Justice, Care, and Integrated Concerns in the Ethical Decision Making of Nurses

Abstract

Past research on the ethical decision making of nurses has used Kohlberg's model of moral reasoning, which does not adequately ad-dress issues of caring. The present study builds on the work of Gilligan, Brown, and colleagues to describe issues of moral concern, including justice, care, and integrated concerns. Nurses in the present study articulated justice concerns for fairness, patients' rights, and autonomy. They also stated care concerns for a patient's needs, pain, emotional support, and relationship. Beyond these, nurses expressed concerns that integrated a principled approach (justice) to caring for patients (care) in dealing with issues of deceit and trust, advocacy, and patient dignity in dying. Whereas many earlier studies reported low moral reasoning scores for nurses, the present analysis shows nurses involved in complex and sophisticated ethical considerations and decisions. The analysis also reveals professional constraints on those ethical decisions.

Understanding the experiences and service needs of siblings of individuals with first‐episode psychosis: a phenomenological study

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Developing services for the carers of young adults with early‐onset psychosis – listening to their experiences and needs

“…Data from the interviews were analysed using the responsive‐reader method (Sherblom et al . 1993, Porter 2000).…”

Charting the course of change

“…An attempt was made to achieve consensus by using a group of independent scrutineers to interpret meaning from comments. Sherblom et al (1993) supports this approach in order to allow the 'multiple voices of subjects' to be heard rather than narrowly focusing on the specific issues that the researcher had already decided upon. This entailed several readings of the questionnaires in order to become attuned to the participants' viewpoints, followed by theme searching and verification by external observers.…”