Nursing Ethics最新文献

This manuscript explores the philosophical implications of ethical principles such as honesty, integrity, fairness, reliability, and objectivity and their impact on professional nursing. By examining these values within Western society, the discussion highlights the importance of integrating these virtues into contemporary nursing education. Through a detailed analysis of each precept, the document underscores their potential to enhance the quality of education, improve interactions among faculty and staff, and achieve positive student outcomes. Ultimately, this treatise advocates for a balanced pedagogical approach in nursing that leverages these elements to foster a more compassionate world, where ethical connections in academia underpin our collective existence.

This article discusses the application of artificially intelligent robots within eldercare and explores a series of ethical considerations, including the challenges that AI (Artificial Intelligence) technology poses to traditional Chinese Confucian filial piety. From the perspective of Confucian ethics, the paper argues that robots cannot adequately fulfill duties of care. Due to their detachment from personal relationships and interactions, the "emotions" of AI robots are merely performative reactions in different situations, rather than actual emotional abilities. No matter how "humanized" robots become, it is difficult to establish genuine empathy and a meaningful relationship with them for this reason. Even so, we acknowledge that AI robots are a significant tool in managing the demands of elder care and the growth of care poverty, and as such, we attempt to outline some parameters within which care robotics could be acceptable within a Confucian ethical system. Finally, the paper discusses the social impact and ethical considerations brought on by the interaction between humans and machines. It is observed that the relationship between humans and technology has always had both utopian and dystopian aspects, and robotic elder care is no exception. AI caregiver robots will likely become a part of elder care, and the transformation of these robots from "service providers" to "companions" seems inevitable. In light of this, the application of AI-augmented robotic elder care will also eventually change our understanding of interpersonal relationships and traditional requirements of filial piety.

Background: Trust is an essential phenomenon of relationship between patients and healthcare professionals and can be described as an accepted vulnerability to the power of another person over something that one cares about in virtue of goodwill toward the trustor. This characterization of interpersonal trust appears to be adequate for patients suffering from chronic illness. Trust is especially important in the context of chronic cardiovascular diseases as one of the main global health problems.

Research aim: The purpose of the qualitative study was to gain a deeper understanding of how people with chronic cardiovascular disease experience and make sense of trust in healthcare professionals.

Research design: Eleven semi-structured interviews with participants analysed using interpretative phenomenological analysis to explore in detail their lived experience of trust as a relational phenomenon.

Participants and research context: Participants with chronic cardiovascular disease were purposively recruited from inpatients on the cardiology ward of the university hospital located in central Slovakia.

Ethical considerations: The study was approved by the faculty ethics committee. Participants gave their written informed consent.

Findings four interrelated group experiential themes: Sense of co-existence; Belief in competence; Will to help; Ontological security with eight subthemes were identified. The findings describe the participants' experience with trust in healthcare professionals as a phenomenon of close co-existence, which is rooted in the participants' vulnerability and dependence on the goodwill and competence of health professionals to help with the consequence of (re)establishing a sense of ontological security in the situation of chronic illness.

Conclusion: Findings will contribute to an in-depth understanding of trust as an existential dimension of human co-existence and an ethical requirement of healthcare practice, inspire patient empowerment interventions, support adherence to treatment, and person-centred care.

With the increasing use of technology in nursing, how nurses perform practice care has changed, inevitably leading to ethical concerns that differ from original ethical norms in nursing. Studies have focused on ethical issues in health informatics from clinicians' or patients' perspectives, while nurses' perspective is needed. This paper conducts a theoretical study on ethical predicaments that arise in nursing informatics from nurses' perspectives. Why and how these predicaments emerge are elaborated. Also, this paper offers countermeasures in realistic contexts from technique, education, and leadership aspects. Collaborations between governments, administrators, educators, technicians, and nurses are needed to step out of these predicaments.

