Nursing Ethics最新文献

{"title":"Long-term seclusion in forensic psychiatry: Bare life, social death, and the role of the nurse.","authors":"Jim A Johansson, Maya Szczepek, Cindy Peternelj-Taylor","doi":"10.1177/09697330261437263","DOIUrl":"10.1177/09697330261437263","url":null,"abstract":"<p><p>BackgroundThe use of seclusion and other restraints in forensic mental health settings are intended to be employed as a last resort and for the shortest time possible to achieve therapeutic effect. And yet, in Canadian forensic hospital settings, patients can remain in seclusion for weeks, months, even years. An ambiguous legal framework across Canadian provinces lacks mechanisms to limit or forbid the long-term seclusion of patients, which we define as any continuous confinement lasting 15 days or longer.Research objectivesThe paper undertakes a critical examination of long-term seclusion practices in forensic hospitals, based on the results of a qualitative study examining nursing practices with 'difficult' patients. Agamben's concepts of homo sacer and bare life and Guenther's concept of social death provide the framework for this critical examination.Research designA qualitative research design was employed, utilizing a critical discourse analysis methodology.Participants and context7 nurses working in a high security forensic hospital setting in Canada participated in qualitative interviews.Ethical considerationsThe paradox of custody and caring is central to the considerable ethical challenges nurses face with patients in long-term seclusion.Findings/resultsIntegration of study findings with existing (limited) studies of this phenomenon illustrate that, though rare, patients in forensic hospital settings may be subject to lengthy and legally ambiguous periods of seclusion. Nursing practices and interventions are aimed at providing patients temporary reprieve from a state of bare life and to alleviate their social death. However, no mechanisms exist to prevent the use of long-term seclusion.ConclusionsLong-term seclusion represents a regrettable practice in forensic hospital settings aimed at the management of 'difficult' patients but is devoid of therapeutic value or intent. Existing nursing practices can only temporarily relieve patients from this state. More substantive and lasting solutions are proposed, focusing on the role of the nurse.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1466-1478"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534106","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":"Patients' experiences of humanising care in Scandinavian intensive care units - a systematic review.","authors":"Monica Evelyn Kvande, Sanne Angel, Anne Højager Nielsen","doi":"10.1177/09697330261435046","DOIUrl":"10.1177/09697330261435046","url":null,"abstract":"<p><p>Using Scandinavian literature reporting patient experiences of intensive care as a case, the aim of this qualitative systematic review was to explore if humanising was addressed in the descriptions of patient experiences and, if so, what words and theoretical perspectives were used to underpin the results. A comprehensive search of qualitative studies published between 1 January 2016 and 12 December 2024 was conducted in Embase, CINAHL, MEDLINE, Scopus, and Web of Science. Twenty-nine studies reporting patient ICU experiences were included and analysed using thematic synthesis following Thomas and Harden. The review adhered to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist. The terms humanisation and de-humanisation were not explicitly used, but the studies engaged with these concepts by corroborating the three themes that defined humanising ICU in this study: (1) feeling recognised as a human being when experiencing connectedness with healthcare professionals, (2) feeling connected with themselves and the situation when experiencing safety and well-being, and (3) feeling connected with significant persons and life outside the ICU. In addition, our analysis identified a further theme: (4) experiencing capacity to influence the situation when able to express themselves. Humanising intensive care involves ethical and caring engagement with the patient, helping them feel connected, experience well-being, and influence their situation. Although Scandinavian literature has not directly studied humanisation, it has focused on understanding patients' experiences and addressing the ontology of critical illness. As such, humanising ICU aligns well with Scandinavian nursing traditions.Implications for clinical practiceICU staff should actively listen to patients and encourage them to express needs and preferences, create a safe and calm environment that supports well-being, and maintain communication with patients and families to promote a humanising approach to intensive care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1479-1503"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532794","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' unprofessional behavior on patient care-A scoping review.","authors":"Satu Lyytikäinen, Mari Kangasniemi, Tanja Moilanen","doi":"10.1177/09697330261441782","DOIUrl":"10.1177/09697330261441782","url":null,"abstract":"<p><p>BackgroundNurses' unprofessional behavior endangers quality of care and patient safety as well as nurses' careers and work communities. Existing knowledge concerning nurses' unprofessional behavior and its effects on patient care should