Journal articles on the topic 'Medical screening Moral and ethical aspects'
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Shultz, Blake N., Benjamin Tolchin, and Katherine L. Kraschel. "The “Rules of the Road”: Ethics, Firearms, and the Physician's “Lane”." Journal of Law, Medicine & Ethics 48, S4 (2020): 142–45. http://dx.doi.org/10.1177/1073110520979415.
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Physicians play a critical role in preventing and treating firearm injury, although the scope of that role remains contentious and lacks systematic definition. This piece aims to utilize the fundamental principles of medical ethics to present a framework for physician involvement in firearm violence. Physicians' agency relationship with their patients creates ethical obligations grounded on three principles of medical ethics — patient autonomy, beneficence, and nonmaleficence. Taken together, they suggest that physicians ought to engage in clinical screening and treatment related to firearm violence. The principle of beneficence also applies more generally, but more weakly, to relations between physicians and society, creating nonobligatory moral ideals. Balanced against physicians' primary obligations to patient agency relationships, general beneficence suggests that physicians may engage in public advocacy to address gun violence, although they are not ethically obligated to do so. A fourth foundational principle — justice — requires that clinicians attempt to ensure that the benefits and burdens of healthcare are distributed fairly.
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Ilieva, Antonia G. "Ethical and Legal Aspects of Medical Screening for Early Diagnosis of Diseases. Prevention and Prophylaxis." Folia Medica 61, no. 3 (September 30, 2019): 451–57. http://dx.doi.org/10.3897/folmed.61.e39410.
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Introduction: The main priorities of the implemented health policies in the Republic of Bulgaria are directly aimed at preserving and improving the health of the population, providing equal access of patients to modern and efficient healthcare, promptness and quality, in compliance with the normative requirements of the offered health service. In this sense, the focus of these health policies is to prioritize prevention and prophylaxis of early diagnosis of diseases. It is much more reasonable to prevent the disease or to manage it at an early stage than to slow down the treatment until the pathological processes develop into severe or irreversible complications. Aim: The aim of this systematic review is to investigate the effectiveness of existing legal acts governing the implementation of a common health policy in the field of health promotion and prevention. Another aim is to localize regulatory gaps and make relevant optimization suggestions. Materials and methods: The analysis of this systematic review is based on a thorough review of the existing regulatory framework (statutory and regulative legislation, case law, European practice) that concerns public health. Articles focused directly on the issues of medical screening and public health in a national and global perspective have been studied.Results: Two major legal acts, two regulations and strategies of the World Health Organization are considered. Suggestions for optimization of the control activity of the administrative bodies in the sector are presented. Conclusions: From the analysis done, proposals for optimization of the existing legal framework in the sector of health-care were made. The proposals were made based on the results of the analysis of w8orld trends regarding the methodology for state funding of medical screening for early diagnosis of diseases. The issue in question is up to date and raises issues related to legislative regulation, moral, ethical and deontological principles to which the medical profession adheres, as well as the health policy that is followed by the Ministry of Health in this aspect.
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Verweij, Marcel, and Koen Kramer. "Donor blood screening and moral responsibility: how safe should blood be?" Journal of Medical Ethics 44, no. 3 (February 11, 2016): 187–91. http://dx.doi.org/10.1136/medethics-2015-103338.
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Some screening tests for donor blood that are used by blood services to prevent transfusion-transmission of infectious diseases offer relatively few health benefits for the resources spent on them. Can good ethical arguments be provided for employing these tests nonetheless? This paper discusses—and ultimately rejects—three such arguments. According to the ‘rule of rescue’ argument, general standards for cost-effectiveness in healthcare may be ignored when rescuing identifiable individuals. The argument fails in this context, however, because we cannot identify beforehand who will benefit from additional blood screening tests. On the ‘imposed risk’ argument, general cost-effectiveness standards do not apply when healthcare interventions impose risks on patients. This argument ignores the fact that imposing risks on patients is inevitable in healthcare and that these risks can be countered only within reasonable limits. Finally, the ‘manufacturing standard’ argument premises that general cost-effectiveness standards do not apply to procedures preventing the contamination of manufactured medical products. We contend that while this argument seems reasonable insofar as commercially manufactured medical products are concerned, publicly funded blood screening tests should respect the standards for general healthcare. We conclude that these particular arguments are unpersuasive, and we offer directions to advance the debate.
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Bremer, Anders, María Jiménez Herrera, Christer Axelsson, Dolors Burjalés Martí, Lars Sandman, and Gian Luca Casali. "Ethical values in emergency medical services." Nursing Ethics 22, no. 8 (October 28, 2014): 928–42. http://dx.doi.org/10.1177/0969733014551597.
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Background: Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. Objectives: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden. Methods: The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. Ethical considerations: This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Findings: Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Discussion: Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. Conclusion: A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care.
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Corley, Mary C., Ptlene Minick, R. K. Elswick, and Mary Jacobs. "Nurse Moral Distress and Ethical Work Environment." Nursing Ethics 12, no. 4 (July 2005): 381–90. http://dx.doi.org/10.1191/0969733005ne809oa.
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This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity.
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Asgari, Sharareh, Vida Shafipour, Zohreh Taraghi, and Jamshid Yazdani-Charati. "Relationship between moral distress and ethical climate with job satisfaction in nurses." Nursing Ethics 26, no. 2 (July 18, 2017): 346–56. http://dx.doi.org/10.1177/0969733017712083.
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Background: Moral distress and ethical climate are important issues in the workplace that appear to affect people’s quality of work life. Objectives: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. Materials and methods: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling. Data were collected using a demographic questionnaire, the Moral Distress Scale–Revised, the Olson’s Hospital Ethical Climate Survey, and the Brayfield and Rothe Job Satisfaction index. Ethical considerations: The research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences and the Medical Deputy of the Social Security Organization. Findings: The mean scores obtained by the critical care nurses for moral distress, ethical climate, and job satisfaction were 87.02 ± 44.56, 3.51 ± 0.53, and 62.64 ± 9.39, respectively. Although no significant relationships were observed between moral distress and job satisfaction, the relationship between ethical climate and job satisfaction was statistically significant (p < 0.05). Conclusion: Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.
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Oelhafen, Stephan, Settimio Monteverde, and Eva Cignacco. "Exploring moral problems and moral competences in midwifery: A qualitative study." Nursing Ethics 26, no. 5 (March 27, 2018): 1373–86. http://dx.doi.org/10.1177/0969733018761174.
