Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 (...) class='Hi'>nursing ethics textbooks, the nursing ethics heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing’s movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing’s ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing’s ethical history, literature, and theory; a neglect of nursing’s ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing’s rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly. (shrink)

This important text draws on decades of research, arguing that modern nursing germinated and grew an ethics from its own native soil, that is a rich, fulsome and philosophically informed; grounded in the tradition, and practice of nursing. This systematic and comprehensive book is an essential contribution for students and scholars of nursing ethics.

Nurses’ religious beliefs influence their motivations and perspectives, including their practice of ethics in nursing care. When the impact of these beliefs is not recognized, great potential for unethical nursing care exists. Thus, this article examines how the theology of one religious tradition, Seventh-day Adventism (SDA), could affect nurses. An overview of SDA history and beliefs is presented, which explains why ‘medical missionary’ work is central to SDAs. Theological foundations that would permeate an SDA nurse’s view (...) of the nursing metaparadigm concepts of person, health, environment (i.e. community), and nursing (i.e. service) are presented. The ethical principles guiding SDA nurses (i.e. principled, case-based, and care ethics) and the implications of these theological foundations for nurses are noted in a case study. (shrink)

The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing’s past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as ‘other’. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the (...) class='Hi'>nursing profession. First of all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession’s past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today. (shrink)

This chapter contains sections titled: Introduction Tracing a History of Nursing Ethics The Sociopolitical Context of Nursing and Nursing Ethics The Renewal of Ethics in Nursing: The Insufficiency of Bioethics Desired Futures Nursing Leadership in Practice and Policy through Attention Ethics Summary References.

The history of nursing in the home: revealing the significance of place in the expression of moral agency The relationship between place and moral agency in home care nursing is explored in this paper. The notion of place is argued to have relevance to moral agency beyond moral context. This argument is theoretically located in feminist ethics and human geography and is supported through an examination of historical documents (1900–33) that describe the experiences and insights of (...) American home care/private duty nurses or that are related to nursing ethics. Specifically, the role of place in inhibiting and enhancing care, justice, good relationships, and power in the practice of private duty nurses is explored. Several implications for current nursing ethics come out of this analysis. (i) The moral agency of nurses is highly nuanced. It is not only structured by nurses’ relationships to patients and health professionals, i.e. moral context, it is also structured by the place of nursing care. (ii) Place has the potential to limit and enhance the power of nurses. (iii) Some aspects of nursing's conception of the good, such as what constitutes a good nurse–patient relationship, are historically and geographically relative. (shrink)

Derek Nurse looks at variations in the form and function of tense and aspect in Bantu, a branch of Niger-Congo, the world's largest language phylum. Bantu languages are spoken in central, eastern, and southern sub-Saharan Africa south of a line between Nigeria and Somalia. By current estimates there are between 250 and 600 of them, as yet neither adequately classified nor fully described. Professor Nurse's account is based on data from more than 200 Bantu languages and varieties, a representative sample (...) of which is freely available on the publisher's website. He devotes substantial chapters to the analysis and comparison of the different tense and aspect systems found in Bantu. He also examines the verbal categories with which they interact, including negation and focus. Synchronic and diachronic perspectives are interwoven throughout the book. Following a brief history of Bantu over the last five thousand years, the final two chapters look systematically at the history of tense and aspect in Bantu. The first deals with the reconstruction of the earlier forms from which contemporary structures, morphemes, and categories are derived, and the second with the processes of change, including grammaticalization, by means of which older analytical structures and independent lexical items moved as they became incorporated as grammatical inflections and categories. (shrink)

