How Nurses and physicians face ethical dilemmas — the Croatian experience

2011 ◽  
Vol 18 (3) ◽  
pp. 341-355 ◽  
Author(s):  
Iva Sorta-Bilajac ◽  
Ksenija Baždarić ◽  
Morana Brkljačić Žagrović ◽  
Ervin Jančić ◽  
Boris Brozović ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Ethical Issue ◽  
Clinical Ethics ◽  
Assisted Suicide ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Complete Information ◽  
Perceived Usefulness ◽  
Physician Assisted Suicide ◽  
Nurses And Physicians

The aim of this study was to assess nurses’ and physicians’ ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N = 364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services.

Ethical and Legal Issues in Intensive Care

1997 ◽  
Vol 12 (6) ◽  
pp. 298-309 ◽  
Author(s):  
John J. Paris ◽  
J. Cameron Muir ◽  
Frank E. Reardon
Keyword(s):  
Decision Making ◽  
Managed Care ◽  
Assisted Suicide ◽  
Ethical Issues ◽  
Care Delivery ◽  
Physician Behavior ◽  
Physician Assisted Suicide ◽  
Emerging Issues ◽  
Ethical And Legal Issues ◽  
Seriously Ill Patients

The findings of the SUPPORT study, the largest, most comprehensive and costly study ever undertaken on decision making for critically ill patients, revealed a wide ranging gap between patient preferences and physician behavior with regard to treatment decisions for seriously ill patients. The ethical issues raised by that disparity are intensified as we enter into a market-driven managed care delivery system. This essay explores recent ethical and legal developments on several emerging issues: the decision making process; DNR orders; brain death; withdrawal of treatment; physician assisted suicide; and the constraints of managed care.

scholarly journals Possible advantages of the clinical policy ethics assessment tool: institutional support or unnecessary bureaucracy?

2020 ◽  
pp. 147775092094668
Author(s):  
Alfonso Rubio-Navarro ◽  
Diego Jose Garcia-Capilla ◽  
Maria Jose Torralba-Madrid ◽  
Jane Rutty
Keyword(s):  
Clinical Practice ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Institutional Support ◽  
Ethical Practice ◽  
Ethical Assessment ◽  
Simple Tool ◽  
Ethics Assessment

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue.

scholarly journals Ethical Decision-Making of Health Professionals Caring for HIV-Infected People in Hunan, China: A Qualitative Study

2020 ◽  
Author(s):  
Hangyu Huang ◽  
Deborah Koniak-Griffin ◽  
Honghong Wang ◽  
Min Yang
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Health Professionals ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Hunan Province ◽  
Negative Attitudes ◽  
Infected People

Abstract Background: Numerous ethical issues surged the moment AIDS was discovered. As advocates of HIV-infected people, health professionals encounter many ethical dilemmas in clinical practice. However, it remains unclear how health professionals solve these issues. To explore the ethical decision-making experiences of health professionals who care for HIV-infected people in Hunan Province, China, and to discuss the strategies for enhancing ethical decision-making competence in AIDS care. Methods: This descriptive qualitative research adopted semi-structured, in-depth interview and thematic analysis. Participants were recruited by purposive sampling. In total, twenty-two participants completed the interview. Results: Three themes emerged from data analyses of the interviews: (1) common ethical dilemma experienced by health professionals, (2) factors influencing ethical judgment, (3) ethical motivations. Conclusion: About two thirds of informants failed to recall ethical dilemmas experienced in their clinical practice. Emotions, gender, occupation, and difficulty balancing different roles may influence the ethical judgments of health professionals. In the ethical decision-making process, most informants took other people’s interests into consideration and conformed to law and professional codes of conduct. However, negative attitudes towards HIV-infected people still exist among a few professionals. Furthermore, some informants showed a misunderstanding of ethical principles. And the fear of medical disputes (conflicts with families and others) was experienced by many informants, influencing their ethical behaviors. Hence, more efforts are needed to eliminate negative attitudes towards HIV-infected patients. This study underscores the importance of continuing ethical education for HIV/AIDS-related professionals to enhance their ethical decision-making competence. Moreover, sound governmental laws may promote ethical behavior in AIDS care.

Ethics in cancer care

2019 ◽  
pp. 159-172
Keyword(s):  
Assisted Suicide ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
The United Kingdom ◽  
Drug Treatments ◽  
Potential Benefits ◽  
The Uk ◽  
The Right

The biomedical ethical principles of autonomy, beneficence, non-maleficence, and justice are well established, though they have been challenged by feminist and nursing ethics. Decision-making in practice requires a balance of not only ethical principles, but also legal and professional frameworks, alongside patient and family wishes. Cancer clinical trials raise ethical issues around the balance between risk and potential benefits to patients, and they may need support making the right decision about whether to participate. The rising cost of cancer drug treatments has raised difficult questions about which drugs should be authorized for use within the United Kingdom (UK)'s National Health Service. End-of-life care raises particularly challenging ethical issues. Mental capacity or competence is defined in law in the UK, and treatment decisions may be made on behalf of patients if they are assessed and found to lack capacity. However, patients and families are encouraged to make advance statements and decisions about treatment in the event of losing capacity. Decisions on whether to give, withdraw, or withhold treatment, artificial hydration and nutrition, and cardiopulmonary resuscitation (CPR) are sensitive, and should be based on assessment, consultation with family, and consideration of ethical, legal, and professional principles. Euthanasia and physician-assisted suicide (assisted dying) are highly contentious issues internationally and illegal in most countries. Some countries allow them under certain circumstances. In response to a patient asking about assisted dying, the nurse should listen to their concerns, be prepared to talk about the process of dying, and support them to establish their priorities.

Ethical issues in physician aid-in-dying

2021 ◽  
pp. 1161-1169
Author(s):  
Lars Johan Materstvedt
Keyword(s):  
Palliative Care ◽  
Assisted Suicide ◽  
Ethical Issues ◽  
Treatment Decisions ◽  
Palliative Sedation ◽  
Physician Assisted Suicide ◽  
International Convention ◽  
Aid In Dying ◽  
Point Of Departure ◽  
Normative Ethical Theory

According to international convention, physician aid-in-dying includes euthanasia and physician-assisted suicide, both of which are voluntarily requested forms of medicalized killings. In the former, a physician injects the patient with lethal drugs, whereas in the latter, the patient self-administers such drugs. The two practices differ fundamentally from non-treatment decisions and from the last-resort treatment, palliative sedation, and details of the differences are outlined in the chapter. Physician aid-in-dying differs considerably in appearance, depending on which normative ethical theory is taken as the point of departure and how various theories can be used either to reject or to defend physician aid-in-dying. The chapter also discusses alternative ways for palliative care physicians to relate to physician aid-in-dying.

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