Nursing, Ethics, & Professional Roles

By Hilliard, Marie T. | The Hastings Center Report, January-February 1990 | Go to article overview

Nursing, Ethics, & Professional Roles


Hilliard, Marie T., The Hastings Center Report


Nursing, Ethics, & Professional Roles

There is growing concern that the teaching of ethics in nursing education programs, which has traditionally followed a medical model dictating that nurses follow directives given to them from medicine, does not adequately address the special issues raised for nurses by conflicts of accountability to conscience, the state, employers, physicians, patients, and their profession itself. Do nurses and physicians share opinions as to the role of the nurse in ethical decision-making? Are philosophers, who frequently teach ethics to nursing students, cognizant of what nurses perceive they need to know for ethical decisionmaking?

A recent study identified the curriculum content that advocates of nursing ethics believe will foster development of ethical decision-making skills among baccalaureate nursing students. Lawyers, philosophers, physicians, practicing nurses, and professional nurse educators were asked to rate such specific topics as patient autonomy and human experimentation for desirability for inclusion in nursing ethics curricula, and to suggest additional desirable content. Participants were also asked to give rationales for their evaluations of the various topics. Although more nurse educators initiated and completed the study, levels of agreement were determined by percentages of agreement within professional subgroups and by overall percentages of agreement. Therefore, there was a control for differences in subgroup size.

The survey results indicate that these professional subgroups do not share a common view of nursing ethics. Philosophers and physicians, in particular, offered responses quite different from those of practicing nurses and nurse educators. Content items related to the patient's right to autonomy frequently were identified as desirable nursing ethics content by total group opinion. For example, privacy was ranked first by overall opinion ratings of desirability. However, this item was rated only somewhat desirable to desirable by philosophers. The content item identified by this study which evoked the least agreement was the ethical theory of utilitarianism, although it was the only ethical theory evoking agreement on desirability among the participants. …

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