With this paper, I will interrogate some of the implications of nursing's dominant historiography, the history written by and about nursing, and its implications for nursing ethics as a praxis, invoking feminist philosopher Donna Haraway's mantra that ‘it matters what stories make worlds, what worlds make stories.’ First, I will describe what I have come to understand as the nursing imaginary, a shared consciousness constructed both by nurses from within and by those outside the (...) discipline from without. This imaginary is fashioned in part by the histories nursing produces about the discipline, our historical ontology, which is demonstrative of our disciplinary values and the ethics we practice today. I assert that how we choose to constitute ourselves as a discipline is itself an ethical endeavour, bound up with how we choose to be and what we allow as knowledge in nursing. To animate this discussion, I will outline the received historiography of nursing and dwell in the possibilities of thinking about Kaiserswerth, the training school that prepared Nightingale for her exploits in Crimea and beyond. I will briefly consider the normative values that arise from this received history and consider the possibilities that these normative values foreclose upon. I then shift the frame and ask what might be possible if we centred Kaiserswerth's contested legacy as a training school for formerly incarcerated women, letting go of the sanitary and sanitised visions of nursing as Victorian angels in the hospital. Much energy over the past 250 years has been invested in the professionalisation and legitimation of nursing, predicated (at least in our shared imaginary) on the interventions of Florence Nightingale, but this is one possibility of many. I conclude with a speculative dream of the terrain opens up for nursing if we shed this politics and ethos of respectability and professionalism and instead embrace community, abolition and mutual aid as organising values for the discipline. (shrink)

The renowned Nobel Prize-winning scientist's elegant and concise explanation of the fundamental ideas in biology and their uses today. Hailed by Philip Pullman as "a great communicator" who is also "as distinguished a scientist as there could be," Paul Nurse writes with delight at life's richness and a sense of the urgent role of biology in our time. With What Is Life? he delivers a brief but powerful work of popular science in the vein of Carlo Rovelli's Seven Brief Lessons (...) in Physics. Nurse takes readers on a wondrous journey through five fundamental biological ideas-the Cell, the Gene, Evolution by Natural Selection, Life as Chemistry, and Life as Information-introducing the scientists who made the most important advances and taking us into his own lab to give us a sense of the thrill of scientific discovery. In a final chapter, Nurse addresses biology's most pressing ethical issues (including gene-editing, genetic testing, and genetically modified crops), and he concludes with a stirring encomium to biology's role in tackling infectious disease. (shrink)

Overtaxed by the realities laid bare in the pandemic, nursing has imminent decisions to make. The exigencies of pandemic times overextend a health care infrastructure already groaning under the weight of inequitable distribution of resources and care commodified for profit. We can choose to prioritise different values. Invoking philosopher of science Isbelle Stengers's manifesto for slow science, this is not the only nursing that is possible. With this paper, I pick up threads of nursing's historical ontology, drawing (...) previous scholarship on the historical narratives nurses use to understand themselves. Peeling back nursing's myth to alternate points of origin allows me to consider alternate lines of flight, a speculative adventure in paths not taken but paths that exist nonetheless. I go on to examine what a collective ethic of nursing could be, when we make space for these alternate histories, considering the confluences and conflicts that enable nurses to care and those that inhibit them from doing so. The imperative for this lies in the central importance of the reproductive labour of nursing health care, which leads me to a critique of nursing's capitulation to the pressures of late stage capitalism. This is a problem with ethical and ontological implications both for nursing, and also for those who require nursing care, an imperative to think about the kinds of present/futures for health, care, and health care we might cocreate in collaboration and solidarity with the communities in which nurses are imbricated, shedding the trappings of neoliberalism. There is significant power in the vision and praxis of 28 million nurses and midwives worldwide. Our ethics can guide our imagination which can in turn create possibility. This kind of endeavour—that of dreams and imagination—leads us to what could be, if only we leap. (shrink)

This study aimed to identify the ethical issues faced by home care physicians and nurses, and the support they require. It was conducted in collaboration with the Japanese Association for Home Care Medicine from November to December 2020. An e-mail was sent to 2785 physicians and 582 nurses who are members of the society, requesting their participation in a web-based survey targeting physicians and nurses with practical experience in home care; 152 physicians and 53 nurses responded. Home care physicians and (...) nurses face ethical issues, some of which are that “the patient’s wishes cannot be reliably understood owing to their impaired decision-making capacity” and “there is disagreement between the patient and their family members over the necessary healthcare.” The respondents sought “experience with, and insight into, healthcare ethics” and “home care” from people with whom they would consult on ethical issues, but at the time of the actual consultation, those individuals were the main healthcare professionals involved with the patient. In addition, the respondents desired to have “multidisciplinary discussions in the community,” “participation of healthcare ethics experts at meetings,” and “meetings held by healthcare ethics experts” to discuss specific cases. Given these results and the history of healthcare ethics education in Japan—which has been implemented mostly for healthcare providers—we conclude that it is important for academic societies that offer healthcare ethics education to healthcare providers and regional core hospitals with ethics support resources to collaborate to provide ethics consultation services in the community. (shrink)

