Letting and making death happen: is there really no difference? The problem of moral linkage.
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Four years ago, as colleagues in our university's law and medical schools, we designed and began offering a course for law, medical, and nursing students, studying professionalism and professional ethics by reading and discussing current and earlier images of nurses, doctors, and lawyers in literature. We wanted to make professional ethics, professional culture, and professional education the objects of study rather than simply the unreflective consequences of exposure to professional language, culture, and training. We wanted to do it in an interdisciplinary course where aspiring professionals could share their self-conceptions and their conceptions of each other, and we wanted to do it by using stories, our primary means for organizing experience and claiming meaning for it. This article tells the story of that experience: why we did it; how we did it; what we learned from doing it.
A comprehensive review of research using the Judgment About Nursing Decisions (JAND) as a measure of nurses' ethical decision making raises numerous concerns about the conceptual basis, reliability, and validity of this widely used instrument. These concerns promoted the present study, which raised specific issues about the JAND. Among these issues are the representatives of ethical dilemmas contained in the JAND, the validity of its scoring scheme, the persistence of low-to-marginal reliability across studies, and questionable validity. Findings from studies using the JAND should be interpreted with caution until the instrument is further refined.
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