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- Madeleine M. Leininger (1990). Ethical and Moral Dimensions of Care. Wayne State University Press.
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The use of ethics in everyday nursing practice will become increasingly important to the individual nurse, and nursing as a profession, as technology has a greater impact on health status and the provision of health care. Resource allocation is only one example of an ethical issue in which nursing must have input. Nursing can expand its contribution to society by ensuring that it plays a major role in shaping public policy and legislation. If nursing is to continue to serve the public, the involvement of nurses within the political process must be accepted as an ethical necessity.
Sara T. Fry maintains that care is a central concept for nursing ethics. This requires, among other things, that care is a virtue rather than a mode of being. But if care is a central virtue of ethics and medical ethics then the claim that care is a central concept for nursing ethics is trivial. Otherwise, it is implausible.
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Palliative care is a recent branch of health care. The doctors, nurses, and other professionals involved in it took their inspiration from the medieval idea of the hospice, but have now extended their expertise to every area of health care: surgeries, nursing homes, acute wards, and the community. This has happened during a period when patients wish to take more control over their own lives and deaths, resources have become scarce, and technology has created controversial life-prolonging treatments. Palliative care is therefore faced with more ethical problems that other areas of health care. This book, by a clinician, teacher, and writer on health care ethics, has been written to provide all those who care for the terminally ill--doctors, nurses, social workers, clergymen, physiotherapists--with the concepts and principles which will assist them with difficult decisions. It challenges many received doctrines of palliative care, but its well-illustrated central theme is that technical expertise must be controlled by humane, non-technical judgments.
Helga Kuhse's recent book, Caring: Nurses, Women and Ethics (Maldon, MA: Blackwell, 1997; 296+xii pp.), is a welcome contribution to the literature in nursing and medical ethics. The author provides an enlightening historical account of nurses' subservience to physicians, which even today discourages nurses from exercising independent ethical judgment. She offers a clear-headed analysis of the moral quandaries facing nurses when ordered by physicians to act in ways detrimental to patients' interests. And, centrally, she engages in a penetrating examination of the "ethics of care," exposing a number of serious conceptual mistakes on the part of its proponents, and criticizing ways in which it has been appropriated uncritically by many contemporary writers in nursing ethics.
This book examines major ethical issues in nursing practice. Eschewing the abstract approaches of bioethics and medical ethics, it takes as its point of departure the difficulties nurses experience practicing within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The book's contributors discuss the role of the nurse in relation to issues of informed consent, privacy, dignity and confidentiality. The book also considers nursing accountability in relation to the contemporary Western health care system as a whole. New and critical essays examine the nature of professional codes, care, medical judgement, nursing research and the law. The contributors also deal openly and honestly with controversial issues faced by nurses such as euthanasia, the epidemiology of HIV and the care of the elderly.
Despite the burgeoning of publications in nursing ethics, only more recently has empirical evidence on nursing ethics been published. How nursing ethics can be empirically studied as well as enriched by empirical data will be the focus of this paper. Two empirical studies will be briefly presented and their contribution to ethics discussed. The first one is a quantitative research project about nurses' ethical behavior in daily practice. Using an adapted version of Kohlberg's theory of moral development, this study tried to describe and explore nurses' responses to ethical dilemmas in daily nursing practice. The second study attempted to describe the specificity of residential palliative care. A qualitative approach was used to explore and describe the processes that take place on an inpatient palliative care unit, and the experiences of patients, relatives and palliative care team members. The analysis of the value of both research projects for ethics underlines the power of empirical understanding in the relationship between research and ethics. The need for integration of both qualitative and quantitative research methodologies is argued.
The purpose of this article is to re-examine an ethic of care as the main ethical approach to nursing practice in light of past and present developments in nursing ethics, and to briefly speculate whether or not it will survive within nursing in the future. Overall, it is maintained throughout that the terms ?caring?, ?nursing? and an ?ethic of care? are inextricably linked. This is because, it is argued, professionally focused nursing practices are based predominantly on a well-recognised moral commitment to deliver expert care, and that a care-based ethic is the major factor in the construction and maintenance of these practices. Subsequently, the influences and developments of a caring ethic in nursing are firstly re-examined, and the discussion is supported by evidence from more recent nursing research and theoretical developments. Consideration is given to the philosophical underpinnings of both care theory and caring ethics, and the fundamental importance of caring in nursing, as an interpersonal relationship and as an appropriate ethical response, is made transparent. Finally, an outline of the future possibilities that may affect an ethic of care in nursing is offered.
: Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this contribution is to develop a fundamental ethical view on nursing care considered as moral practice. Three main components are analyzed more deeply--i.e., the caring relationship, caring behavior as the integration of virtue and expert activity, and "good care" as the ultimate goal of nursing practice. For the development of this philosophical-ethical interpretation of nursing, we have mainly drawn on the pioneering work of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. We will also show that the European philosophical background offers some original ideas for this endeavor.
This book offers a long-overdue exploration of care at a pivotal moment in the history of health care.
Every day nurses are required to make ethical decisions in the course of caring for their patients. Ethics in Nursing Practice provides the background necessary to understand ethical decision making and its implications for patient care. The authors focus on the individual nurse’s responsibilities, as well as considering the wider issues affecting patients, colleagues and society as a whole. This third edition is fully updated, and takes into account recent changes in ICN position statements, WHO documents, as well as addressing current issues in healthcare, such as providing for the health and care needs of refugees and asylum seekers, bioethics and the enforcement of nursing codes.
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