therefore be considered to facilitate early identification and the development of preventive strategies.AimThe aim of this scoping review is to systematically map and summarize existing knowledge about unprofessional behavior among nurses in order to support the development of strategies for its early detection and prevention.MethodA scoping review was performed based on electronic searches of the CINAHL, PubMed, Scopus, Web of Science, and ERIC databases together with manual searches of the reference lists of all publications retrieved in the initial searches. The database searches spanned the period from database creation to October 2024. Only peer-reviewed empirical research papers published in English were considered for inclusion. Publications were selected using predefined inclusion and exclusion criteria, and altogether 40 studies were included. Data was analyzed using descriptive methods.FindingsThe terms used in relation to unprofessional behavior are related to neglect and abuse, unethical behavior, and misbehavior. Types of unprofessional nursing behavior during patient care include neglecting nursing tasks, betraying professional confidence, and violating patient integrity. These behaviors may create risks to patient safety and cause patient dissatisfaction. Reasons for unprofessional behavior included nurses' personal life histories, lack of professional competencies, and factors relating to the work environment and community.ConclusionsOur findings indicate that unprofessional behavior by nurses is an umbrella term, covering various forms of inadequate and unethical behavior. In future, more attention must be paid to nurses' working conditions and ethical skills to protect patients' safety and strengthen the nursing profession.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1515-1534"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647295","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":"Patients' perspectives and experiences of privacy: A qualitative study.","authors":"Gul Hatice Tarakcioglu Celik, Ozlem Ariburnu, Leyla Dinc","doi":"10.1177/09697330261441781","DOIUrl":"10.1177/09697330261441781","url":null,"abstract":"<p><p>BackgroundPatient privacy is a fundamental value and core ethical principle in healthcare. In Turkey, privacy is protected by legal regulations while also shaped by cultural and religious norms, which together influence how it is perceived and practiced in clinical settings.AimThis study explores how adult hospitalized patients perceive and experience patient privacy.Research DesignA descriptive qualitative approach guided by COREQ checklist was employed.Participants and Research ContextPurposive sampling was used to ensure variation, and thirty-three adult inpatients from general medical and surgical wards in five hospitals across Ankara participated in the study between the period of October and November 2024. Data collection involved face-to-face semi-structured interviews, and data saturation was reached when no additional findings, codes, or themes emerged. Braun and Clarke's six-phase thematic analysis was applied to analyze the data. Some of the patient statements were included to illustrate key points.Ethical ConsiderationsApproval was granted by the Hacettepe University Health Sciences Research Ethics Committee (ID: 2023/08-24). All participants provided written and verbal informed consent.ResultsFour main themes emerged: (1) \"The concept of privacy\"-patients viewing privacy as a moral and human right connected to bodily integrity; (2) \"Perception of patient privacy\"-including bodily, informational, and emotional aspects; (3) \"Protection of patient privacy\"-practices that promote feelings of safety, well-being, and respect; (4) \"Violation of patient privacy\"-experiences that evoke fear, regret, and avoidance of healthcare. Cultural and religious norms-especially modesty and confidentiality-strongly shape perceptions.ConclusionsPatient privacy in Turkey is shaped by ethical, legal, and cultural values. Culturally sensitive patient care that respects patients' physical, informational, and emotional boundaries is essential. To promote trust-based, ethical practice, we recommend improving environmental arrangements, enhancing data security measures, and providing ongoing ethics education for healthcare professionals.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1545-1558"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646771","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 ethical challenges in midwifery experiences: A scoping review.","authors":"Mansoureh Hasanzadeh, Zeinab Hashemi, Zohreh Shahhosseini","doi":"10.1177/09697330251407219","DOIUrl":"10.1177/09697330251407219","url":null,"abstract":"<p><p>Healthcare ethics involves applying ethical frameworks (principlism, consequentialism, virtue ethics, and care ethics) to guide healthcare decisions. This study aims to review the stresses and ethical tensions experienced by midwives to provide a clearer understanding of these issues. Researchers searched PubMed, Scientific Information Database, Scopus, and WOS using keywords (\"ethical challenges,\" \"ethical distress,\" \"moral distress,\" \"moral tensions,\" \"stress,\" \"psychological/emotional distress,\" \"professional practice,\" \"decision-making,\" \"ethical professionalism,\" \"midwifery,\" \"midwife,\" \"obstetrics,\" and \"delivery\"). Over 3 months (June-September 2024). Full texts of 