Ethics in nursing: A systematic review of the framework of evidence perspective

Yıldız, Erman

doi:10.1177/0969733017734412

Cited by 26 publications

(19 citation statements)

References 58 publications

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“…We identified challenges that were predominantly related to specific scenarios or contexts rather than the general application of broader ethical principle frameworks. This finding of a context-focus is in line with systematic reviews examining ethics within dementia care 70 , 71 and nursing, 72 as well as individual studies in general practice, 11 community pharmacy, 73 Canadian hospitals, 74 renal medicine, 12 pain medicine 10 and generalist end of life care. 75 – 79 The focus on detail has been termed ‘microethics’, and proponents argue that this is the level at which most ethically challenging decision-making occurs.…”

Section: Discussionsupporting

confidence: 77%

Real-world ethics in palliative care: A systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice

et al. 2020

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Background: Ethical issues arise daily in the delivery of palliative care. Despite much (largely theoretical) literature, evidence from specialist palliative care practitioners about day-to-day ethical challenges has not previously been synthesised. This evidence is crucial to inform education and adequately support staff. Aim: To synthesise the evidence regarding the ethical challenges which specialist palliative care practitioners encounter during clinical practice. Design: Systematic review with narrative synthesis (PROSPERO registration CRD42018105365). Quality was dual-assessed using the Mixed-Methods Appraisal Tool. Tabulation, textural description, concept mapping and thematic synthesis were used to develop and present the narrative. Data sources: Seven databases (MEDLINE, Philosopher’s Index, EMBASE, PsycINFO, LILACS, Web of Science and CINAHL) were searched from inception to December 2019 without language limits. Eligible papers reported original research using inductive methods to describe practitioner-reported ethical challenges. Results: A total of 8074 records were screened. Thirteen studies from nine countries were included. Challenges were organised into six themes: application of ethical principles; delivering clinical care; working with families; engaging with institutional structures and values; navigating societal values and expectations; philosophy of palliative care. Challenges related to specific scenarios/contexts rather than the application of general ethical principles, and occurred at all levels (bedside, institution, society, policy). Conclusion: Palliative care practitioners encounter a broad range of contextual ethical challenges, many of which are not represented in palliative care ethics training resources, for example, navigating institutional policies, resource allocation and inter-professional conflict. Findings have implications for supporting ethical practice and training practitioners. The lack of low- and middle- income country data needs addressing.

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Section: Discussionsupporting

confidence: 77%

Real-world ethics in palliative care: A systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice

et al. 2020

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“…25 A study in the Netherlands suggested that treatment should generally be considered conditional and if the treatment fails, it could be abandoned. 26 It is noted that for all healthcare providers who have the decisive role in end of life decisions, euthanasia and decision making on the provision of care can create serious ethical problems 27 and needs to be discussed in more details in future studies.…”

Section: Discussionmentioning

confidence: 99%

Physicians’ and nurses’ decision making to encounter neonates with poor prognosis in the neonatal intensive care unit

et al. 2020

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Background Decision making regarding the treatment of neonates with poor prognoses is difficult for healthcare staff working in the neonatal intensive care unit (NICU). This study aimed to investigate the attitudes of physicians and nurses about the value of life and ethical decision making when encountering neonates with poor prognosis in the NICU. Methods This cross-sectional study was conducted in five NICUs of five hospitals in Tehran city, Iran. The attitudes of 144 pediatricians, gynecologists and nurses were assessed using the questionnaire of attitude toward the value of life and agreement on intensive care management based on three hypothetical case scenarios of neonates with poor prognosis. Data were analyzed using descriptive and inferential statistics via the SPSS software. Results The negative agreement on the no initiation of intensive care measures and the discontinuation of resuscitation in neonates with poor prognosis was more than the positive agreement. Also, various factors influenced the participants’ decision making for the provision of care to neonates. Regarding the case scenarios, the participants agreed on the provision of aggressive, conservative, and palliative care with various frequencies. This study confirms the importance of healthcare providers’ perspectives and their impacts on ethical decision making. The participants favored the value or sacredness of life and agreed on the use of all therapeutic measures for saving the lives of neonates with poor prognosis. Conclusion More studies are required to improve our understandings of factors influencing ethical decision making by healthcare providers when encountering neonates with poor prognosis in NICUs.

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“…Nineteen studies recommended new/additional guidelines and frameworks for managing challenges regarding information within the clinical context; 23 studies specifically recommended more ethics training that focuses on improving health professionals' competence in different contexts (Beck et al, 2008;Cantini & Ells, 2007;Chih et al, 2016;Duval et al, 2004;Martin et al, 2014Pye, 2013. Yildiz (2019), for example, recommended additional professional ethics training for nurses so that these professionals can better understand the ethical aspects of nursing. This will also enhance their competence in managing ethical dilemmas.…”

Section: Moral Reasoning and Influencing Factorsmentioning

confidence: 99%

How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies

2021

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Aim This study is a systematic review that aims to assess how healthcare professionals manage ethical challenges regarding information within the clinical context. Method and Materials We carried out searches in PubMed, Google Scholar and Embase, using two search strings; searches generated 665 hits. After screening, 47 articles relevant to the study aim were selected for review. Seven articles were identified through snowballing, and 18 others were included following a system update in PubMed, bringing the total number of articles reviewed to 72. We used a Q-sort technique for the analysis of identified articles. Findings This study reveals that healthcare professionals around the world generally employ (to varying degrees) four broad strategies to manage different types of challenges regarding information, which can be categorized as challenges related to confidentiality, communication, professional duty, and decision-making. The strategies employed for managing these challenges include resolution, consultation, stalling, and disclosure/concealment. Conclusion There are a variety of strategies which health professionals can adopt to address challenges regarding information management within the clinical context. This insight complements current efforts aimed at enhancing health professional-patient communication. Very few studies have researched the results of employing these various strategies. Future empirical studies are required to address this. Abbreviations CIOMS: Council of International Organization of Medical Sciences; WHO: World Health Organization; AMA: American Medical Association; WMA: World Medical Association; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ISCO: International Standard Classification of Occupations; ILO: International Labour Office; SPSS: The Statistical Package for the Social Sciences

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Ethics in nursing: A systematic review of the framework of evidence perspective

Cited by 26 publications

References 58 publications

Real-world ethics in palliative care: A systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice

Real-world ethics in palliative care: A systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice

Physicians’ and nurses’ decision making to encounter neonates with poor prognosis in the neonatal intensive care unit

How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies

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