Nurse educators, like many of their health care professional colleagues, frequently face moral dilemmas when they identify a student as presenting an unacceptable risk to public safety. In this situation, the statutory requirement of nurse educators to protect the public, under the Health Practitioners Competence Assurance Act (2003), competes with the rights of the student to receive education under the Education Act (1989). Using the different moral voices of justice and care, identified by ), this moral dilemma is examined within (...) the context of one school of nursing in a New Zealand tertiary education organisation. Overall, the justice voice dominated within the tertiary education organisation. Academic committees, and appeal panels, operating within the educational statutory framework, used democratic processes to reach decisions. The individual committee members, acting as autonomous moral agents, made decisions using universal principles and abstract moral reasoning. The focus was on individual rights, natural justice and due process. Nurse educators articulated both justice and care moral voices. Those with care voices described how they agonised between their duty to protect the public, and their wish to facilitate students, with whom they had built relationships, to succeed. The education management process did not acknowledge the statutory obligations of nurse educators, as registered nurses, or the implications of this within the education context. The moral dilemmas were either ignored, or rendered invisible. As a result of this, nurse educators engaged in various survival strategies, and the broader educational context remained intact and unchallenged. (shrink)

Nursing, a scientific and practical discipline, faces continuing challenges of finding new direction in order to decipher its core values and develop current ethical codes for nursing practice. In 2009–10, 28 nurses were purposely selected and interviewed using a semi-structured format in focus groups and individually. Thematic Content Analysis helped explore the perception of Iranian nurses on ethical values in patient care. Seven major themes emerged: respect for dignity, professional integrity, professional commitment, developing human relationships, justice, honesty, and promoting individuals (...) and the nursing profession. Iranian nurses revealed a unique and culture-based set of ethical values. This study found that Iranian nurses place a greater emphasis on preserving the dignity of those accompanying the patient and in showing regard for patients' religious beliefs in a gender appropriate environment. (shrink)

This article is intended to raise the question of whether sacrifice can be regarded as constituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today’s ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and can serve as general sources of (...) knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotion with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring science literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out the importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas’ ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer’s ethical outlook, but sacrifice can also be understood as a potential process of transformation towards health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of transformation to achieve atonement and healing. Atonement then implies finding meaningfulness in one’s suffering. The concept of sacrifice, understood in a novel way, opens up a deeper dimension in the understanding of suffering and makes caring in ‘the patient’s world’ possible. (shrink)

Recent work in clinical nursing ethics has been influenced by two main areas of insight associated with the challenge levelled by the women's movement to traditional thinking about morality and ethics. Broadly speaking these two realms have been distinguished as articulating ‘feminist’ socio‐political and ‘feminine’ ethic of care concerns. Often these two impulses are seen as pulling against each other, or worse, the ‘feminine’ emphasis on the ethics of care is seen as reinforcing the dynamics that elicit the ‘feminist’ concern. (...) In this paper I suggest how an expanded understanding of an ethic of care in clinical settings can provide resources for dealing with both concerns. A discussion of the way institutional relations can ride rough‐shod over the ‘feminist’ insights of ethical care, in the second part of the paper, provides evidence for my conclusion that ethical nursing care depends on recognizing that both areas of insight are imperative for its success. (shrink)