scholarly journals Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review

Aquichan ◽  
2019 ◽  
Vol 19 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Ivonne Vargas Celis ◽  
Camila Andrea Concha Méndez
Keyword(s):  
Interpersonal Relationships ◽  
Ethical Climate ◽  
Moral Distress ◽  
Ethical Issues ◽  
Organizational Factors ◽  
Oncology Nurses ◽  
Oncology Nursing ◽  
Ethical Problems ◽  
Moral Agents ◽  
Deliberation Process

Objective: To describe the factors that influence the emergence of moral distress in oncology nurses. Methodology: integrative review of the literature whose search will be performed in Web of Science databases, CINAHL (EBSCO), Scielo, Proquest, Pubmed and PsycInfo using the keywords moral distress and oncology nursing and their similes in Spanish, without restriction for years of publication until 2017. Results: The results of this review were grouped into three groups of factors each with subgroups: 1) Organizational factors: ethical climate, evasive culture and resources for ethics delivered by the organization. 2) Particular clinical situations: pain management, information delivery, futile treatment, and assistance to the patient and their family in the process of death, 3) Interpersonal relationships: poor communication, power relations, trust in the team’s competence. Conclusion: the three factors described are triggers of moral distress in oncology nurses. When there are ethical problems and the nurses do not participate in the deliberation process, these problems can be hidden and be normalized, which can diminish the moral sensitivity of the professionals, as well as the possibility of acting as moral agents.

scholarly journals Ethical climate and moral distress in paediatric oncology nursing

2021 ◽  
pp. 096973302199416
Author(s):  
Päivi Ventovaara ◽  
Margareta af Sandeberg ◽  
Janne Räsänen ◽  
Pernilla Pergert
Keyword(s):  
Ethical Climate ◽  
Moral Distress ◽  
Ethical Issues ◽  
Paediatric Oncology ◽  
Study Data ◽  
Ethical Review ◽  
Oncology Nursing ◽  
Ethical Behaviour ◽  
Cross Sectional ◽  
Distress Scale

Background: Ethical climate and moral distress have been shown to affect nurses’ ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses’ perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. Ethical considerations: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. Results: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. Discussion: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. Conclusion: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.

The role of online ethics consultation on mental health

2020 ◽  
Vol 27 (5) ◽  
pp. 1261-1269
Author(s):  
Kayoko Ohnishi ◽  
Teresa E Stone ◽  
Takashi Yoshiike ◽  
Kazuyo Kitaoka
Keyword(s):  
Mental Health ◽  
Moral Distress ◽  
Ethical Issues ◽  
Physical Restraint ◽  
Ethics Consultation ◽  
Mental Health Nurses ◽  
Ethical Problems ◽  
Improving Patient Care

Background Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice. Research objective To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness. Ethical considerations The research was conducted in accordance with the Declaration of Helsinki. Research design This evaluation describes the outcomes of 5 years of operation of the Online Ethics Consultation on mental health in Japan Participants The Online Ethics Consultation received 12 emails requesting consultation. Consultees included mental health nurses, psychiatrists, and service users. Findings The most common questions directed to the service were about seclusion and physical restraint. Response time from receipt of email to sending a reply was between 1 and 14 days. Despite the disappointing number of consultations, feedback has been positive. Discussion The Online Ethics Consultation was established to assist morally sensitive nurses in resolving their ethical problems through provision of unbiased and encouraging advice. Mental health care in Japan has been less than ideal: long-term social hospitalization, seclusion, and restraint are common practices that often lead to moral distress in nurses and the questions received reflected this. The head of the Online Ethics Consultation sent a supportive, facilitative response summarizing the opinions of several consultants. Conclusion This study provides key information for the establishment of an online ethics resource the adoption of which has the potential to improve the experience of nurses, allied health and clients of mental health services. This paper has implications for services concerned with improving patient care, managing nurses’ moral distress, building ethics into decision-making.

Judgments of Marketing Professionals about Ethical Issues in Marketing Research: A Replication and Extension

1989 ◽  
Vol 26 (1) ◽  
pp. 112-120 ◽  
Author(s):  
Ishmael P. Akaah ◽  
Edward A. Riordan
Keyword(s):  
Research Ethics ◽  
Ethical Issues ◽  
Marketing Research ◽  
Organizational Factors ◽  
Top Management ◽  
Ethical Problems ◽  
Ethical Judgments ◽  
Organizational Role ◽  
Management Actions

The authors examine, in the context of Crawford's 1970 study, changes in marketing professionals’ research ethics judgments and the influence of organizational factors on those judgments. The results indicate several significant changes in ethical judgments. In addition, they suggest that three organizational factors—extent of ethical problems within the organization, top management actions on ethics, and organizational role (researchers vs. executives)—underlie differences in ethical judgments.

scholarly journals Clarification and Mitigation of Ethical Problems Surrounding Withdrawal of Extracorporeal Membrane Oxygenation

