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Bioethical Decision Making for Nurses
... Page (2012) suggested that ethical theory may not be included in day-to-day decision-making within clinical practice, but is helpful in discussions such as this one. Thompson and Thompson's (1985) ethical decision-making model placed emphasis on the identification of the ethical dilemma. The PROFESSIONAL theory is separated into a 10-step process of identifying the context of the problem, the possible conflicts with values or principles, and evaluating and reviewing the results of the decision taken. ...
The COVID-19 pandemic has had a devastating impact on the UK, as well as many other countries around the world, affecting all aspects of society. Nurses and other health and care professionals are a group particularly exposed to the virus through their work. Evidence suggests that vaccines form the most promising strategy for fighting this pandemic. Should vaccination against be mandatory for nurses and other health professionals? This article explores this question using an ethical framework.
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... Futhermore, most authors recognize the combination of the decision-making process and ethics as the basis for 4. Nurses' perceptions of ethical problems, dilemmas, and decision-making (Allen, 1972;Boyd, 1977;Davis, 1983;Gramelspacher et al, 1986;Sietsma, 1987;Tate, 1977;Youell, 1986 and concepts (Curtin,1987;Crisham, 1985;Thompson and Thompson, 1985). Three decision-making models developed by Curtin (1978), Crisham (1985), and Janis and Mann (1977) are particularly relevant to the focus of this study and will now be described. ...
... This handbook is the result of an appraisal of major bioethical decision-making processes. These models include Brody's Model, 1 Bunting and Webb's Model, 2 Thompson and Thompson's Model, 3 Murphy and Murphy's Model, 4 Aroskar's Model, 5,6 Curtin and Flaherty's Model, 7 Grundstein-Amado's Model, 8 Laurence McCullough's Model, 9 Jonsen, Siegler and Winslade's Model, 10 College of Nurses of Ontario's Model, 11 and Chidwick's Model. 12 This decision-making model has been peer-reviewed and evaluated for external validity in several health care institutions by administrators, clinicians and patients. ...
... Predicting content from organizational cues. (Bandman and Bandman 1988;Thompson and Thompson 1985) Claims and proofs. Argument strategies and types. ...
ABSTRACT Because clinical experience is essential for nursing education, even students with modest-to-low proficiency in English as a second language (ESL) receive training and provide care in clinics. Yet modest-to-low language proficiency could prove hazardous for the students or their patients. Therefore, these nursing students would benefit from special classes in ESL Such classes require prior needs analyses that precisely articulate academic and clinical language needs. These needs statements serve as suggestions for course content. Reported here are the results of an extensive needs analysis for ESL-speaking graduate nursing students. The approach to needs definition derives from Stufflebeam et al. (1985). The analysis focuses on skills required for school, clinical practice, and interaction with a multicultural, socially stratified patient population. Resulting needs statements are organized in terms of (1) Speech Production Accuracy, (2) Academic Performance, (3) Clinical Performance, (4) Dialect (Cultural) Variation, and (5) Inferencing Skills.
La importancia de la toma de decisiones éticas en ciencias de la salud ha promovido la generación de esquemas que orientan este proceso. El objetivo es proponer un modelo teórico de toma de decisiones bioéticas. Se hizo una búsqueda y revisión de la literatura en bases de datos y bibliotecas electrónicas con palabras clave, se identificaron y analizaron once modelos de toma de decisiones éticas según parámetros establecidos y se incluyeron resultados de estudios sobre el tema. Los esquemas analizados plantean una toma de decisiones basada en la razón a partir de un número variable de pasos cognitivos y, en general, aportan pocos elementos para su aplicación práctica. Se planteó el Modelo de Integración Razón Emoción para la Toma de Decisiones Bioéticas en Ciencias de la Salud. Este modelo sintetiza los pasos cognitivos para tomar decisiones adecuadas, mediante la integración de la razón y la emoción, la posibilidad de aplicación de diversos marcos éticos y la puesta en juego de la competencia ética y las habilidades de pensamiento crítico.
Resumen: En este trabajo se presentan los resultados parciales de los docentes del curso de fundamentos tecnológicos de la maestría en educación de la UNAB, ante una situación compleja, en el cual los docentes asumen roles de personajes ficticios que pretende persuadir al otro en la toma de decisiones tomando como referente la reflexión argumentativa y consensuada de los participante del ejercicio. Para lograrlo se utilizó como elemento mediador la actividad del barco. Dicha actividad, se suscribe en la categoría de dilema etico de situación compleja, su objetivo es la de despertar la sensibilidad e indagar los valores personales, de cada uno de los miembros del colectivo docente. En este ejercicio contextualizado quedo demostrado, que para la toma de decisiones de dilemas éticos no es un asunto fácil y por consiguientes no existen patrones algorítmicos o recetas para solucionarlo, porque, que cada situación es única, en su propio contexto y particularidades que deben analizarse y tenerse en cuenta. Summary: This paper presents the partial results of teachers in the course of technological foundations of the master's degree in education of the UNAB, a complex situation, in which teachers assume the roles of fictional characters which aims to persuade each other in decision-making argumentative and agreed upon reflection of the exercise participants taking as a reference. To achieve this was used as a mediator boat activity. Such activity, subscribe in the category of complex situation ethical dilemma, your goal is to awaken sensitivity and investigate the personal, each of the members of the collective teaching values. This contextualized exercise was shown, that for decision
This study aims to examine the effect of microeconomic and macroeconomic factors on the profitability of commercial banks in the United Arab Emirates during the post crisis period. Using SURE model technique, a balanced panel data from the period 2009-2013 was analyzed to determine the impact of the macroeconomic and CAMELS factors on the ROA and ROE of the banks. Results suggest that the above factors explain a significant part of the bank profitability. All bank specific variables with the exception of liquidity affect bank profitability significantly. The impact of capital adequacy is significantly positive while Management efficiency and sensitivity to market risk is found to have a significant negative impact on both ROA and ROE. GDP and interest rate has a significant negative impact on both ROA and ROE whereas contrary to our expectation, debt-GDP has a significant positive impact on ROA.