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Background: Most undergraduate midwifery curricula comprise ethics courses to strengthen the moral competences of future midwives. By contrast, surprisingly little is known about the specific moral competences considered to be relevant for midwifery practice. Describing these competences not only depends on generic assumptions about the moral nature of midwifery practice but also reflects which issues practitioners themselves classify as moral. Objective: The goal of this study was to gain insight into the ethical issues midwives encounter in their daily work, the key competences and resources they consider indispensable to understand and deal with them, and to assess phenomena linked to moral distress. Methods: We conducted individual semi-structured interviews with eight midwives and two other health professionals, varying in terms of years of experience and work setting. Interview transcripts were analyzed in an interdisciplinary research group, following thematic analysis. Ethical considerations: This study was not subject to approval according to the Swiss Law on Research with Humans. Participants were informed about the study goals and gave written informed consent prior to participation. Results: External constraints limiting the midwife’s and the patient’s autonomy and resulting interpersonal conflicts were found to be the most relevant ethical issues encountered in clinical practice and were most often associated with moral distress. These conflicts often arise in the context of medical interventions midwives consider as not appropriate and situations in which less experienced midwives in particular observe a lack of both interprofessional communication and trust in their professional competence. Ethical issues related to late abortions or prenatal diagnostics and selective abortions were also frequently addressed, but many midwives involved had learned to cope with them. Discussion: In the light of the ethical issues and factors contributing to phenomena of moral distress, an empirically grounded profile of moral competences is drafted. Curricular implications in the light of possible adaptations within undergraduate midwifery education are critically discussed.
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Piryani, R. M. "Medical ethics education." Journal of Chitwan Medical College 5, no. 1 (March 31, 2015): 1. http://dx.doi.org/10.3126/jcmc.v5i1.12557.
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Ethics education is essential for everyone but indispensable for health care professionals. Health care professionals must strive for excellence as much as possible. The moral duty of health care professionals is to do the best for their patients and take healthcare decision based on evidence and clinical, technical and ethical ground. However, most of the times ethical aspects are either ignored, undermined or overlooked. There seems to be some gap in teaching and learning and its application in practice. The fundamental idea to teach medical ethics at undergraduate level is to sow the seeds to ethics at an early stage in the minds of health care professionals to deliver excellent health care to the community. All religions prescribe ethical and moral behaviour and thought for their followers. Hinduism through Bhagwat Gita preaches karma as the only dharma, Islam speaks of Khuluq, Buddhism of the 10 meritorious deeds, Jainism of three ratnas, Christianity of service and stewardship. Let’s invest our efforts in enhancing medical ethics education in our institutions besides technical education and produce quality healthcare professionals who can take healthcare decision based on evidence, and clinical, technical and ethical ground.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12557
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ASLAMOVA, M. "ACCIOLOGICAL ASPECTS OF IMPROVING MORAL-ETHICAL QUALITIES OF THE FUTURE DOCTOR." ТHE SOURCES OF PEDAGOGICAL SKILLS, no. 20 (November 22, 2017): 11–15. http://dx.doi.org/10.33989/2075-146x.2017.20.209479.
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The author analyzes the problem of upbringing the moral and ethical qualities of the future doctor through the prism of the value perception of professional requirements, reveals the tasks of educational influence on the student in the educational process, ensures the formation of a humanistic, professionally verified system of values as a basis for perfect moral choice in professional activity. With the purpose of research, the criteria (motivational-value, cognitive, procedural-analytical) and levels (elementary, low, medium, high) education of the moral and ethical qualities of the future doctor, which can be achieved in the educational process of medical education, are described and described. requirements for professional activities in the field of medicine. The means of the confirmatory experiment noted how stable the pattern of positive dynamics of education of moral and ethical qualities of future physicians from the first to the graduation course, which was achieved by the traditional means of organizing the educational process in higher education, which allows us to conclude that the orientation of professional training for the education of each student as highly moral, conscious regarding his professional duty of the individual. As a direction of further research, a hypothesis was formulated in relation to the growth of the established dynamics, provided that the future system of exercises that include the axiological aspect of the education of moral and ethical qualities is included in the humanitarian training of future physicians.
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Zhang, Na, Mingfang Li, Zhenxing Gong, and Dingxin Xu. "Effects of ethical leadership on nurses’ service behaviors." Nursing Ethics 26, no. 6 (August 5, 2018): 1861–72. http://dx.doi.org/10.1177/0969733018787220.
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Background: Nurses’ service behaviors have critical implications for hospitals. However, few studies had adequate ethical considerations of service behaviors and accounted for how organizational or individual antecedents can induce nurses to engage in service behaviors. In addition, they mainly focused on the one side of role-prescribed or extra-role service behavior. Objective: This study aims to explore the chained mediation effect of ethical climate and moral sensitivity on the relationship between organizational ethical leadership and nurses’ service behaviors and to examine the relationship, from a comparative view, of the role-prescribed service behavior and extra-role service behavior. Methods: In all, 476 nurses from three tertiary hospitals were investigated with the Ethical Leadership Scale, Ethical Climate Scale, Moral Sensitivity Questionnaire and Service Behavior Questionnaire. Structural equation modeling was adopted to analyze the data. SPSS and Mplus statistical software was used in the data analysis. Ethical considerations: Approval was obtained from the Ethics Committee at School of Nursing, Hebei Medical University. Data privacy and confidentiality were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection. Results: The effects of ethical leadership on nurses’ service behaviors are mediated by two variables in turn: ethical climate and nurses’ moral sensitivity. Ethical climate and moral sensitivity partially mediated the relationship between ethical leadership and nurses’ role-prescribed service behavior and fully mediated the relationship between ethical leadership and nurses’ extra-role service behavior. Conclusion: Organizational ethical leadership positively affected ethical climate, which positively affected nurses’ moral sensitivity and affected both their role-prescribed service behavior and extra-role service behavior.
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MAXWELL, BRUCE, and ERIC RACINE. "Should Empathic Development Be a Priority in Biomedical Ethics Teaching? A Critical Perspective." Cambridge Quarterly of Healthcare Ethics 19, no. 4 (August 18, 2010): 433–45. http://dx.doi.org/10.1017/s0963180110000320.
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Biomedical ethics is an essential part of the medical curriculum because it is thought to enrich moral reflection and conduce to ethical decisionmaking and ethical behavior. In recent years, however, the received idea that competency in moral reasoning leads to moral responsibility “in the field” has been the subject of sustained attention. Today, moral education and development research widely recognize moral reasoning as being but one among at least four distinguishable dimensions of psychological moral functioning alongside moral motivation, moral character, and moral sensitivity. In a reflection of this framework, medical educators and curriculum planners repeatedly advance the idea that educators should be concerned with supporting empathy, and this, very often, as a means of improving on and broadening medical ethics education’s traditional focus on moral reasoning.
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Pikuza, O. I., A. M. Zakirova, and N. K. Shoshina. "Actual aspects of medical ethics in training of the pediatrician." Kazan medical journal 95, no. 3 (June 15, 2014): 469–71. http://dx.doi.org/10.17816/kmj1538.
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Nowadays the problems of medical ethics are gaining the special significance as a result of changes in social and economic relations, healthcare modernization due to appearance of new effective methods for instrumental and laboratory examinations, treatment approaches, development of market relations in medicine. The aim of the presented paper is to cover the actual aspects of medical ethics in pediatrics. The paper reviews the ethical aspects of the work of a in detail. Differentiated approach in choosing pediatrician interns, which is based not only on academic progress, but also on professional and moral qualities of the medical university alumni and continuity in their upbringing starting form the first years of the medical school until the end of post-graduate education, seems rationale. It is during the student years when the cognitive and moral values of a forthcoming specialist are formed, which may be a criterion of a suitability of working with children. The roles of the competition, including the modular approach to knowledge evaluation, professional competencies and rating system are stressed. Considering the modern requirements to a young professional, the accent is made on the role of the leading tutor in a forthcoming specialist formation. The requirements to a higher education teacher and the importance of the moral atmosphere in hospitals and faculties for forming the ethical features of a forthcoming pediatrician and improving his/her professional level according to the medical progress are outlined. Thus, teaching pediatrics has a lot of particularities, including teaching the basics of medical ethics, having an extremely important role in professional education of pediatricians for proper forming of the young professional according to contemporary life requirements.
