Nursing Ethics

This article will address the question: how can health care education best take seriously the task of educating for professional practice within a post-traditional, liberal democratic society?

In the setting of modernity, the altered personal and professional self has to be explored and constructed as part of a reflective process of connecting personal and professional change: in essence, to develop self-knowledge. A moral life, or ‘working morality’, that evolves out of a process of ongoing dialogue and conversation is required. What is advocated here is a more social model of health care education that acknowledges a social or communal dimension to knowledge and the centrality of relationships for the full development of the individual personally and professionally, fosters our capacity to identify who we are both personally and professionally, connects reason and dialogue, and educates for dialogue and dialogic relationships.

This article is based on the assumption that the researcher cannot detach from his or her own view in phenomenological research. The researcher is assumed to be able to understand the experiences of an individual only through the points of departure created by the researcher's own view. The goal of this article is to describe practical aspects and their theoretical grounds that are of crucial importance in overcoming a researcher's views in data gathering and analysis. Its purpose is to clarify the authenticity and ethical standards concerning the views of the researcher in phenomenological research.

This article is designed to explore and examine the key components of communication that emerged during the interactional analysis of a role play that took place in the classroom. The ‘actors’ were nurses who perceived the interaction to reflect an everyday encounter in a hospital ward. Permission to tape the interaction was sought and given by all persons involved. The principal ‘players’ in the scenario were: the patient, a 70-year-old-woman who had been admitted with dementia, her son and daughter, and the nurse in charge of the ward. The fundamental dynamics of the use of power and restriction, truth telling, family stress, interpersonal conflict, ageism, sexism, empathy and humanism surfaced during the analysis. The findings show that therapeutic communication should be the foundation on which nursing should stand.

The article continues with an exploration of the theoretical frameworks that guided the analysis of interaction and concludes by suggesting tentatively some meaningful implications for nursing practice. It plans to furnish provocative new insights into the sometimes covert communication dynamics occurring within the nurse-patient relationship. Finally, it aims to generate discussion on this little-charted realm of human social interaction.

The issue of what constitutes a person is examined in relation to whether or not the fetus or newborn has qualities of personhood. The discussion also dwells on birth and viability as determining factors in decisions concerning terminations. Such decisions are stated to be constrained by both biological and social factors, particularly in the way in which the fetus can possess personhood only through the ‘absorption’ of such froni its mother; both mother and fetus together are ‘the person’. This article also considers whether, on Piagetian grounds, one can make personhood comparisons between infants and adults and suggests that such comparisons are a mistake. A social critique of Piagetian principles shifts the emphasis from individualism towards consideration of school, family and environmental factors. Equally, it is not feasible to view the fetus as an entity that is separate from its mother's perceptions of its social as well as its physical status. Finally, because termination decisions occur against ‘real life’ (and highly charged) backgrounds, we must reject any notion that such decisions are only an intel-lectual exercise. It is assumed that nurses would implicitly understand this and some attempt is made to state why this is so.

Abortion is one of the great moral debates of the epoch. Is there a rational method by which the debate can be resolved? Can bioethics' promise of such a method be fulfilled? Surely, a strictly rational approach can establish solid grounds for our beliefs once and for all. We would then be justified in deeming as unreasonable anyone who does not accept the perfectly rational conclusions. I present two scenarios to show that there can be no such philosophically grounded method and therefore no such facts to which everyone must agree. This does not mean that it is in fact impossible for people to reach agreement. It simply means that there is no incontrovertibly rational means by which they must do so.

Hospitalization is a unique health-illness transition for most elderly people. Whether the patient's health-related needs are met or not often iiifluence his or her appraisal of quality of life during hospitalization. This qualitative study explored the health needs of elderly Chinese male cardiac patients during their hospitalization. Eighteen subjects were recruited from a veterans' hospital in northern Taiwan. These men all lived alone before their hospital admission. Data were gathered using semistructured interviews and then analysed by content analysis. Ninety-four per cent of the subjects described up to three categories of needs: met needs (72%), unmet needs (78%), and expected needs (50%0). Needs that participants believed were met were those for psychological support, spiritual support, tangible support and information. Unmet needs were those for participation in decision making, maintaining daily activities and resuming a preadmission lifestyle. The expected needs included those for learning self-care strategies to maintain their daily activities after discharge from the hospital. The factors that framed the participants' perceptions of different health needs were identified to be lack of family support and locus of control. Finally, a discussion of the context background of this phenomenon, as well as some suggestions for its implications, are provided from a culturally sensitive ethical aspect.

It is rare to find honest accounts of the difficulties and dilemmas encountered when conducting sensitive research with vulnerable research populations. This account explores some of the ethical issues raised by a qualitative interview study with lesbians and gay men about their experiences of nursing care. There is tension between the moral duty to conduct research with vulnerable and stigmatized groups in order to improve care, and the inevitable lack of resources that go with such a venture. This increases the risk of harm during the process of research.

The risk of harm to both the researchers and the researched is explored and the need for a support structure for both groups is raised. There is a pressing need to develop further understanding about the ways in which the dissemination of research can potentially harm already vulnerable research populations.