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PubMedDate not supplied

Ethical decision making in a bureaucratic context by senior nursing students.

This study examined the priorities reflected in the decisions reported by 775 senior baccalaureate nursing students in 16 Midwestern colleges and universities when presented a case depicting an ethical dilemma in nursing practice. In small groups of five each, the students arrived at a course of action to take in dealing with the dilemma. Categories for classifying responses were derived from the literature in nursing ethics. Categories used in content analysis of responses were: (1) patient-centered responses, (2) physician-centered responses, and (3) bureaucratic-centered responses. The small groups of students made from 3 to 17 decisions trying to resolve the dilemma, with a mean number of 8 decisions per group. Of the 1,163 decisions, 9% were in the patient-centered category, 19% were in the physician-centered category, and 60% were in the bureaucratic-centered category. Select characteristics of participants were examined for relationships to group responses. Group responses did not differ significantly by education, clinical experience, previous experience with a similar dilemma, or RN status of group members. Students agreed on the first steps to take to resolve the dilemma, but achieved no consensus about where the nurse's responsibility ended. Examining the decisions made by nurses in response to an ethical dilemma is important in arriving at a better understanding of the relationship between ethical problems in professional practice and the influence of social organizations or bureaucracies on nursing roles.

Decision Making↗
PubMedDate not supplied

Ethics and the physician.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1993

An assessment of ethical sensitivity: implications for interdisciplinary education.

The purpose of this study was to examine the relationship between discipline-specific knowledge and ethical sensitivity among health professions students, as related to different levels of education. Specifically, the study addressed the question, do health professions students, grouped according to their disciplines and levels of education, differ in their ethical sensitivity to selected discipline-specific ethical dilemmas? Subjects included 48 senior students from the disciplines of dental assisting, dental hygiene, and dentistry, and the disciplines of surgical technology, respiratory therapy, and medicine. Dental and nondental disciplinary groups represented the certificate, associate degree, and graduate levels of education. Differences between and among groups' ethical sensitivity scores, as derived from the Dental Ethical Sensitivity Test (DEST), were statistically analyzed. Results of the study indicated that, given dental-related case studies, students with discipline-specific knowledge in dentistry did not differ in ethical sensitivity from students who did not possess discipline-specific knowledge in that field. However, the results also demonstrated that students enrolled at different levels of education did differ significantly in ethical sensitivity, regardless of discipline-specific knowledge in dentistry. These findings have implications for teaching applied professional ethics in health professions education, from an interdisciplinary perspective.

Allied Health Personnel↗
PubMed1995

Medical ethics education: past, present, and future.

This paper examines undergraduate medical ethics education in the United States during its 25-year history. Included is a brief description of early efforts in medical ethics education and a discussion of the traditional model of ethics teaching, which emphasizes the knowledge and cognitive skills necessary for ethical decision making. The authors also discuss alternatives to the traditional model that focus more directly on students' personal values, attitudes, and behavior. Current areas of consensus in the field are then explored. Finally, the authors identify three incipient trends in medical ethics education--toward increased emphasis on everyday ethics, student ethics, and macroethics. Throughout the paper, examples of specific courses and curricula are used to illustrate the modes and trends described.

Curriculum↗
PubMedDate not supplied

Medical students' understanding of ethical issues in the ambulatory setting.

BACKGROUND: The education of medical students concerning ethical issues focuses mainly on critically ill hospitalized patients. However, in the outpatient setting physicians encounter many problems that require ethical decision making. The present study is an assessment of medical students' awareness and understanding of ethical issues commonly encountered in the ambulatory setting. METHODS: A questionnaire was designed to evaluate general knowledge of medical ethics using 12 clinical vignettes. These vignettes depict situations in the ambulatory setting which involve ethical problems. The questionnaire was distributed to medical students who were asked to state whether an ethical issue was present, its significance, and what the specific issue was. RESULTS: Students' abilities to identify that an ethical issue was involved in each vignette ranged from 34.2% to 96.4%. A majority of students identified the presence of an ethical dilemma in seven out of 12 vignettes. The significance rating varied from 2.8 to 4.4 on a scale of 1 to 5. The results indicate that traditional education in medical ethics does not necessarily prepare students to recognize these problems in the clinical setting. CONCLUSIONS: The medical students surveyed for this study seem to be variably prepared to recognize obvious ethical dilemmas in the ambulatory setting. Medical education must prepare students to recognize and appropriately manage these commonly encountered situations.

Beneficence↗
PubMed1994

Ethical dilemmas of nurse executives. Part 2.

A nationwide survey of nurse executives found that they experience ethical dilemmas about a wide range of topics, that resources used to resolve dilemmas are varied and diverse, and that dilemmas are experienced in many situations. The most important factors influencing decisions that have implications were the superiors of the nurse executives and the politics within the institution. In Part 1 (JONA, July/August 1994), the method, quantitative results, and conflict based on role were discussed. In this part, the author discusses the results from the open-ended questions and the implications.

Attitude of Health Personnel↗
PubMed1994

Psychiatry and the death penalty: the landmark Supreme Court cases and their ethical implications for the profession.

The U.S. Supreme Court has made a number of recent rulings in regard to the death penalty that will likely have the effect of increasing the use of psychiatry during the trial and sentencing process in capital cases. Any such changes are bound to increase the number of ethical dilemmas faced by psychiatrists involved in such work. The rulings affecting psychiatry include: (1) The Eighth Amendment forbids the execution of persons who are mentally incompetent in regard to their ability to appreciate the reasons for punishment. (2) A mentally-ill prisoner may be forcibly given neuroleptics if he presents a danger to himself or others. (3) Forced medication may not be used during the trial and sentencing phase if it has the potential to change the defendant's demeanor significantly enough to affect his defense. (4) Aggravating psychological factors affecting a convictee may be balanced against mitigating factors in considering whether death sentence should be imposed. (5) The psychosocial impact of the crime upon the victim's family may be presented during the sentencing phase as factors relevant to sentencing. (6) Adolescents and retarded individuals are not immune from the death penalty simply by virtue of their age or level of intelligence.

Age Factors↗