Australia II: A Case Study in Engineering Ethics.

Australia II became the first foreign yacht to win the America's Cup in 1983. The boat had a revolutionary wing keel and a better underwater hull form. In official documents, Ben Lexcen is credited with the design. He is also listed as the sole inventor of the wing keel in a patent application submitted on February 5, 1982. However, as reported in New York Times, Sydney Morning Herald, and Professional Boatbuilder, the wing keel was in fact designed by engineer Peter van Oossanen at the Netherlands Ship Model Basin in Wageningen, assisted by Dr. Joop Slooff at the National Aerospace Laboratory in Amsterdam. Based on telexes, letters, drawings, and other documents preserved in his personal archive, this paper presents van Oossanen's account of how the revolutionary wing keel was designed. This is followed by an ethical analysis by Martin Peterson, in which he applies the American NSPE and Dutch KIVI codes of ethics to the information provided by van Oossanen. The NSPE and KIVI codes give conflicting advice about the case, and it is not obvious which document is most relevant. This impasse is resolved by applying a method of applied ethics in which similarity-based reasoning is extended to cases that are not fully similar. The key idea, presented in Peterson's book The Ethics of Technology (Peterson, The ethics of technology: A geometric analysis of five moral principles, Oxford University Press, 2017), is to use moral paradigm cases as reference points for constructing a "moral map".

Between mandatory and aspirational ethics in nursing codes: a case study of the Italian nursing code of conduct.

BACKGROUND: Over the years, national and international nurses' organisations have drawn up Codes of Conduct and Codes of Ethics. A new differentiation has emerged over time between mandatory and aspirational approaches underlying how nurses can be supported by documents with rules to be respected (mandatory ethics) or by incentives (aspirational ethics). However, to date, no research has applied these approaches to analyse available Codes and to identify which approach are predominantly used. METHODS: In this case study, the Italian Nursing Code of Conduct (NCC), published in 2019, composed of 53 articles distributed in eight chapters, was first translated, and then analysed using a developed matrix to identify the articles that refer to mandatory or aspirational ethics. A nominal group technique was used to minimise subjectivity in the evaluation process. RESULTS: A total of 49 articles addressing the actions of the individual nurse were considered out of 53 composing the NNC. Articles were broken down into 97 units (from one to four for each article): 89 units (91.8%) were attributed to a unique category, while eight (8.2%) to two categories according to their meaning. A total of 38 units (39.2%) were categorised under the mandatory ethics and 58 (59.8%) under the aspirational ethics; however, one (1.0%) reflected both mandatory and aspirational ethics. CONCLUSIONS: According to the findings, the Italian Professional Body (FNOPI) has issued a modern code for nursing professionals in which an aspirational perspective is dominant offering a good example for other nursing organisations in the process of updating their codes when aimed at embodying an aspirational ethics.

A systematic review documenting reasons whether physicians should provide treatment to their family and friends.

BACKGROUND: Physicians are likely to be asked to provide medical care to relatives or friends. Evidence suggests that most physicians treat loved ones during their active years. However, in the academic literature, critical approaches to the matter are dominating. Ethical guidelines often discourage physicians from treating family members and friends outside of exceptional circumstances. OBJECTIVE: This systematic review aims to identify reasons for and against treating family and friends as portrayed in the literature published. METHODS: A search string designed for the database "PubMed," snowball sampling, and hand searching was used to identify possibly eligible publications. Seventy-six publications were screened for all reasons presented in favour of and against physicians treating loved ones. Qualitative content analysis was used for data extraction. Combining a deductive and inductive approach, a coding system was developed. RESULTS: Many publications analysed represent articles portraying personal experiences; fewer show original research. Reasons against and in favour of treating family and friends were identified. Several publications specify conditions under which the treatment of loved ones may be legitimate. The reasons identified can be assigned to a micro or macro level of human interaction. CONCLUSIONS: This systematic review shows that the discourse of physicians treating loved ones is held predominantly in the context of personal experiences. The majority of authors seem to have a rather pragmatic interest in the topic, and systematic or analytic approaches are rare. While most authors mention various codes of ethics, several publications criticize these or consider them insufficient.

