http://nej.sagepub.com Nursing Ethics RSS feed -- current issue September 2008 Nursing Ethics 0969-7330 http://nej.sagepub.com:80/icons/banner/title.gif http://nej.sagepub.com http://nej.sagepub.com/cgi/reprint/15/5/569?rss=1 2008-08-07 info:doi/10.1177/0969733008092866 5 15 570 2008-09-01 569 Article http://nej.sagepub.com/cgi/reprint/15/5/571?rss=1 2008-08-07 info:doi/10.1177/0969733008092867 5 15 572 2008-09-01 571 Article http://nej.sagepub.com/cgi/content/abstract/15/5/573?rss=1 This study investigated 204 doctors' and nurses' perceived knowledge of bloodborne pathogens and their attitudes towards bloodborne pathogen-infected health care workers. A structured questionnaire examined: (1) their perceived knowledge of bloodborne pathogens; (2) their attitudes towards bloodborne pathogen-infected personnel; and (3) their opinions on limitation of employment of bloodborne pathogen-infected personnel and restrictions on performing clinical procedures. The levels of HIV-related knowledge were significantly higher than for hepatitis C and B viruses. Although the participants demonstrated more positive attitudes towards hepatitis C- and B-infected health care workers, 64% recommended restricting infected personnel from performing invasive procedures. Attitudes were negatively correlated with opinions on restricting infected personnel from health care work or limiting their involvement in clinical activities. This study highlights the need to formulate a policy to cope with the professional and moral dilemmas related to infected health care workers employed in hospitals, especially for those involved in invasive procedures.

]]> 2008-08-07 info:doi/10.1177/0969733007088362 5 15 585 2008-09-01 573 Article http://nej.sagepub.com/cgi/content/abstract/15/5/586?rss=1 This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland (n =427), Estonia (n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% (n = 322) in Finland, 54% (n =119) in Estonia and 86% (n = 160) in Lithuania. A modified version of a scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs.

]]> 2008-08-07 info:doi/10.1177/0969733008092868 5 15 600 2008-09-01 586 Article http://nej.sagepub.com/cgi/content/abstract/15/5/601?rss=1 Key words: code of ethics; rejected patients; terrorism; terrorist victims; terrorists; values

]]> 2008-08-07 info:doi/10.1177/0969733008092869 5 15 613 2008-09-01 601 Article http://nej.sagepub.com/cgi/content/abstract/15/5/614?rss=1 The purpose of this study was to measure professional and personal values among nurses, and to identify the factors affecting these values. The participants were 323 Israeli nurses, who were asked about 36 personal values and 20 professional values. The three fundamental professional nursing values of human dignity, equality among patients, and prevention of suffering, were rated first. The top 10 rated values all concerned nurses' responsibility towards patients. Altruism and confidentiality were not highly rated, and health promotion and nursing research were rated among the last three professional values. For personal (instrumental) values, honesty, responsibility and intelligence were rated first, while ambition and imagination were rated 14th and 16th respectively out of 18. Significant differences (P < 0.05) were found among some personal and professional values rated as functions of culture, education, professional seniority, position and field of expertise. The results may assist in understanding the motives of nurses with different characteristics and help to promote their work according to professional ethical values.

]]> 2008-08-07 info:doi/10.1177/0969733008092870 5 15 630 2008-09-01 614 Article http://nej.sagepub.com/cgi/content/abstract/15/5/631?rss=1 This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after whistleblowing, wavering emotions were observed, consisting of a guilty conscience, fear of retribution, and pride, which subsequently transformed to stable emotions containing a sense of relief and regret for delayed action. It is necessary for nurses to recognize that their professional responsibility is primarily to patients, not to organizations. Nurses should also have professional judgment about appropriate allegiance and actions.