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Miller, Franklin G. "Research Ethics and Misguided Moral Intuition." Journal of Law, Medicine & Ethics 32, no. 1 (2004): 111–16. http://dx.doi.org/10.1111/j.1748-720x.2004.tb00455.x.
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The term therapeutic misconception was coined by Paul Appelbaum and his colleagues to describe the tendency of patients enrolled in clinical trials to confuse research participation with the personal clinical attention characteristic of medical care. It has not been recognized that an analogous therapeutic misconception pervades ethical thinking about clinical research with patient-subjects. Investigators and bioethicists often judge the ethics of clinical research based on ethical standards appropriate to the physician-patient relationship in therapeutic medicine. This ethical approach to clinical research constitutes a misconception because it fails to appreciate the ethically significant differences between clinical research and clinical care.In this article I argue that the assumption that the ethical principles governing the practice of therapeutic medicine should also apply to clinical research with patient- subjects produces incoherence in research ethics and erroneous guidance concerning certain controversial research designs.
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Yaremin, B. I., S. Yu Pushkin, A. S. Navasardyan, A. A. Selyutin, K. K. Gubarev, and V. E. Alexandrova. "Moral and ethical aspects of organ donation for transplantation – catechism project." Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH), no. 1 (April 13, 2021): 97–108. http://dx.doi.org/10.20340/vmi-rvz.2021.1.tx.3.
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The moral and ethical aspects of organ donation for transplantation constitute a new section of the doctor's activity. The correct and motivated awareness of the answers to the main questions that may arise from members of the public, patients, members of their families, medical personnel, undoubtedly, is within the competence of the doctor. This work is devoted to the analysis of existing approaches to answering the main questions arising around the activity of preserving the organs of the deceased for transplantation. The work was done in the format of a catechism, questions and the answers offered to them. Answers are given as one of the options.
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Zorin, Konstantin V. "Professional competences of a doctor: Ethical and Deontological aspects." Alma mater. Vestnik Vysshey Shkoly, no. 4 (April 2022): 73–76. http://dx.doi.org/10.20339/am.04-22.073.
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The article formulates a number of ethical and deontological aspects of the training and work of a doctor. It has been revealed that there is a need for medical students and practicing doctors to form some important professional competencies, based on spiritual and moral culture, personal maturity, conscientiousness, mercy, as well as the ability to avoid and overcome conflict situations using the basic principles of biomedical ethics. Group discussion and solution of controversial ethical and deontological cases using the method of analysis of the presented situation prepares a medical student for communication, treatment, diagnostic and educational and preventive work with a patient who is faced with a difficult choice and must make an important decision.
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Woods, Martin. "Balancing Rights and Duties in ‘Life and Death’ Decision Making Involving Children: a role for nurses?" Nursing Ethics 8, no. 5 (September 2001): 397–408. http://dx.doi.org/10.1177/096973300100800504.
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In recent years, increasing pressures have been brought to bear upon nurses and others more closely to inform, involve and support the rights of parents or guardians when crucial ‘life and death’ ethical decisions are made on behalf of their seriously ill child. Such decisions can be very painful for all involved, and may easily become deadlocked when there is an apparent clash of moral ideals or values between the medical team and the parents or guardians. This article examines a growing number of such cases in New Zealand and analyses the moral parameters, processes, outcomes and ethical responses that must be considered when life and death ethical decisions involving children are made. The article concludes with a recommendation that nurses should be recognized as perhaps the most suitable of all health care personnel when careful mediation is needed to produce an acceptable moral outcome in difficult ethical situations.
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Schipper, Karen, Elleke Landeweer, and Tineke A. Abma. "Living with end-stage renal disease: Moral responsibilities of patients." Nursing Ethics 25, no. 8 (January 18, 2017): 1017–29. http://dx.doi.org/10.1177/0969733016687154.
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Background: Living with a renal disease often reduces quality of life because of the stress it entails. No attention has been paid to the moral challenges of living with renal disease. Objectives: To explore the moral challenges of living with a renal disease. Research design: A case study based on qualitative research. We used Walker’s ethical framework combined with narrative ethics to analyse how negotiating care responsibilities lead to a new perspective on moral issues. Participants and research context: One case was chosen from 20 qualitative interviews with renal patients in the Netherlands. Ethical considerations: Several actions have been taken to ensure the informed consent, privacy, anonymity and confidentiality of the patient in this article. More details are offered in this article. The study has been conducted in line with the recommendations of the Medical Ethical Committee of the VU Medical Center. Findings: A renal disease can force people to change their identity, relationships, values and responsibilities. The case study illustrates the moral challenges confronting renal patients. Discussion and conclusion:: Moral issues can be raised by the changes to identities, relationships, values and responsibilities caused by renal disease. Support services for renal patients and their relatives should pay more attention to these issues in order to promote self-management.
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Ko, Hsun-Kuei, Hui-Chen Tseng, Chi-Chun Chin, and Min-Tao Hsu. "Phronesis of nurses: A response to moral distress." Nursing Ethics 27, no. 1 (April 11, 2019): 67–76. http://dx.doi.org/10.1177/0969733019833126.
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Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress.
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Lantukh, I. V., N. F. Merkulova, and V. M. Ostapenko. "Medical research and their ethical nature." Reports of Vinnytsia National Medical University 25, no. 1 (March 27, 2021): 147–51. http://dx.doi.org/10.31393/reports-vnmedical-2021-25(1)-26.
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Annotation. The article examines the problem of medical researches, which is so relevant and necessary especially today, during the COVID-19 pandemic. It turns out that medical researches have an ethical nature, due to two interrelated aspects – the first aspect relates to professional medical practice, the second – to the patient's personality. Human medical research is based on the "rule of consent". This is necessary to protect the subject of medical research against various threats. The ethical implications of medical research stem from the need to comply with social requirements. The ratio of internal (professional) and external (public) control over medical research is both moral and social problems. Public control over medical research should be limited to such an extent as to leave room for the professional work of scientists. One aspect of this problem is related to the physical well-being of the subject of medical research: an adequate balance between risk and success is determined solely by the physician. The second aspect is related to the well-being of the person being studied as an individual and comes down to the question of who should determine this balance. Physicians attribute this right exclusively to themselves: only they can obtain the necessary information, without putting pressure on their patients. It is important to affirm the "principle of support" for medical research: the only one who can assess the human aspect of research is the subject himself. At first, the patient usually trusts his doctor, but later he must be able to decide how justified this trust was. The scientist-physician must realize that his future as a researcher depends not only on scientific but also moral qualities. On the other hand, fear of the sad consequences of the experiment should not be an obstacle to scientific progress. Important characteristics of the experiment are its reliability and validity. Therefore, medical experiments are an important tool for the development of medical knowledge about a person, about his health.