26 articles were included. Although scoping reviews synthesize existing literature and do not involve primary data collection, our study formally obtained ethical approval from the Ethics Committee of Mazandaran University of Medical Sciences for our support in the development of this research to ensure methodological rigor and transparency. Ethical code: IR.MAZUMS.REC.1403.557. From 2227 records, 2010 underwent screening; 26 were reviewed. Findings revealed three categories of ethical challenges and tension: Professional challenges: Burnout; complex emergency decision-making; work-life imbalance; insufficient system support; stressful environments; knowledge gaps; resource shortages; decision discrepancies with clients; fear of punitive errors; limited autonomy; lack of professional recognition, Moral/Psychological challenges: Anxiety; inadequate peer support; poor client communication; low decision-making confidence; discomfort conveying adverse news; privacy protection difficulties, Social challenges: Societal expectations for precise clinical decisions in uncertainty and unwavering adherence to ethics despite constraints. Midwives face significant challenges requiring careful attention and broad knowledge for ethical decisions in complex, unexpected cases.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1574-1606"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693216","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' challenges in caring for criminal inmates in hospitals.","authors":"Tajmohammad Arazi, Sepideh Mohammadi, Vahid Moeini, Zohreh Sarchahi, Mehrdad Rohaninasab","doi":"10.1177/09697330261424354","DOIUrl":"10.1177/09697330261424354","url":null,"abstract":"<p><p>BackgroundNurses caring for criminal inmates in hospitals face complex challenges that can compromise holistic and ethical care. In Iran, where incarceration rates are high, this issue is pressing, yet insufficiently explored.Research aimThis study aimed to explore the challenges Iranian nurses encounter when caring for criminal inmates transferred from prison to public hospitals.Research designA descriptive qualitative study using content analysis.Participants and research contextA qualitative study was conducted using purposive sampling with maximum variation to recruit 32 clinical nurses from five major departments (Emergency Medicine, Medical-Surgical, Orthopedics, General Surgery, and Operating Room) of general hospitals affiliated with Neyshabur University of Medical Sciences. Data were collected between October 2024 and January 2025 via in-depth, semi-structured interviews, continuing until theoretical saturation was reached. Data analysis was performed concurrently with data collection using the Granheim & Lundman content analysis method.Ethical considerationsEthical approval was granted by the Research Committee of the xxxx (Ethical code: xxx).ResultsThe central theme emerging from the data was \"Failure to provide dignified care.\" It included three categories: \"Barriers to creating a therapeutic relationship,\" \"Discrimination in care,\" and \"Lack of training and Inadequate qualification.\"ConclusionsThe findings of the present study revealed ethical, behavioral, communicative, and competency-related challenges faced by nurses. To address these challenges, a comprehensive approach involving structural, educational, organizational, and cultural interventions is essential. It is imperative that nurses provide non-judgmental and unbiased care, with a fundamental emphasis on respecting patients' humanity.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1452-1465"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516131","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":"Negative moral emotions as the affective component of moral distress.","authors":"Alexander Christian Harbst","doi":"10.1177/09697330261441784","DOIUrl":"10.1177/09697330261441784","url":null,"abstract":"<p><p>This article examines the affective component of moral distress and argues for its theoretical specification through reference to negative moral emotions. It claims that the affective component of moral distress has been inadequately addressed in existing research. This omission has led to an ambiguous relationship between the affective and causal components of moral distress and to difficulties in distinguishing it from other forms of psychological distress. This article argues that the affective component of moral distress must be specified in order to operationalize the concept properly, and that this should be done by referring to a psychological phenomenon necessarily tied to a moral problem. Moral psychology suggests that negative moral emotions-such as guilt and anger-fulfill this condition, insofar as they arise in response to perceived violations of normative expectations concerning one's own conduct or that of others. On this basis, the affective component of moral distress is identified with negative moral emotions. This approach provides a theoretically grounded and empirically tractable framework for conceptualizing moral distress, integrates separate lines of research, and opens new ways to describe, assess, and address it.