Validity of the Italian Code of Ethics for everyday nursing practice

2016 ◽  
Vol 25 (7) ◽  
pp. 906-917
Author(s):  
Paola Gobbi ◽  
Maria Grazia Castoldi ◽  
Rosa Anna Alagna ◽  
Anna Brunoldi ◽  
Chiara Pari ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Nursing Practice ◽  
Code Of Ethics ◽  
Research Question ◽  
Daily Practice ◽  
Ethical Considerations ◽  
Clinical Competencies ◽  
Ethical Problems ◽  
Specific Theme

Background: The research question for this study was as follows: Is the Code of Ethics for Nurses in Italy (Code) a valid or useful decision-making instrument for nurses faced with ethical problems in their daily clinical practice? Method: Focus groups were conducted to analyze specific ethical problems through 11 case studies. The analysis was conducted using sections of the Code as well as other relevant documents. Each focus group had a specific theme and nurses participated freely in the discussions according to their respective clinical competencies. Ethical considerations: The executive administrative committee of the local nursing licensing council provided approval for conducting this project. Measures were taken to protect the confidentiality of consenting participants. Findings: The answer to the research question posed for this investigation was predominantly positive. Many sections of the Code were useful for discussion and identifying possible solutions for the ethical problems presented in the 11 cases. Conclusion: We concluded that the Code of Ethics for Nurses in Italy can be a valuable aid in daily practice in most clinical situations that can give rise to ethical problems.

Hindrances to achieve professional confidence: The nurse’s participation in ethical decision-making

2017 ◽  
Vol 26 (3) ◽  
pp. 715-727 ◽  
Author(s):  
Anne Storaker ◽  
Dagfinn Nåden ◽  
Berit Sæteren
Keyword(s):  
Decision Making ◽  
Data Storage ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Research Question ◽  
Daily Practice ◽  
Clinical Work ◽  
Ethical Guidelines ◽  
Science Data ◽  
Written Information

Background: Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient’s dignity in their clinical work. Objectives: The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice. The chosen research question is “How do nurses participate in ethical decision-making for the patient?” Design and method: We use Gadamer’s philosophical hermeneutics as well as Kvale and Brinkmann’s three levels of understanding in interpreting the data material. Nine registered nurses were interviewed. Ethical considerations: The Ombudsman of Norwegian Social Science Data and the head of the hospital approved the investigation. The participants received both oral and written information about the study and they gave their consent. We informed the participants that the participation was voluntary and that they were free to withdraw at any point in the course of the study. The requirement of anonymity and proper data storage was in accordance with the World Medical Association Declaration of Helsinki (1964). The participants were assured that privacy, and confidentiality would be duly protected. Results: Four key themes emerged: (1) confusion in relation to professional and operational expectations of role, (2) ideal somnolence, (3) inadequate argumentation skills, and (4) compound pressure. Conclusion: Ethical ideals appear to be latent in the mindset of the participants; however, the main finding of this investigation is that nurses need to activate the ideals and apply them into practice. Furthermore, management needs to initiate professional reasoning and interdisciplinary discussions leading to common goals for patients.

Ethical considerations in oncology: balancing the interests of patients, oncologists, and society.

1995 ◽  
Vol 13 (9) ◽  
pp. 2464-2470 ◽  
Author(s):  
T J Smith ◽  
J N Bodurtha
Keyword(s):  
Decision Making ◽  
Conflicts Of Interest ◽  
Daily Practice ◽  
Ethics Committees ◽  
Ethical Principles ◽  
Allocation Of Resources ◽  
Ethical Considerations ◽  
Ethical Frameworks ◽  
Choice Of Treatment ◽  
Hospital Ethics

