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Abstract: The new theoretical ethical framework is a general frame or tool for ethical agents, developed to guide ethical reasoning during public health emergency preparedness and response. The TEF is based on the assumption that no existing ethical discourse in medical ethics alone is sufficient to address ethical issues of a PHE. The solutions suggested by existing approaches are limited in practicability and effectiveness, because they cannot address root problems and interplay among ethical problems. The reason for this insufficiency rests on the argument that ethical problems of PHEs have causal and reciprocal relationships, and any ethical decision-making framework should provide a wide enough perspective to consider relevant ethical norms and theories to suggest practical, implementable, coherent solutions compatible with the communal values and cultural norms. The TEF we suggest for PHEs embraces a holistic and integrated ethical perspective that enables us to comprehend that ethical problems that arise in various settings caused by PHE phenomena are in relationship with each other instead of addressing them as a standalone problem. The TEF provides decision-makers to achieve a coherent web of considered judgements compatible with ethical values and principles in various settings. This type of conceptualization offers a wide perspective to see causal and relational relationships among problems and produce outcomes that would not be possible by eclectic approaches.
Resumen: El nuevo Marco Ético Teórico (MET) es una estructura general o herramienta para eticistas, desarrollada para guiar el razonamiento ético durante la preparación y respuesta a emergencias de salud pública (ESP). Supone que no existe un discurso ético en la ética médica que por sí solo sea suficiente para abordar temas éticos de ESP. Las soluciones sugeridas de aproximaciones existentes son limitadas en la práctica y en la efectividad, debido a que no pueden abordar problemas de raíz sin considerar las interacciones entre los problemas éticos. Esta insuficiencia es porque los problemas éticos de ESP tiene relaciones causales y recíprocas, y cualquier estructura de toma de decisiones éticas debería proporcionar una perspectiva suficientemente amplia como para considerar normas éticas y teorías relevantes, y sugerir soluciones prácticas que sean coherentes y compatibles con valores comunes y normas culturales. El MET que sugerimos para ESP abarca una perspectiva ética integral e integrada, que posibilita la comprensión de que los problemas éticos que surgen en varías situaciones causadas por fenómenos ESP se hallan en relación entre ellos, en vez de abordarlos como un problema aislado. El MET proporciona a los que toman decisiones el lograr una red coherente de juicios compatibles con los valores y principios éticos en varias situaciones. Este tipo de conceptualización ofrece una amplia perspectiva para ver relaciones causales y relacionales entre problemas y producir resultados que no serían posibles mediante aproximaciones eclécticas.
Resumo: O novo referencial ético teórico (NT: TEF, sigla em inglês) é um referencial geral ou instrumento para agentes éticos, desenvolvido para guiar o raciocínio ético durante o preparo e resposta a emergências de saúde pública (NT: PHE, sigla em inglês). O TEF é baseado na suposição de que nenhum discurso ético existente em ética médica sozinho é suficiente para abordar aspectos éticos de uma PHE. As soluções sugeridas pelas abordagens existentes são limitadas em praticabilidade e efetividade, porque elas não podem abordar problemas fundamentais e inter-relacionar problemas éticos. A razão para essa insuficiência repousa no argumento de que problemas éticos de PHEs têm relações causais e recíprocas, e qualquer referencial para tomada de decisão ética deve propiciar uma perspectiva ampla o suficiente para considerar normas e teorias éticas relevantes para sugerir soluções práticas, implementáveis e coerentes, compatíveis com valores comunitários e normas culturais. A TEF que sugerimos para PHEs abarca uma perspectiva ética holística e integrada que nos permite compreender que os problemas éticos que surgem em diversos ambientes causados pelo fenômeno da PHE estão em relação entre si, ao invés de abordá-los como um problema isolado. O TFE propicia a tomadores de decisões alcançar uma rede de julgamentos considerados compatíveis com valores e princípios éticos em ambientes diversos. Esse tipo de conceitualização oferece uma perspectiva ampla para observar relações causais e relacionais entre problemas e produzir desfechos que não seriam possíveis por abordagens ecléticas.
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Humans , Public Health/ethics , Decision Making/ethics , COVID-19 , Bioethics , Disaster Preparedness , PandemicsABSTRACT
Based on the characteristics of BOPPPS mode,this article discussed its application.Following the teaching mode of BOPPPS,teachers can adjust teaching objectives and plans according to the students' needs.With the modularization of the teaching mode of BOPPPS,the students' interests can be stimulated so as to explore things initiatively,which was conducive to training students' ability of ethical decision-making and professional spirit.Finally,the teaching mode of BOPPPS assessed the learning effect with post-tests so as to enhance the effectiveness of medical ethics teaching.
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This paper explores in brief history and development of nursing ethics in the past decades in China. In the past ten years, many original articles and textbooks are published and academic communication is active in the area of nursing ethics. Currently China nursing ethics has set up its concepts framework, and formed the ethical problem-based research paradigm, and published its ethical guideline. This paper concludes with recommendations for improving the quality of nursing ethics research in contemporary China.
