Ethical problems related to intravenous fluids in nursing homes

2014 ◽  
Vol 21 (8) ◽  
pp. 890-901 ◽  
Author(s):  
May-Elin T Horntvedt ◽  
Maria Romøren ◽  
Betty-Ann Solvoll
Keyword(s):  
Decision Making ◽  
Nursing Homes ◽  
Internal Pressure ◽  
Collaborative Research ◽  
Ethical Problem ◽  
Organizational Factors ◽  
External Pressure ◽  
Intravenous Fluids ◽  
Research Project ◽  
Ethical Problems

Background: Intravenous fluids and/or antibiotics are applied to only a limited extent in Norwegian nursing homes, and the patients are often sent to hospital in these situations. A transfer and a stay in hospital may be unnecessary strains for frail older patients. Given this background, a collaborative research project was initiated in a Norwegian county in 2009. A teaching programme was developed, which aimed to strengthen the awareness of ethics, assessments and practical procedures related to intravenous fluid and/or antibiotics among healthcare professionals. Objectives: This qualitative study aimed to increase our knowledge of the ethical problems experienced by nursing home nurses in situations related to the administration of intravenous fluids and/or antibiotics. Research design: An exploratory design was used, and five focus group interviews were conducted with 26 registered nurses. A hermeneutic analytic approach was applied. Ethical considerations: This study was reported to the Norwegian Social Science Data Services in May 2010. The Regional Committee for Medical and Health Research Ethics approved the collaborative research project. Findings: The analysis showed that the nurses experienced difficult decision-making situations, which were interpreted as external pressure and internal pressure. External pressure emerged in interactions with patients and relatives. Organizational factors were also interpreted as external pressure. Internal pressure was interpreted as the nurses’ experience of feeling inadequate in situations where it was difficult to protect the dignity of patients. Discussion: These findings correspond with international studies, which show that ethical problems often arise during decision-making situations. Conclusion: In agreement with the definition of an ethical problem, we found that the nurses experienced uncertainty and disagreements about how situations should be managed. External and internal pressures related to intravenous fluids and/or antibiotics in nursing homes have not been reported in previous studies. Thus, these findings merit further exploration.

Moral Decision Making in Business: A Phase-Model

2000 ◽  
Vol 10 (4) ◽  
pp. 773-803 ◽  
Author(s):  
Aviva Geva
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Problem ◽  
Real Life ◽  
Phase Model ◽  
Second Phase ◽  
Illustrative Case ◽  
Moral Decision ◽  
Ethical Problems

Abstract:The traditional model of ethical decision making in business suggests applying an initial set of principles to a concrete problem and if they conflict the decision maker may attempt to balance them intuitively. The centrality of the ethical conflict in the accepted notion of “ethical problem” has diverted the attention of moral decision modelers from other ethical problems that real-world managers must face—e.g., compliance problems, moral laxity, and systemic problems resulting from the structures and practices of the business organization. The present article proposes a new model for ethical decision making in business—the Phase-model—designed to meet the full spectrum of business-related ethical problems. Drawing on the dominant moral theories in business literature, the model offers additional strategies for tackling ethical issues beyond the traditional cognitive operations of deductive application of principles to specific cases and the balancing of ethical considerations. Its response to the problems of moral pluralism in the context of decision making lies in its structural features. The model distinguishes between three phases of the decision-making process, each having a different task and a different theoretical basis. After an introductory stage in which the ethical problem is defined, the first phase focuses on a principle-based evaluation of a course of action; the second phase provides a virtue-based perspective of the situation and strategies for handling unsettled conflicts and compliance problems; and the third phase adapts the decision to empirical accepted norms. An illustrative case demonstrates the applicability of the model to business real life.

