Caring ethics and a Somali reproductive dilemma.

The use of traditional ethical methodologies is inadequate in addressing a constructed maternal-fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma.

Principles for establishing trust when developing a substance abuse intervention with a Native American community.

This article traces the development of a research project with a Native American community. Four principles were used to guide the development of the "Community Partnership to Affect Cherokee Adolescent Substance Abuse" project using a community-based participatory research approach. The principles suggest that establishing trust is key when developing and conducting research with a Native American community.

Utilitarian and common-sense morality discussions in intercultural nursing practice.

Two areas of ethical conflict in intercultural nursing - who needs single rooms more, and how far should nurses go to comply with ethnic minority patients' wishes? - are discussed from a utilitarian and common-sense morality point of view. These theories may mirror nurses' way of thinking better than principled ethics, and both philosophies play a significant role in shaping nurses' decision making. Questions concerning room allocation, noisy behaviour, and demands that nurses are unprepared or unequipped for may be hard to cope with owing to physical restrictions and other patients' needs. Unsolvable problems may cause stress and a bad conscience as no solution is 'right' for all the patients concerned. Nurses experience a moral state of disequilibrium, which occurs when they feel responsible for the outcomes of their actions in situations that have no clear-cut solution.

Cultural safety and the socioethical nurse.

This article explores the social and ethical elements of cultural safety and combines them in a model of culturally safe practice that should be of interest and relevance for nurses, nurse educators and nurse ethicists in other cultures. To achieve this, the article briefly reviews and critiques the main underpinnings of the concept from its origins and development in New Zealand, describes its sociocultural and sociopolitical elements, and provides an in-depth exploration of the key socioethical elements. Finally, a model is presented to illustrate the strong connection between the social and ethical components of cultural safety that combine to produce culturally safe practice through the activities of a 'socioethical' nurse.

Ontologies of nursing in an age of spiritual pluralism: closed or open worldview?

North American society has undergone a period of sacralization where ideas of spirituality have increasingly been infused into the public domain. This sacralization is particularly evident in the nursing discourse where it is common to find claims about the nature of persons as inherently spiritual, about what a spiritually healthy person looks like and about the environment as spiritually energetic and interconnected. Nursing theoretical thinking has also used claims about the nature of persons, health, and the environment to attempt to establish a unified ontology for the discipline. However, despite this common ground, there has been little discussion about the intersections between nursing philosophic thinking and the spirituality in nursing discourse, or about the challenges of adopting a common view of these claims within a spiritually pluralist society. The purpose of this paper is to discuss the call for ontological unity within nursing philosophic thinking in the context of the sacralization of a diverse society. I will begin with a discussion of secularization and sacralization, illustrating the diversity of beliefs and experiences that characterize the current trend towards sacralization. I will then discuss the challenges of a unified ontological perspective, or closed world view, for this diversity, using examples from both a naturalistic and a unitary perspective. I will conclude by arguing for a unified approach within nursing ethics rather than nursing ontology.

Transcultural nursing: its importance in nursing practice.

Transcultural nursing is an essential aspect of healthcare today. The ever-increasing multicultural population in the United States poses a significant challenge to nurses providing individualized and holistic care to their patients. This requires nurses to recognize and appreciate cultural differences in healthcare values, beliefs, and customs. Nurses must acquire the necessary knowledge and skills in cultural competency. Culturally competent nursing care helps ensure patient satisfaction and positive outcomes. This article discusses changes that are important to transcultural nursing. It identifies factors that define transcultural nursing and analyzes methods to promote culturally competent nursing care. The need for transcultural nursing will continue to be an important aspect in healthcare. Additional nursing research is needed to promote transcultural nursing.

Breaching the wall: interviewing people from other cultures.

