The basic nature of ethical problems experienced by persons with acquired immunodeficiency syndrome: implications for...

The purpose of this research was to describe and examine the basic nature of ethical problems that are experienced by persons with acquired immunodeficiency syndrome (AIDS). The participants were 25 persons with AIDS and 5 significant persons, not infected with the human immunodeficiency virus, who provided contextual understanding. The conceptual framework and method combined ethical inquiry and phenomenology. During an in-depth audiotaped interview, each participant answered the question, "What situation involving AIDS has caused you the most conflict about the right thing to do?" To assure scientific adequacy, the participant validated the analysis of the first interview in a second interview 2 weeks later, and five experts and two independent judges validated the combined analyses. From 117 ethical problems emerged a basic nature consisting of (1) conflict of values about what to believe, who to be, and what to do; (2) resolutions based on intuitive beliefs, desire to be a good person, and rational choice; and (3) rationale revolving around a desire for integrity and meaning. The findings suggest strategies for improving nursing ethics education and, ultimately, nursing practice: (1) base content on ethics research and philosophical analysis, (2) address real-life ethical problems, (3) discuss virtue ethics in addition to principled thinking and ethical caring, and (4) teach ethical listening.