Despite achieving broad acceptance of the moral case for treating animals fairly, the animal rights movement has reached an impasse concerning legal rights for animals. Zoopolis proposes a new approach to addressing this failure: integrating animal interests into human society via political institutions and practices. Zoopolis’s central theory that humans owe animals citizenship rights in a shared human-animal society, but that acceptance of responsibilities by animals also is required, has merit for the advancement of animal rights discourse. But its anthropocentric (...) approach, which itself exerts power over animals, necessitating suppression and policing of animals’ natural behavior, is problematic. (shrink)

Elderly people are a particularly vulnerable group in society and have special health problems. The world population of older people is increasing. People who are 65 years or older constitute 6% of the Turkish population, 90% of whom have chronic health problems. In Turkey, there is a high possibility that elderly people’s requirements are not met by today’s health care system in the way they would wish. They prefer not to be hospitalized when they have health problems. From a wider (...) perspective, various countries are still seeking how to provide the best care for elderly people. Our goal was to characterize home-based care for elderly people using an ethical approach as an area of interest for nurses and other health care professionals now and in the future, both for Turkey specifically and from a global perspective. We studied four case histories and then prepared a composite scenario and a short questionnaire for elderly people living in a specific district of Istanbul to evaluate their expectations from the health care system. We compared our findings with situations in other countries and have proposed some practical solutions. The results showed that these older people preferred to receive nursing care at home instead of in hospital in Turkey, and also in many other countries. In this article we discuss our findings, comparing them with those in the literature, and suggest that there should be nursing care at home with insurance coverage while using a proper ethical approach. (shrink)

This comprehensive collection offers a unique look at nursing practice, theory, research and nursing history from various critical theoretical perspectives. It aims to initiate an international discussion among scholars from diverse countries, particularly Germany and Anglo-American countries, coming from distinctive schools of thought, e.g. German Critical theory and Post-structural approaches, and influenced by their respective histories of sciences. This book analyzes and criticizes nursing theory, nursing research and practice along several dimensions: Nursing Ethics, (...) Subjectivity, Body and Flesh (Leib), Technology, Power, History, and Education. (shrink)

This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline‐specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are (...) achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change. (shrink)

The nursing profession in Germany is facing a public debate on legal and ethical questions concerning euthanasia on request and physician-assisted suicide. However, it seems questionable if the profession itself, individual nurses or the professional associations are prepared to be involved in such a public debate. To understand this hesitation, the present situation is considered in the light of the tradition and history of professional care in Germany. Obedience to medical as well as to religious authorities was long (...) part of nurses' professional identity, but is no longer relevant. The lack of reflection and discussion on how to take a balanced view of ethical and political questions concerning nursing, and the role and responsibility of nurses in end-of-life decisions and situations of caring for dying people are discussed using the situation of nurses in the Netherlands as a comparison. (shrink)

This study aimed to examine the meanings that nurses attached to the ‘treatments’ administered to cure ‘sexual deviation’ (SD) in theUK, 1935–1974. In theUK, homosexuality was considered a classifiable mental illness that could be ‘cured’ until 1992. Nurses were involved in administering painful and distressing treatments. The study is based on oral history interviews with fifteen nurses who had administered treatments to cure individuals of theirSD. The interviews were transcribed for historical interpretation. Some nurses believed that their role was (...) to passively follow any orders they had been given. Other nurses limited their culpability concerning administering these treatments by adopting dehumanising and objectifying language and by focussing on administrative tasks, rather than the human beings in need of their care. Meanwhile, some nurses genuinely believed that they were acting beneficently by administering these distinctly unpleasant treatments. It is envisaged that this study might act to reiterate the need for nurses to ensure their interventions have a sound evidence base and that they constantly reflect on the moral and value base of their practice and the influence that science and societal norms can have on changing views of what is considered ‘acceptable practice’. (shrink)

