Dr. Sara T. Fry. Interview by Eve Henderson.
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Biomedical subjects
Publications and source records attributed to S T Fry.
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The teaching of ethics in nursing education has become increasingly important in recent years. While it was an important part of early nursing education, it nearly disappeared from the nursing curriculum during the 1950s and 1960s. The traditional method of ethics teaching, the Scientific Model, is no longer used in nursing education. However, the contemporary models of ethics teaching--the Moral Concepts Model, the Moral Issues Model, the Clinical Practice Model, and the Ethics Inquiry Model--are being implemented into baccalaureate, graduate, and doctoral education in nursing. Having different goals and employing different teaching methods, these models promise to achieve the overall goal for teaching ethics to nurses: to produce a morally accountable practitioner who is skilled in ethical decision making. The uses of these model are encouraged in all aspects of nursing education, regardless of type of curriculum and faculty preparation to teach ethics. Given the availability of ethics resources and faculty seminars/workshops on ethics teaching strategies, all or part of any of the models can be easily implemented in the majority of nursing education programs.
Clinical research involves a number of ethical issues for the nurse researcher and clinician. When new treatments, such as experimental drugs, are used in patient care, the issues of informed consent to treatment and the balancing of risks and benefits may be especially difficult to resolve. By understanding the functions and elements of informed consent, nurses can assist their patients to ask for and to comprehend the information they need to be truly and fully informed about treatment choices. Likewise, assessing the risks and benefits of an experimental treatment option, such as an experimental drug for the treatment of primary hypertension, may be important to the long-term health of patients. Nurses assist patient decision making and the assessment of relevant risks and benefits by being fully informed about the planned research and by applying knowledge of ethical principles to patient care. When nurses incorporate this type of ethical reflection and moral skill into nursing practice, they meet minimal moral obligations to patients.
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New technologies have dramatically increased the number of fetal abnormalities that can be detected and, in some cases, effectively treated during the prenatal period. Considering the potential health benefits to children and parents from early detection of fetal abnormalities, various forms of mandatory prenatal screening programs have been suggested. In order to explicate the ethical dimensions of mandatory screening in general and to demonstrate the role of nurses in prenatal screening programs, maternal serum alpha-fetoprotein screening is analyzed. The benefits, risks, and potential consequences from the broad use of this technology are discussed in conjunction with the rights of fetuses and pregnant women. An active role in the formation of health policy that might regulate new technologies affecting maternal-fetal-newborn health is suggested as a fundamental responsibility of the nursing profession.
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In this paper the ethical tension between the obligation to benefit the individual client and the obligation to benefit society is critically examined. Descriptions of both obligations in nursing practice as found in professional statements on practice standards, social policies and codes of ethics are discussed. Theoretical foundations for both ethical obligations are described and their implications for nursing practice are discussed. Since promoting one good over the other has serious implications for requirements of moral accountability in nursing practice, several strategies for the distribution of nursing resources and the balancing of the two obligations are proposed. It is concluded that meeting requirements for moral accountability in today's health care delivery system means being answerable for how the nurse determines the justifiability of promoting one good over the other and for articulating justifiable reasons for limiting the provision of either individual or aggregate good in specific nursing care situations.
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The purpose of this study was to identify the types of ethical conflict reported by certified registered rehabilitation nurses (CRRNs) and their relationship to demographic, educational, and practice-setting variables. Ethical conflicts expressed by CRRNs in active practice in Maryland, Virginia, and the District of Columbia were analyzed according to four themes. Disagreements about medical or institutional practice, patients' rights, and payment issues were the most frequent practice contexts for ethical conflicts, reflecting these nurses' considerable underlying concerns about resource allocation in rehabilitation practice. Participants believed that 60% of the ethical conflicts were resolved, frequently through discussions with other team members and patients' family members. Ethics committees and consultants were used infrequently. There were no statistically significant relationships between the kinds of conflicts or their resolution and the participants' demographic, educational, and practice-setting variables.
Research in Alzheimer disease (AD) is required to advance knowledge for the ultimate goal of finding a cure or prevention and to improve care for persons with AD and their caregivers. All research needs to be planned and conducted ethically, but research in AD has many ethical issues to consider due to the diminished cognitive capacity of potential subjects and genetic testing for AD. This paper describes the development of guidelines for ethical research, applying ethical principles to issues in human subjects research, and ethical issues in AD research. Important ethical questions must be addressed in AD research and basic moral and professional values will certainly be tested as the state of the science improves and research on AD, especially research involving genetic testing for the disease, becomes more acceptable and available.
The purpose of this pilot study was to identify types of ethical conflicts reported by Certified Diabetes Educators who also are Registered Nurses (RN/CDEs). Ethical conflicts expressed by RN/CDEs in active practice in Maryland, Virginia, and the District of Columbia were described by these healthcare professionals. Each conflict was analyzed according to three themes: the practice context, the ethical principles in conflict, and how the conflict was experienced by the nurse subject. The majority of ethical conflicts (75%) concerned disagreement with the quality of medical care the patient was receiving. The principles most often in conflict were beneficence and nonmaleficence. Most conflicts were experienced as dilemmas (two or more principles that seem to apply but support mutually inconsistent courses of action).