Understanding moral issues in health care: seven essential ideas.

Journal of Professional Nursing (Impact Factor: 0.88). 3(5):268-77.
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    ABSTRACT: The current reform of nursing education is resulting in major changes in the curricula of colleges of nursing. For the first time, ethical and moral issues are being seen as an important theme underpinning the entire course. The moral theorist with whose work most nurse teachers are acquainted is Kohlberg. In this paper, it is suggested that his work, and the conventions of morality which he exemplifies, may not be the most appropriate from which to address the moral issues facing the nurse. The author suggests that the work of Carol Gilligan of Harvard university is of great significance, not only for nurses involved in the teaching of ethics, but for all nurses. Gilligan's emphasis on caring and relationships accords with the common experience of the nurse, and echoes the current revival of interest within nursing in examining, and valuing, the phenomenon of caring.
    Journal of Medical Ethics 01/1993; 18(4):202-5. DOI:10.1136/jme.18.4.202 · 1.69 Impact Factor
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    ABSTRACT: Moral agency involves risk. It is an action that is at odds with the traditional role of the nurse. However, as nurses assume more responsibility and accountability for client management and outcomes in an increasingly complex and uncertain environment, it is essential to approach ethical dilemmas in a manner consistent with the caring component of nursing. Case examples are utilized to illustrate the attributes necessary for nurses to fulfill their obligations in their nurse-client relationships.
    Nursing Forum 01/1994; 29(1):5-11. DOI:10.1111/j.1744-6198.1994.tb00144.x
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    ABSTRACT: It is time for the noon conference. Your job is to impart a career-changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1 1/2 h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this "tragic case" approach to ethics education is of limited value because it limits understanding of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider-patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties.
    Journal of Medical Ethics 12/2006; 32(11):672-7. DOI:10.1136/jme.2005.013060 · 1.69 Impact Factor