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Semenoh, Olena, and Olena Kravchenko. "PROFESSIONAL ETHICS IN LINGUA-CULTURAL DIMENSIONS: AMERICAN EXPERIENCE." Aesthetics and Ethics of Pedagogical Action, no. 16 (September 9, 2017): 70–83. http://dx.doi.org/10.33989/2226-4051.2017.16.175981.
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The article outlines the concepts "nurse", "professional ethics of nurses." The professional ethics of nurses has been defined as a component of medical ethics which studies moral consciousness, moral and ethical aspects of professional activity, moral principles and values that regulate the moral relationship between s nurse and s patient, the patient's family, other members of the medical community and community. The analysis of foreign and Ukrainian experience of formation of nurses’ professional ethics gives grounds to characterize the quality as a set of interrelated cognitive, praxeological, communicative components; their presence allows to interact productively with the professional and social environment on the basis of professionally important ethical knowledge, skills, professional important qualities that are aimed at the effective organization of the medical-preventive process and the solution of professional tasks. The content of the professional ethics of a future nurse consists of ethical categories and professionally important ethical qualities such as: professional duty, responsibility, dignity, conscience, honor, respect, mercy, empathy, tolerance.The peculiarities of educational programs of future licensed younger nurses training (LPN) in the United States aimed at the formation of professional ethics have been outlined. A review of the linguistic- cultural aspect of the formation of nurses’ professional ethics at American higher education institutions has been conducted. The experience of classes on "Nursing Ethics", "Foreign Language" at Cherkasy Medical Academy has been presented; they are aimed at understanding the world of the profession, the culture of communication in medical community, ethical behavior, moral relations, prevention of conflict situations, and provision of psychological support.
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Torabi, Mohammad, Fariba Borhani, Abbas Abbaszadeh, and Foroozan Atashzadeh-Shoorideh. "Barriers to ethical decision-making for pre-hospital care professionals." Nursing Ethics 27, no. 2 (June 11, 2019): 407–18. http://dx.doi.org/10.1177/0969733019848044.
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Background: Emergency care providers are frequently faces with situations in which they have to make decisions quickly in stressful situations. They face barriers to ethical decision-making and recognizing and finding solutions to these barriers helps them to make ethical decision. Objectives: The purpose of this study was to identify barriers of ethical decision-making in Iranian Emergency Medical Service personnel. Methods: In this qualitative research, the participants (n = 15) were selected using the purposive sampling method, and the data were collected by deep and semi-structured interviews. Finally, the data are analyzed using the content analysis approach. Ethical considerations: Permission to conduct the study was obtained from the Ethics Committee of the Shahid Beheshti University of Medical Sciences. The objectives of the study were explained to the participants and written consent was received from them. Also, participants were assured that necessary measures were taken to protect their anonymity and confidentiality. Findings: The results of the analysis are classified in five main categories. It encompasses the following areas: perception of situation, patient-related factors, input and output imbalance, uncoordinated health system, and paradoxes. Conclusion: Emergency Medical Service personnel make ethical decisions every day. It is important that prehospital personnel know how to manage those decisions properly so that clients’ moral rights are respected. Hence, by identifying the dimensions and obstacles of ethical decision-making in Emergency Medical Service personnel, it is possible to enhance the moral judgment and ethical accountability of the personnel and develop the strategies necessary for ethical decision-making in them.
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Mohammed, Shan, and Elizabeth Peter. "Rituals, Death and the Moral Practice of Medical Futility." Nursing Ethics 16, no. 3 (May 2009): 292–302. http://dx.doi.org/10.1177/0969733009102691.
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Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker's `expressivecollaborative' model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive care measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria.
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Borhani, Fariba, Abbas Abbaszadeh, Elham Mohamadi, Erfan Ghasemi, and Mohammad Javad Hoseinabad-Farahani. "Moral sensitivity and moral distress in Iranian critical care nurses." Nursing Ethics 24, no. 4 (September 28, 2015): 474–82. http://dx.doi.org/10.1177/0969733015604700.
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Background: Moral sensitivity is the foremost prerequisite to ethical performance; a review of literature shows that nurses are sometimes not sensitive enough for a variety of reasons. Moral distress is a frequent phenomenon in nursing, which may result in paradoxes in care, dealing with patients and rendering high-quality care. This may, in turn, hinder the meeting of care objectives, thus affecting social healthcare standards. Research objective: The present research was conducted to determine the relationship between moral sensitivity and moral distress of nurses in intensive care units. Research design: This study is a descriptive-correlation research. Lutzen’s moral sensitivity questionnaire and Corley Moral Distress Questionnaire were used to gather data. Participants and research context: A total of 153 qualified nurses working in the hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected for this study. Subjects were selected by census method. Ethical considerations: After explaining the objectives of the study, all the participants completed and signed the written consent form. To conduct the study, permission was obtained from the selected hospitals. Findings: Nurses’ average moral sensitivity grade was 68.6 ± 7.8, which shows a moderate level of moral sensitivity. On the other hand, nurses also experienced a moderate level of moral distress (44.8 ± 16.6). Moreover, there was no meaningful statistical relationship between moral sensitivity and moral distress (p = 0.26). Discussion: Although the nurses’ moral sensitivity and moral distress were expected to be high in the intensive care units, it was moderate. This finding is consistent with the results of some studies and contradicts with others. Conclusion: As moral sensitivity is a crucial factor in care, it is suggested that necessary training be provided to develop moral sensitivity in nurses in education and practical environments. Furthermore, removing factors that contribute to moral distress may help decrease it in nurses.
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Self, Donnie J., DeWitt C. Baldwin, and Fredric D. Wolinsky. "Further Exploration of the Relationship Between Medical Education and Moral Development." Cambridge Quarterly of Healthcare Ethics 5, no. 3 (1996): 444–49. http://dx.doi.org/10.1017/s0963180100007271.
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In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken to train medical students, interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development.
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McAndrew, Natalie S., and Joshua B. Hardin. "Giving nurses a voice during ethical conflict in the Intensive Care Unit." Nursing Ethics 27, no. 8 (July 14, 2020): 1631–44. http://dx.doi.org/10.1177/0969733020934148.
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Background: Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit (ICU). There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit. Research question/objectives/methods: The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice. Participants and research context: Responses to two open-ended questions were collected from critical care nurses working in five intensive care units at a large, academic medical center in the Midwestern region of the United States. Ethical considerations: This study was approved by the Institutional Review Board at the organization where the study took place. Findings: Three main interwoven themes emerged: nurses perceive (1) intensive care unit culture, practices, and organizational priorities contribute to patient suffering; (2) nurses are marginalized during ethical conflict in the intensive care unit; and (3) organizational resources have the potential to reduce nurse moral distress. Nurses identified ethics education, interprofessional dialogue, and greater involvement of nurses as important strategies to improve the management of ethical conflict. Discussion: Ethical conflict related to healthcare system challenges is intrinsic in the daily practice of critical care nurses. Nurses want to be engaged in discussions about their perspectives on ethical conflict and play an active role in addressing ethical conflict in their practice. Organizational resources that support nurses are vital to the resolution of ethical conflict. Conclusion: These findings can inform the development of interventions that aim to proactively and comprehensively address ethical conflict in the intensive care unit to reduce nurse moral distress and improve the delivery of patient and family care.
