Nursing Ethics最新文献

This paper explores how contemporary US healthcare, shaped by neoliberal biopolitics and thanatopolitics, functions as a death-making institution that commodifies care while systematically disposing of certain lives, reflecting an ethics not of care but of capital. Drawing from critical theory, historical analysis, and lived experience, we examine how death is deeply embedded in the structures of power and capitalism. Through the lens of haunting and organized forgetting, we analyze how institutions sanitize death, muting human loss into metrics and decontextualized data points, while erasing the tragedies of systemic violence. We argue that nurses, who are situated in physical and spiritual proximity to death, are uniquely positioned to act as witnesses, truth-tellers, and conjurers of the dead. Rather than comply with the institutional imperative to forget, we advocate for a practice of conjuring; calling forth the ghosts of those lost to violence of medical neglect, structural racism, and economic abandonment as a form of parrhesia: dangerous, necessary truth-telling. We explore how organized forgetting rewrites radical histories into palatable myths, disciplining contemporary activism and muting its transformative potential. We turn to examples like the Marys of ACT UP, whose embodied activism illustrates the power of public grief and haunting to incite justice. Inspired by theorists such as Foucault, Giroux, Derrida, and Ahmed, we locate in mourning a form of resistance, in memory a political act, and in storytelling a path to rehumanization. Ultimately, we argue that to conjure our dead is not only to remember them but to be transformed by them, allowing their voices to shape our ethical responsibilities, professional identities, and collective futures. In being possessed by our dead, we foreclose upon the institutional disavowal of suffering and reclaim a politics rooted in compassionate reckoning and the belief that another world is possible.

BackgroundAmbulance clinicians regularly encounter medical, caring, existential and ethical challenges. Meeting patients with complex medical presentations underscore the need for holistic decision-making and actions as ambulance clinicians struggle to strike a balance between addressing medical and caring needs.AimThis study aimed to explore action alternatives considered and discussed during ethics case reflections in response to care-related challenges in ambulance services.Research designA qualitative descriptive study design was applied. Data were analyzed using conventional and summative content analysis.Participants and research contextEthics case reflections were performed with 14 groups comprising a total of 78 ambulance clinicians. Prior to the reflections, a video depicting the encounter between two ambulance clinicians and an older patient and his spouse was viewed.Ethical considerationsThe principles of the Declaration of Helsinki were applied throughout the research process, and an advisory statement was obtained from the Swedish Ethical Review Authority (No. 2019-02127 and 2021-03490).FindingsThe ethics case reflections generated a variety and breadth of action alternatives to manage challenges in caring, suggesting that this format is suitable for discussing ethical issues in clinical cases that depart from standard medical emergencies. Furthermore, the breadth of the results reveals the wide professional discretion afforded to ambulance clinicians and suggest the presence of tacit competences embedded in professional practice.ConclusionsEthics case reflection has a potential to enhance ambulance clinicians' ethical decision-making by deepening reflections about patient autonomy as well as highlighting the potential for a caring approach and promoting holistic care. By generating a breadth of specific action alternatives, many possible ways forward even in situations with complex care-related challenges are illustrated. Further investigation regarding the role of ethics case reflections to articulate implicit attitudes and tacit competencies is warranted.

BackgroundThe rapid integration of artificial intelligence (AI) into healthcare has transformed how health professionals learn, communicate, and make clinical decisions. However, AI-generated images and digital outputs often reproduce societal stereotypes, particularly regarding gender and race.AimThis study examined how nursing students' perceptions of gender, race, and professional roles are shaped by AI-generated images of healthcare professionals, and how these perceptions influence their communication styles and ethical awareness in interactions with AI.DesignA multimethod, cross-sectional design integrating quantitative and qualitative approaches was used. Quantitative data assessed gender attitudes in the nursing profession, while qualitative data explored visual interpretations and language patterns in AI interactions.Participant PopulationThe sample included 132 second- and fourth-year nursing students from a health sciences faculty in Türkiye.Ethical ConsiderationThe study was approved by the institutional ethics committee.FindingsResults indicated that nursing students largely relied on visual cues particularly clothing and posture when identifying professional roles in AI-generated images. Despite claiming objectivity, students frequently associated doctors with men and nurses with women, reflecting persistent gender schemas. Female participants demonstrated greater sensitivity to both gender and racial imbalances, whereas males perceived AI-generated visuals as more neutral. Language analysis revealed two main communication styles in chatbot interactions: polite and direct. Quantitative findings showed that being female, having lower income, and higher GPA were associated with more egalitarian attitudes.ConclusionNursing students' perceptions and interactions with AI are influenced by implicit gender and racial stereotypes embedded in visual and linguistic representations. Integrating AI ethics, gender equity, and digital literacy into nursing curricula will foster critical awareness, algorithmic fairness, and equitable professional identity formation among future nurses.