BACKGROUND Oncologists face ethical dilemmas every day in deciding about choice of treatment, continuation of treatments, events near the end of life, conflicts of interest, and risk management. Yet, many oncologists have limited training in ethics. METHODS Review of existing studies and definitions of useful terms. Case studies analyzed according to ethical principles. RESULTS Individual oncology cases can be analyzed according to ethical principles with benefit to the patient, physician, and possibly society. Ethics cannot resolve many of the thorny questions about allocation of resources, justice, or possible conflict of interest. CONCLUSION Oncology decision-making fits into formal ethical frameworks, and understanding both can help doctors and patients make difficult choices. Understanding of ethical principles can help daily practice, but does not solve current dilemmas of allocation of resources, unrealistic demands, etc. More formal collaboration between hospital ethics committees or personnel and clinical oncologists is recommended for the day-to-day decision-making process.

Ethical Issues Encountered by Military Nurses During Wartime

2016 ◽  
Vol 34 (1) ◽  
pp. 227-246 ◽  
Author(s):  
Janice Agazio ◽  
Petra Goodman ◽  
Oluwakemi Opanubi ◽  
Patricia McMullen
Keyword(s):  
Decision Making ◽  
Ethical Issues ◽  
Code Of Ethics ◽  
Ethical Dilemmas ◽  
Daily Practice ◽  
Professional Behavior ◽  
Future Research ◽  
Ethical Practice ◽  
Military Nurses ◽  
The Military

Military nurses encounter similar issues as civilian nurses in daily practice situations; however, wartime and humanitarian missions may bring unique and difficult ethical dilemmas. While nursing has the American Nurses Association code of ethics to provide a framework to guide ethical practice decisions, conflicts may arise from the unique aspects of nursing within a wartime environment. Understanding those conflicts occuring within the military wartime scenario can provide nurses with experiential examples from which to derive strategies for personal coping and professional behavior and decision making. This chapter describes the research that has focused upon the identification of these issues, the effects from uresolved issues, and those directions for future research to better prepare miltiary nurses before and during deployment.

Navigating the “Passaggio” Between Voice Therapy and a Singing Lesson: Ethical Considerations for the Speech-Language Pathologist

2020 ◽  
Vol 5 (3) ◽  
pp. 658-661
Author(s):  
Katherine McConville
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Code Of Ethics ◽  
Voice Therapy ◽  
Speech Language Pathology ◽  
Ethical Considerations ◽  
Therapeutic Purpose ◽  
Speech Language Pathologist ◽  
Language Pathology

Purpose The purpose of this article is to discuss factors that guide ethical decision making in determining what constitutes medically necessary voice therapy that involves or targets singing, which is distinct from a singing lesson. Method Different treatment tasks and scenarios are identified, and their rationales are compared with deference to precedent literature and relevant portions of the American Speech-Language-Hearing Association Code of Ethics. These materials are referenced in an effort to define the boundaries between voice therapy involving singing technique and a singing lesson. Results Suggestions regarding goal writing and documentation to highlight apparent boundaries are made. Conclusions In the care of injured voices, both precedent and ethical principles support speech-language pathology treatment that targets singing. However, it is incumbent upon the treating speech-language pathologist to determine when they are venturing into tasks that no longer serve a therapeutic purpose and to refer the patient for voice lessons as appropriate.

Psychiatric ethics

2012 ◽  
pp. 28-32
Author(s):  
Sidney Bloch ◽  
Stephen Green
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Ethical Dilemmas ◽  
Theoretical Perspective ◽  
Codes Of Ethics ◽  
Clinical Decision ◽  
Mental Health Practice ◽  
Ethical Problems

A myriad of ethical problems pervade clinical practice and research in psychiatry. Yet with few exceptions, psychiatric ethics has generally been regarded as an addendum to mainstream bioethics. An assumption has been made that ‘tools’ developed to deal with issues like assisted reproduction or transplant surgery can be used essentially unmodified in psychiatry. These tools certainly help the psychiatrist but the hand-me-down approach has meant that salient features of psychiatric ethics have been prone to misunderstanding. Psychiatric ethics is concerned with the application of moral rules to situations and relationships specific to the field of mental health practice. We will focus on ethical aspects of diagnosis and treatment that challenge psychiatrists, and on codes of ethics. Resolution of ethical dilemmas requires deliberation grounded in a moral theoretical framework that serves clinical decision-making, and we conclude with our preferred theoretical perspective.