Ethical guidelines, such as the Code of Medical Ethics of the American Medical Association, ask physicians not to treat their family members and friends. However, studies show that most physicians are confronted with loved ones asking for medical interventions during their careers. The divide between the ethical guidelines and the physicians' actual practice demonstrates the ethical dilemma at hand. In this systematic review, literature addressing the topic of physicians treating family and friends (PTFF) is analysed. The majority of publications voice concerns about PTFF. A common reason against PTFF is the risk of losing objectivity. Other publications endorse PTFF, mentioning, for example, the possibility of saving costs. Specific situations in which PTFF is justified are presented as well. The analysis of publications on the topic indicates a rather clinical approach, less of a philosophical one. Several authors criticize too little assistance in this matter of the ethical guidelines. The examination of the existing literature on the topic of PTFF suggests that, as the circumstances are very context-specific, a universal answer applying to each case of PTFF will hardly be found.

Development and validation of the code of ethics for midwives in Iran.

BACKGROUND: Considering ethical issues in midwifery care is essential for improving the quality of health services and the client's satisfaction. This study aimed to develop and validate the code of ethics for Midwives in Iran (ICEM). MATERIALS AND METHODS: This was a mixed sequential study that was performed in three phases including a qualitative study, a review, and the content validity assessment. The first phase was a qualitative study with a content analysis approach. The data were collected by conducting in-depth semi-structured individual interviews with 14 midwifery and ethics experts. The purposive sampling method was used to recruit the participants and sampling continued until data saturation. The data were analyzed using the conventional content analysis described by Graneheim and Lundman. Lincoln and Guba's criteria were used to confirm the trustworthiness of the data. Then, a narrative review of the selected national and international codes of ethics for Midwives was performed to complete the items of the ICEM. For validity assessment, the face and content validity of the items of ICEM was assessed by 15 experts to calculate the content validity ratio (CVR) and index (CVI). RESULTS: Fourteen experts were interviewed in the qualitative phase, and 207 codes were extracted from a content analysis which were categorized into 23 sub-categories and 6 main categories. The extracted codes were considered as the items for ICEM that were completed by a review of the selected national and international code of ethics for Midwives. The content validity and ratio assessment of the items demonstrated an average CVI = 0.92 and CVR = 0.85. Then, the final version of ICEM was developed with 92 items in 6 domains about; 1) "professional Commitments" with 30 items; 2) "providing midwifery services to the client and her companions" with 26 items; 3) "relationship with colleagues" with 11 items; 4) "herself" with 6 items; 5) "education and research" with 8 items; and, 6) "management" with 11 items. CONCLUSION: ICEM was prepared with 92 items in six sections that facilitate its use for midwives who are working in the different fields of care, counseling, education, research, and management. In this new version of the ICEM, the items related to recent social-, scientific, and technical improvements were considered for providing ethical midwifery care.

Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity.

This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change.

Scientific consensus views are useful, but dangerous, without a code of ethics.

Using the Fukushima accident experience, this letter discusses recent efforts on measuring scientific consensus views-that is, quantifying the agreement among scientists. In the field of radiological protection, the efforts to measure scientific consensus views deserve attention, because hoaxes have been spreading even after the Fukushima nuclear accident. We discussed two points. First, the visualization of the diversity of scientific opinions shatters the diversity illusion caused by the mass media's irresponsible dissemination of pro and con arguments. Second, the use of scientific consensus views without an ethical code is dangerous. Measuring scientific consensus views should be accompanied with the development of ethical guidelines on using it.

Professional responsibility, nurses, and conscientious objection: A framework for ethical evaluation.

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of the nurse and of those who must evaluate such claims. We synthesized the framework using Rest's Four Component Model of moral reasoning along with tenets of the International Council of Nursing's (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action.

Current approaches and future directions for addressing ethics in infant and early childhood mental health.

In this paper, we consider whether the field of infant and early childhood mental health (IECMH) needs its own code of ethics. We begin by describing unique features of infant and early childhood mental health (IECMH) and the diverse strategies that the field has developed to address complex clinical dilemmas, among them workforce development, clinical supports, policy statements, and statements of ethical values. Because of the field's interdisciplinary nature, we also consider how various contributing professions and organizations address ethical issues. While these are important resources that can inform ethical decision-making, we identify some of the limitations of the current approaches. We argue that it is time for the field of IECMH to take an intentional, systematic approach to directly address the complex and unique ethical dilemmas faced by infant and early childhood mental health practitioners, and we grapple with some of the challenges developing such a code might entail. We suggest several avenues for better understanding the scope of ethical issues and ethical decision-making processes in IECMH that could be used to support developing an ethics code that is responsive to the unique and challenging world of infant and early childhood mental health.