Background Nursing is a humanitarian and social field that provides health services. It combines science and art and has a rich history. Despite fundamental changes in the provision of medical services and nursing education, the concept of “good nurse” is still unclear. Purpose The purpose of this article is to investigate the characteristics of a good nurse from the nurses’ perspective. Research design and method A qualitative study was applied using conventional content analysis. The participants were 30 (...) nurses that selected with purposive sampling method. Data were collected through unstructured interviews and simultaneously analyzed via the conventional content analysis approach of Graneheim and Lundman. Ethical considerations This study was approved by the Research Ethics Committee of Hormozgan University of Medical Sciences, Iran. Findings The study revealed that personal characteristics (Adherence to ethical and human principles, Physical health, Attractive appearance, and Ability to communicate properly); and professional characteristics (knowledge - clinical skill - nursing roles) are essential to being a good nurse. Conclusion Coming to know the distinctive features of a good nurse as perceived by nurses themselves creates an opportunity for nurses to rethink their profession and to reflect on the characteristics of the good nurse. (shrink)

It may be the case that the most challenging moral problem of the twenty‐first century will be the relationship between the individual moral agent and the practices and institutions in which the moral agent is embedded. In this paper, we continue the efforts that one of us, Joan Liaschenko, first called for in 1993, that of using feminist ethics as a lens for viewing the relationship between individual nurses as moral agents and the highly complex institutions in which they (...) do the work of nursing. Feminist ethics, with its emphasis on the inextricable relationship between ethics and politics, provides a useful lens to understand the work of nurses in context. Using Margaret Urban Walker's and Hilde Lindemann's concepts of identity, relationships, values, and moral agency, we argue that health care institutions can be moral communities and profoundly affect the work and identity and, therefore, the moral agency of all who work within those structures, including nurses. Nurses are not only shaped by these organizations but also have the power to shape them. Because moral agency is intimately connected to one's identity, moral identity work is essential for nurses to exercise their moral agency and to foster moral community in health care organizations. We first provide a brief history of nursing's morally problematic relationship with institutions and examine the impact institutional master narratives and corporatism exert today on nurses’ moral identities and agency. We close by emphasizing the significance of ongoing dialogue in creating and sustaining moral communities, repairing moral identities, and strengthening moral agency. (shrink)

It was reported in 2006 that a regime of ‘supervised self harm’ had been implemented at St George’s Hospital, Stafford. This involves patients with a history of self-harming behaviour being offered both emotional and practical support to enable them to do so. This support can extend to the provision of knives or razors to enable them to self-harm while they are being supervised by a nurse. This article discusses, and evaluates from an ethical perspective, three competing responses to self-harming (...) behaviours: to prevent it; to allow it; and to make provision for supervised self-harm. It is argued that of these three options the prevention strategy is the least plausible. A tentative conclusion is offered in support of supervised self-harm. (shrink)

In the United States, information about a person’s criminal history is accessible with a name and date of birth. Ruth Crampton has studied nurses’ care for prisoner-patients in hospital settings and found care to be perfunctory and reactive. This article examines whether it is morally permissible for nurses in hospital settings to access information about prisoner-patients’ criminal histories. Nurses may argue for a right to such information based on the right to personal safety at work or the obligation to (...) provide prisoner-patients with the care that they deserve. These two arguments are considered and rejected. It is further argued that accessing information about a prisoner-patient’s criminal history violates nurses’ duty to care. Care, understood through Sarah Ruddick’s account as work and relationship, requires nurses to be open and unbiased in order to do their part in forming a caring relationship with patients. Knowledge of a prisoner-patient’s criminal history inhibits the formation of this relationship and thus violates nurses’ duty to care. (shrink)

Collegiality is one of the fundamental values of the nursing profession. During the nursing history, collegiality has been described as part of a nurse’s relationship with their peers and it influences the quality of care they provide and job satisfaction and commitment to their work. Despite earlier definitions, the concept of collegiality in nursing has remained unclear. The aim of this study was to clarify the concept of collegiality in the nursing profession, using Rodger’s evolutionary (...) concept analysis. We carried out electronic searches using the CINAHL, PubMed, Scopus, Web of Science, SocINDEX, PsycINFO and Eric databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers published in English language from the inception of database to November 2022. This identified 25 papers. Based on our analysis, the attributes of the concept of collegiality were achieving mutual goals together with equality, reciprocity, trusted advocacy, powerful self-regulation and engaged belongingness. Antecedents of the concept included existing professional group, connection between professionals and professional self-esteem. The consequences were strengthening nurses’ professional status, job satisfaction and their ability to provide the best possible patient care. We found that nurses’ collegiality was a value-based concept, with a unique character based on professional connections. The concept brought together ethical and pragmatic strategies to achieve the best possible results for the nursing profession. Provided knowledge can be applied for further development of the concept and applying it in clinical research and practice. The concept of nurses’ collegiality should also be studied in the future because both the profession and their working environment are constantly changing. (shrink)