2016 ◽  
Vol 36 (5) ◽  
pp. 56-65 ◽  
Author(s):  
Susan B. Williams ◽  
Michael D. Dahnke
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Moral Distress ◽  
Life Support ◽  
Ethical Issues ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Care Providers ◽  
Ethical Problems ◽  
Practice Nurses ◽  
Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice. In particular, these issues are considered in relation to how they affect and can be addressed by staff nurses and advanced practice nurses in the intensive care unit. Advanced practice nurses in particular can represent the voice of nurses to promote a healthier workplace in situations of moral distress related to stopping ECMO life-support technology and in developing clear and consistent guidelines for ceasing ECMO treatment, all leading toward clarification and mitigation of the ethical problems surrounding the withdrawal of this critical technology.

scholarly journals GESTÃO DE ENFERMAGEM E CONSTRUÇÃO DE AMBIENTES ÉTICOS

2017 ◽  
Vol 7 (3/4) ◽  
pp. 41-45 ◽  
Author(s):  
Valéria Lerch Lunardi ◽  
Wilson Danilo Lunardi Filho ◽  
Rosemary Silva Da Silveira ◽  
Priscila Arruda Da Silva ◽  
Joel Rolim Mancia
Keyword(s):  
Moral Distress ◽  
Ethical Issues ◽  
Active Role ◽  
Nursing Leadership ◽  
Nursing Management ◽  
Ethical Problems ◽  
Leadership Management ◽  
Institutional Values ◽  
Health Institutions ◽  
And Coping

Objetivo: destacar a relevância da gestão das chefias de enfermagem para a construção de ambientes éticos, em que o usual silêncio sobre os problemas éticos vivenciados seja substituído pela liberdade de enfrentá-los. Metodologia: trata-se de uma reflexão teórica em que enfocaremos a organização das instituições de saúde e a ética, o sofrimento moral (SM) dos trabalhadores e estratégias de enfrentamento. Resultados: ressaltamos que o cuidado em saúde nem sempre favorece uma atuação ética, contribuindo para a emersão de problemas éticos; a divergência entre os valores profissionais e institucionais desencadeiam SM aos trabalhadores; a relevância de uma atuação mais ativa de enfrentamento das chefias de enfermagem. Conclusão: a construção de ambientes éticos requer a contínua construção de ambientes com espaço para a voz em substituição ao silêncio sobre os problemas morais frequentemente vivenciados.Descritores: Ética em enfermagem, Enfermagem, Gestão, Gestão hospitalarNURSING MANAGEMENT AND CONSTRUCTION OF ETHICAL ENVIRONMENTSObjective: to highlight the importance of nursing leadership management for the construction of ethical environments, where the usual silence on ethical problems experienced is replaced by the freedom to face them. Methodology: his is a theoretical reflection that will focus on the organization of health institutions and ethics, the moral suffering of workers and coping strategies. Results: we emphasize that health care does not always favor an ethical performance, contributing to the emergence of ethical issues; the divergence between the professional and institutional values trigger moral distress to workers; the importance of a more active role in confronting the nursing supervisors. Conclusion: The construction of ethical environment requires continuous build environments with space for voice replacing silent about the often experienced moral problems.Descriptors: Nursing Ethics, Nursing, Management, Hospital ManagementGESTIÓN DE ENFERMERÍA Y CONSTRUCCIÓN DE ENTORNOS ÉTICOSObjetivo: Para resaltar la importancia de la gestión de liderazgo de enfermería para la construcción de entornos éticos, donde el silencio habitual en los problemas éticos experimentados se sustituye por la libertad de enfrentarse a ellos. Metodología: Se trata de una reflexión teórica que se centrará en la organización de las instituciones de salud y la ética, la moral, el sufrimiento de los trabajadores y estrategias de afrontamiento. Resultados: Hacemos hincapié en que la asistencia sanitaria no siempre favorece el ejercicio ético, lo que contribuye a la aparición de problemas éticos; la divergencia entre los valores profesionales e institucionales desencadenar sufrimiento moral de los trabajadores; la importancia de un papel más activo en hacer frente a los supervisores de enfermería. Conclusión: La construcción del entorno ético requiere entornos de compilación continuas con espacio para la sustitución de la voz en silencio acerca de los problemas morales que a menudo experimentan.Descriptores: Ética en enfermería, Enfermería, Administración, Gestión Hospitalaria

scholarly journals Ethical Calculator: from Philosophical «Computational Morality» to Machine Ethics of Artificial Moral Agents (АMA)

2020 ◽  
pp. 18-27
Author(s):  
Artem Vladimirovich Makulin
Keyword(s):  
Ethical Issues ◽  
Point Of View ◽  
Machine Ethics ◽  
Ethical Problems ◽  
Moral Agents ◽  
Artificial Moral Agents ◽  
Problems And Solutions ◽  
Tech Nologies ◽  
History Of

One of the features of modern socio-philosophical knowledge is its involvement in the solution of ethi-cal problems in new conditions, determined by the consequences of the “information explosion”, digi-talization, the massive introduction of digital tech-nologies in the humanitarian spheres. One of the key problems is understanding the role of the so-called “machine ethics”, ie. a set of theoretical ap-proaches to hypothetical problems of the moral be-havior of machines in the framework of artificial in-telligence. The paper expounds the point of view according to which ethics, over the centuries of the formation of various philosophical systems, has developed many mechanisms of its own algorithmi-cization, which opens up wide opportunities for the formation of “computational morality”, up to the appearance of artificial moral agents (AMA). The paper briefly examines the history of the formaliza-tion of ethical problems and solutions. The key at-tempts of algorithmicization of ethical issues in the history of philosophy are identified, the socio-philosophical component of such a phenomenon as the “ethical calculator” is characterized.