En este estudio, consideramos si el campo de la salud mental infantil y la temprana niñez (IECMH) necesita su propio código de ética. Comenzamos describiendo características distintivas de la salud mental infantil y la temprana niñez (IECMH) y la diversidad de estrategias que el campo ha desarrollado para tratar los complejos dilemas clínicos, incluyendo el desarrollo de la fuerza laboral, los apoyos clínicos, las afirmaciones de las políticas, así como las afirmaciones de valores éticos. Debido a la naturaleza interdisciplinaria del campo, también consideramos cómo varias profesiones y organizaciones que aportan contribuciones tratan los asuntos éticos. Aunque estos son recursos importantes que pueden servir de apoyo para la toma de decisiones éticas, identificamos algunas de las limitaciones de los acercamientos en el presente. Sostenemos que es el momento de que el campo de IECMH asuma un acercamiento intencional, sistemático que directamente trate los complejos y distintivos dilemas que enfrentan quienes ejercen en la práctica profesional de la salud mental infantil y la temprana niñez, y nos enfrentemos con algunos de los retos que el desarrollo de tal código pudiera significar. Sugerimos varias maneras de comprender mejor el ámbito de los asuntos éticos y los procesos éticos de toma de decisiones en IECMH con el fin de apoyar un código de ética que tome en cuenta el distintivo y desafiante mundo de la salud mental infantil y la temprana niñez.

Dans cet article nous réfléchissons et étudions si le domaine de la santé mentale du nourrisson et de la petite enfance (IECMH) a besoin de son propre code d'éthique. Nous commençons par la description des traits uniques de la santé mentale du nourrisson et de la petite enfance (IECMH) et de la diversité de stratégies que notre domaine a développées afin de faire face à des dilemmes cliniques complexes, y compris pour ce qui concerne la formation du personnel, les soutiens cliniques, les déclarations de principes, et les déclarations de valeurs éthiques. Du fait de la nature pluridisciplinaire de notre domaine, nous évoquons également la manière dont différentes professions et différentes organisations qui contribuent à notre domaine abordent les problèmes éthiques. Sachant que ce sont là des ressources importantes qui peuvent informer nos décisions éthiques, nous identifions certaines des limitations des approches actuelles. Nous faisons valoir qu'il est temps que le domaine de l'IECMH aborde intentionnellement et systématiquement les dilemmes éthiques complexes et uniques auxquels font face les praticiens de la santé mentale du nourrisson et de la petite enfance, et nous nous attaquons à certains des défis qu'un tel code peut présenter. Nous suggérons plusieurs directions afin de mieux comprendre l'étendue des questions éthiques et des processus de prises de décision éthiques au sein de l'IECMH de façon à soutenir un code éthique qui est sensible au monde unique de la santé mentale du nourrisson et de la petite enfance ainsi qu'aux défis auxquels il fait face.

Nurses and global health responsibility: In light of the COVID-19 pandemic and the war in Ukraine.

AIM: The aim of this paper was to reflect on global ethical challenges for nurses in light of the COVID-19 pandemic and the war in Ukraine and to discuss 'Nurses and Global Health', a new element in the revised ICN Code of Ethics for Nurses, 2021, and its implications for nurses. BACKGROUND: The authors participated in the latest revision of the Code. When we were revising the ICN Code of Ethics, there was neither an ongoing pandemic nor a war in Europe. SOURCES OF EVIDENCE: Relevant scientific articles and other academic literature, documents from international organisations, and authors' views. DISCUSSION: The discussion emanated from our reflections on how to actually apply the ICN Code of Ethics, i.e., moving the words from the document itself into everyday practice, in light of the COVID-19 pandemic and the war in Ukraine. In the Code, the nurse's responsibility is highlighted, but there is little or no instruction on how to undertake it. CONCLUSION AND IMPLICATIONS FOR NURSES: The ICN Code of Ethics needs to be operationalised through ethical reflection and discussion in all contexts where nurses work, from policy level to the care environment.

Clinical Ethics and Professional Integrity: A Comment on the ASBH Code.

The Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants instructs clinical ethics consultants to preserve their professional integrity by "not engaging in activities that involve giving an ethical justification or stamp of approval to practices they believe are inconsistent with agreed-upon standards" (ASBH, 2014, p. 2). This instruction reflects a larger model of how to address value uncertainty and moral conflict in healthcare, and it brings up some intriguing and as yet unanswered questions-ones that the drafters of the Code, and the profession more broadly, should seek to address in upcoming revisions. The objective of this article is to raise these questions as a way of urging greater clarification of the Code's overall approach to professional integrity, its meaning, and implications.