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1535-1544"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647317","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":"Beyond competence: Nursing leadership as an ethical expression of professional identity.","authors":"Mazzoleni Beatrice, Cosmai Simone","doi":"10.1177/09697330261468549","DOIUrl":"10.1177/09697330261468549","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1293-1295"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431382","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 gift of love: A contemporary view of love in end-of-life nursing care.","authors":"Peter Stuart","doi":"10.1177/09697330261424352","DOIUrl":"10.1177/09697330261424352","url":null,"abstract":"<p><p>BackgroundHistorically love in nursing has been expressed as tender loving care but a move to technological thinking in nursing and the integration of healthcare systems may have changed this to one where love may be distant or avoided from the arena of care. It may now uncertain if love in nursing is an essential part of care, or supererogatory and additional to a paid duty of care.Research aimA study was conducted to investigate hospital nurses' experiences of providing end-of-life care. A core theme from the study was the nurse's expression of love. This article reports on this outcome and aims to provide clarity regarding the current nature of love in nurses' care.Research designInterpretative phenomenology was used to explore hospital nurses' experiences of providing end-of-life care.Participants and research context6 UK registered nurses with experience of hospital end-of-life care took part.Ethical considerationsEthical approval was gained before commencing the study. All participants consented to take part.FindingsThe nurses' end-of-life care actions were done willingly with goodness, selflessness, sometime courage, placing others before themselves and going beyond their duty of care. As a consequence, their love is universal and not bound by a professional care ethic but given freely of themselves as a gift.DiscussionThe nurses' action described love as both agape and eros suggesting a universal love. This was suggested a love not bound by a professional care ethic but one given freely of themselves as a gift.ConclusionsA contemporary view of love in nursing care is presented; when caring for dying vulnerable people in hospital, the value of love for another person is prevalent in the nursing care provided. It is not bound by a duty to care but is an addition to the process of care and is given freely of self.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1316-1332"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437262","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 issues in nursing care for older adults in community settings: A scoping review.","authors":"Lei Huang, Xinying Peng, Yifei Zhao, Wenrui Chen, Zhongkang Xu, Yizheng Dang, Shujun Wang, Anning Hou, Yitong Wang, Lili Zhu, Bing Han, Wenna Wang, Peng Wang, Shulei Yuan, Lina Wang","doi":"10.1177/09697330261437274","DOIUrl":"10.1177/09697330261437274","url":null,"abstract":"<p><p>BackgroundEthical issues in nursing care for older adults in community setting are becoming more visible as population aging accelerates. However, existing studies are fragmented and lack a comprehensive synthesis to inform ethical practice and governance.AimsTo identify major ethical issues, their impacts, and related strategies in nursing care for older adults in community setting, providing evidence for ethical practice, education, and policy development.MethodsA scoping review was conducted following JBI methodology. PubMed, Web of Science, Scopus, CINAHL, Ovid-Embase, PhilPapers, and PsycINFO were searched up to 8 February 2026. Two reviewers independently screened, extracted, and synthesized data.ResultsFourteen studies were included in this review. Evidence was synthesized at three levels including nursing staff, older adults, and the care system, and categorized into three domains: ethical challenges, ethical impacts, and improvement strategies. Ethical challenges mainly arise from three aspects: role ambiguity and competence limitations among nursing staff under contextual constraints, restrictions on older adults' autonomy and opportunities to participate in decision-making, and structural conditions related to resource allocation and governance mechanisms. These ethical issues manifested as increased moral distress and emotional strain among nurses, diminished trust in nurses and reduced care adherence among older adults, and systemic pressures on the quality, equity, and sustainability of community nursing services. To address these challenges, the literature proposed strategies including strengthening ethics education and reflective practice, promoting supportive communication and shared decision-making, and improving governance structures and resource support.ConclusionsEthical issues in community nursing for older adults demonstrate multilevel characteristics embedded within practice contexts and institutional conditions. Strengthening ethical competence, promoting supportive communication and participatory decision-making, and advancing institutionalized ethical governance are essential for fostering more equitable and sustainable community nursing practice. Future research should expand geographical representation and further strengthen the evidence base for ethical governance in community nursing through high-quality empirical studies.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1298-1315"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494522","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}