Nursing Students’ Experience of Ethical Problems and Use of Ethical Decision-Making Models

2001 ◽  
Vol 8 (5) ◽  
pp. 432-447 ◽  
Author(s):  
Miriam E Cameron ◽  
Marjorie Schaffer ◽  
Hyeoun-Ae Park
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Baccalaureate Nursing ◽  
Ethics Education ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Problem ◽  
Baccalaureate Nursing Students ◽  
Ethical Problems ◽  
Decision Making Model

Using a conceptual framework and method combining ethical enquiry and phenomenology, we asked 73 senior baccalaureate nursing students to answer two questions: (1) What is nursing students’ experience of an ethical problem involving nursing practice? and (2) What is nursing students’ experience of using an ethical decision-making model? Each student described one ethical problem, from which emerged five content categories, the largest being that involving health professionals (44%). The basic nature of the ethical problems consisted of the nursing students’ experience of conflict, resolution and rationale; 85% of the students stated that using an ethical decision-making model was helpful. Although additional research is needed, these findings have important implications for nursing ethics education and practice.

scholarly journals Are We Done Yet? Reflections on the Sustainability of Knowledge Products

2021 ◽  
Vol 20 ◽  
pp. 160940692110609
Author(s):  
Karen Gallant ◽  
Susan Hutchinson ◽  
Catherine White ◽  
Fenton Litwiller ◽  
Barbara Hamilton-Hinch ◽  
...  
Keyword(s):  
Decision Making ◽  
Lived Experience ◽  
Collaborative Research ◽  
Limited Attention ◽  
Research Project ◽  
Community Partners ◽  
Knowledge To Action

While collaborative research approaches help ensure that knowledge products resulting from research will be relevant to stakeholders and increase the likelihood that they will be integrated into practice, there has been limited attention given to the supports essential to maintaining knowledge products. Focussing on one research project whose knowledge products are heavily used, in this paper, we discuss the challenges associated with maintaining the integrity of these knowledge products, particularly tensions associated with: (1) lack of alignment of our needs, timelines and resources as researchers with those of community partners; (2) the ongoing need to support the evolution of knowledge products despite the conclusion of funding and project infrastructure and (3) lack of clarity about decision-making responsibility related to the ongoing evolution of these knowledge products. Out of these challenges, we offer recommendations for negotiating the evolution of knowledge products and sustaining the Knowledge to Action (KTA) cycle. These recommendations focus on documenting responsibilities for knowledge product maintenance and communication, assigning expiry dates to knowledge products, identifying secure, long-term repositories for knowledge products and planning for engagement of research partners with lived experience in the maintenance of research products.

Korean Nursing Students’ Ethical Problems and Ethical Decision Making

2003 ◽  
Vol 10 (6) ◽  
pp. 638-653 ◽  
Author(s):  
Hyeoun-Ae Park ◽  
Miriam E Cameron ◽  
Sung-Suk Han ◽  
Sung-Hee Ahn ◽  
Hyo-Sook Oh ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Ethics Education ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Problem ◽  
Ethical Problems ◽  
Education Practice ◽  
Korean Study ◽  
Decision Making Model

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students’ experience of ethical problems involving nursing practice? and, (2) What is nursing students’ experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision-making models. From 97 ethical problems, five content categories emerged, the largest being health professionals (69%). The basic nature of the ethical problems was the students’ experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research.

Ethical problems in the nurses action in the beginning of life

2021 ◽  
pp. 147775092110618
Author(s):  
Sandra Paço ◽  
Sérgio Deodato
Keyword(s):  
Decision Making ◽  
Human Life ◽  
Ethical Problem ◽  
Qualitative Approach ◽  
Social Recognition ◽  
Structured Interviews ◽  
Ethical Problems ◽  
In The Beginning ◽  
Descriptive Method ◽  
Early Human

Introduction The act of caring in nursing requires previous deliberation and decision, however this perception only arises when an ethical problem emerges. Objective: Identify ethical problems of nurses action in the area of beginning of human life Method: Exploratory and descriptive method, with a qualitative approach. Semi-structured interviews were used to collect data, who were submitted to content analysis. The sample was constituted by 26 nurses. Results 18 categories of problem areas and 56 ethical problems in early human life were identified. The results obtained are very diverse, including areas such as termination of pregnancy, informed consent or maintaining privacy. However, other problem areas also emerge and numerous new subcategories/ethical problems, including: dealing with miscarriage, extreme situations, minors’ pregnancy, serious malformations detected at birth, consent regarding care during childbirth, Non- identification of a ethical problem, nurse social recognition and non-involvement of the person in labour. Conclusion Nurses face different ethical problems that impact their lives. We intend to contribute in helping to make decisions in this field, which the outset is of hope and joy, but which hides, behind this evidence, countless situations of suffering for everyone involved. The identification of ethical problems in this field, it is the first step to reflect about theme and helping decision-making for nurses that are taking care in this area of beginning of human life, when confronted whit the same type of ethical problems.

