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J Liaschenko

Publications and source records attributed to J Liaschenko.

32 records · Page 2Linked to original sources
PubMed1995

Artificial personhood: nursing ethics in a medical world.

Artificial persons are those who speak and act for others. Nurses speak and act for patients as well as for physicians and institutions, or, more aptly, institutionalized medicine. Yet, acting for institutionalized medicine can be harmful to nurses, due to the psychological experience of moral distress and the loss of integrity of their practice. This paper illustrates the harm to nurses as expressed in narratives of their practice, and suggests some initial steps we might take in resisting the artificial personhood imposed by institutionalized medicine.

Adult↗
PubMed1995

Ethical practice in a technological age.

Our culture highly values technology, and believes that technological solutions are the answer to most human problems. The role of nursing, however, is to hold foremost the overall well being of the patient and to advocate for the patient, not for the technology. This article discusses the technological imperative and its relationship to an ethical nursing practice.

Critical Care↗
PubMed1994

The moral geography of home care.

One result of the historical division of labor between nurses and physicians is that nurses became the eyes and ears of the physician, extending their perceptual capabilities across space and time. This "gaze of medicine" has evolved with the rise of technology, hospitals, and the medical profession to a sort of scientific totalitarianism. Protecting and enhancing patient agency, which is part of the moral work of nursing practice, can be difficult under such circumstances. Yet the geography of sickness is changing as patients move from the hospital back to the home. Because home is thought of as private, as the patient's domain, nurses may think that supporting patient agency will be easier with this transformation of health care. But that assumption may not be warranted since the gaze of medicine will follow patients and change the landscape of the home. The challenge for nursing will be to sharpen the "gaze of nursing," which is an antidote to the strictly biomedical understanding of disease.

Ecology↗
PubMed1993

Feminist ethics and cultural ethos: revisiting a nursing debate.

In this article the author re-examines from a feminist perspective the now well-known debate between Yarling and McElmurry and Bishop and Scudder. The central point of this critique is that a feminist ethics requires we attend to the social and institutional form of life in which given practices exist. The endorsement of a single concept, even the extremely important one of care, is insufficient for a nursing ethics. Without attention to the institutional factors, which support or reform care, we have only a feminine ethics. In this author's view, nursing needs a feminist ethics.

Culture↗
PubMed1991

Nurses and physicians on nutritional support: a comparison.

During the last decade, several court cases have focused attention on the moral and legal aspects of withholding or withdrawing food and fluids from certain patients. The courts have not been unanimous in their judgements on these matters. In attempting to explore this issue, this article reviews both the nursing and medical literature on the withdrawing and withholding of food and fluids with particular attention to empirical studies. Several themes which emerge from the literature are used to explore the similarities and differences between the practices of nursing and medicine where nutritional support is concerned.

Attitude of Health Personnel↗
PubMed1989

Changing paradigms within psychiatry: implications for nursing research.

A major shift in paradigms is occurring within contemporary psychiatry; the previously dominant psychological paradigm is being superseded by a biological paradigm. How should psychiatric nursing research respond to this challenge? The goal of this report is to explore three questions relevant to our answer: First, if we undertake a program of research in the neurosciences do we violate our profession's commitment to holism? Second, is there a danger that embracing the biological sciences will result in the loss of the art of psychiatric nursing? Third, what are the pros and the cons for patients and our profession in undertaking such a project? The author draws on the works of several scholars to explore these issues.

Holistic Health↗
PubMedDate not supplied

A sense of place for patients: living and dying.

In references to an individual, agency refers to the capacity of the individual for meaningful action. Protecting and nurturing patient agency is a central feature of nursing work. The moral ideals and aim of nursing practice reflect a commitment to the patient that includes the patient as central to the determination of what happens to her or him. Whereas we most commonly think of the capacity to make these determinations as autonomy, I use the term agency because autonomy is a complicated and contested issue within philosophy and ethics. In an earlier issue, I suggested that an understanding of place is important to ethics. This is so because different places or institutions do different kinds of work, have different values, endow ethical concepts with different meanings, are structured by different visions, and are controlled and influenced by different kinds of knowledge and power. All these factors work together to determine a person's agency within a given place or environment. For example, home care providers cannot act in patients' homes in the same way they can act in a hospital, and providers cannot act in a school the way they act in a hospital. At the same time, patients' power to act is constrained in the hospital in ways that it is not in their homes. In the following narrative of an experienced home care nurse, I examine the ethical concern that can result from a commitment to patient agency by home care providers.

Community Health Nursing↗