Case description:Nurses face more and more ethical dilemmas during their practice nowadays,especially when they are taking care of the patient at end of life stage.The case study demonstrates an ethical dilemma when n...Case description:Nurses face more and more ethical dilemmas during their practice nowadays,especially when they are taking care of the patient at end of life stage.The case study demonstrates an ethical dilemma when nursing staff are taking care of an end stage aggressive prostate cancer patient Mr Green who expressed the suicide thoughts to one of the nurses and ask that nurse keep secret for him in Brisbane,QLD,Australia.Ethical dilemma identification:The ethical dilemma is identified as“if the nursing staff should tell other health care team members about patient's suicide attempt without patient's consent”.Analysis:To better solving this case and making the best moral decision,the ethical theory,the ethical principles and the Australian nurses'code of ethics values statement,the associated literature relative with this case are analyzed before the decision making.Ethical decision making:After consider all of the above factors,in this case,the best ethical decision for the patient is that the nurse share the information of Mr Green's suicide attempt with other health care professionals.Results:In Mr Green's case,the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals.The nursing team followed the self-harm and suicide protocol of the hospital strictly,they maintained the effective communication with Mr Green,identified the factors which cause patient's suicide attempt,provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care.The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.展开更多
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 hospita...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.展开更多
Case description:Withdrawal of treatment is a common practice in critical care settings,perticularly when treatment is considered futile.The case study demonstrates an ethical dilemma,in which Danny is unlikely to mak...Case description:Withdrawal of treatment is a common practice in critical care settings,perticularly when treatment is considered futile.The case study demonstrates an ethical dilemma,in which Danny is unlikely to make a functional recovery because of multiple organ dysfunction syndromes.Under such a circumstance,withdrawal of treatment will inevitably be considered,although his family refused to do so.Consequently,acritical question must be answered:Who should make the decision?Ethical dilemma identification:Danny decided to withdraw the use of life-support,whilst his wife and adult children refused to do so.The ethical dilemma is illustrated by the following question:Who decides the withdrawal of treatment in a critical care setting?Analysis:To provide an opotional solution to this case and make the best moral decision,the current study will critically discuss this issue in conjunction with ethical principles,philosophical theories and the values statement of the European and Chinese nurses'codes of ethics.Additionally,the associated literature relative to this case are analysed before the decision-making.Ethical decision-making:The best ethical decision is Danny can decide whether to withhold or withdraw life-sustaining treatment.If his family is involved in the discussion,the medical staff should balance the ethical principles when they make the decision and allocate reasonable resources for patients.Results:In Danny's case,health professionals opted to respect his decision to withdraw treatment.The medical staff maintained an effective communication with the family involved,and provided the appropriate intervention to collaborate with other health care professionals to perfect further care.展开更多
The clinical use of placebo that involves some ethical issues has led to much controversy.From the standpoint of both supporters and opponents,this article discusses this topic from three ethical principles such as be...The clinical use of placebo that involves some ethical issues has led to much controversy.From the standpoint of both supporters and opponents,this article discusses this topic from three ethical principles such as beneficence,justice,and autonomy and also gives the recommendations.Finally,the moral dilemma caused by the different views between nurses and doctors in clinical practice is discussed.展开更多
Forensic medical workers are faced with unique ethical challenges in their attempt to deliver medical care in a custodial environment.We first figure out the reasons why the doctor is standing opposed to the patient t...Forensic medical workers are faced with unique ethical challenges in their attempt to deliver medical care in a custodial environment.We first figure out the reasons why the doctor is standing opposed to the patient through questionnaire and interview of the prison doctor in Shanghai,China,which turn to be a bilateral issue.Both sides should take more active approaches and put themselves to the right position to contribute to a better medical environment in the prison hospital,which can reduce medical tangles and help the criminals to accomplish their reform process.展开更多
Catiline, Ibsen’s first play, has often been undervalued. Ibsen’s comments on this play that the ideas he expressed in this juvenile attempt are still what he thinks of after he has made great achievements in dramat...Catiline, Ibsen’s first play, has often been undervalued. Ibsen’s comments on this play that the ideas he expressed in this juvenile attempt are still what he thinks of after he has made great achievements in dramatic creation exactly show its true value. To a large extent, it is Catiline’s persistent pursuit of his ideal that may have moved the dramatist who has throughout his own life pursued his own ideal. What’s more, Ibsen may also have noticed the similar ethical dilemma that faces him and Catiline: the contraction between his earthly duties and his pursuit of the ideal.展开更多
Purpose: This study sought to clarify the relationship between a nurse’s exposure to elderly relatives and their perspective in using restraints on the elderly in health care situations. Methods: We approached nursin...Purpose: This study sought to clarify the relationship between a nurse’s exposure to elderly relatives and their perspective in using restraints on the elderly in health care situations. Methods: We approached nursing staff supervisors at 17 general hospital wards and explained the objectives of the study. Supervisors at 14 hospitals agreed to participate, giving us a sampling pool of 1929 nurses. We used a chi square test to compare nurses who had spent time with elderly relatives and those who had not on several variables related to using restraints on elderly patients. Results and Conclusion: This study found that nurses who live with elderly family members were significantly more likely to believe that restraints cause diseases (including chronic diseases) based on a chi square test (p < 0.05). Therefore it would be important that essential was the experiences of individuals with elderly family members when making programs of decreasing nurse’s dilemma to restraining the elderly.展开更多
Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilem...Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.展开更多
文摘Case description:Nurses face more and more ethical dilemmas during their practice nowadays,especially when they are taking care of the patient at end of life stage.The case study demonstrates an ethical dilemma when nursing staff are taking care of an end stage aggressive prostate cancer patient Mr Green who expressed the suicide thoughts to one of the nurses and ask that nurse keep secret for him in Brisbane,QLD,Australia.Ethical dilemma identification:The ethical dilemma is identified as“if the nursing staff should tell other health care team members about patient's suicide attempt without patient's consent”.Analysis:To better solving this case and making the best moral decision,the ethical theory,the ethical principles and the Australian nurses'code of ethics values statement,the associated literature relative with this case are analyzed before the decision making.Ethical decision making:After consider all of the above factors,in this case,the best ethical decision for the patient is that the nurse share the information of Mr Green's suicide attempt with other health care professionals.Results:In Mr Green's case,the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals.The nursing team followed the self-harm and suicide protocol of the hospital strictly,they maintained the effective communication with Mr Green,identified the factors which cause patient's suicide attempt,provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care.The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.
文摘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.
文摘Case description:Withdrawal of treatment is a common practice in critical care settings,perticularly when treatment is considered futile.The case study demonstrates an ethical dilemma,in which Danny is unlikely to make a functional recovery because of multiple organ dysfunction syndromes.Under such a circumstance,withdrawal of treatment will inevitably be considered,although his family refused to do so.Consequently,acritical question must be answered:Who should make the decision?Ethical dilemma identification:Danny decided to withdraw the use of life-support,whilst his wife and adult children refused to do so.The ethical dilemma is illustrated by the following question:Who decides the withdrawal of treatment in a critical care setting?Analysis:To provide an opotional solution to this case and make the best moral decision,the current study will critically discuss this issue in conjunction with ethical principles,philosophical theories and the values statement of the European and Chinese nurses'codes of ethics.Additionally,the associated literature relative to this case are analysed before the decision-making.Ethical decision-making:The best ethical decision is Danny can decide whether to withhold or withdraw life-sustaining treatment.If his family is involved in the discussion,the medical staff should balance the ethical principles when they make the decision and allocate reasonable resources for patients.Results:In Danny's case,health professionals opted to respect his decision to withdraw treatment.The medical staff maintained an effective communication with the family involved,and provided the appropriate intervention to collaborate with other health care professionals to perfect further care.
文摘The clinical use of placebo that involves some ethical issues has led to much controversy.From the standpoint of both supporters and opponents,this article discusses this topic from three ethical principles such as beneficence,justice,and autonomy and also gives the recommendations.Finally,the moral dilemma caused by the different views between nurses and doctors in clinical practice is discussed.
文摘Forensic medical workers are faced with unique ethical challenges in their attempt to deliver medical care in a custodial environment.We first figure out the reasons why the doctor is standing opposed to the patient through questionnaire and interview of the prison doctor in Shanghai,China,which turn to be a bilateral issue.Both sides should take more active approaches and put themselves to the right position to contribute to a better medical environment in the prison hospital,which can reduce medical tangles and help the criminals to accomplish their reform process.
文摘Catiline, Ibsen’s first play, has often been undervalued. Ibsen’s comments on this play that the ideas he expressed in this juvenile attempt are still what he thinks of after he has made great achievements in dramatic creation exactly show its true value. To a large extent, it is Catiline’s persistent pursuit of his ideal that may have moved the dramatist who has throughout his own life pursued his own ideal. What’s more, Ibsen may also have noticed the similar ethical dilemma that faces him and Catiline: the contraction between his earthly duties and his pursuit of the ideal.
文摘Purpose: This study sought to clarify the relationship between a nurse’s exposure to elderly relatives and their perspective in using restraints on the elderly in health care situations. Methods: We approached nursing staff supervisors at 17 general hospital wards and explained the objectives of the study. Supervisors at 14 hospitals agreed to participate, giving us a sampling pool of 1929 nurses. We used a chi square test to compare nurses who had spent time with elderly relatives and those who had not on several variables related to using restraints on elderly patients. Results and Conclusion: This study found that nurses who live with elderly family members were significantly more likely to believe that restraints cause diseases (including chronic diseases) based on a chi square test (p < 0.05). Therefore it would be important that essential was the experiences of individuals with elderly family members when making programs of decreasing nurse’s dilemma to restraining the elderly.
文摘Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.
