.1177/09697330251339731","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1007-1012"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","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":"Professional values, cultural competence, and moral sensitivity of surgical nurses: Mediation analysis and structural equation modeling.","authors":"Didem Kandemir, Serpil Yüksel","doi":"10.1177/09697330241295373","DOIUrl":"10.1177/09697330241295373","url":null,"abstract":"<p><p>BackgroundDeveloping a framework that illustrates causal relationships and an in-depth comprehension of contextual elements is essential for steering the development of ethical interventions to enhance nurses' ethical decision-making.Research aimTo examine the relationship between cultural competence, professional nursing values, and moral sensitivities of surgical nurses with a mediation analysis and structural equation model.Research designThis study is descriptive and correlational.Participantsand research context: This study was conducted with a total of 201 surgical nurses from two university hospitals in Konya, Türkiye. Data were gathered face-to-face between June and October 2023 with the Moral Sensitivity Questionnaire (MSQ), Nurses Professional Values Scale-Revised (NPVS-R), and Nurse Cultural Competence Scale (NCCS).Ethical considerationsEthical approval from Necmettin Erbakan University Ethics Committee was obtained (Number: 2023/419).ResultsIn this study, the mean scores for the surgical nurses were as follows: 89.3 ± 19.33 on the MSQ, 113.1 ± 20.74 on the NPVS-R, and 72.06 ± 18.61 on the NCCS. Nurses' cultural competence level significantly affected their professional nursing values (β = 0.192; <i>p</i> = .007; R² = 0.04), and their professional nursing values, in turn, had a significant effect on their moral sensitivities (β = -0.363; <i>p</i> < .001; R² = 0.16). However, it was determined that the direct effect of nurses' cultural competence level on their moral sensitivity was not statistically significant. In contrast, the indirect effect of nurses' cultural competence level on their moral sensitivity, mediated by their professional nursing values was seen to be statistically significant (B = -0.070; <i>p</i> = .008).ConclusionsThis study showed that there is a significant positive relationship between the professional nursing values and cultural competence levels of surgical nurses and that as professional nursing values increase, their moral sensitivity also rises. Sensitivity with higher professional nursing values. Additionally, it was found that nurses' professional values served as a mediating factor between their levels of cultural competence and moral sensitivity. Therefore, it is crucial to enhance the cultural competence, professional nursing values, and moral sensitivity of nursing students and registered surgical nurses and to improve their reasoning and decision-making skills in ethical dilemmas.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1253-1267"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511720","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 descriptive and interpretive theory of ethical responsibility in public health nursing.","authors":"Anne Clancy, Julia Thuve Hovden, Hilde Laholt","doi":"10.1177/09697330241291161","DOIUrl":"10.1177/09697330241291161","url":null,"abstract":"<p><p>This article presents a descriptive, interpretive theory of ethical responsibility in public health nursing. The theory is based on qualitative empirical studies, a purposeful literature review and meta-ethnography of public health nurses' experiences of ethical responsibility, interpreted within a philosophical framework. Levianasian philosophy provides the main direction for the authors' interpretations. The path for theory development consists of three phases: <i>an inspirational phase</i>, <i>an explorative phase and the third phase</i> '<i>joining the dots</i>'. The theory illustrates that ethical responsibility in public health nursing is related to the life existentials of temporality and human relationships. Due to blurred boundaries in these essential life structures, public health nurses can experience a sense of satisfaction but also worries, uncertainties and loneliness. The study reveals paradoxical connections between fear and courage, and between freedom, autonomy and a sense of entrapment in responsible relationships. The authors purport that the results of this study are relevant for education and practice and can provide direction for further studies on developing theories of ethical responsibility in other nursing specialities.