Knowledge development, technology and questions of nursing ethics.

This article explores emerging ethical questions that result from knowledge development in a complex, technological age. Nursing practice is at a critical ideological and ethical precipice where decision-making is enhanced and burdened by new ways of knowing that include artificial intelligence, algorithms, Big Data, genetics and genomics, neuroscience, and technological innovation. On the positive side is the new understanding provided by large data sets; the quick and efficient reduction of data into useable pieces; the replacement of redundant human tasks by machines, error reduction, pattern recognition, and so forth. However, these innovations require skepticism and critique from a profession whose mission is to care for and protect patients. The promise of technology and the new biological sciences to radically and positively transform healthcare may seem compelling when couched in terms of safety, efficiency, and effectiveness but their role in the provision of ethical nursing care remains uncertain. Given the profound moral and clinical implications of how today's knowledge is developed and utilized, it is time to reconsider the relationship between ethics and knowledge development in this new uncharted area.

The relationship amongst ethical position, religiosity and self-identified culture in student nurses.

BACKGROUND/PURPOSE: Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students' ethical position; no studies have been conducted in the United States on students' ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States. PARTICIPANTS AND RESEARCH CONTEXT OBJECTIVES: The study's two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students' level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated. RESEARCH DESIGN: A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA. ETHICAL CONSIDERATIONS: The study was approved by the Institutional Review Board at Adelphi University. RESULTS: Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents' place of birth, and if participants were US born. Students' level of education or participation in past courses on ethics did not influence idealism. CONCLUSIONS: The study's findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students' culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education.

The essential imperative of basic nursing education: an ethical discourse.

The presence of multiple educational pathways into professional nursing is not without ethical consequences. If the essential duty of nursing is to the patient then education must focus on teaching the highest provision of patient care. The humanities component of the baccalaureate provides both insight into the human condition and exposure to alternate problem-solving methodologies, both of which augment the nursing process and improve patient care. An argument is made that by not requiring more rather than less education, we ultimately fail the patient and thus, our ethical duty.

The ethics curriculum for doctor of nursing practice programs.

Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.

From intrusive to oscillating thoughts.

This paper focused on the possibility that intrusive thoughts (ITs) are a form of an evolutionary, adaptive, and complex strategy to prepare for and resolve stressful life events through schema formation. Intrusive thoughts have been studied in relation to individual conditions, such as traumatic stress disorder and obsessive-compulsive disorder. They have also been documented in the average person experiencing everyday stress. In many descriptions of thought intrusion, it is accompanied by thought suppression. Several theories have been put forth to describe ITs, although none provides a satisfactory explanation as to whether ITs are a normal process, a normal process gone astray, or a sign of pathology. There is also no consistent view of the role that thought suppression plays in the process. I propose that thought intrusion and thought suppression may be better understood by examining them together as a complex and adaptive mechanism capable of escalating in times of need. The ability of a biological mechanism to scale up in times of need is one hallmark of a complex and adaptive system. Other hallmarks of complexity, including self-similarity across scales, sensitivity to initial conditions, presence of feedback loops, and system oscillation, are also discussed in this article. Finally, I propose that thought intrusion and thought suppression are better described together as an oscillatory cycle.