BackgroundWith the widespread adoption of artificial intelligence (AI) in healthcare and nursing, nurses' subjective perception of AI has become a key indicator of their professional adaptability. However, the underlying mechanisms shaping this perception remain insufficiently understood. This study adopts a dual-perspective approach, integrating organizational management and individual psychology, to investigate the synergistic role of ethical leadership and moral sensitivity in facilitating nurses' technological adaptation. The findings provide new insights into the development of a supportive and ethically grounded nursing work environment in the digital era.ObjectiveTo examine how ethical leadership influences nurses' AI perception over time and the mediating role of moral sensitivity.MethodsData were collected in three waves from 584 nurses across six tertiary hospitals in China. Cross-lagged panel modeling and structural equation modeling were used to analyze the temporal predictive pathways and mediating mechanisms among the key variables.ResultsEthical leadership measured at Time 1 (T1) significantly and positively predicted AI perception at Time 2 (T2; β = 0.25, p < .001) and Time 3 (T3; β = 0.26, p < .001) and also significantly enhanced nurses' moral sensitivity (T2: β = 0.36, p < .001; T3: β = 0.18, p < .001). Further mediation analysis revealed that moral sensitivity at T2 partially mediated the effect of ethical leadership on AI perception at T3, accounting for 18.50% of the total effect. These results highlight a synergistic mechanism between the organizational ethical climate and individual moral resources in the process of adapting to AI technologies.ConclusionsEthical leadership and moral sensitivity jointly promote nurses' understanding and acceptance of AI systems, thereby strengthening their psychological adaptability and professional integration during technological transitions. These factors serve as essential supports for fostering a healthy nursing work environment.

BackgroundCompassion fatigue is a significant problem faced by nurses. Understanding the relationship between compassion fatigue and caring behaviors is essential in terms of reducing situations that negatively affect nurses and, thus, care.AimThis study aimed to investigate the relationship between compassion fatigue and caring behaviors among oncology nurses.Research designThis study employs a descriptive and correlational approach.Participants and research contextThe study was conducted with 241 oncology nurses working in hospitals with oncology inpatient services located within the provincial borders of Ankara. Data were collected face-to-face between July 15, 2023, and July 1, 2024, using the Descriptive Characteristics Form for Nurses, the Caring Behaviors Inventory-24, and the Compassion Fatigue-Short Scale. The data obtained from the study were analyzed with IBM SPSS 26. The analysis involved t-tests, ANOVA, Tukey tests, and Pearson correlation analysis.Ethical considerationsData were collected after obtaining ethics committee approval, institutional permissions, and informed consent from the nurses.ResultsThe mean total score of Caring Behaviors Inventory was 5.22, and the mean total score of Compassion Fatigue Scale was 67.71. There was a very weak positive correlation between the Caring Behaviors Inventory sub-dimension "respectful" and the Compassion Fatigue Scale sub-dimension "secondary trauma" (r = 0.153, p = .017). According to the findings obtained from the study, it was determined that oncology nurses had a high level of perception of caring behaviors and experienced compassion fatigue at a moderate level.ConclusionCompassion fatigue and caring behaviors are affected by many situations. Despite these situations, oncology nurses with empathic thinking, altruism, and ethical and professional values continue to care for their patients.