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Leonova, Olga M., and Alexander N. Salnikov. "Historical aspects and organizational issues of deontology in dental institutions." Medicine and Physical Education: Science and Practice, no. 9 (2021): 39–44. http://dx.doi.org/10.20310/2658-7688-2021-3-1(9)-39-44.
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A large number of works are devoted to the problem of medical ethics and deontology. They mainly consider the relationship between a medical worker and a patient, a medical worker and society. The issue of adherence to medical deontology and ethics between doctors is not often raised in the professional literature. We considered issues of relationship of the health worker and patient, the personal qualities of the doctor and moral installations defining his behavior; relations with colleagues and rationing the vocational and ethical field of medicine in the form of a vocational and ethical code. The key principles of bioethics are the following: the principle of humanism, professionalism, the scientific nature of medical interventions, self-criticism. Modern successes in the field of science and technology, the transfer of their results to medical practice have determined the relevance of the relationship between the doctor and the patient from the point of view of law, morality and religious beliefs. This problem area is the subject of biomedical ethics, the task of which is to solve ethical problems closely related to medical practice and biomedical research. We defined modern medical ethics through correlation with the bioethical model.
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Humphries, Anne, and Martin Woods. "A study of nurses’ ethical climate perceptions." Nursing Ethics 23, no. 3 (January 6, 2015): 265–76. http://dx.doi.org/10.1177/0969733014564101.
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Background: Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice – hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind carried out in New Zealand. Aim/objective: The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate. Research design/participants/context: This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research. Ethical considerations: Ethics approval for this study was granted by the New Zealand Ministry of Health’s Central Regional Health and Disability Ethics Committee on 14 June 2012. Findings: The themes identified in the data centred on three dominant elements that – together – shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff. Discussion: While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses’ ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere. Conclusion: Moral distress is inevitable in an ethical climate where the organisation’s main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care.
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Pergert, Pernilla, Cecilia Bartholdson, Klas Blomgren, and Margareta af Sandeberg. "Moral distress in paediatric oncology: Contributing factors and group differences." Nursing Ethics 26, no. 7-8 (November 9, 2018): 2351–63. http://dx.doi.org/10.1177/0969733018809806.
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Background: Providing oncological care to children is demanding and ethical issues concerning what is best for the child can contribute to moral distress. Objectives: To explore healthcare professionals’ experiences of situations that generate moral distress in Swedish paediatric oncology. Research design: In this national study, data collection was conducted using the Swedish Moral Distress Scale-Revised. The data analysis included descriptive statistics and non-parametric analysis of differences between groups. Participants and research context: Healthcare professionals at all paediatric oncology centres in Sweden were invited to participate. A total of 278 healthcare professionals participated. The response rate was 89%. Ethical considerations: In its advisory statement, the Regional Ethical Review Board decided that the study was of such a nature that the legislation concerning ethical reviews was not applicable. All participants received written information about the aim of the study and confidentiality. Participants demonstrated their consent by returning the survey. Findings: The two situations with the highest moral distress scores concerned lack of competence and continuity of personnel. All professional groups reported high levels of disturbance. Nurses rated significantly higher frequencies and higher total Moral Distress Scale scores compared to medical doctors and nursing assistants. Discussion: Lack of competence and continuity, as the two most morally distressing situations, confirms the findings of studies from other countries, where inadequate staffing was reported as being among the top five morally distressing situations. The levels of total Moral Distress Scale scores were more similar to those reported in intensive care units than in other paediatric care settings. Conclusion: The two most morally distressing situations, lack of competence and continuity, are both organisational in nature. Thus, clinical ethics support services need to be combined with organisational improvements in order to reduce moral distress, thereby maintaining job satisfaction, preventing a high turnover of staff and ensuring the quality of care.
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Zorin, K. V. "Medical education under conditions of pandemic of coronavirus infection: social and ethical recommendations." Alma mater. Vestnik Vysshey Shkoly, no. 2 (February 2021): 38–41. http://dx.doi.org/10.20339/am.02-21.038.
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Presented are social-ethical recommendations for medical education under conditions of pandemic of coronavirus infection. In the modern world there are many social and ethical problems, that depend on the worldview, philosophical and spiritual and moral positions of the state, society in general and individual in particular. Social and ethical issues of digital learning technologies caused by the new coronavirus infection have not yet been fully studied. The author analyzes a number of these aspects, related to medical education during the 2020 COVID-19 pandemic. The following research methods were used in the work, i.e. study and analysis of special literature, synthesis, modeling, comparison, generalization, observation, system analysis and theoretical knowledge. The article contains a number of social and ethical recommendations to help teachers and students better adapt to the distance learning format.
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Lee, Susan, Ellen M. Robinson, Pamela J. Grace, Angelika Zollfrank, and Martha Jurchak. "Developing a moral compass: Themes from the Clinical Ethics Residency for Nurses’ final essays." Nursing Ethics 27, no. 1 (April 28, 2019): 28–39. http://dx.doi.org/10.1177/0969733019833125.
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Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making.
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Vincent, Heather, Deborah J. Jones, and Joan Engebretson. "Moral distress perspectives among interprofessional intensive care unit team members." Nursing Ethics 27, no. 6 (May 14, 2020): 1450–60. http://dx.doi.org/10.1177/0969733020916747.
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Aim: To examine interprofessional healthcare professionals’ perceptions of triggers and root causes of moral distress. Design: Qualitative description of open-text comments written on the Moral Distress Scale–Revised survey. Methods: A subset of interprofessional providers from a parent study provided open-text comments that originated from four areas of the Moral Distress Scale–Revised, including the margins of the 21-item questionnaire, the designated open-text section, shared perceptions of team communication and dynamics affecting moral distress, and the section addressing an intent to leave a clinical position because of moral distress. Open-text comments were captured, coded, and divided into meaning units and themes using systematic text condensation. Participants: Twenty-eight of the 223 parent study participants completing the Moral Distress Scale–Revised shared comments on situations contributing to moral distress. Results: All 28 participants working in the four medical center intensive care units reported feelings of moral distress. Feelings of moral distress were associated with professional anguish over patient care decisions, team, and system-level factors. Professional-level contributors reflected clinician concerns of continuing life support measures perceived not in the patient’s best interest. Team and unit-level factors were related to poor communication, bullying, and a lack of collegial collaboration. System-level factors included clinicians feeling unsupported by senior administration and institutional culpability as a result of healthcare processes and system constraints impeding reliable patient care delivery. Ethical considerations: Approval was obtained from the Institutional Review Board (IRB) of the University of Texas Health IRB and the organization in which the study was conducted. Conclusion: Moral distress was associated with feelings of anguish, professional intimidation, and organizational factors that impacted the delivery of ethically based patient care. Participants expressed a sense of awareness that they may experience ethical dilemmas as a consequence of the changing reality of providing healthcare within complex healthcare systems. Strategies to combat moral distress should target team and system interventions designed to improve interprofessional collaboration and support professional ethical values and moral commitments of all healthcare providers.
