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Nursing Ethics, Vol. 7, No. 4,
360-366 (2000)
DOI: 10.1177/096973300000700409
Nurses’ Ethical Conflicts: what is really known about them?
Barbara K Redman
Wayne State University, Detroit, MI, USA
Sara T Fry
Boston College School of Nursing, Chestnut Hill, MA, USA
The purpose of this article is to report what can be learned about nurses’ ethical conflicts by the systematic analysis of methodologically similar studies. Five studies were identified and analysed for: (1) the character of ethical conflicts experienced; (2) similarities and differences in how the conflicts were experienced and how they were resolved; and (3) ethical conflict themes underlying four specialty areas of nursing practice (diabetes education, paediatric nurse practitioner, rehabilitation and nephrology). The predominant character of the ethical conflicts was disagreement with the quality of medical care given to patients. A significant number of ethical conflicts were experienced as ‘moral distress’, the resolution of which was variable, depending on the specialty area of practice. Ethical conflict themes underlying the specialty areas included: differences in the definition of adequacy of care among professionals, the institution and society; differences in the philosophical orientations of nurses, physicians and other health professionals involved in patient care; a lack of respect for the knowledge and expertise of nurses in specialty practice; and difficulty in carrying out the nurse’s advocacy role for patients.
Key Words: bioethics • ethical conflict • nursing quality
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