Codes of ethics for psychiatrists: past, present and prospect.

BACKGROUND: Codes of ethics in medicine have an ancient tradition, extending back to the Oath of Hippocrates. Yet it was only in the early 1970s that the speciality of psychiatry developed a specific code to address the unique ethical dilemmas and complexities arising in psychiatric practice. As the 50th anniversary of the publication of psychiatry's first code of ethics approaches, it is timely to reflect on the progress, role, and impact of such codes.Our aim is to provide a historically informed review of codes of ethics in psychiatry - their origins and evolution, the current picture, and the possibilities for future development. METHODS: We conducted a selective review of relevant literature (including all codes of ethics accessible on the websites of World Psychiatric Association members states), analysis of the form and content of codes and related documents in psychiatry, and interviews of psychiatrists who have played central roles in their evolution. RESULTS: Of the 143 WPA member states, only 15 codes of ethics for psychiatrists were identified, and few of these were associated with professional disciplinary processes. We found that these codes are rarely revised and sometimes supplemented with other statements and guidelines. CONCLUSIONS: While there are difficulties in measuring the direct effectiveness of codes of ethics on the practice of psychiatrists, we conclude that these codes help to (1) promote professional solidarity and autonomy, (2) enhance moral sensitivity, and (3) aid in psychiatric education and training.

Practice of code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021: a mixed-method study design.

BACKGROUND: Ethics is the science of moral and ethical rules recognised in human life and attempts to verify what is morally right and wrong. Healthcare ethics is seen as an integrated part of the daily activities of health facilities. Healthcare professionals' standardisation and uniformity in healthcare ethics are urgent and basic requirements. Therefore, this study aimed to assess the practice of the code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021. METHODS: A facility-based cross-sectional study design with a mixed method was conducted on 631 health professionals from Central Gondar Zone public hospitals. For the quantitative part, pre-tested self-administered questionnaires were used, and for the qualitative part, key informant interviews with a semi-structured questionnaire were used. Variables with a p value of < 0.2 in binary logistic regression entered into a multivariable logistic regression, then p value < 0.05 and AOR were used to declare statistically significant variables in quantitative data. A thematic content analysis was used for qualitative data analysis. RESULTS: This study revealed that only 286 (46.7%) health professionals had good practice of the code of ethics. Good ethical knowledge (AOR = 1.95, 95% CI 1.37, 2.77), favourable attitude (AOR = 1.55, 95% CI 1.11, 2.16), and satisfaction of health professionals with their jobs (AOR = 1.45, 95% CI (1.04, 2.04) were significantly associated with the practice of health care ethics. CONCLUSIONS: Health professionals' overall level of practice of health care ethics in the Central Gondar Zone public hospitals was poor. This necessitates practical training, ongoing follow-up, availing of necessary medical equipment, a smooth working environment, and modification of the recognition system for health professionals.

The effectiveness of online team-based learning in introduction to medical ethics education for medical students at a medical college of Nepal: a pilot study.

BACKGROUND: The effectiveness of online classes is always a concern, and it can be overcome by opting for active learning strategies like team-based learning (TBL). This study was conducted to find out the effectiveness of online TBL as an active learning strategy. We also aimed to explore the satisfaction and perception of students toward TBL. METHODS: This is a mixed-method study conducted among 29 third-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students of Gandaki Medical College using purposive sampling method in the duration of January to September 2021. Three two hours online TBL sessions were used for teaching introduction to medical ethics. The individual readiness assurance test (IRAT) scores were compared to the group readiness assurance test (GRAT) scores to evaluate the effect of TBL through cooperative learning. Learner reactions and satisfaction of students towards TBL were assessed using a validated questionnaire comprising of a five-point Likert scale. An open-ended question asking the participants to describe their overall experience of the TBL sessions was also included to explore their perceptions towards TBL. The data were collected using Google form and exported to Microsoft Excel and the quantitative data were then analyzed using Statistical Package for Social Sciences (SPSS) version 16.0. To check the normal distribution of the data, Kolmogorov Smirnov and Shapiro-Wilk test were used. Non-parametric tests were used for the non-normally distributed data. P value of < 0.05 was regarded as significant. Thematic analysis was conducted for the qualitative data. RESULTS: The median GRAT scores were significantly higher (p = 0.006 in TBL 1 and 0.001 in TBL 2) than IRAT scores. Learner reactions toward TBL sessions were positive as shown by the mean scores which were in the range of 3.59 to 4.66. Five themes were generated from the codes: "effective learning method", "positive experience", "gained knowledge", "expression of gratitude" and "the way of conduction of the sessions". CONCLUSION: Online TBL in medical ethics was effective as a teaching learning tool in our setting. The students were satisfied with the learning process and rated the learning strategy positively.