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Heath, Joseph. "Ethical Issues in Physician Billing Under Fee-For-Service Plans." Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 45, no. 1 (January 10, 2020): 86–104. http://dx.doi.org/10.1093/jmp/jhz029.
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Abstract Medical ethics has become an important and recognized component of physician training. There is one area, however, in which medical students receive little guidance. There is practically no discussion of the financial aspects of medical practice. My objective in this paper is to initiate a discussion about the moral dimension of physician billing practices. I argue that physicians should expand their conception of professional responsibility in order to recognize that their moral obligations toward patients include a commitment to honest and forthright billing practices. I argue that physicians should aspire to a standard of clinical accuracy—not legal adequacy—in describing their activities. More generally, physicians should strive to promote an integrity-based professional culture, first and foremost by stigmatizing rather than celebrating creative billing practices, as well as condemning the misguided sense of solidarity that currently makes it taboo for physicians to criticize each other on this score.
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Sherwin, Susan. "Feminist and Medical Ethics: Two Different Approaches to Contextual Ethics." Hypatia 4, no. 2 (1989): 57–72. http://dx.doi.org/10.1111/j.1527-2001.1989.tb00573.x.
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Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with, the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort of details that should be included in the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of generality, i. e. a political understanding of context.
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McQueen, Matthew J. "Ethics and Laboratory Medicine." Clinical Chemistry 36, no. 8 (August 1, 1990): 1404–7. http://dx.doi.org/10.1093/clinchem/36.8.1404.
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Abstract Ethical issues have been given limited attention by professionals in laboratory medicine. Professional ethics is the moral bond that links a profession, the people it serves, and society. Understanding the complexities of individual and common good is essential for full professional participation in major issues in health care. Specific issues that challenge laboratory professionals in clinical research are allocation of health-care resources, testing conducted nearer the patient, confidentiality, screening tests, and molecular biology. A voice in ethical issues is an essential element of professional independence. The ethical attitudes we display influence the kind of people who choose to work in our profession. More open discussion about ethics is necessary in our professional literature.
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Pesotskaya, Elena N., Vera I. Inchina, Svetlana V. Aksyonova, Angelina V. Zorkina, and Lyudmila V. Сhegodaeva. "The problem of the synthesis of pedagogical strategy and moral practice in modern medical education (aspects of integrating international experience)." Revista Tempos e Espaços em Educação 14, no. 33 (February 23, 2021): e15276. http://dx.doi.org/10.20952/revtee.v14i33.15276.
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The article is devoted to the phenomenon of "medical humanities" as an independent interdisciplinary area of research, formed on the basis of the international experience integration as a reality. Тhe phenomenon is comprehended simultaneously in the field of Russian patristic tradition and medicine, since it focuses pedagogical strategy and moral practice. In the Russian spiritual tradition, it fits into the processes of educating humanity, which receives a modern consideration both in moral and religious categories, and in the categories of natural science, which are significant for medicine. Spirituality is the category of thinking that changes the idea of a person in the existing reductionist approach to his integrity in medicine. The action of the worldview of the individual is considered as a mandatory constant, which acts as a constructive mechanism for the transformation of the value foundations of thinking and ethical reflection. The fundamentals of spiritual and moral education and patristic experience make complex conditions for the restoration of humanitarian culture in medicine. The purpose of the process is to qualitatively change its anthropological, ethical and psychological components. Systemic humanitarian knowledge is main for medical education. The author reveals the significance of the positive convergence of the humanities for medicine.
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Tronconi, Giulia. "Ethical Criticism and There Will Be Blood: Autonomism, Moralism, and Immoralist Perspectives." Film Matters 13, no. 1 (March 1, 2022): 118–33. http://dx.doi.org/10.1386/fm_00209_1.
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The article explores the role played by moral categories in the assessment of an artwork’s overall aesthetic value. By means of close analysis of Paul Thomas Anderson’s 2007 There Will Be Blood, the work maintains an immoralist approach, where an artwork’s unethical attitude may yield cognitive gain to its receiver—or perhaps unsettle their moral compass in an unusual, pleasant way. There Will Be Blood is considered a cinematic masterwork; yet, the viewing experience is complicated by the film’s greedy and self-obsessed protagonist, Daniel Plainview (Daniel Day-Lewis). The article scrutinizes the film’s most notable sequence—the explosion of the oil derrick—to formulate an aesthetic evaluation that manages to assess, simultaneously, formal and moral aspects.
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Litton, Paul, and Franklin G. Miller. "A Normative Justification for Distinguishing the Ethics of Clinical Research from the Ethics of Medical Care." Journal of Law, Medicine & Ethics 33, no. 3 (2005): 566–74. http://dx.doi.org/10.1111/j.1748-720x.2005.tb00519.x.
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In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects.Some commentators and ethics documents claim that physicians, whether acting as care givers or researchers, have the same duty of beneficence towards their patients and subjects: namely, that they must provide optimal medical care. In discussing placebo surgery in research on refractory Parkinson's disease, Peter Clark succinctly states this view: “The researcher has an ethical responsibility to act in the best interest of subjects.”
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Storaker, Anne, Dagfinn Nåden, and Berit Sæteren. "From painful busyness to emotional immunization: Nurses’ experiences of ethical challenges." Nursing Ethics 24, no. 5 (January 24, 2016): 556–68. http://dx.doi.org/10.1177/0969733015620938.
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Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched.
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Soleimani, Mohammad Ali, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, and Bianca Panarello. "Psychometric evaluation of the Moral Distress Scale–Revised among Iranian Nurses." Nursing Ethics 26, no. 4 (June 17, 2016): 1226–42. http://dx.doi.org/10.1177/0969733016651129.
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Background: Experiencing moral distress is traumatic for nurses. Ignoring moral distress can lead to job dissatisfaction, improper handling in the care of patients, or even leaving the job. Thus, it is crucial to use valid and reliable instruments to measure moral distress. Objective: The purpose of this study was to determine the reliability and the validity of the Persian version of the Moral Distress Scale–Revised among a sample of Iranian nurses. Research design: In this methodological study, 310 nurses were recruited from all hospitals affiliated with the Qazvin University of Medical Sciences from February 2014 to April 2015. Data were collected using a demographic questionnaire and the Moral Distress Scale–Revised. The construct validity of the Moral Distress Scale–Revised was evaluated using principal component analysis and confirmatory factor analysis. Internal consistency reliability was assessed with Cronbach’s alpha. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: The construct validity of the scale showed four factors with eigenvalues greater than one. The model had a good fit ( χ2(162) = 307.561, χ2/ df = 1.899, goodness-of-fit index = .904, comparative fit index = .927, incremental fit index = .929, and root mean square error of approximation (90% confidence interval) = .049 (.040–.057)) with all factor loadings greater than .5 and statistically significant. Cronbach’s alpha coefficients were .853, .686, .685, and .711for the four factors. Moreover, the model structure was invariant across different income groups. Discussion and conclusion: The Persian version of the Moral Distress Scale–Revised demonstrated suitable validity and reliability among nurses. The factor analysis also revealed that the Moral Distress Scale–Revised has a multidimensional structure. Regarding the proper psychometric characteristics, the validated scale can be used to further research about moral distress in this population.
