Do we treat individuals as patients or as potential donors? A phenomenological study of healthcare professionals' experiences.

Abstract:

BACKGROUND:Organ donation and transplantation have made it possible to both save life and to improve the quality of life for a large number of patients. In the last years there has been an increasing gap between the number of patients who need organs and organs available for transplantation, and the focus worldwide has been on how to meet the organ shortage. This also rises some ethical challenges. OBJECTIVE:The objective of this study was to explore healthcare professionals' experience of ethics related to care and interaction with critically ill patients with severe brain injuries and their families. RESEARCH DESIGN:A hermeneutic phenomenological approach was used to explore the participants' experiences. Methods for collecting data were a combination of participant observations and in-depth interviews. PARTICIPANTS AND RESEARCH CONTEXT:Two ICUs in a Norwegian university hospital were recruited for data collection. A total of 12 cases were observed, and 32 of the healthcare professionals involved were interviewed. ETHICAL CONSIDERATIONS:The study was approved by the Regional Committee for Research Ethics. Permission to the study in the ICUs was obtained from the Chief Physician in the two ICUs respectively. The right of the participants was ensured by written, voluntary, and informed consent. FINDINGS:From the thematic analysis, a structure of the participants' experiences emerged as a process. While the patients' condition was clarified through phases of prognostic ambiguity, gradual clarification and prognostic certainty, interaction with the families was characterized by ambiguity that involved withholding. The prognostic process had a great impact on how the healthcare professionals interacted with the family. The interaction challenged the participants' caring values in various ways and captured an important structure in their experiences of the ethical interaction with the patients' families. These challenges distinguish caring for families in donation situations from caring for relatives of critically ill patients in general. DISCUSSION:In the discussion we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. CONCLUSION:Ethical questions should be discussed more both in educations of healthcare professionals and in clinical practice.

journal_name

Nurs Ethics

journal_title

Nursing ethics

authors

Orøy A,Strømskag KE,Gjengedal E

doi

10.1177/0969733014523170

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

163-75

issue

2

eissn

0969-7330

issn

1477-0989

pii

0969733014523170

journal_volume

22

pub_type

杂志文章
  • Invisibility, moral knowledge and nursing work in the writings of Joan Liaschenko and Patricia Rodney.

    abstract::The ethical 'eye' of nursing, that is, the particular moral vision and values inherent in nursing work, is constrained by the preoccupations and practices of the superordinate biomedical structure in which nursing as a practice discipline is embedded. The intimate, situated knowledge of particular persons who construc...

    journal_title:Nursing ethics

    pub_type: 传,历史文章,杂志文章

    doi:10.1191/0969733004ne677oa

    authors: Bjorklund P

    更新日期:2004-03-01 00:00:00

  • Nurses' attitudes towards euthanasia in conflict with professional ethical guidelines.

    abstract:BACKGROUND:Despite the significant role of nurses in end-of-life care, their attitudes towards euthanasia are under-represented both in the current literature and the controversial debate that is ongoing in several countries. RESEARCH QUESTIONS:What are the attitudes towards euthanasia among Finnish nurses? Which char...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733016643861

    authors: Terkamo-Moisio A,Kvist T,Kangasniemi M,Laitila T,Ryynänen OP,Pietilä AM

    更新日期:2017-02-01 00:00:00

  • Ideology of nursing care in child psychiatric inpatient treatment.

    abstract::Research on nursing ideology and the ethics of child and adolescent psychiatric nursing care is limited. The aim of this study was to describe and explore the ideological approaches guiding psychiatric nursing in child and adolescent psychiatric inpatient wards in Finland, and discuss the ethical, theoretical and prac...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733007077887

    authors: Ellilä H,Välimäki M,Warne T,Sourander A

    更新日期:2007-09-01 00:00:00

  • Relational narratives: solving an ethical dilemma concerning an individual's insurance policy.

    abstract::Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient's nurse and an interested insu...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/096973300000700208

    authors: Lindsay R,Graham H

    更新日期:2000-03-01 00:00:00

  • Ethical perspectives in communication in cancer care: An interpretative phenomenological study.

    abstract:BACKGROUND:In cancer care, many clinical contexts still lack a good-quality patient-health professional communication about diagnosis and prognosis. Information transmission enables patients to make informed choices about their own healthcare. Nevertheless, disclosure is still an ethically challenging clinical problem ...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733020916771

    authors: Melis P,Galletta M,Gonzalez CIA,Contu P,Herrera MFJ

    更新日期:2020-09-01 00:00:00

  • Operationalization of patients' rights in Sudan: Quantifying nurses' knowledge.

    abstract:BACKGROUND:Promoting patients' rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients' rights within a healthcare system. As such, assessing the knowledge of nurses about patie...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733018787224

    authors: Abdalla SM,Mahgoub EA,Abdelgadir J,Elhassan N,Omer Z

    更新日期:2019-11-01 00:00:00

  • Practising virtue: a challenge to the view that a virtue centred approach to ethics lacks practical content.