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, (...) the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here. (shrink)

This article discusses the serious problem of the shortage of about 50 000 nurses in Japan today. If efficient measures to solve it are not adopted by administrators, it is clear that the shortage will become still more alarming in the future, in a society with more people in advanced years and in which the numbers in the younger generation will decrease from now on. The main factors behind the Japanese nursing labour shortage are, among others: a rapid increase (...) in the number of hospital beds between 1986 and 1989; poor working conditions; and nurses’ low social position in their places of work. Behind these factors, there has always been a contempt for the art of nursing in our society. Why has Japanese society made light of nursing? Three points can be identified: traditional discrimination against women; our disregard for a religious mentality; and our short history of hospital nursing. To overcome these problems, we must first of all change fundamentally our sense of values, such as love for one another and compassion. We must now reconstruct a caring culture in our society. (shrink)

This is a revised edition of Walker's well-known book in feminist ethics first published in 1997. Walker's book proposes a view of morality and an approach to ethical theory which uses the critical insights of feminism and race theory to rethink the epistemological and moral position of the ethical theorist, and how moral theory is inescapably shaped by culture and history. The main gist of her book is that morality is embodied in "practices of responsibility" that express our (...) identities, values, and connections to others in socially patterned ways. Thus ethical theory needs to be empirically informed and politically critical to avoid reiterating forms of socially entrenched bias. Responsible ethical theory should reveal and question the moral significance of social differences. The book engages with, and challenges, the work of contemporary analytic philosophers in ethics. Moral Understandings has been influential in reaching a global audience in ethics and feminist philosophy, as well as in tangential fields like nursing ethics; research ethics; disability ethics; environmental ethics, and social and political theory. This revised edition contains a new preface, a substantive postscript to Chapter 1 about "the subject of moral philosophy"; the addition of a new chapter on the importance of emotion in practices of responsibility; and the addition of an afterword, which responds to critics of the book. (shrink)

The concept of moral distress can be extended from clinical settings to larger environmental concerns affecting health care. Moral distress—a common experience in complex societies—arises when individuals have clear moral judgments about societal practices, but have difficulty in finding a venue in which to express concerns. Since health care is large in scale and climate change is proving to be a major environmental problem, scaling down health care is inevitably a necessary element for mitigating climate change. Because it is extremely (...) challenging to discuss these concerns in health care settings, those concerned about climate change and health care experience distress. This article outlines some philosophical concepts and perspectives that may be useful in mitigating this distress. (shrink)

This book offers a long-overdue exploration of care at a pivotal moment in the history of health care.

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as (...) law and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Background The field of nursing has long been concerned with ethical issues. The history of the nursing profession has a rich legacy of attention to social justice and to societal questions regarding issues of fairness, access, equity, and equality. Some nurses have found that their clinical experiences spur an interest in ethical patient care, and many are now nurse bioethicists, having pursued additional training in bioethics and related fields (e.g., psychology, sociology). Purpose The authors describe how the (...) clinical and research experiences of nurses give them a unique voice in the field of bioethics. Results Authors present reasons for the relative invisibility of nurse bioethicists, compared with physician, theologian, or philosopher bioethicists, as well as current efforts to increase the visibility of nurse bioethicists. They also describe four specific areas where nurse bioethicists have made and continue to make important contributions: as ethics consultants to colleagues in hospitals and other settings; as bioethics researchers or as advisers to researchers conducting trials with human subjects; as educators of trainees, patients and families, healthcare providers, and the public; and in helping to draft humane and ethical policies for the care of vulnerable patients and underserved populations. Conclusion Nurse bioethicists are central to the future goals of healthcare bringing a unique perspective to the day-to-day ethical challenges of both clinical care and research, as well as to the education of health professionals and the public. (shrink)