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Objective To explore the effect of organizational commitment and leader-member exchange on ethical decision-making in nurses. Methods 520 nurses were questionnaired by the Chinese Employees′ Organizational Commitment Scale,Leader-Member Exchange Scale and the Ethical Decision-making Scale. Results The total scores of organizational commitment and leader-member exchange and ethical decision-making in nurses were respectively (2.11 ± 0.39), (3.54 ± 0.51), (286.62 ± 20.14) points. Pearson correlation analysis showed that the scores of organizational commitment and leader-member exchange were positively correlated with ethical decision-making (r=0.352-0.464,P<0.05). Hierarchical regression analysis showed that leader-member exchange, opportunity commitment and affective commitment, economic commitment could explain 35.3%of the total variance of ethical decision-making in nurses. Conclusions The organizational commitment and leader-member exchange are the influencing factors of ethical decision-making in nurses.
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Objective To investigate the posttraumatic stress disorder(PTSD) and ethical decision-making in nurses suffered workplace violence, and analyze the relmionship between them. Methods Totally 340 nurses suffered workplace violence were questionnaired by the PTSD Scale and the Ethical Decision- making Scale. Results The incidence rate of PTSD was 17.06%(58/340), the total score of PTSD was (38.77± 13.57).The scores of ideal ethical practice, actual ethical practice and ethical decision- making in the PTSD group were 121.36±8.33, 105.56±7.76, 226.92±15.52, and were significantly lower than that in the non-PTSD group (140.60±9.01, 117.65±8.41, 258.27±16.73) (t=-14.996, -10.015, -13.153, P < 0.01). The score of PTSD was negtively correlated with the scores of ideal ethical practice, actual ethical practice and ethical decision- making (r=-0.415, -0.431,-0.420, P < 0.05). Conclusions The PTSD probably occurred after workplace violence, nursing administrators should pay close attention to the PTSD and therefore improve nurses′ethical decision-making.
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Objective To investigate the level of the clinical nurses' critical thinking disposition and the competence about nursing ethical decision making,and analyze the relationship between them.Methods A total of 359 clinical nurses were recruited by stratified random sampling method.They were investigated with general situation questionnaire,critical thinking disposition inventory-Chinese version (CTDI-CV) and judgment about nursing decisiors(JAND).Results The total score of CTDI-CV was (285.06±26.79),the total score of JAND was(267.91±16.62).The influencing factors of clinical nurses' competence about nursing ethical decision making was education background,ways of obtaining occupational knowledge,training of nursing ethical decision.The clinical nurses' competence about nursing ethical decision making was positively correlated with critical thinking disposition.Conclusions The level of clinical nurses' critical thinking disposition and competence about nursing ethical decision making are medium,in order to improve the level of competence about nursing ethical decision making,both school education and the continue education among hospital should strengthen the training of nurses' critical thinking disposition.
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En el siglo XXI, el reto para la medicina es utilizar nuevamente términos, como filantropía y filotecnia, para la práctica clínica contemporánea, ya que estos términos se adaptan a nuestro actual entendimiento de que la medicina basada en valores y la medicina basada en evidencias deben ir siempre de la mano. Nuestro propósito es proponer un método integral de deliberación ética que implique una visión holística de los dilemas éticos en la práctica clínica de la pediatría.
A challenge for 21st century medicine is to rediscover the value of philanthropy and philotechnia in contemporary clinical practice because both are terms that adapt to our more current understanding of how value-based medicine and evidence-based medicine must always go "hand in hand." Our proposal is to offer an integral ethical deliberation method that implies a holistic view of the ethical dilemmas in pediatric clinical practice.
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El objetivo de este trabajo es revisar las teorías de toma de decisiones en general y en bioética, identificando teorías normativas y descriptivas. Se argumenta sobre la necesidad de desarrollar modelos basados en el conocimiento empírico disponible y en presupuestos antropológicos claros, en el que las emociones son consideradas como un aspecto inseparable de la cognición (racionalidad). Estos modelos permitirán comprender mejor la acción moral de la persona humana.
We review general decision making theories and in bioethics, identifying those normative and descriptive theories. I argue about the need to develop models, based in empiric research and in anthropologica arguments, in which emotions are considered along with cognition. These models will help to understand better moral action.
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Humans , Cognition , Decision Making , Emotions , Ethics, MedicalABSTRACT
PURPOSE: This study was conducted to study on 1) What is nursing students' experience of ethical problems involving nursing practice? 2) What is nursing students' experience of using ethical decision-making models? METHOD: In order to answer these two questions, we selected 97 senior baccalaureate nursing students from two Korean universities using a conceptual framework and method of content analysis. RESULT: From 97 ethical problems emerged five content categories, the largest being ethical problems involving health professionals (69%); the basic nature of the nursing students' experience of ethical problems consisted of conflict, resolution, and rationale; 94% of the students stated that using an ethical decision-making model was helpful. CONCLUSION: Although additional research is needed, these findings have important implications for nursing ethics education and practice.
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Humans , Education , Ethics, Nursing , Health Occupations , Nursing , Students, NursingABSTRACT
This article discusses the issues of the practice of medical ethics.It expounds the significance of the clinical practice of medical ethics and how to carry out medical ethics in clinical practice from the perspective of medical ethics,ethical decision-making,ethical practice,as well as ethics supervision.