    abstract::A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act apprai...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1191/0969733005ne832oa

    authors: Begley AM

    更新日期:2005-11-01 00:00:00

  • Professional self-concept and professional values of senior students of the nursing department.

    abstract:AIM:This study was carried out in order to determine professional self-concept and professional values in the students, who were studying in the final year of the nursing department in schools providing undergraduate education in the Inner Anatolia Region. METHOD:This cross-sectional study was conducted on a total of ...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733018761171

    authors: Çöplü M,Tekinsoy Kartın P

    更新日期:2019-08-01 00:00:00

  • Ethical reasoning observed: a longitudinal study of nursing students.

    abstract::All nursing courses in the UK include ethics in the curriculum, although there is considerable variation in the content of ethics courses and the teaching methods used to assist the acquisition of ethical reasoning.The effectiveness of ethics courses continues to be disputed, even when the perceptions and needs of stu...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1191/0969733002ne507oa

    authors: Nolan PW,Markert D

    更新日期:2002-05-01 00:00:00

  • Nurses' moral distress in end-of-life care: A qualitative study.

    abstract:BACKGROUND:Moral distress is a neglected issue in most palliative education programmes, and research has largely focused on this phenomenon as an occupational problem for nursing staff. RESEARCH QUESTION:The primary outcome of this study was to explore the causes of morally distressing events, feelings experienced by ...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733020964859

    authors: De Brasi EL,Giannetta N,Ercolani S,Gandini ELM,Moranda D,Villa G,Manara DF

    更新日期:2020-12-03 00:00:00

  • How nurses and physicians face ethical dilemmas--the Croatian experience.

    abstract::The aim of this study was to assess nurses' and physicians' ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N=364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, p...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733011398095

    authors: Sorta-Bilajac I,Baždarić K,Žagrović MB,Jančić E,Brozović B,Čengic T,Ćorluka S,Agich GJ

    更新日期:2011-05-01 00:00:00

  • Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers.

    abstract:BACKGROUND::Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understand...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733017712080

    authors: Sellevold GS,Egede-Nissen V,Jakobsen R,Sørlie V

    更新日期:2019-03-01 00:00:00

  • Dignity in care in the clinical setting: a narrative review.

    abstract::This review aimed to explore nursing literature and research on dignity in care of inpatients and to evaluate how the care patients received in the hospital setting was related to perceived feelings of being dignified or undignified. Studies conducted between 2000 and 2010 were considered, using Cumulative Index to Nu...

    journal_title:Nursing ethics

    pub_type: 杂志文章,评审

    doi:10.1177/0969733012458609

    authors: Lin YP,Watson R,Tsai YF

    更新日期:2013-03-01 00:00:00

  • Nurses' perception of ethical climate, medical error experience and intent-to-leave.

    abstract::We examined nurses' perceptions of the ethical climate of their workplace and the relationships among the perceptions, medical error experience and intent to leave through a cross-sectional survey of 1826 nurses in 33 Korean public hospitals. Ethical climate was measured using the Hospital Ethical Climate Survey. Alth...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733013486797

    authors: Hwang JI,Park HA

    更新日期:2014-02-01 00:00:00

  • Legal implications of task rearrangement for nurses in the Netherlands.

    abstract::The central question in this article concerns the implications of developments in the rearrangement of tasks in health care, particularly for nurses in terms of their duties and responsibilities. Attention is focused on the transfer of medical tasks from physicians to nurses. An investigation was carried out on the im...

    journal_title:Nursing ethics

    pub_type: 杂志文章,评审

    doi:10.1191/0969733005ne812oa

    authors: de Bijl NP

    更新日期:2005-09-01 00:00:00

  • Moral distress experienced by non-Western nurses: An integrative review.

    abstract:BACKGROUND:Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the lit...

    journal_title:Nursing ethics

    pub_type: 杂志文章,评审

    doi:10.1177/0969733019880241

    authors: Prompahakul C,Epstein EG

    更新日期:2020-05-01 00:00:00

  • Limitation of therapeutic effort experienced by intensive care nurses.

    abstract:BACKGROUND::Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level. OBJECTIVES::To describe the experience of intensive care nurses practicing limitation of therapeutic effort. METHOD::A q...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733016679471

    authors: Velarde-García JF,Luengo-González R,González-Hervías R,Cardenete-Reyes C,Álvarez-Embarba B,Palacios-Ceña D

    更新日期:2018-11-01 00:00:00

  • Nurse Activism in the newborn intensive care unit: actions in response to an ethical dilemma.

    abstract::Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn in...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733012475254

    authors: Settle PD

    更新日期:2014-03-01 00:00:00

  • A Calvinist account of nursing ethics.

    abstract::A relatively small but intellectually robust strand in the Christian religion is the Reformed tradition. Especially, its Calvinist sensibilities inform this Protestant stance towards human culture in general and vocations in particular. Correspondingly, there are some small but robust contributions to academic discour...