Surgery

2018 ◽  
pp. 441-462
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Decision Making ◽  
Patient Safety ◽  
Communication Skills ◽  
Nursing Practice ◽  
Professional Values ◽  
Ethical Considerations ◽  
Surgical Safety ◽  
Primary Nursing ◽  
Policies And Procedures ◽  
Type Of Surgery

When working with people who are having any type of surgery, the primary nursing responsibility is minimizing risk and maintaining patient safety. Nurses should always act within the limits of their knowledge, skills, and competence. All nursing decision-making in relation to surgery is framed by legal and ethical considerations, professional values, and teamwork, and grounded in respectful, appropriate communication skills. Anaesthetics, recovery, and operating departments are specialized areas of nursing practice, but general adult nurses will be involved in preparing people for surgery and in supporting them after their operation until they are discharged from hospital. All organizations will have policies and procedures for surgical safety, and it is incumbent on nurses to operate within local requirements. This chapter describes generic principles of safe surgery and surgical nursing practices.

Conscientious objection and nurses: Results of an interpretive phenomenological study

2018 ◽  
Vol 26 (5) ◽  
pp. 1337-1349 ◽  
Author(s):  
Christina Lamb ◽  
Yolanda Babenko-Mould ◽  
Marilyn Evans ◽  
Carol A Wong ◽  
Ken W Kirkwood
Keyword(s):  
Clinical Practice ◽  
Lived Experience ◽  
Nursing Practice ◽  
Phenomenological Study ◽  
Ethical Issues ◽  
Research Question ◽  
Science Research ◽  
Conscientious Objection ◽  
Health Science ◽  
Health Science Research

Background: While conscientious objection is a well-known phenomenon in normative and bioethical literature, there is a lack of evidence to support an understanding of what it is like for nurses to make a conscientious objection in clinical practice including the meaning this holds for them and the nursing profession. Research question: The question guiding this research was: what is the lived experience of conscientious objection for Registered Nurses in Ontario? Research design: Interpretive phenomenological methodology was used to gain an in-depth understanding of what it means to be a nurse making a conscientious objection. Purposive sampling with in-depth interview methods was used to collect and then analyze data through an iterative process. Participants and research context: Eight nurse participants were interviewed from across practice settings in Ontario, Canada. Each participant was interviewed twice over 9 months. Ethical considerations: This study was conducted in accordance with Health Science Research Ethics Board approval and all participants gave consent. Findings: Six themes emerged from data analysis: encountering the problem, knowing oneself, taking a stand, alone and uncertain, caring for others, and perceptions of support. Discussion: This study offers an initial understanding of what it is like to be a nurse making a conscientious objection in clinical practice. Implications for nursing practice, education, policy, and further research are discussed. Conclusion: Addressing ethical issues in nursing practice is complex. The need for education across nursing, healthcare disciplines and socio-political sectors is essential to respond to nurses’ ethical concerns giving rise to objections. Conscience emerged as an informant to nurses’ conscientious objections. The need for morally inclusive environments and addressing challenging ethical questions as well as the concept of conscience are relevant to advancing nursing ethics and ethical nursing practice.

scholarly journals Systematic and integrative reviews: synthesising evidence for community nursing practice

2020 ◽  
Vol 25 (1) ◽  
pp. 6-9
Author(s):  
Catriona Kennedy ◽  
Mokholelana Margaret Ramukumba
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Nursing Practice ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Evidence Synthesis ◽  
Clinical Decision ◽  
Evidence Based ◽  
The Status ◽  
Ease Of Access

Ease of access to vast amounts of information presents significant opportunities and challenges for nurses in the community as they seek to base their practice on the best available evidence. Growing expectations around evidence-based practice have developed alongside developments in evidence synthesis, which adopts robust approaches to identifying, appraising and synthesising key evidence for clinical decision-making. The context in which evidence-based practice occurs is key, and this article discusses the skills and knowledge needed for community nurses to discern how evidence and information should influence their decisions to review and change approaches to clinical practice. Importantly, if nurses understand the status of evidence underpinning areas of practice, they can ensure that the preferences and needs of patients and families are met.

