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Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience  [PDF]
Miwa Yamamoto, Shizue Mizuno, Masako Aota
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.35064
Abstract: Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment; (ii) allocating elderly care specialists to wards to promote alternatives to restraints; (iii) establishment of safety standards to define nurses’ responsibilities; and (iv) institution of continuous ethical education for nurses.
Nursing and the resolution of ethical dilemmas
Investigación y Educación en Enfermería , 2012,
Abstract: inherent to nursing care, ethical dimension includes having to decide about the dilemmas that arise in practice. experience shows that generally we do not have a reference and then sufficient training to judge the ethical quality of our decisions and actions, reason why, in this article some methods are introduced that will facilitate this ethical analysis when faced with a conflict or dilemma that warrants it.
Action ethical dilemmas in surgery: an interview study of practicing surgeons
Kirsti Torjuul, Ann Nordam, Venke S?rlie
BMC Medical Ethics , 2005, DOI: 10.1186/1472-6939-6-7
Abstract: Five male and five female surgeons at a University hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of physicians and nurses about ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation.No gender differences were found in the kinds of ethical dilemmas identified among male and female surgeons. The main finding was that surgeons experienced ethical dilemmas in deciding the right treatment in different situations. The dilemmas included starting or withholding treatment, continuing or withdrawing treatment, overtreatment, respecting the patients and meeting patients' expectations. The main focus in the narratives was on ethical dilemmas concerning the patients' well-being, treatment and care. The surgeons narrated about whether they should act according to their own convictions or according to the opinions of principal colleagues or colleagues from other departments. Handling incompetent colleagues was also seen as an ethical dilemma. Prioritization of limited resources and following social laws and regulations represented ethical dilemmas when they contradicted what the surgeons considered was in the patients' best interests.The surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable.Surgeons are responsible for all activities related to patients' treatment and care in surgical units and it is therefore important for them to act in a the best and correct way towards patients, relatives, and colleagues. Studies have shown, however, that physicians often are in doubt about the best and correct actions to take for the patients in specific situations [1-3]. This question is not only a medical one, but can be understood in both action and relational ethical perspe
Ethical and Legal Dilemmas in Radiology
Ma. Ashrafi,Mo. Ashrafi,L. Mirzaei
Iranian Journal of Radiology , 2005,
Abstract: Background and objectives: Today with so many so-phisticated modalities in radiology, it is very difficult, if at all possible, for radiologist to master every thing and sometimes they are put in the position of reading a study where they really don't have the expertise they ought to have. Thus there are more malpractice suits against radiologists than the past decades. It is the purpose of this review to find guidelines for deal-ing with ethical and legal dilemmas in radiology. Materials & Methods: In this retrospective study, we reviewed malpractice and lawsuit cases stated against radiologists in the Iran University of Medical Sciences during 2001-2004 with comparative study of mal-practice cases in France, India, and USA. Results: We found that the most prevalent causes which radiologists are sued for are, (1) deviation from standards, misdiagnoses; (2) over-charging patients; (3) poor communication; (4) refusing to seek consul-tations when necessary; (5) referral to site of self-interest and fee splitting (Dichotomy);(6) misleading and untruthful advertising; (7) other ethical negli-gences such as inadequate respect for "belief and ideas of patients, autonomy, the right to consent and refuse procedure", breech of confidentiality, etc. Conclusions: Like other health care providers, radi-ologists should have their own Code of ethics and guidelines to describe standards of profession, disci-plinary procedures for violation of ethical and legal rules. These should be preferably provided by the Iranian Society of Radiology.
Ethical dilemmas experienced by nurses presented in nursing publications
Monteiro, Maria Adelane Alves;Barbosa, Régia Christina Moura;Barroso, Maria Graziela Teixeira;Vieira, Neiva Francenely Cunha;Pinheiro, Ana Karina Bezerra;
Revista Latino-Americana de Enfermagem , 2008, DOI: 10.1590/S0104-11692008000600019
Abstract: this systematic literature review used nursing studies about "ethics" published in the scielo database. the objective was to identify the ethical dilemmas of nursing, based on a literature review of nursing publications between 2002 and 2006. forty publications were found, of which seventeen were selected. the analysis of the articles permitted the organization of the following categories: ethics, the health system and nursing practice; ethics and nursing teaching-learning; ethics and nursing care. we noticed that the authors attributed a multidimensional approach to ethical issues. however, we considered it necessary to pay closer attention to the ethical aspects involved in nursing practice. there is a clear need for further studies, showing new ethical dilemmas experienced by nurses, so that they can contribute to a change in attitude, with outcomes for professional practice.
Ethical and legal dilemmas in infertility treatment  [PDF]
Dragojevi?-Diki? Svetlana,Dragani? Saveta,Diki? Sr?an S.,Pilija Vladimir
Zbornik Matice Srpske za Prirodne Nauke , 2004, DOI: 10.2298/zmspn0417085d
Abstract: One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART) and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity.