Does midwifery-led care demonstrate care ethics: A template analysis.

BACKGROUND: Ethical care in maternity is fundamental to providing care that both prevents harm and does good, and yet, there is growing acknowledgement that disrespect and abuse routinely occur in this context, which indicates that current ethical frameworks are not adequate. Care ethics offers an alternative to the traditional biomedical ethical principles. RESEARCH AIM: The aim of the study was to determine whether a correlation exists between midwifery-led care and care ethics as an important first step in an action research project. RESEARCH DESIGN: Template analysis was chosen for this part of the action research. Template analysis is a design that tests theory against empirical data, which requires pre-set codes. PARTICIPANTS AND CONTEXT: A priori codes that represent midwifery-led care were generated by a stakeholder consultative group of nine childbearing women using nominal group technique, collected in Perth, Western Australia. The a priori codes were applied to a predesigned template with four domains of care ethics. ETHICAL CONSIDERATIONS: Ethics approval was granted by the Edith Cowan University research ethics committee REMS no. 2019-00296-Buchanan. FINDINGS: The participants generated eight a priori codes representing ethical midwifery care, such as: 1.1 Relationship with Midwife; 1.2 Woman-centred care; 2.1 Trust women's bodies and abilities; 2.2. Protect normal physiological birth; 3.1. Information provision; 3.2. Respect autonomy; 4.1. Birth culture of fear (midwifery-led care counter-cultural) and 4.2. Recognition of rite of passage. The a priori codes were mapped to the care ethics template. The template analysis found that midwifery-led care does indeed demonstrate care ethics. DISCUSSION: Care ethics takes into consideration what principle-based bioethics have previously overlooked: relationship, context and power. CONCLUSION: Midwifery-led care has been determined in this study to demonstrate care ethics, which suggest that further research is defensible with the view that it could be incorporated into the ethical codes and conduct for the midwifery profession.

The 30th anniversary of the code of ethics of the Royal Australian and New Zealand College of Psychiatrists-a worthy milestone.

OBJECTIVE: To appraise the evolution of the RANZCP's Code of Ethics on the occasion of its 30th anniversary. METHOD: We scrutinised its five editions, focussing on the revision procedure and changes made, and reviewed relevant literature. RESULTS: The procedure of revision has remained constant: incorporating feedback from college members, committees and faculties, and consulting professional medical bodies and mental health advocacy organisations. Seven major themes of change have emerged with respect to patient exploitation, recognition of family and carers, the special place of Indigenous Peoples, confidentiality, engaging patients in decision-making, multidisciplinary collaboration and the well-being of psychiatrists. CONCLUSIONS: The code has proved to be a dynamic instrument in keeping abreast of changes in psychiatry and society, and promises to maintain a prominent role in promoting high ethical standards in the profession.

Medical Assistance in Dying (MAiD) Care Coordination: Navigating Ethics and Access in the Emergence of a New Health Profession.

Medical assistance in dying (MAiD) in Canada is a complex, novel interprofessional practice governed by stringent legal criteria. Often, patients need assistance navigating the system, and MAiD providers/assessors struggle with the administrative challenges of MAiD. Resultantly, the role of the MAiD care coordinator has emerged across the country as a novel practice dedicated to supporting access to MAiD and ensuring compliance with regulatory requirements. However, variability in the roles and responsibilities of MAiD care coordinators across Canada has highlighted the need for accountability and standardization for this practice. This manuscript constitutes a first attempt to describe this emerging role, through discussion of proposed standards of practice, as well as roles and responsibilities, and ethical duties of this emergent professional practice. We detail the core commitments of MAiD care coordinators to patients, providers/assessors and institutions involved in the MAiD process. We address the core competencies that inform the unique skillset required by MAiD care coordinators to facilitate high-quality care, while highlighting the moral and ethical considerations embedded in this work. To illustrate the complexity of the MAiD care coordinator role, case examples involving ethical dilemmas encountered in practice are included. Finally, a code of ethics is proposed to serve as a guide for appropriate professional practice and conduct. This manuscript is intended to illustrate the importance of transparency and accountability for this new role that provides service to vulnerable patients and families; this is especially critical as the ethical complexity of MAiD is likely to increase with future changes in legislation opening MAiD access to new populations.

Nursing ethics in an era of pandemic.

