Care and justice reasoning in nurses' everyday ethics

Area of Science:

• Nursing Ethics
• Moral Reasoning in Healthcare
• Professional Decision-Making

Background:

• Nurses employ ethics of care and justice for moral reasoning in ethical dilemmas.
• Understanding the types of dilemmas and reasoning used is vital for nursing practice.

Purpose of the Study:

• To identify common ethical dilemmas faced by nurses.
• To assess the extent to which nurses use care versus justice reasoning in resolving these dilemmas.

Main Methods:

• Cross-sectional survey design with 334 registered nurses and 177 practical nurses in Finland.
• Analysis of open-ended responses using an adjusted taxonomy of moral dilemmas and orientations.
• Statistical analysis of quantified data, including chi-squared tests and analysis of variance.

Main Results:

• Six types of ethical dilemmas were reported by nurses.
• Care reasoning was more prevalent in 'needs of others' and 'conflicting demands' dilemmas.
• Applying rules and 'needs of others' dilemmas were most common; practical nurses reported more non-ethical dilemmas.

Conclusions:

• Ethical dilemmas in nursing are diverse, with reasoning use varying by dilemma type.
• Care reasoning is key for patient needs, while justice reasoning applies to rules and procedures.
• Healthcare environments may favor justice reasoning, potentially hindering patient-centered care; education should promote ethical considerations.