If euthanasia were to be made legal in other countries apart from the Netherlands and Belgium, nurses would be faced with ethical dilemmas that could impact on their professional accountability and their personal moral beliefs. As a part of history has demonstrated, the introduction of the practice of euthanasia could also significantly change the relationship between nurses and patients. In Germany between 1940 and 1945, in response to a government directive, nurses participated in the practice of euthanasia and as (...) a result many innocent German people were killed by what were considered to be ‘mercy deaths’. It is important to try and understand the moral thinking and examine the complex issues at this historical junction that led German nurses to participate in the killing of thousands of innocent people. Such reflection may help to stimulate an awareness of the moral issues that nurses in the twenty-first century could confront if euthanasia were to be made legal in their own country. This has implications for future nursing practice. (shrink)

Background: A small minority of nurses are investigated when they fail to meet the required professional standards. Unprofessional conduct does not just affect the nurse but also patients, colleagues and managers. However, it has not been clearly defined. Objective: The objective was to identify unprofessional conduct by registered nurses by examining disciplinary decisions by a national regulator. Design: A retrospective document analysis. Data and research context: Disciplinary decisions delivered to 204 registered nurses by the Finnish national regulatory authority from 2007 (...) to 2016. The data were analysed with quantitative statistics. Ethical consideration: The study received permission from the Finnish National Supervisory Authority for Welfare and Health and used confidential documents that were supplied on the basis of complete anonymity and confidentiality. Findings: The mean age of the registered nurses who were disciplined was 44 years and 81% were female. Two-thirds had worked for their employer for 5 years or less, 53% had two or more employers and 18% had a criminal history. All the decisions included a primary reason for why the nurses were investigated, but there were also 479 coexisting reasons. In most cases, unprofessional conduct was connected to substance abuse. In addition, stealing of medicine, a decreased ability to work and neglect of nursing guidelines were reported. Discussion: We found that the nurses were investigated for unprofessional conduct for complex combinations of primary and coexisting reasons. Our study highlighted that more attention needs to be paid to the key markers for unprofessional conduct. Conclusion: Unprofessional conduct is a complex phenomenon that is connected to nurses’ individual and working backgrounds and has an impact on their work performance. More research is needed to identify how nursing communities can detect, manage and limit the serious effects and consequences of unprofessional conduct. (shrink)

Fanny Bré was a volunteer nurse in the International Brigades, who fought in the Spanish Civil War (1936–1939) on the side of the democratically elected Republican government. The objective of this study is to understand the relationship between Bré's antifascist ideas, her conception of care and the activities she carried out in the Spanish hospitals of Casa Roja (Murcia), Villa Paz (Selices, Cuenca) and Vic (Barcelona). We use narrative biography to describe Bré's personal, political and professional trajectory. To do so, (...) we conducted a content analysis of primary sources archived in Spain, Russia and France and secondary sources that emerged from a thorough literature review. We identified three thematic axes: (1) a concept of nursing in the service of the antifascist struggle, (2) nursing activity for high‐quality care and (3) political action for improving hospital organisation and care. The interest of Bré's texts transcends the war in Spain because, in them, Bré questions the neutrality of care by revealing that care can itself be a political act. (shrink)

Objectives: Efficient procedures for obtaining informed (proxy) consent may contribute to high influenza vaccination rates in nursing homes. Yet are such procedures justified? This study’s objective was to gain insight in informed consent policies in Dutch nursing homes; to assess how these may affect influenza vaccination rates and to answer the question whether deviating from standard informed consent procedures could be morally justified. Design: A survey among nursing home physicians. Setting & Participants: We sent a questionnaire to (...) all (356) nursing homes in the Netherlands, to be completed by one of the physicians. Results: We received 245 completed questionnaires. As 21 institutions appeared to be closed or merged into other institutions, the response was 73.1% (245/335). Of all respondents 81.9% reported a vaccination rate above 80%. Almost 50% reported a vaccination rate above 90%. Most respondents considered herd immunity to be an important consideration for institutional policy. Freedom of choice for residents was considered important by almost all. Nevertheless, 106 out of 245 respondents follow a tacit consent procedure, according to which vaccination will be administered unless the resident or her proxy refuses. These institutions show significantly higher vaccination rates (p < 0.03). Conclusions: In our discussion we focus on the question whether tacit consent procedures can be morally justifiable. Such procedures assume that vaccination is good for residents either as individuals or as a group. Even though this assumption may be true for most residents, there are good reasons for preferring express consent procedures. (shrink)

Research question and aimClinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020,...