]]> 2008-08-07 info:doi/10.1177/0969733008092871 5 15 642 2008-09-01 631 Article http://nej.sagepub.com/cgi/content/abstract/15/5/643?rss=1 In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of the Report and the events that led to the inquiry will bring to light. We consider how sex and gender feature in the Lourdes case, draw attention to the deeply gendered asymmetries of power and privilege that existed between the men and women at the centre of this inquiry, and explore the impact such asymmetries had on this particular situation.

]]> 2008-08-07 info:doi/10.1177/0969733008092873 5 15 655 2008-09-01 643 Article http://nej.sagepub.com/cgi/content/abstract/15/5/656?rss=1 Ethical problems surrounding organ donation have been discussed since before technologies supported the procedure. In addition to issues on a societal level (e.g. brain-stem death, resource allocation), ethical concerns permeate the clinical practice of health care staff. These latter have been little studied. Using qualitative methods, this study, focused on transplant co-ordinators and their descriptions of dilemmas, ethical concerns and actions in response to them. Interviews with three co-ordinators in Japan and two in the UK revealed five areas in which dilemmas occurred: aspects of discrimination; conditions placed on who should be the recipient and the related issues of directed donation; respect for a person's right to make a decision and the extent of information provided and understood by donors and recipients; potential issues of coercion, compensation and rewards in live-related and live-unrelated donations; and potential conflicts in duties. This study describes the dilemma areas revealed. Their meaning for co-ordinators will be presented in a subsequent report.

]]> 2008-08-07 info:doi/10.1177/0969733008092874 5 15 669 2008-09-01 656 Article http://nej.sagepub.com/cgi/content/abstract/15/5/670?rss=1 This study focuses on investigating habits in perioperative nursing culture, which are often simply accepted and not normally considered or discussed. A hermeneutical approach was chosen as the means of understanding perioperative nurses' experiences of and reflections on operating theatre culture. Focus group discussions were used to collect data, which was analysed using hermeneutical text analysis. The results revealed three main categories of habits present in perioperative nursing culture: habits that promote ethical values (by temporary friendship with patients, showing respect for each other, and spending time on reflection on ethics and caring); habits that hinder progress (by seeing the patient as a surgical case, not acknowledging colleagues, and not talking about ethics); and habits that set the cultural tone (the hidden power structure and achieving more in less time).

]]> 2008-08-07 info:doi/10.1177/0969733008092875 5 15 681 2008-09-01 670 Article http://nej.sagepub.com/cgi/content/abstract/15/5/682?rss=1 This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values.

]]> 2008-08-07 info:doi/10.1177/0969733008092876 5 15 695 2008-09-01 682 Article http://nej.sagepub.com/cgi/reprint/15/5/696?rss=1 2008-08-07 info:doi/10.1177/0969733008092877 5 15 697 2008-09-01 696 Article http://nej.sagepub.com/cgi/reprint/15/5/697?rss=1 2008-08-07 info:doi/10.1177/0969733008093821 5 15 699 2008-09-01 697 Article http://nej.sagepub.com/cgi/reprint/15/5/700?rss=1 2008-08-07 info:doi/10.1177/0969733008092880 5 15 702 2008-09-01 700 Article http://nej.sagepub.com/cgi/reprint/15/5/703?rss=1 2008-08-07 info:doi/10.1177/09697330080150051302 5 15 704 2008-09-01 703 Article http://nej.sagepub.com/cgi/reprint/15/5/703-a?rss=1 2008-08-07 info:doi/10.1177/0969733008092878 5 15 703 2008-09-01 703 Article http://nej.sagepub.com/cgi/reprint/15/5/704?rss=1 2008-08-07 info:doi/10.1177/09697330080150051303 5 15 705 2008-09-01 704 Article http://nej.sagepub.com/cgi/reprint/15/5/706?rss=1 2008-08-07 info:doi/10.1177/09697330080150051304 5 15 706 2008-09-01 706 Article http://nej.sagepub.com/cgi/reprint/15/5/707?rss=1 2008-08-07 info:doi/10.1177/0969733008092879 5 15 708 2008-09-01 707 Article