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1143-1161"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479126","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":"Humans: An integrative review exploring dehumanisation in advanced dementia.","authors":"Jesper Bøgmose, Benjamin Miguel Olivares Bøgeskov, Tom Dening, Bente Martinsen","doi":"10.1177/09697330241277989","DOIUrl":"10.1177/09697330241277989","url":null,"abstract":"<p><p><b>Background:</b> People living with advanced dementia risk being seen as someone without personhood in contemporary societies, an understanding that has been described and challenged for decades in dementia scholarly literature. Such perception can be characterised as forms of existential dehumanisation, which still asserts itself in dementia care practices, adversely affecting the ethical and caring aspects of such care.<b>Aim:</b> To challenge dehumanisation in dementia care, we must first learn to recognise what foster it in caring relations. Thus, the aim of our study is to identify existing perceptions of care recipients living with advanced dementia, which elicit dehumanising attitudes among formal caregivers.<b>Research design:</b> We conducted an integrative review based on Whittemore and Knafl's updated methodology. This allowed us to identify and analyse 26 articles incorporating both qualitative- and quantitative studies as well as theoretical- and grey literature all describing perceptions of care recipients living with dementia that lead to dehumanisation.<b>Ethical considerations:</b> Studying the darker sides in caring relations was to be beneficial in improving dementia care practices.<b>Findings:</b> Through an analytical process five themes that can sprout dehumanising attitudes in caring relations were identified, which include perceiving people living with advanced dementia as (1) absurd, (2) shadow, (3) perilous, (4) void, or (5) repugnant. We argue that these perceptions can be seen as unintentional and stem from a misled embodied perception, which caregivers should learn to recognise and consequently be able to resist through virtue ethics.<b>Conclusion:</b> Our study indicates that challenging dehumanisation is a practical matter of identifying and reacting in a timely way to ones misled embodied perceptions. We suggest the five themes offer a potential means to warn formal caregivers of impending dehumanising attitudes and help them to review how they ethically are thinking and perceiving the person living with advanced dementia.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1090-1112"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511705","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":"Unethical conduct as a multifaceted phenomenon in psychiatric care: Nurse leaders' perspectives.","authors":"Julia Björklund, Jessica Hemberg","doi":"10.1177/09697330241299523","DOIUrl":"10.1177/09697330241299523","url":null,"abstract":"<p><p><b>Background:</b> Mental healthcare can be considered a unique practice due to its ethical characteristics, and an awareness of ethics is crucial when working in a mental health setting. Several ethical challenges exist, and professionals may not always recognize the ethical aspects of psychiatric care. Research on psychiatric care from nurse leaders' perspective is scarce but important, because nurse leaders can impact and cultivate workplace culture. <b>Aim:</b> To explore the phenomenon of unethical conduct in a psychiatric inpatient context from nurse leaders' perspectives. <b>Research design:</b> Qualitative exploratory design. In-depth semi-structured interviews. <b>Participants and research context:</b> Eight nurse leaders from two different healthcare organizations in Finland. Leadership experience ranged between 2 and 30 years. <b>Ethical considerations:</b> Research ethics permission was received from a Research Ethics Board where the researchers are domiciled. Guidelines on good scientific practice as delineated by the Finnish Advisory Board on Research Integrity TENK were followed. <b>Findings:</b> Six main categories were generated: Unethical conduct and violations against patients, Unethical conduct and violations against staff, Unethical conduct and violations by staff against other staff, Unethical conduct and violations against leaders, Reasons underlying unethical conduct, and Consequences of unethical conduct and the positive development of psychiatric care. <b>Conclusions:</b> Unethical conduct was seen to be a multifaceted phenomenon, and patients and staff alike can experience and engage in unethical conduct. Unethical conduct against patients was linked to power imbalance (nature of involuntary care, staff attitudes) and a focus on rules based in historical precedent (paternalistic, routine-focused, not patient-centered). Unethical conduct against staff was linked to the nature of involuntary care and patient ill-health. Unethical conduct by staff against other staff was linked to a lack of understanding for others' work, interpersonal chemistry, (length of) work experience, and staff character. Unethical conduct against leaders was linked to leaders being perceived as the organization.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1297-1312"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630990","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}