The aim of the research was to analyse the experience of medical volunteers during World War II in the context of nursing history. Oral history data used in the study consisted of 30 interviews with Finnish wartime medical volunteers, known locally as Lottas. Interview data were analysed both thematically and by using the oral history method. Based on the analysis, the Lottas' experiences during wartime nursing became the leitmotif of this study. The main themes consisted (...) of the following: ‘taking care of wounded and ill patients', ‘taking care of dying and deceased patients’, ‘taking care of mentally ill and psychoactive substance‐addicted patients’ and ‘confronting ethical and role dilemmas in nursing’. The interview results showed that the Lottas' duties were sometimes more demanding than basic nursing tasks and that their education was not adequate for the challenges that they faced. In this paper, the terms Lotta, medical Lotta or medical volunteer are used interchangeably and refer to people who were assigned to medical volunteer tasks, regardless of whether or not they were trained. It also includes junior members of the organisation who served as medical volunteers as minors, with special permission. (shrink)

Polish society has found itself at a very important point in its history. The transformation from a traditional to a postmodern pluralistic society involves changes in many spheres of social life. These trends give rise to the question of which way the younger generation of Polish nurses will be going. The main objective of this research was to elucidate the opinions of nurses on life and health as basic values, and on their ethical and religious background regarding their (...) class='Hi'>nursing care. The study made use of a questionnaire for collection and interpretation of the data. Although this article shows some lack of consistency, and even contradictions, it is possible to conclude that life and health are cherished with affection by the great majority of nurses as positive factors of human existence. (shrink)

With this paper, we walk out some central ideas about posthumanisms and the ways in which nursing is already deeply entangled with them. At the same time, we point to ways in which nursing might benefit from further entanglement with other ideas emerging from posthumanisms. We first offer up a brief history of posthumanisms, following multiple roots to several points of formation. We then turn to key flavors of posthuman thought to differentiate between them and clarify our (...) collective understanding and use of the terms. This includes considerations of the threads of transhumanism, critical posthumanism, feminist new materialism, and the speculative, affirmative ethics that arise from critical posthumanism and feminist new materialism. These ideas are fruitful for nursing, and already in action in many cases, which is the matter we occupy ourselves with in the final third of the paper. We consider the ways nursing is already posthuman—sometimes even critically so—and the speculative worldbuilding of nursing as praxis. We conclude with visions for a critical posthumanist nursing that attends to humans and other/more/nonhumans, situated and material and embodied and connected, in relation. (shrink)

This book discusses feature films that enrich our understanding of doctor-patient dilemmas. The book comprises general clinical ethics themes and principles and is written in accessible language. Each theme is discussed and illuminated in chapters devoted to a particular film. Chapters start with a discussion of the film itself, which shares details behind the making of the film; critical reception; casting and other facts about production. The chapter situates the film in a history of medicine and medical sociology (...) context, analyzes ethical issues raised in the film from a clinical ethics lens, and explains to readers how to use each film as a teaching aid for clinical ethics. Readers will understand how each film in this collection served to bring particular clinical ethics issues to the public’s attention, or reflected medico-legal issues that were part of the public discourse. The book is a perfect instructor's guide for anyone teaching bioethics, healthcare ethics, medical sociology, medical history, healthcare systems narrative medicine, or nursing ethics. (shrink)

Concepts and Cases in Nursing Ethics is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth (...) edition includes an added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation. (shrink)

The intensified nurse migration leads to severe problems for the health care systems in many developing countries. Using the Philippines as an example, this paper will address the question of global nurse migration from a philosophical perspective. John Rawls' liberal and Michael Walzer's communitarian theory of justice will be examined in view of the ethical problem of nurse migration. In line with Rawls' A Theory of Justice, nurse migration undermines the ability of the people in developing countries to make use (...) of their basic rights and liberties. Walzer's communitarian assessment of nurse migration, on the other hand, will stress the shared ‘thin’ morality, as well as the shared history between the ‘donating’ and receiving countries. This paper argues that the commonality of a shared history and common values implies the moral obligation to ensure a fairer distribution of nurses. (shrink)

Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each (...) from the staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics. (shrink)