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Nurses' responses to ethical dilemmas in nursing practice: meta-analysis
Bernadette Dierckx de Casterlé1, Shigeko Izumi, Nelda S Godfrey
1Centre of Health Services and Nursing Research, Catholic University Leuven, Belgium. bernadette.dierckxdecasterle@med.kuleuven.be
Journal of Advanced Nursing
|September 24, 2008
Summary
Nurses often rely on conventions rather than patient needs when facing ethical dilemmas, hindering ethical practice. Promoting nurses' ethical development beyond conventional reasoning is crucial for improved patient care.
Area of Science:
- Nursing Ethics
- Bioethics
- Professional Ethics
Background:
- Growing concern regarding nurses' ethical competence and ethical practice.
- Identified workplace barriers that compromise nurses' ethical performance.
- Limited understanding of nurses' ethical decision-making processes in daily care.
Purpose of the Study:
- To explore nurses' responses to ethical dilemmas in their daily practice.
- To investigate how nurses engage in ethical decision-making and action.
- To analyze ethical behavior patterns among registered nurses.
Main Methods:
- Meta-analysis of nine studies involving 1592 registered nurses across four countries.
- Utilized the Ethical Behaviour Test, adapted from Kohlberg's theory of moral development.
- Employed random-intercept regression analysis for data interpretation.
Main Results:
- Most nurses exhibited conventional ethical reasoning and practice, prioritizing conventions over patient needs.
- Expert nurses were an exception, showing different ethical reasoning patterns.
- Ethical dilemmas led nurses to rely on established norms rather than individual patient well-being.
Conclusions:
- Conformist practice, prioritizing conventions, impedes appropriate ethical actions due to lack of critical reflection.
- Urgent need to foster nurses' ethical development towards postconventional practice.
- Further research is required to bolster empirical evidence on nurses' ethical behavior.
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