Ethical decision-making in nursing homes: Influence of organizational factors

2011 ◽  
Vol 18 (4) ◽  
pp. 514-525 ◽  
Author(s):  
Anne Dreyer ◽  
Reidun Førde ◽  
Per Nortvedt
Keyword(s):  
Decision Making ◽  
Nursing Homes ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Organizational Factors ◽  
Patient Treatment ◽  
Professional Collaboration ◽  
Ethical Considerations ◽  
Dying Patients ◽  
Decision Making Processes

In this article we report findings from a qualitative study that explored how doctors and nurses in nursing homes describe professional collaboration around dying patients. The study also examined the consequences this can have for the life-prolonging treatment of patients and the care of them and their relatives. Nine doctors and 10 nurses from 10 Norwegian nursing homes were interviewed about their experience of decision-making processes on life-prolonging treatment and care. The findings reveal that the frameworks for the professional collaboration and organization of physicians and nurses prevent patient treatment and care complying with ethical considerations and the law. These conditions have a challenging impact on the care of dying patients and their relatives.

Automated argument adjudication to solve ethical problems in multi-agent environments

2021 ◽  
Vol 12 (1) ◽  
pp. 310-335
Author(s):  
Selmer Bringsjord ◽  
Naveen Sundar Govindarajulu ◽  
Michael Giancola
Keyword(s):  
Ethical Problem ◽  
Propositional Content ◽  
Ethical Principles ◽  
Artificial Agents ◽  
Artificial Agent ◽  
Ethical Problems ◽  
Multi Agent

Abstract Suppose an artificial agent a adj {a}_{\text{adj}} , as time unfolds, (i) receives from multiple artificial agents (which may, in turn, themselves have received from yet other such agents…) propositional content, and (ii) must solve an ethical problem on the basis of what it has received. How should a adj {a}_{\text{adj}} adjudicate what it has received in order to produce such a solution? We consider an environment infused with logicist artificial agents a 1 , a 2 , … , a n {a}_{1},{a}_{2},\ldots ,{a}_{n} that sense and report their findings to “adjudicator” agents who must solve ethical problems. (Many if not most of these agents may be robots.) In such an environment, inconsistency is a virtual guarantee: a adj {a}_{\text{adj}} may, for instance, receive a report from a 1 {a}_{1} that proposition ϕ \phi holds, then from a 2 {a}_{2} that ¬ ϕ \neg \phi holds, and then from a 3 {a}_{3} that neither ϕ \phi nor ¬ ϕ \neg \phi should be believed, but rather ψ \psi instead, at some level of likelihood. We further assume that agents receiving such incompatible reports will nonetheless sometimes simply need, before long, to make decisions on the basis of these reports, in order to try to solve ethical problems. We provide a solution to such a quandary: AI capable of adjudicating competing reports from subsidiary agents through time, and delivering to humans a rational, ethically correct (relative to underlying ethical principles) recommendation based upon such adjudication. To illuminate our solution, we anchor it to a particular scenario.

scholarly journals Giving a Voice to Students with Disabilities to Design Library Experiences: An Ethnographic Study

Societies ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 61
Author(s):  
Monica Cerdan Chiscano
Keyword(s):  
Resource Allocation ◽  
Focus Groups ◽  
Students With Disabilities ◽  
Design Process ◽  
Collaborative Research ◽  
Management Style ◽  
Ethnographic Study ◽  
Experience Design ◽  
Research Project

Although librarians generally display an inclusive management style, barriers to students with disabilities remain widespread. Against this backdrop, a collaborative research project called Inclusive Library was launched in 2019 in Catalonia, Spain. This study empirically tests how involving students with disabilities in the experience design process can lead to new improvements in users’ library experience. A mix of qualitative techniques, namely focus groups, ethnographic techniques and post-experience surveys, were used to gain insights from the 20 libraries and 20 students with disabilities collaborating in the project. Based on the participants’ voices and follow-up experiences, the study makes several suggestions on how libraries can improve their accessibility. Results indicate that ensuring proper resource allocation for accessibility improves students with disabilities’ library experience. Recommendations for library managers are also provided.

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