    journal_title:Nursing ethics

    pub_type: 传,历史文章,杂志文章

    doi:10.1177/0969733012473010

    authors: Cusveller B

    更新日期:2013-11-01 00:00:00

  • Patients' perspectives on person-centred participation in healthcare: a framework analysis.

    abstract::The aim of this article was to critically analyse the concept of person-centred participation in healthcare from patients' perspectives through a review of qualitative research findings. In accordance with the integrative review method of Broom, data were retrieved from databases, but 60 studies were finally included ...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733013490593

    authors: Thórarinsdóttir K,Kristjánsson K

    更新日期:2014-03-01 00:00:00

  • Workplace justice and intention to leave the nursing profession.

    abstract:BACKGROUND::Poor psychosocial work environments are considered critical factors of nurses' intention to leave their profession. Workplace injustice has been proven to increase the incidence of psychiatric morbidity among workers. However, few studies have directly investigated the effect of workplace justice on nurses'...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733016687160

    authors: Chin W,Guo YL,Hung YJ,Hsieh YT,Wang LJ,Shiao JS

    更新日期:2019-02-01 00:00:00

  • Patients' transcultural needs and carers' ethical responses.

    abstract::Many Turkish people migrated to Germany between 1955 and 1975. This study was carried out in Göttingen, Germany. Fifty Turkish people (described as patients) were asked about the care they had received from German health care personnel, and 50 German nurses and 50 German physiotherapists were questioned about care the...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733009341396

    authors: Dogan H,Tschudin V,Hot I,Ozkan I

    更新日期:2009-11-01 00:00:00

  • The mediating effect of ethical climate on religious orientation and ethical behavior.

    abstract:BACKGROUND:Nurses' behavior in Educational-Medical centers is very important for improving the condition of patients. Ethical climate represents the ethical values and behavioral expectations. Attitude of people toward religion is both intrinsic and extrinsic. Different ethical climates and attitude toward religion cou...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733017738133

    authors: Hassanian ZM,Shayan A

    更新日期:2019-06-01 00:00:00

  • Addressing ethical concerns arising in nursing and midwifery students' reflective assignments.

    abstract:BACKGROUND:Written reflections on practice are frequently requirements of nursing curricula. They are widely accepted as necessary for improving critical thinking and problem-solving skills. Faculty, are expected to review reflections and provide feedback that helps professional development and facilitates good practic...

    journal_title:Nursing ethics

    pub_type: 杂志文章,评审

    doi:10.1177/0969733016674767

    authors: McCarthy B,McCarthy J,Trace A,Grace P

    更新日期:2018-09-01 00:00:00

  • Human rights and nursing codes of ethics in Canada 1953-2017.

    abstract::Human rights are foundational to the health and well-being of all individuals and have remained a central tenet of nursing's ethical framework throughout history. The purpose of this study is to explore continuity and changes to human rights in nursing codes of ethics in the Canadian context. This study examines nursi...

    journal_title:Nursing ethics

    pub_type: 历史文章,杂志文章

    doi:10.1177/0969733020906606

    authors: Tisdale D,Symenuk PM

    更新日期:2020-06-01 00:00:00

  • Nurses' reflections on good nurse traits: Implications for improving care quality.

    abstract:BACKGROUND:Good nurses show concern for patients by caring for them effectively and attentively to foster their well-being. However, nurses cannot be taught didactically to be "good" or any trait that characterizes a good nurse. Nurses' self-awareness of their role traits warrants further study. OBJECTIVES:This study ...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733014547973

    authors: Chen SY,Hsu HC

    更新日期:2015-11-01 00:00:00

  • Research with bereaved families: a framework for ethical decision-making.

    abstract::Theoretical debates about the nature of grief and bereavement draw attention to the sensitivity of carrying out research with bereaved people, the possible threats that this may pose and the ethical considerations required to ameliorate potentially damaging outcomes. The authors of this article present a framework for...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733014521097

    authors: Sque M,Walker W,Long-Sutehall T

    更新日期:2014-12-01 00:00:00

  • Moral injury in healthcare professionals: A scoping review and discussion.

    abstract::Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733020966776

    authors: Čartolovni A,Stolt M,Scott PA,Suhonen R

    更新日期:2021-01-11 00:00:00

  • Moral distress in Turkish intensive care nurses.

    abstract:BACKGROUND:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced...

    journal_title:Nursing ethics

    pub_type: 杂志文章

    doi:10.1177/0969733015593408

    authors: Karagozoglu S,Yildirim G,Ozden D,Çınar Z

    更新日期:2017-03-01 00:00:00

  • Nurse moral distress: a proposed theory and research agenda.

    abstract::As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a resea...

    journal_title:Nursing ethics

    pub_type: 杂志文章,评审

    doi:10.1191/0969733002ne557oa

    authors: Corley MC

    更新日期:2002-11-01 00:00:00