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Krajnovic, Dusanka. "Ethical and social aspects on rare diseases." Filozofija i drustvo 23, no. 4 (2012): 32–48. http://dx.doi.org/10.2298/fid1204032k.
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Rare diseases are a heterogenic group of disorders with a little in common except of their rarity affecting by less than 5 : 10.000 people. In the world is registered about 6000-8000 rare diseases with 6-8% suffering population only in the European Union. In spite of rarity, they represent an important medical and social problem due to their incidence. For many rare diseases have no treatment, but if it exists and if started on time as being available to patients, there is a good prognosis for them to be able for normal life. The problems of patients affected by rare diseases are related to the lack of diagnosis and timely undergoing as well as their treatment or prevention. Orphan drugs are products intended for treatment, diagnosis or prevention of rare diseases, but for their development and marketing the industry has not been interested in yet because of their marketing reasons. Patients suffering from a rare disease although belonging to the vulnerable group for their specific health needs, is becoming invisible in the health care system due to their additional needs un properly recognized. Ethical problems faced by patients, but also health care professionals are related to the allocation of medical diagnostics, unequal approach to health care, inappropriately specialized social services as well as therapy and rare orphan drugs unavailability. Ethical questions related to clinical trails on orphan drugs, population screening and epidemiology testing on rare diseases will also be discussed in this paper.
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Pesut, Barbara, Madeleine Greig, Sally Thorne, Janet Storch, Michael Burgess, Carol Tishelman, Kenneth Chambaere, and Robert Janke. "Nursing and euthanasia: A narrative review of the nursing ethics literature." Nursing Ethics 27, no. 1 (May 21, 2019): 152–67. http://dx.doi.org/10.1177/0969733019845127.
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Background: Medical Assistance in Dying, also known as euthanasia or assisted suicide, is expanding internationally. Canada is the first country to permit Nurse Practitioners to provide euthanasia. These developments highlight the need for nurses to reflect upon the moral and ethical issues that euthanasia presents for nursing practice. Purpose: The purpose of this article is to provide a narrative review of the ethical arguments surrounding euthanasia in relationship to nursing practice. Methods: Systematic search and narrative review. Nine electronic databases were searched using vocabulary developed from a stage 1 search of Medline and CINAHL. Articles that analysed a focused ethical question related to euthanasia in the context of nursing practice were included. Articles were synthesized to provide an overview of the literature of nursing ethics and euthanasia. Ethical Considerations: This review was conducted as per established scientific guidelines. We have tried to be fair and respectful to the authors discussed. Findings: Forty-three articles were identified and arranged inductively into four themes: arguments from the nature of nursing; arguments from ethical principles, concepts and theories; arguments for moral consistency; and arguments from the nature of the social good. Key considerations included nursing’s moral ontology, the nurse–patient relationship, potential impact on the profession, ethical principles and theories, moral culpability for acts versus omissions, the role of intention and the nature of the society in which euthanasia would be enacted. In many cases, the same assumptions, values, principles and theories were used to argue both for and against euthanasia. Discussion: The review identified a relative paucity of literature in light of the expansion of euthanasia internationally. However, the literature provided a fulsome range of positions for nurses to consider as they reflect on their own participation in euthanasia. Many of the arguments reviewed were not nursing-specific, but rather are relevant across healthcare disciplines. Arguments explicitly grounded within the nature of nursing and nurse–patient relationships warrant further exploration.
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Zolala, Shahrzad, Amir Almasi-Hashiani, and Forouzan Akrami. "Severity and frequency of moral distress among midwives working in birth centers." Nursing Ethics 26, no. 7-8 (October 22, 2018): 2364–72. http://dx.doi.org/10.1177/0969733018796680.
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Background: When individuals are aware of the appropriate ethical practice, but lack the ability to do it, they will suffer from moral distress. Moral distress is a frequent phenomenon in clinical practice which can have different effects on the performance of physicians, nurses, and midwives, and therefore patients and health care systems. Research objective: The present study aimed to determine the severity and frequency of moral distress in midwives working in birth centers. Research design: This study is a descriptive cross-sectional research. Researcher-made questionnaire was used to gather data. Participants and research context: A total of 180 midwives working in the labor ward of the public birth centers affiliated to Shahid Beheshti University of Medical Sciences were included to the study by census. Ethical considerations: Official permission for data collecting was obtained from the directors of the birth centers affiliated to Shahid Beheshti University of Medical Sciences. Then, after explaining the objectives of the study and assuring the confidentially of information, verbal consent of the participants was obtained. Findings: The total mean ± standard deviation of the severity and frequency of moral distress were 3.85 ± 0.75 and 3.03 ± 0.48, respectively. The highest severity and the lowest frequency of moral distress were obtained for the assistance for abortion and the lowest severity of moral distress was related to the organizational domain. However, the highest frequency of moral distress was related to futile care field. The mean of moral distress severity in the midwives with associate degree was significantly lower than other levels of education. Also, there was a significant relationship between age and moral distress frequency (p = 0.010). Discussion: The midwives’ moral distress was relatively high as expected. This finding is consistent with the results of similar studies in intensive care unit nurses. Conclusion: After identifying the level and most important factors of moral distress among midwives, the next step is empower them to prevent moral distress, in particular efforts to change structures.
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Bingham, Sarah-Louise. "Refusal of treatment and decision-making capacity." Nursing Ethics 19, no. 1 (January 2012): 167–72. http://dx.doi.org/10.1177/0969733011431925.
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This article explores refusal of medical treatment by adult patients from ethical and legal perspectives. Initially, consequentialist and deontological ethical theory are outlined. The concepts of autonomy, paternalism and competence are described and an overview of Beauchamp and Childress’s principle-based approach to moral reasoning is given. Relevant common law is discussed and the provisions of the Mental Capacity Act 2005 in assessing competence is evaluated. In order to demonstrate the consideration of moral issues in clinical practice, ethical theory is applied to two well-known incidents: the case of Re MB, where doubt over decision-making capacity led to a paternalistic act to override a patient’s choice; and the death of Emma Gough, a situation where respect for autonomy prevailed when healthcare staff acted lawfully in following a patient’s refusal of life-saving treatment. Finally, guidance from regulatory bodies on the roles and responsibilities of health professionals in relation to this topic are considered.
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Jalili, Fereshteh, Zahra Saeidnejad, and Mohammad Aghajani. "Effects of spirituality training on the moral sensitivity of nursing students: A clinical randomized controlled trial." Clinical Ethics 15, no. 1 (January 16, 2020): 1–10. http://dx.doi.org/10.1177/1477750919898346.
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Training nurses on spiritual principles and values helps to stimulate moral imagery and a deep understanding of moral problems in them. However, spirituality issue was not included in ethical educational content. There was still no interventional study on the effect of spirituality education on ethical sensitivity. This study was conducted to determine the effect of spirituality training on moral sensitivity of nursing students. A randomized controlled trial design was used. Data were collected by a moral sensitivity questionnaire and analyzed using Chi-square, Fisher, independent and paired t-test in SPSS 13v. This research was performed on 60 nursing students of Kashan University of Medical Sciences, Iran, in 2018. Participants were randomly assigned to two groups. The intervention group was under the spirituality group training in seven 60 min sessions. The control group was traditionally trained. Baseline characteristics were similar in the two groups. The differences between the two groups were statistically significant in the moral sensitivity score ( p < 0.0001). A significant difference was observed between the mean of moral sensitivity score of the intervention group, before and after the training ( p < 0.001), while no significant change was observed in the control group, before and after the study ( p = 0.93). The spirituality education increased the moral sensitivity of nursing students. That provides a new perspective on the role and effect of spirituality education on the ethical sensitivity of nursing students.