BACKGROUND: The ANA Code of Ethics for Nurses, regularly revised since 1896, may not provide guidance in an era of pandemic and sociopolitical unrest. PURPOSE: This study explored whether the Code of Ethics comprehensively address current nursing challenges. METHODS: 23 nurses participated in six Zoom focus groups to discuss whether provisions were applicable to their current practice. An iterative approach was used to review transcripts independently and then merge findings to identify ethical themes. FINDINGS: Provisions 4, 6, and 8 were most relevant. None of the provisions addressed the guilt secondary to isolating patients from support systems and not being "on the front lines" of COVID care. DISCUSSION: The co-occurring crises of COVID-19 and social unrest created an ethical crisis for many nurses. The Code of Ethics provided a useful guide for framing discussion and formulating strategies for change, but did not eliminate distress during a time of novel challenges.

A qualitative examination of graduating nurses' response to the Covid-19 pandemic.

BACKGROUND: Currently, graduating nurses face pandemic-related uncertainty including gaps in risk perception, unexpected Covid-19 moral dilemmas, and distress surrounding personal health risk. RESEARCH QUESTION/AIM/OBJECTIVES/METHOD: The purpose of this basic qualitative descriptive study is to describe the willingness of graduating nurses to provide care during the Covid-19 pandemic. PARTICIPANTS AND RESEARCH CONTEXT: One week prior to graduation, students were required to submit a written assignment describing willingness to practice in light of the ongoing pandemic. ETHICAL CONSIDERATIONS: This study was approved by an Institutional Review Board. FINDINGS/RESULTS: Eighty-four (n = 84) assignments were used for analysis. Of these, 82% (n = 69) of the graduating nurses describe a willingness to voluntarily care for Covid-19 patients. After summarizing narrative responses, two themes emerged including self-assessment of personal and familial risk and conflicting obligations. DISCUSSION: The assessment of risk to self and family are key in determining whether graduating nurses will care for Covid-19 patients. Conflicting obligations may contribute to stress and uncertainty potentially leading to early burnout. CONCLUSION: Findings from this study can inform academicians of the need to adequality prepare graduating nurses for Covid-19-associated risks and ethical decision making. Organizations should alter residencies and orientation to support the needs of new nurses.

European Nursing Council Code for European nursing and the UN Sustainable Development Goals.

A code of ethics for the practice of nursing seeks to capture, in a written document, the normative values, ethical principles and standards of good care to guide nurses - qua moral agents. A codification of the accepted collective values of nursing can play a constitutional and directional role for the profession. It can further stimulate discussions about nursing that reflect the dynamic essence of the profession. Consequently, there is merit to continually reflecting on a code's function and role especially when a new or revised code is introduced to the nursing profession and the wider public such as the European Nursing Council's Code of Ethics and Conduct for European Nursing. This paper examines codes of ethics in general and the European Nursing Council Code in particular using the framework of Gaumnitz and Lere. Although the European Nursing Council Code has all the ingredients of a contemporary professional ethics code, our position is that future iterations or addenda to this Code should be aligned to the UN Sustainable Development Goals and take a more radical step in becoming an exemplar of a nursing code that can be a catalyst for the advancement of the Sustainable Development Goals.

[Between care for others and self-care: intensive care nursing in times of the COVID-19 pandemic]. / Intensivpflege in Zeiten der COVID-19 Pandemie: Zur Frage des Verhältnisses von Fürsorge und Selbstsorge.

DEFINITION OF THE PROBLEM: The COVID-19 pandemic poses a considerable challenge to the capacity and functionality of intensive care. This concerns not only resources but, above all, the physical and psychological boundaries of nursing professionals. The question of how care for others and self-care of nurses in intensive care units are related to each other in the context of the COVID-19 pandemic has not been addressed in public and scientific discourse so far. ARGUMENTS: The present contribution reflects this relationship with reference to the Code of Ethics of the International Council of Nurses, particularly considering principlism and the Care Ethics according to Joan Tronto. As a result, it shows a corridor of ethically justifiable care with several borders, above all: (1) self-care must not be given up completely for the benefit of care for others, and (2) a categorical subordination of care for others to self-care is ethically not justifiable. CONCLUSION: The article makes an important contribution to a differentiated ethical consideration of the rights and responsibilities of intensive care nurses as moral actors within the pandemic in Germany. It, thus, provides a first starting point for a broad social and political discourse which is urgently needed not only during but also after the pandemic in order to improve the situation of intensive care nurses and those who are cared for.