Nursing Ethics

The application of care technology is complex, and has an impact on all stakeholders. A specific issue with surveillance technologies is the resulting ethical dilemmas. These dilemmas often touch on people’s values, which arise from their perspectives and determine their attitudes and behaviour. One of the prerequisites for successful stakeholder involvement is knowing and acknowledging their values. Schwartz’s theory of human values has been empirically tested and facilitates the prediction of attitudes and behaviours in different contexts.

To develop, test and validate a conversation instrument suitable for use in interviews to explore stakeholders’ values regarding the application of surveillance technologies. The instrument was based on Schwartz’s ten values model and adapted to fit the stakeholders’ (professional) backgrounds, education and language levels.

We integrated and adapted Schwartz’s ten and nineteen values model, the Personal Value Dictionary, the Portrait Values Questionnaire and Schwartz’s Value Survey to value cards tailored to the stakeholders’ education and language levels. The adaption was an iterative process involving expert consultation. The value cards were validated in 34 interviews with stakeholders involved in the application of surveillance technologies for people with dementia in nursing homes.

This study was approved by the Ethical Research Board of Tilburg University (ID TSB_RP771).

The iterative process resulted in a concept version of the value cards, with expert feedback and ‘member checks’ guiding final revisions. The value cards helped participants articulate their values and were seen as useful tools for reflecting on key considerations related to surveillance technologies.

Value cards assisted stakeholders in sharing their most important principles regarding the application of surveillance technologies and may help explore their values related to complex technological innovations in the context of psychogeriatrics.

Caregivers in nursing homes are crucial in looking after disabled older adults. They often resort to physical restraints for various reasons, including safety concerns and resource limitations. However, this practice can impact the dignity of these individuals. In China, current research has rarely explored this issue at the caregiver level, leaving a critical gap in our understanding of this complex situation.

The purpose was to understand Chinese nursing home caregivers’ perceptions and practices of dignity maintenance for physically restrained disabled older adults, as well as to provide a reference point for dignity maintenance.

This is a qualitative descriptive study in which data were collected through semi-structured interviews. The collected data were analyzed using Colaizzi’s 7-step method.

Between October and December 2024, 13 caregivers from three nursing homes in Wenzhou City, China, were selected for the study using purposive sampling.

The ethics committee approved the study design on December 4, 2020 (approval number 2020-126).

A total of three main themes and 11 sub-themes were distilled. The main themes included “Diverse perspectives on dignity maintenance in physical restraint,” “The realistic dilemma of dignity maintenance practices in physical restraint,” and “The practice of physical restraint based on the principle of whole-person care.”

Nursing home caregivers have multiple views of dignity maintenance for physically restrained disabled older adults, and there are numerous barriers to maintaining dignity. Measures should be taken to optimize dignity maintenance practices, improve the quality of older adult care services, maintain the dignity and rights of disabled older persons, reduce the pressure on caregivers, and enhance occupational satisfaction.

The promotion of human dignity lies at the core of ethical patient-centered healthcare and encompasses the inherent worth, value, and respect that patients deserve. Little is known about how this concept applies to the distinct needs and challenges faced by young adults (young adults) seeking mental healthcare.

This study hopes to provide deeper insights into young adults perspectives about the factors that contribute to and hinder their sense of human dignity within the mental healthcare system.

A descriptive qualitative approach was used to explore participant perspectives through semi-structured interviews. Thematic analysis was performed on the interview transcripts by three coders.

Thirteen young adults patients attending an ambulatory mental health clinic for mood and anxiety disorders in London, Ontario participated in this study.

This study was conducted in accordance with the Declaration of Helsinki. It was approved by the Health Sciences Research Ethics Board at the University of Western Ontario.

Yound adults interviewed emphasize equality and equity as crucial aspects of dignity, value agency and involvement in healthcare decision-making as well as opportunities to engage with peers, and recognize system wide constraints as a barrier to feeling as though they have dignity within the healthcare system.

While the young adults interviewed acknowledged that dignity is inherent to all people, they emphasized that all people are not treated as though they have dignity either in mental healthcare or in broader society based on their social location. To provide dignity affirming mental healthcare for young adults, clinicians should: approach their relationship with clients from a lens of cultural humility to provide individualized care, directly involve clients in their treatment plans, encourage client connection with their peers and communities, and actively consider and address systemic challenges that impact client wellbeing and sense of dignity at the societal level.

Lecturers who are working in empowering environments and are treated with respect by students and managers, feel dignified and capable of being positive role models to their students. The opposite happens when they are not treated with respect and experience challenging working environments.

The aim of the study was to explore and describe how nursing lecturers of a designated education institution in South Africa experienced factors that influenced their perceived professional dignity.

A descriptive phenomenological research design with a constructivist paradigm applied. Individual interviews were conducted with lecturers to obtain answers to the question ‘How do you experience factors at the institution that influence your dignity as a professional person?’ Probes were used encouraging the participants to comprehensively describe their experiences. The data were analysed according to the steps designed by Giorgi in which the natural dimension of the phenomenon as narrated by the participants was transformed into the phenomenological dimension of the phenomenon.