In recent years, research in robotics and artificial intelligence (AI) has made rapid progress. It is expected that robots and AI will play a part in the field of nursing and their role might broaden in the future. However, there are areas of nursing practice that cannot or should not be entrusted to robots and AI, because nursing is a highly humane practice, and therefore, there would, perhaps, be some practices that should not be replicated by robots or AI. Therefore, this paper focuses on several ethical concepts (advocacy, accountability, cooperation, and caring) that are considered important in nursing practice, and examines whether it is possible to implement these ethical concepts in robots and AI by analyzing the concepts and the current state of robotics and AI technology. Advocacy: Among the components of advocacy, safeguarding and apprising can be more easily implemented, while elements that require emotional communication with patients, such as valuing and mediating, are difficult to implement. Accountability: Robotic nurses with explainable AI have a certain level of accountability. However, the concept of explanation has problems of infinite regression and attribution of responsibility. Cooperation: If robot nurses are recognized as members of a community, they require the same cooperation as human nurses. Caring: More difficulties are expected in care-receiving than in caregiving. However, the concept of caring itself is ambiguous and should be explored further. Accordingly, our analysis suggests that, although some difficulties can be expected in each of these concepts, it cannot be said that it is impossible to implement them in robots and AI. However, even if it were possible to implement these functions in the future, further study is needed to determine whether such robots or AI should be used for nursing care. In such discussions, it will be necessary to involve not only ethicists and nurses but also an array of society members.

Artificial intelligence revolutionizes nursing informatics and healthcare by enhancing patient outcomes and healthcare access while streamlining nursing workflow. These advancements, while promising, have sparked debates on traditional nursing ethics like patient data handling and implicit bias. The key to unlocking the next frontier in holistic nursing care lies in nurses navigating the delicate balance between artificial intelligence and the core values of empathy and compassion. Mindful utilization of artificial intelligence coupled with an unwavering ethical commitment by nurses may transform the very essence of nursing.

Background: Healthcare leader support and facilitation for ethics work are of great importance for healthcare professionals' handling of ethical issues, moral distress, and quality care provision. A digital tool for ethical reflection in long-term care was developed in response to the demand for appropriate tools.

Research aim: This study aimed to explore healthcare leaders' expectations of using a digital tool for ethical reflection among their home nursing care staff.

Research design: A qualitative research design with vignettes and focus group interviews was used. The data were analyzed using reflexive thematic analysis.

Participants and research context: The sample comprised ten healthcare leaders from municipal long-term care in Norway.

Ethical considerations: Participation was voluntary and based on informed consent. The Norwegian Agency for Shared Services in Education and Research approved this study.

Findings: The analysis resulted in the development of three themes representing leaders' expectations of the tool: (i) giving staff a voice, (ii) revealing ethics in practice, and (iii) keeping the pot boiling.

Discussion: Leaders must be informed about the ethical issues experienced to engage in supportive measures for their staff. Digital channels can increase the democratization, safety, and efficiency of communication between employees and leaders and increase awareness of ethical aspects in daily care work. The leaders had positive expectations of employees' activities and benefits from using the tool for ethical reflection. However, they admitted that realizing the tool's potential to ensure continuity in ethics work requires considerable organizational and leader involvement.

Conclusions: This study shows that healthcare leaders are open to digital solutions for managing ethics work in home nursing care. Both opportunities and important prerequisites for successfully implementing the digital tool were identified.

Background: Home-based care workers mainly work alone in the patient's home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges.

Aim: The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges.

Research design: The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach.

Participants and research context: The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants.

Ethical considerations: The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form.

Findings: A main challenge was that staff found it difficult to respect the patient's autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff's threshold for considering the use of coercion appeared to be high.

Conclusions: Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems.

Background: Changes in health needs led to an increase in virtual care practices such as telemedicine. Nursing plays an essential role in this practice as it is the key to accessing the healthcare system. It is important that this branch of nursing is developed considering all the ethical aspects of nursing care, and not just the legal concepts of the practice. However, this question has not been widely explored in the literature and it is of crucial relevance in the new concept of care.

Objective: The purpose of this scoping review is to identify the ethical aspects of the development of telemedicine from a nursing practice perspective.

Methods: A scoping review of the literature based on Arksey and O'Malley's framework. The search was conducted in Scopus, PubMed/MEDLINE and CINAHL databases, from 2012 to 2022. A total of 1322 articles were retrieved, of which 12 met the inclusion criteria.

Ethical considerations: The research was conducted in accordance with the best scientific practices.

Findings: The most relevant aspects were the safety of the patient, the benefits for the user and the digital competence of the professionals. Informed consent and patient's willingness to use new technologies were relevant to the practice, as was person-centered care and how telemedicine can influence the quality of the therapeutic relationship. Another relevant issue was the concern about professional competence for optimal outcomes.

Conclusion: It is necessary to further explore and develop the ethical aspects of the new practices, disassociating them from the legal aspects only. Professionals demand more training providing them with more competence and confidence.