Ethically difficult situations in hemodialysis care – Nurses' narratives

2014 ◽  
Vol 22 (6) ◽  
pp. 711-722 ◽  
Author(s):  
Catarina EC Fischer Grönlund ◽  
Anna IS Söderberg ◽  
Karin M Zingmark ◽  
S Mikael Sandlund ◽  
Vera Dahlqvist
Keyword(s):  
Registered Nurses ◽  
Ethical Dilemmas ◽  
Research Question ◽  
Moral Integrity ◽  
Ethical Considerations ◽  
Ethical Problems ◽  
Deliberative Dialogue ◽  
Stage Renal Disease ◽  
End Stage ◽  
Difficult Situations

Background: Providing nursing care for patients with end-stage renal disease entails dealing with existential issues which may sometimes lead not only to ethical problems but also conflicts within the team. A previous study shows that physicians felt irresolute, torn and unconfirmed when ethical dilemmas arose. Research question: This study, conducted in the same dialysis care unit, aimed to illuminate registered nurses’ experiences of being in ethically difficult situations that give rise to a troubled conscience. Research design: This study has a phenomenological hermeneutic approach. Participants: Narrative interviews were carried out with 10 registered nurses working in dialysis care. Ethical considerations: The study was approved by the Ethics Committee of the Faculty of Medicine, Umeå University. Results: One theme, ‘Calling for a deliberative dialogue’, and six sub-themes emerged: ‘Dealing with patients’ ambiguity’, ‘Responding to patients’ reluctance’, ‘Acting against patients’ will’, ‘Acting against one’s moral convictions’, ‘Lacking involvement with patients and relatives’ and ‘Being trapped in feelings of guilt’. Discussion: In ethically difficult situations, the registered nurses tried, but failed, to open up a dialogue with the physicians about ethical concerns and their uncertainty. They felt alone, uncertain and sometimes had to act against their conscience. Conclusion: In ethical dilemmas, personal and professional integrity is at stake. Mistrusting their own moral integrity may turn professionals from moral actors into victims of circumstances. To counteract such a risk, professionals and patients need to continuously deliberate on their feelings, views and experiences, in an atmosphere of togetherness and trust.

Awareness and Decision Making in Professional Ethics

2000 ◽  
Vol 5 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Ronny Swain
Keyword(s):  
Decision Making ◽  
Professional Ethics ◽  
Ethical Decision Making ◽  
Code Of Ethics ◽  
Professional Autonomy ◽  
Ethical Awareness ◽  
Ethical Decisions ◽  
The Right ◽  
Aid Decision

The paper describes the development of the 1998 revision of the Psychological Society of Ireland's Code of Professional Ethics. The Code incorporates the European Meta-Code of Ethics and an ethical decision-making procedure borrowed from the Canadian Psychological Association. An example using the procedure is presented. To aid decision making, a classification of different kinds of stakeholder (i.e., interested party) affected by ethical decisions is offered. The author contends (1) that psychologists should assert the right, which is an important aspect of professional autonomy, to make discretionary judgments, (2) that to be justified in doing so they need to educate themselves in sound and deliberative judgment, and (3) that the process is facilitated by a code such as the Irish one, which emphasizes ethical awareness and decision making. The need for awareness and judgment is underlined by the variability in the ethical codes of different organizations and different European states: in such a context, codes should be used as broad yardsticks, rather than precise templates.

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