Learners in the marketplace: Ethical and educational dilemmas  [cached]
Elize C. du Plessis,Petro Marais
Koers : Bulletin for Christian Scholarship , 2012, DOI: 10.4102/koers.v77i1.48
Abstract: Since the abolishment of legislation (the South African Schools Act, No. 84 of 1996) stipulating that a learner may only attend a certain school in an area, there is great competition amongst schools to attract learners to their schools. There is a tendency to regard as commodities learners who can be seen as assets to the school, especially if these learners show a talent for sports and have outstanding sporting achievements. The main aim of the research was to determine whether school principals, learners and parents think that it is unethical to ‘buy’ talented learners. A qualitative research approach was undertaken to determine the views of a purposefully selected sample of school principals, learners and parents regarding the ‘buying’ of talented learners. These participants were chosen as they were important role players in the process of ‘buying’ talented learners. Data were collected by means of a questionnaire with semistructured and open-ended questions. The participants’ answers were critically analysed, and the ethical correctness was determined by evaluating them against the ethical ideas identified in five ethical approaches, namely the utilitarian approach, the rights approach, the fairness or justice approach, the virtue approach and the ethical problem solving approach. An extrapolation of these findings gives one an idea of our society’s attitude to the ‘buying’of talented learners and whether a need exists to actively create greater awareness of this practice. The findings are significant to illustrate the different viewpoints of school principals,talented learners and parents on the ethical and educational dilemmas of schools that ‘buy’ talented learners.
The ethical dilemmas experienced by nurses: an approach from the philosophy of max scheler
Marlise Silva Barros, Rose Mary Costa Rosa Andrade Silva, Eliane Ramos Pereira, Marcos Andrade Silva
Revista de Enfermagem UFPE On Line , 2009,
Abstract: Objective: this study intends reflect philosophically about the ethical dilemmas experienced by nurses from the Intensive Care Center at University Hospital Antonio Pedro, from the Theory of Value of Max Scheler. Methods: this is a descriptive study with a qualitative approach. The population shall be defined by the technique of saturation, consisting of nurses of the sector, to be interviewed after the signing of the Free Informed Consent forms, if they wish participate spontaneously in the study. The information will be transcribed, categorized in order of significance and analyzed from the theoretical framework of Max Scheler who looks on the objectivity of values and the process of seizure of emotional character. The project has received approval from the Research Ethics Committee of the Faculty of Medicine / University Hospital Antonio Pedro. Expected results: through the analysis of data, based on theoretical referential, the study intends to contribute to the decision making process of nurses, in front of the possible ethical dilemmas experienced with regard to practical work and, moreover, with the quality of care provided by nurses in the Intensive Care Center.
Ethical Dilemmas of Intra-vitro Fertilization  [cached]
Management in Health , 2010,
Abstract: The article reviews the issues of in vitro fertilization and the ethical dilemmas that rise from the impact of the medical, social, moral and legal framework of this method of assisted human reproduction, starting with the origin of gametes, the status of embryos and of biological or shedding parents, the maternal age, the sexual orientation of parents, the fate of embryos, the experimentation on embryo, taking into account the legislative framework, but also the moral and religious ones.The dilemmas are all under review, seeking to highlight the positive and negative aspects of the process, considering fairly the need of these techniques and the benefits of their use and the benefit they would bring to society.
Code of ethics and ethical dilemmas' management in health professions
Sofia Triadafyllidou,Evangelos Papageorgiou
To Vima tou Asklipiou , 2011,
Abstract: As the main interest of health professionals is for the well-being of patients/clients, ethical decision making is one of the prominent elements of his/her professionalism. Aim: The present study aims to illustrate the role of ethical judgment and the so-called "moral imagination" in health professions. Method and material: Review of theoretical and research literature, including both classic and recent sources about ethical dilemmas that health professionals may anticipate, as well as the suggested ways to manage these dilemmas. Results: Health professionals often have to act in complicated situations. Review of relevant literature indicates that the professionals' ethical decisions are structured not only through the codes of ethics, but also through other collective practices, such as organizational culture and cultural schemas about the role of health professional. Resorting to schematic thinking may temporarily release the professional from his/her concerns, but in the long run, it may devoid him/her of the sense of satisfaction from work and of the ability to offer clients the optimal care. The development of the so-called "moral imagination" permits the professional to advance from the typical application of the rules to actual ethical judgment. Conclusions: Ethical decision making presupposes not only a thorough knowledge of ethical guidelines, but also the development of the ability to openly reflect upon the ethical dimensions of an issue (moral imagination) that allows health professionals to overcome schematic thinking and investigate comprehensive solutions to ethical dilemmas.
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