PurposesThe aim of this study was to deeply explore and elucidate the factors that trigger moral distress in dementia nursing staff based on society ecosystems theory (SET), to provide a theoretical basis for alleviating the experience and severity of moral distress among dementia nursing staff.MethodsThis study was a mixed-methods systematic review that searched eight electronic databases, including PubMed, Web of Science, EMBASE, CINAHL, PsycINFO, EBSCO, Cochrane, and Scopus. And we searched the literature from 1984 until June 2025. Studies were selected based on predetermined inclusion and exclusion criteria, focusing on factors that contribute to moral distress in dementia nursing staff. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT), and data were analyzed and synthesized to extract relevant themes.FindingsThe study identified 21 studies that categorized factors contributing to moral distress as macro (nursing staff prevalent issues, dementia nursing staff specific issues), mezzo (relationships with others, caregiving conflicts), and micro (individual differences, conflicting values, psychological imbalances, or feelings of distress).ConclusionsMoral distress among dementia nursing staff is driven by dementia symptoms, artificial nutritional issues, resource constraints, and caregiving conflicts. Synergistic interventions can be made at the micro, mezzo, and macro levels. However, systematic interventions for dementia nursing staff are currently inadequate, and effective and sustainable interventions need to be developed in clinical practice in the future.

In current China, the 9073 elderly care system is accelerating the process of intelligentization. The fundamental tension between conventional filial piety ethics and technological rationality is evident in the numerous ethical debates triggered by intelligent older people's care services, despite their convenience. This study proposes an analytical paradigm called relational vulnerability, which creatively combines the philosophy of technology with Confucian relational ethics. Through the use of intricate mechanisms, this framework seeks to shed light on how technological mediation alters intergenerational ethics. According to research, intelligent services that improve physical care for older people while weakening emotional ties have a paradoxical effect that creates new kinds of alienation, such as the measurement of filial duty and the breakdown of ritual-embodied behaviors. By incorporating cultural calibration into the development of human-machine symbiosis, this study addresses this issue by proposing the design concepts of "differential regulation" and "embodiment retention." This counteracts the interpretive shortcomings of the Western autonomy-based ethical paradigm in the context of Chinese older people care, creating new avenues for the application of Confucian bioethics in the age of technology and offering fresh perspectives on moral dilemmas in intelligent older people care.

BackgroundCaregivers in nursing homes are crucial in looking after disabled older adults. They often resort to physical restraints for various reasons, including safety concerns and resource limitations. However, this practice can impact the dignity of these individuals. In China, current research has rarely explored this issue at the caregiver level, leaving a critical gap in our understanding of this complex situation.Research objectivesThe purpose was to understand Chinese nursing home caregivers' perceptions and practices of dignity maintenance for physically restrained disabled older adults, as well as to provide a reference point for dignity maintenance.Research designThis is a qualitative descriptive study in which data were collected through semi-structured interviews. The collected data were analyzed using Colaizzi's 7-step method.Participants and research contextBetween October and December 2024, 13 caregivers from three nursing homes in Wenzhou City, China, were selected for the study using purposive sampling.Ethical considerationsThe ethics committee approved the study design on December 4, 2020 (approval number 2020-126).ResultsA total of three main themes and 11 sub-themes were distilled. The main themes included "Diverse perspectives on dignity maintenance in physical restraint," "The realistic dilemma of dignity maintenance practices in physical restraint," and "The practice of physical restraint based on the principle of whole-person care."ConclusionsNursing home caregivers have multiple views of dignity maintenance for physically restrained disabled older adults, and there are numerous barriers to maintaining dignity. Measures should be taken to optimize dignity maintenance practices, improve the quality of older adult care services, maintain the dignity and rights of disabled older persons, reduce the pressure on caregivers, and enhance occupational satisfaction.

Ethics has been central to the nursing profession. Challenges in patient care have arisen through advances in medicine through science and technology. These advances have led to patients being sustained in ethically difficult situations. Nurses have uniquely witnessed both the suffering of patients and rendered care for extended periods of time at the bedside. Through these caring relationships nurses have developed expertise in advocating for their patients. Many nurses have also returned to graduate school to develop their nursing science and ethical reasoning. Recently, the field of nursing has developed the role of the nurse ethicist. Nurse ethicists often also work as clinical ethics consultants. Additionally, nursing has advanced to include nurse practitioners as advanced practice nurses. Nurse practitioners have also obtained additional education in ethical reasoning and are working in roles similar to nurse ethicists and clinical ethicists. Given the science and nature of the nurse practitioner there may be unique facets to nurse practitioners who are ethicists. To date there are no proposals for nurse practitioner ethicists. Let this be the first proposal addressing the distinctions of the nurse practitioner ethicist.