Developing Ethical Competence in Health Care Organizations

2007 ◽  
Vol 14 (6) ◽  
pp. 825-837 ◽  
Author(s):  
Sofia Kälvemark Sporrong ◽  
Bengt Arnetz ◽  
Mats G. Hansson ◽  
Peter Westerholm ◽  
Anna T. Höglund
Keyword(s):  
Health Care ◽  
Training Program ◽  
Moral Distress ◽  
Ethical Issues ◽  
Organizational Factors ◽  
Education And Training ◽  
Financial Strain ◽  
Evaluation Instrument ◽  
Structured Education ◽  
And Training

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.

Ethical climate in nursing environment: A scoping review

2017 ◽  
Vol 26 (2) ◽  
pp. 327-345 ◽  
Author(s):  
Janika Koskenvuori ◽  
Olivia Numminen ◽  
Riitta Suhonen
Keyword(s):  
Scoping Review ◽  
Ethical Climate ◽  
Moral Distress ◽  
Turnover Intentions ◽  
Ethical Issues ◽  
Research Area ◽  
Related Factors ◽  
Work Related ◽  
Scoping Reviews ◽  
Quantitative Descriptive

Background: In the past two decades, interest in the concept of ethical climate and in its research has increased in healthcare. Ethical climate is viewed as a type of organizational work climate, and defined as the shared perception of ethically correct behavior, and how ethical issues should be handled in the organization. Ethical climate as an important element of nursing environment has been the focus of several studies. However, scoping reviews of ethical climate research in nursing have not been conducted to guide further research in this area. Objective: The purpose of this scoping review is to describe and analyze studies focusing on ethical climate in nursing environment to elicit an overall picture of the research in this field. Methods: A scoping review methodology guided by Arksey and O’Malley and Levac et al. was used. Studies were identified by conducting electronic searches on PubMed/MEDLINE, CINAHL, Web of Science Core Collection, PsycINFO, and Scopus and Philosophers’ Index databases. Of 1051 citations, 56 articles matched the inclusion criteria. Ethical considerations: This study was conducted according to good scientific guidelines. Findings: Ethical climate is a topical research area which has been explored with different methods and outcomes, in different environments, and has mainly been perceived positively. The focus of the studies was on finding associations between ethical climate and work-related factors such as job satisfaction, moral distress, and turnover intentions. Methodologically, research was rather homogeneous using quantitative, descriptive, and correlative research designs. Conclusion: Novel perspectives and more diverse methodological approaches paying attentions to issues affecting generalizability of the findings could expand our knowledge in this area.

Ethical Issues in Clinical Psychology

2010 ◽  
pp. 183-210
Author(s):  
Kenneth S. Pope
Keyword(s):  
Clinical Psychology ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
American Psychological Association ◽  
Future Research ◽  
Ethical Problems ◽  
Basic Assumptions ◽  
Ethics Code ◽  
Canadian Psychological Association

This chapter examines how ethical issues are approached differently by two prominent psychological associations, how they are encountered by psychologists, the formal complaints they give rise to, and how they can be approached systematically to avoid missteps. Included are basic assumptions about ethics; the unique approaches to developing a ethics code taken by the American Psychological Association (APA) and the Canadian Psychological Association (CPA), and what each of these two codes provides; empirical data about what ethical problems psychologists encounter and what formal complaints they face; four major sets of ethical issues that are particularly complex and challenging (confidentiality, informed consent, competence, and boundaries); an area of major controversy (clinical psychology and national security); steps in ethical decision-making; and four possible lines of future research.

scholarly journals Ethical issues relating to qualitative research

2005 ◽  
Vol 61 (1) ◽  
Author(s):  
J. Jelsma ◽  
S. Clow
Keyword(s):  
Qualitative Research ◽  
Health Research ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Ethical Review ◽  
Paper Briefly ◽  
Ethical Problems ◽  
Scientific Rigour ◽  
Hands On

Qualitative research or naturalistic research has moved from the sidelines into the mainstream of health research and an increasing number of qualitative research proposals are being presented for ethical review Qualitative research presents ethical problems that which are unique to the intensive hands-on paradigm which characterises naturalistic research. This paper briefly outlines the most common methodologies used in this research. The four ethical principles of benevolence, non-maleficence, autonomy and justice will be used as a framework to explore specific ethical issues related to this form of inquiry. The need for scientific rigour will also be explored as research that is scientifically unsound can never be ethical.

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