Nursing ethics is a topic included in most health care institutions as a requirement for accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This article provides an overview of nursing ethics in a format that allows the reader to understand the basic principles while applying the information to daily work situations in a format for use in a classroom environment. The issue of dilemma recognition is addressed as well as mechanisms that may be used to facilitate dilemma resolution. Information is also provided for use in the development of skills in ethical decision-making.
Nurses need to become more aware of everyday ethical decisions and the many factors which influence them in order to develop skills in this cognitive process This author's model of ethical decision making has been designed and developed to illustrate an overall conception of the interaction between nurse and client within an ethical framework. This model lends itself to the examination of all factors which enter into the ethical decision making process descriptive, normative and meta-ethics
Greipp's model of ethical decision making clarifies the ethical process by defining ethical behaviour within the centre of the model, and delineating relevant variables on both the caregiver's and care recipient's sides which can dramatically alter the outcome of the decision making process The value of this model for the practitioner lies in its diagrammatic structure which will keep the nurse focused and aware of the influence that psychosociocultural variables have on decision making interactions
The model also makes evident the power of those potential inhibitors (variables) to violate basic ethical principles and negate the framework Locating the violation is essential in finding a solution “Men are not evil Most of the evil gets done without malice Evil comes less from malice and sadism than from good intentions that are stupid and low-level” (Maslow 1972)
Each professional nurse carries responsibility for right behaviour and right knowledge The search and quest for that behaviour and knowledge is a never-ending process fired by a commitment to personal ideals and professional excellence
Academic nursing programs are increasing the amount of ethical instruction presented to undergraduate and graduate students. However, nurses who graduated several years ago may find themselves without the background and skills needed to discuss the complex bioethical dilemmas they now face. This article presents the development of a continuing education program to acquaint nurses with basic ethical concepts and bioethical decision-making processes. Presentations were piloted with a small group of nurses from the outpatient department of a pediatric tertiary care hospital.
Much controversy exists today regarding the "salvaging" of high-risk infants. There are many ethical concerns surrounding these children. The advancement of technology has had a profound effect on the treatment of preterm infants or infants with deformities. In this article the authors address selected ethical concerns regarding personhood, autonomy, beneficence, parental authority, quality of life, sanctity of life, and optional, obligatory, and wrong forms of treatment. The article begins with an overview of the history of infanticide as well as the history of neonatal intensive care units. Financial and legal issues are also discussed. In addition, the nurse's role in working with high-risk infants and their families is briefly explored.
Community health nursing practice has always been directed by a genuine concern for other persons. Flaherty (1980) wrote that the profession now, perhaps more than ever before, requires that nurses go beyond direct care and be involved with the nature and shape of the health-care system, the practice of all team members, and "the changing roles of consumers in the maintenance of their own health" (p.8). The ethics of care in a society that no longer values old age is a challenge that must be met head on by CHNs.
Modern health-care technology has complicated the ethical considerations of not only diagnosis and treatment, but also the social implications of diseases. Nurses are facing daily challenges as they struggle to protect and support confidentiality, justice, and beneficience for their clients. Community health nurses (CHNs), in light of their manner of primary care delivery, are often involved in these challenges. CHNs, due to their manner of primary care delivery, may find themselves in situations very different from those of other health-care workers. Often these situations have a moral component that cannot be addressed by the traditional problem-solving methods. Knowledge of ethical theories that offer frameworks for problem solving is essential as these CHNs struggle with ethical dilemmas.
Increasingly, the professional literature reflects a call for the adoption of a (feminist) "ethic of caring" as a model for moral education in nursing. But what is not clear is the relationship between "care" and "ethics," or between an "ethic of caring" and "moral education." Has ethics, and the issue of ethics education for nurses, become entangled with what may be a separate issue of an "ethic of caring" for the nursing profession?
This article presents an overview of evolving ethical stances of three professions, and shows how the dichotomous views within philosophy and psychology have strongly influenced ethical thought in nursing. Major questions concerning the stances are raised. Nurse educators need to have a critical awareness of the scope and complexity of the discussion, and the ability to closely scrutinize conclusions reached by each profession's theorists. Viewpoints concerning what should comprise ethics education in nursing will depend on the particular ethical stance adopted. Ethics education for nurses will continue in its present confused state until there is focused and directed critical reflection about what is currently known regarding moral development, ethical thought, and the role of education in both.
This article examines how cultural misunderstandings and language differences generate ethical dilemmas in cross-cultural nursing. It explores the consequences of actions that result when health care providers lack an awareness of the value systems of patients that differ from their own. Described are the principles arising from ethical theory, their application to nursing, and incorporation into professional codes of ethics. Two case studies illustrate the close relationship between culture, health, and communication, with language barriers a significant factor in predicting the outcomes of care. Recommendations are offered for cultural competency training for health care institutions, nursing administrators, and nursing educators.
In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care.
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