The study was undertaken in South Africa at a nursing education institution and 18 voluntary purposively selected lecturers were involved.

The Faculty of Health Sciences Research Ethics Committee at the University of Pretoria approved the proposal and the applicable authorities gave written permission for the research to be conducted. Informed voluntary consent was obtained from the participants before the research commenced.

The essence of the participants’ experiences refer to ‘longing for professional dignity.’ The supporting constituents are: ‘acknowledging lecturers as specialists’, ‘enhancing their self-determination’, ‘acknowledging their capabilities’, ‘promoting collegiality’, ‘creating conducive teaching environments’, ‘being respected by students’, and ‘perceiving lecturers as possessing integrity’.

The participants’ perceived dignity was influenced by the way they had been treated by students and managers at the designated institution. Their working environment also impacted on their perceived professional dignity.

Complex health care environments present moral dilemmas for clinical nurses and nursing students that challenge their professional development as well as their physical and mental health. Ethical sensitivity (ES) is seen as a prerequisite that enables clinical nurses to make appropriate ethical decisions when facing a dilemma; therefore, ES should be a development focus for nursing students.

The aim of this study is to conduct a systematic evaluation of existing instruments to assess moral sensitivity (MS) or ES in nursing students. We subsequently provide recommendations of the proper research tools that can be used in future studies based on our study results.

A systematic literature search across nine databases from their inception to November 17, 2024 was first conducted. Two researchers then independently screened these studies, which were published in English or Chinese. The studies evaluated were designed to develop or validate a scale used to measure ES or MS among nursing students. The COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) guidelines were followed to evaluate both the methodological quality and the quality of the psychometric properties of the identified tools. Finally, data synthesis was performed.

We ultimately included 13 assessment tools used for the assessment of ES or MS among nursing students. Only one tool was rated A, and four tools were rated C and not recommended for use. The remaining tools were rated B, and they have potential for assessing MS and ES among nursing students.

A majority of the tools included in this study still require further revision to enhance their quality prior to their effective use in MS and ES assessments. The COSMIN guidelines indicated that future studies should describe the development and validation of measurement tools in detail and improve their current data analysis methods.

Nurses caring for hospitalised children can be told not to disclose information to the patient. Such non-disclosure directives in adult care pose recognised ethical problems, as they impinge on a patient’s autonomy and right to their own information, and have been discussed widely in the literature, from a physician’s perspective. Despite the ethical implications, there is less discussion of the ethics of withholding information from children. Nurses are well positioned to advocate for the rights of a child while considering their best interests; hence, nurses’ thinking about the ethics of non-disclosure directives is valuable.

The aim of this study was to explore the experiences and attitudes of nurses with truth-telling to seriously ill children, specifically how nurses frame and think about the ethical challenges when given a directive not to tell the truth to a child.

An interpretive phenomenological approach was employed for this research, with data collected by semi-structured interviews.

Twenty-six nurses in Australia who had cared for children hospitalised with a serious illness in the previous 5 years.

Ethics approval was granted by the University of Melbourne’s Human Research Ethics Committee (37283A). Informed consent was acquired from all participants.

Four themes encompass the views nurse-participants expressed about the ethics of a non-disclosure directive: (i) Lying is wrong, (ii) Children should know, (iii) It’s hard for us when the child doesn’t know, but (iv) It’s not our place to tell. Nurse-participants described how a non-disclosure directive affected how they cared for their patients.

Nurse-participants believed they should be honest and articulated ethical reasons why children should be told the truth about their medical condition, but did not feel they were able to initiate this. It is recommended that nurses are supported in these ethically challenging situations and included in decision-making about how to respond when parents direct that information be withheld from their child.

Globally, ethics is recognized as a critical component for ensuring equitable and sustainable genomic healthcare. However, prior research has largely overlooked the ethical aspects when assessing nurses’ genomic competence.

This study aimed to assess the genomic competence of nurses in Finland, with a specific focus on their perspectives regarding ethics in genomics.

This was a cross-sectional study conducted among registered nurses in Finland.

The data were collected via an online survey between October 30 and December 31, 2023, using the Canadian Adaptation of the Genetics Genomics Nursing Practice Survey (GGNPS-CA), which evaluates attitudes, receptivity, confidence, competency, knowledge, social systems, and the decision adoption process in genomics with ethical dimensions. A total of 234 registered nurses participated.

The study was ethically approved by the Ethics Committee of the Tampere Region, statement number 46/2023.

While 76.8% of nurses rated their self-assessed understanding of genomics as poor, their actual Knowledge Score was relatively good (mean 9.12/12, SD 1.44). In addition, nurses reported limited understanding of the ethical issues associated with genomics, particularly concerning equity. The majority (59.4%) believed it was very important for nurses to become more educated on ethical issues, while 28.6% considered it somewhat important.

The findings suggest a strong perceived need among nurses for further education in both genomics and its ethical implications. The discrepancy between self-assessed and actual knowledge may reflect low confidence, which was additionally reported in the ethical issues. Low confidence is possibly influenced by the early stage of genomics integration into nursing practice.