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Nalini, Annaswamy. "The Significance of the Hidden Curriculum in Medical Ethics." International Journal of User-Driven Healthcare 3, no. 4 (October 2013): 1–12. http://dx.doi.org/10.4018/ijudh.2013100101.
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The need to teach medical professionalism, especially medical ethics, has been emphasized by medical educators. The aim of medical ethics education is providing the basic knowledge regarding ethical analysis, enabling the students to develop the analytical skills for resolving the ethical dilemmas in clinical practice. But, a more important aspect is the assimilation of the core values of the profession by the students. The hidden curriculum, “the informal learning in which the students engage and which is unrelated to what is taught” (Harden, 2001, p.16) has a greater role in imparting education regarding the humanistic aspects of medical practice than the formal curriculum. Experiences of the medical students in the clinical setting should be considered significant for ethics education by the teachers. A review of the experiences of the students and the ethical dilemmas they face during the clinical clerkships is provided and their impact on the moral development of the students is analysed.
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Soleimani, Mohammad Ali, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, Mohammad Reza Sheikhi, Bianca Panarello, and Ma Thin Mar Win. "Spiritual well-being and moral distress among Iranian nurses." Nursing Ethics 26, no. 4 (June 16, 2016): 1101–13. http://dx.doi.org/10.1177/0969733016650993.
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Background: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. Research design: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress ( r = −.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. Discussion and conclusion: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.
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Humenna, I. R., and Ya M. Nakhaieva. "THE MORAL PRINCIPLES FORMATION OF FUTURE DOCTORS DURING THE EDUCATIONAL PROCESS." Медична освіта, no. 2 (June 2, 2020): 56–60. http://dx.doi.org/10.11603/me.2414-5998.2020.2.11147.
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The article reveals the issue of moral principles formation during professional education, the concept of moral characters of a specialist in the field of medicine as a system of moral qualities and actions.
The aim of humanitarian education is to form the future doctors’ needs for continuous education, development of general culture, formation of professional and communicative competence, legal consciousness, tolerance, humanity. In addition to the aesthetic, such training also has a moral impact on the younger generation of doctors, helping to understand the internal state of the patient. The importance of moral principles in the medical profession are found out. It is revealed that the principle of collegiality in medicine contributes to the development of professional and ethical culture of medical workers. Theoretical aspects of this problem are considered.
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Sgarlata, Sara, Alicja Dłużewicz, and Karolina Napiwodzka. "Ars Moriendi. Ethical Challenges of the Ultimate Realities of Life." ETHICS IN PROGRESS 13, no. 2 (December 23, 2022): 4–10. http://dx.doi.org/10.14746/eip.2022.2.1.
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The aim of this issue of Ethics in Progress is to provide a provisional, open-ended view on the ultimate realities of life and the ethical challenges they pose in medical, sociological, and existential contexts. The issue explores axiologies and meta-ethical narratives related to the art of dying, or in other words the moral domain encompassing the quest for a good life and a good death. Two problematic aspects emerge from the latest body of research: (1) the difficulty involved in tackling ethical challenges in medical and sociological contexts; and (2) the marginal role of the patient’s agency and narrative-ownership of end-of-life decision-making. A direction is pointed out that suggests that interventions across interdisciplinary groups involved in medical aid to dying should focus on promoting ethical behaviour on the side of healthcare personnel. Finally, attention to language, discourse, communication, and the narratives of death and dying call this edition of Ethics in Progress to examine the ontological and epistemological categories that underlie the study of lifeworlds and ‘discourse communities’, which are those associated with moral agents interlacing historical motives, language, communication, normative beliefs, social norms and roles, power relations, hard clinical evidence, and contested values in the context of medical practices and, broadly speaking, practices surrounding death.
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Amiri, Elham, Hossein Ebrahimi, Maryam Vahidi, Mohamad Asghari Jafarabadi, and Hossein Namdar Areshtanab. "Relationship between nurses’ moral sensitivity and the quality of care." Nursing Ethics 26, no. 4 (January 16, 2018): 1265–73. http://dx.doi.org/10.1177/0969733017745726.
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Background: To provide care with high quality, nurses face a number of moral issues requiring them to have moral abilities in professional performance. Moral sensitivity is the first step in moral performance. However, its relation to the quality of care patients receive is controversial. Research objective: This study aims to determine the relationship between the moral sensitivity of nurses and the quality of care received by patients in the medical wards. Research design: A descriptive correlational study using validated tools, including Moral Sensitivity Questionnaire and the Quality Patient Quality Scale. Participants and research context: In total, 198 nurses and 198 patients in 17 medical wards of hospitals affiliated with Tabriz University of Medical Sciences, Iran. Ethical considerations: The study was reviewed and approved by the Ethics Committee of Tabriz University of Medical Sciences. Findings: The mean values of nurses’ moral sensitivity and nurses’ quality care were 136.47 ± 13.30 and 196.36 ± 44.10, respectively. There was no significant relationship between the patient care quality and nurses’ moral sensitivity ( r = −.14, p = .5). However, there was a significant inverse relationship between the dimension of “Experiencing moral conflicts” and the overall score of quality care ( r = −.50, p = .04), the dimensions of “psychosocial ( r = −.50, p = .04)” and “physical ( r = −.50, p = .03).” Conclusion: Considering the significant inverse relationship between the score of patient quality care and the dimension of moral conflict experience, it seems when nurses make moral decisions, they experience a conflict between personal and professional values in their careers and thus experience moral tension. If this tension is not resolved properly, it can provide a way for them to distance themselves from patients, thereby making nurses indifferent to moral care.
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Sporrong, Sofia Kälvemark, Anna T. Höglund, and Bengt Arnetz. "Measuring Moral Distress in Pharmacy and Clinical Practice." Nursing Ethics 13, no. 4 (July 2006): 416–27. http://dx.doi.org/10.1191/0969733006ne880oa.
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This article presents the development, validation and application of an instrument to measure everyday moral distress in different health care settings. The concept of moral distress has been discussed and developed over 20 years. A few instruments have been developed to measure it, predominantly in nursing. The instrument presented here consists of two factors: level of moral distress, and tolerance/openness towards moral dilemmas. It was tested in four medical departments and three pharmacies, where 259 staff members completed a questionnaire. The two factors were found to be reliable. Differences in levels of moral distress were found between pharmacies and clinical departments, and between the youngest and oldest age groups; departmental staff and the youngest group experienced higher levels of moral distress. Departments reported less tolerance/openness towards moral dilemmas than pharmacies. The instrument needs to be tested further, but its strengths are the focus on everyday ethical dilemmas and its usefulness in different health care settings.