The interview as a data collection tool is an essential component of qualitative research. Many nurses are familiar with the process of interviewing through its use in the practice environment; however, in-depth interviewing for the purpose of research is a unique process. The ability to conduct an effective in-depth interview requires skill in the use of specific techniques, in particular when interviewing people from other cultures. A number of factors specific to the researcher, the participant, and the research context can affect the interview procedure. As global margins diminish, nurse researchers will increasingly find themselves working with people from ethnic groups that are different from the dominant culture. This article discusses strategies to improve the interview process in such circumstances. Techniques to enhance the process, along with avoidable potential pitfalls, will be illustrated using an example of conducting research with participants from the culturally diverse environment of Malaysian Borneo.

Practical strategies for providing culturally sensitive, ethical care in developing nations.

Providing health care in developing nations results in cultural and ethical challenges for health care professionals. The authors' intent is to raise readers' awareness of how to maintain an ethical and culturally sensitive approach to practice in developing nations. Four practical approaches to ethical decision-making, developed from the literature and praxis, in conjunction with traditional moral theory and guidelines from professional and international organizations are discussed. Ethical multiculturalism, a view that combines universalism and multiculturalism undergirds culturally appropriate and ethically responsive decisions.

Doing the right thing: nursing students, relational practice, and moral agency.

Registered nurses and nurse educators are often unaware of how nursing students experience the nursing profession. In the current practice climate of increased workloads, reduced funding, and higher patient acuity, nurse educators are likely to hear from colleagues how unprepared newly qualified nurses are for the needs of practice. It is difficult for many nursing students to see value in their practice because they become preoccupied with their perceived lack of knowledge and technical skills. Nurses and nurse educators should be aware of how this brands new graduates and informs their sense of developing professional identity. Despite their feelings of deficit in terms of skills and knowledge, it is clear that many nursing students are, in fact, effectively negotiating relational ethics. This article presents a collaborative account of the important relational work being undertaken by one group of nursing students in New Zealand.

[Care and anthropology: a thinking process]. / Soins et anthropologie; une démarche reflexive.

Caring for human beings, calls for relating unity and diversity in order to respect the equality of cultures and to recognize their cultural differences. Cultural difference is, however, privileged by recent publications within the culture caring domain, based on cultural relativism and disregarding the unity of humanity, transcultu-ral nursing theory is the case. For this reason, some historical elements related to the two original anthropological theories are included in this text to understand the philosophical and ethical implications of transcultural nursing theory. The objective of this article is to analyse six recent publications within the caring and anthropology field, through a reflexive method identifying two different caring traditions and demonstrating their philosophical and ethical reach for caring practice.

Compassionate nursing professionals as good citizens of the world.

Globalization is reshaping the world and its people. Nursing, likewise, is in the process of expanding its worldview to one that accommodates global care. The authors further articulate a global ethic for nursing by distinguishing 2 concepts: world citizenship, as described by Martha Nussbaum, which calls nurses to critically evaluate personal and culture-based beliefs, and compassionate professional, which calls nurses to nurture partnerships of mutual respect. It is also important that nursing participate and support professional and international organizations that address social injustices related to healthcare, poverty, and public health.

Spiritual assessment: developing an assessment tool.

Patients' 'spirituality' is widely considered to be a factor that nurses need to consider in their assessments. But Jeanette Power suggests ways in which assessments can be undertaken, and questions whether one assessment tool can prove adequate in measuring the significance of spirituality in the lives of individuals, all of whom may interpret its meaning differently?

Issues in patient education.

Nurses and nurse midwives have historically considered patient education one of their most important responsibilities. Increasingly, however, appropriate and comprehensive patient education has become more difficult to accomplish. There are many reasons for this, including the huge influx of clients of varying cultures into virtually all health care systems across the United States, the lack of time available for patient education in tightly scheduled managed care visits, the dearth of educational materials written at appropriate readability levels and/or in languages other than English, and the lack of reimbursement for time spent on patient education. In addition, many providers might not have specific training in the provision of patient education or in the development of appropriate health educational materials for the population they serve. This article discusses these issues, suggesting also that there are ethical dilemmas inherent in the provision of some aspects of patient education.