This case study focuses on decision-making for minors who are permanently unconscious and dependent on life-sustaining therapies. Cases of this type often cause anguish and angst for health care providers and caregivers and can lead to mistrust, moral distress, and communication problems. After presenting a particular case, an ethical analysis is applied to determine whether there is an apparent course of action or an ethical dilemma. The ethical analysis focuses on the currently accepted guidance principle for surrogate decision-making for minors (...) and applies them to the case. The conclusion drawn shows that the case was not, in fact, an ethical dilemma by definition and that there is a reasonable course of action to be taken. (shrink)

Introduction Good quality of care is dependent on nurses’ strong clinical skills and moral competencies, as well. While most nurses work with high moral standards, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The study reported in this paper aimed to explore the experiences of nurses regarding negative changes in their moral practice. Materials and methods This was a qualitative study utilizing an inductive thematic analysis approach, which was conducted from (...) February 2017 to September 2019. Twenty-five nurses participated in semi-structured interviews. Results The main theme that emerged from our analysis was one of moral neutralization in the context of an unethical moral climate. We found five sub-themes, including: feeling discouraged; normalization; giving up; becoming a justifier; and moral indifference. Conclusions Unethical moral climates in health organizations can result in deterioration of morality in nurses which can harm both patients and health systems. Some unethical behaviors in nurses can be explained by this process. (shrink)