Dialogical Nursing Ethics: the Quality of Freedom Restrictions

Abstract

This article deals with the question of how ethicists respond to practical moral problems emerging in health care practices. Do they remain distanced, taking on the role of an expert, or do they become engaged with nurses and other participants in practice and jointly develop contextualized insights about good care? A basic assumption of dialogical ethics entails that the definition of good care and what it means to be a good nurse is a collaborative product of ongoing dialogues among various stakeholders engaged in the practice. This article discusses the value of a dialogical approach to ethics by drawing on the work of various nursing scholars. We present a case example concerning the quality of freedom restrictions for intellectually disabled people. Issues for discussion include the role and required competences of the ethicist and dealing with asymmetrical relationships between stakeholders.

Nurses' views of shortcomings in patent care encounters in one hospital in Sweden

“…Sayers and de Vries (2008) state that a trusting relationship can be developed through maturity, experience, knowledge and awareness of the self and others, a result also described by the nurses in this study. A trusting relationship requires a dialogue with active listening and feedback that generate feelings of meaningfulness for both the patient and the nurse (Abma et al 2008, Ferrell & Coyle 2008. The nurses in this study noted the importance of dialogue and feedback instead of simply providing information to the patient.…”

“…A trusting relationship requires a dialogue with active listening and feedback that generate feelings of meaningfulness for both the patient and the nurse (Abma et al . , Ferrell & Coyle ). The nurses in this study noted the importance of dialogue and feedback instead of simply providing information to the patient.…”

Understanding respect: learning from patients

“…In addition, to the extent that mutual respect is viewed as a pre-condition for appropriate ethical decision-making procedures, conceptions of respect may help to identify and define the appropriate procedural conditions. Redefinition of a principle of respect for persons, however, would be less important on these accounts, given the fact that these traditions generally do not attempt to define and establish abstract principles 20 – 22…”

Moral margins concerning the use of coercion in psychiatry

“…Dialogical ethics supplements Haidts' model in that it claims that people can morally learn from each other in dialogue. 8,29 Perspectives of participants are bound by their specific view of a situation. In dialogue, a confrontation between perspectives can lead to the awareness that one's view is not necessarily right.…”

“…This is not an easy process, and care workers experience moral stress in deciding and conducting the morally appropriate action, [5][6] especially in deciding whether or not seclusion is needed. [7][8] Several values and norms are involved and might contradict, such as good care versus safety and autonomy versus beneficence. Developing a critical reflective stance towards one's moral perspectives and arguments that guide decisions may help to improve the quality of decisions and decision making processes.…”