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Nursing Ethics E-Book

Nursing Ethics E-Book

Ian E. Thompson | Kath M. Melia | Kenneth M. Boyd | Dorothy Horsburgh

(2006)

Additional Information

Book Details

Abstract

This title is directed primarily towards health care professionals outside of the United States. The authors have developed a holistic approach that explores: ethics in hospital and community settings, inter-disciplinary teamwork, ward and hospital management, nursing research, performance management and the political ethics of nursing administration, health service re-structuring and reform. The content has been substantially revised for this edition and significant new material added to reflect developments in theory and practice.

  • covers a wide range of ethical issues - much more than just ‘clinical' dilemmas and decision-making skills
  • a down-to-earth and practical approach to applied ethics
  • user-friendly layout
  • material on moral theory kept to a minimum (but dealt with thoroughly at the end of the book)
  • focuses on ethical issues in nursing and case studies taken from nursing practice i.e. the concrete concerns of nurses and other front-line workers
  • pedagogical features include: chapter aims, learning outcomes and further reading for possible essay, tutorial and project topics
  • also useful as a general work of reference on ethic in health care
  • An up-to-date analysis of professions in the context of modernity, to enable health professionals to make sense of global cultural & social developments
  • An analysis of the ethics of evidence-based practice
  • An examination of professional accountability and ethics in performance management to help practitioners/managers understand the ethical basis of management
  • useful web links and teaching notes on a dedicated website: http://evolve.elsevier.com/Thompson/nursingethics/

Table of Contents

Section Title Page Action Price
Front Cover Cover
Nursing Ethics iii
Copyright Page iv
Contents v
Preface and acknowledgements ix
Introduction - Ethics in nursing — continuity and change 1
Ethics in nursing today 2
Changes with a bearing on nursing ethics 3
Preparation for practice 4
Professional accountability and the lay perspective 5
‘Nursing ethics’ or ‘healthcare ethics’? 6
Change and continuity 6
The perennial and current issues in nursing 7
The relevance of research in nursing and applied ethics 8
Teaching ethics in nursing 9
The place of moral theory in practical nursing ethics 11
Competency-based training and virtue ethics 14
Structure of the book 14
Further reading 16
Part 1: Cultural issues, methods and approaches to nursing ethics 17
Chapter 1. Nursing ethics: historical, cultural and professional perspectives 19
Part A: Nursing, professions and history 20
The history and logic of professionalism 21
The growth of modern professions 21
Loss of trust 22
Modernity 22
Scapegoating 24
Responding to the current challenges to professionalism 24
Part B: Foundations of ethics — religious, cultural and philosophical 26
Sources of inspiration for ethics 26
Quest for the foundations of ethics 27
Shared and changing values 28
Cultural diversity and common ethical principles 29
Constitutive and regulative principles in ethics 31
Conflict, change and stability in human life and values 32
Further reading 34
Chapter 2. Nursing ethics – what do we mean by ‘ethics’? 35
Part A: Ethics – issues of power and responsibility 36
Ethics and the ethos of a community 36
Individual and social dimensions of ethical responsibility 36
Changing perceptions of the relationship of the individual and community 38
Ethics and politics – questions of power and questions of principle 39
Different levels or spheres of responsibility 40
Part B: Ethics – some basic conceptual distinctions and definitions 42
What do we mean by ‘ethics’ and/or ‘morals’? 42
Considering what ethics is and is not 42
The relations between right and wrong, good and bad, virtue and vice 44
The structure of moral action and moral theory 45
Moral problems and moral dilemmas 47
Making ethical decisions we can justify 49
Fundamental ethical principles 52
Fundamental ethical principles in the context of healthcare 53
Confronting three types of moral relativism 55
Further reading 57
Part 2: Socialisation, professionalisation and nursing values 59
Chapter 3. Becoming a nurse and member of the profession 61
Introduction — sociological perspectives on nursing and ethics 62
Nursing: informal and professional 63
The role of the media 64
Conceptions of care 67
Socialisation: care settings 70
Reflection on practice 73
Further reading 76
Chapter 4. Power and responsibility in nursing practice and management 77
Power and moral responsibility 78
Four models for the ethics of carer–client relations 87
Power relations in interprofessional teamwork 94
Further reading 99
Chapter 5. Professional responsibility and accountability in nursing 101
Introduction 102
Accountability: what does it mean in practice for nurses? 102
Codes of ethics and conduct 104
Accountability for assessment of students 108
Nurses and industrial action 111
Codes of conduct/ethics: summary 112
Conclusion 114
Further reading 115
Part 3: Nursing ethics – issues in clinical practice 117
Chapter 6. Classical areas of controversy in nursing and biomedical ethics 119
What are the ‘big’ ethical dilemmas for nurses? 120
Caring and the duty of care in nursing ethics 121
The vital importance of the specific case 124
General rules and particular moral decisions 125
The ‘big issues’ in a wider nursing context 127
Our different value-judgements about health 128
The ‘medicalisation of life’ and the ‘big dilemmas’ 131
Individual ‘health careers’ and professional control 134
Some classical issues in biomedical ethics 136
Further reading 151
Chapter 7. Direct responsibility in nurse/patient relationships 153
Introduction – the rights and duties of nurses and patients 154
Rights and duties of nurses in dealing with patients 161
The rights of patient as people 164
Telling the truth to patients or relatives 168
Deciding between therapeutic and palliative care 171
Further reading 176
Chapter 8. Conflicting demands in nursing groups of patients 177
Personal autonomy versus the common good 178
Balancing the rights of patients with the interests of third parties 190
Further reading 198
Part 4: Ethics in nursing management, research and teaching 201
Chapter 9. Ethics in healthcare management: research, evaluation and performance management 203
Ethical responsibilities in management 204
What is meant by evaluation in healthcare? 207
Different types of research design and their ethical rationales 209
Evidence-based practice and continuous quality improvement 215
Different ethical responsibilities at different levels in management 217
Four models for the ethics of management 220
Further reading 225
Chapter 10. The political ethics of healthcare: health policies and resource allocation 227
The political ethics of health care 228
Thinking about health in a global context 229
Thinking about health in a national context 233
Frameworks for policy-making on resource allocation and management 239
Some practical dilemmas of resource allocation in healthcare 245
Further reading 258
Chapter 11. Corporate ethics in healthcare: strategic planning and ethical policy development 259
Accountability in healthcare – strategic ethical management 260
Strategic management of the National Health Service 260
Developing ethical policy in healthcare 262
Strategic ethical management and clinical governance in healthcare 269
Strategic planning and strategic ethical management 271
Identification and involvement of stakeholders 272
Are there limits to the state’s responsibility for healthcare? 274
Different ethical and political rationales for reform of healthcare 276
Evaluating the New Right’s and New Labour’s reforms of the NHS 281
Further reading 290
Part 5: Ethical decision-making and moral theory 293
Chapter 12. Making moral decisions and being able to justify our actions 295
Having to take a moral decision 296
Conscience, feeling, intuition and moral judgement 298
Does a good moral agent need sound methods or sound character? 301
Approaches to teaching ethics 305
Classical approaches to ethical decision-making 310
Problem-solving models for clinical and ethical decisions 314
Moral agency – when are we responsible for our actions? 323
Further reading 328
Chapter 13. The relevance of moral theory: justifying our ethical policies 331
The relevance of moral theory 332
Varieties of moral theory 335
Deontological ethical theories – focus on principles, rights and duties 336
Pragmatic ethical theories – focus on means and methods 342
Teleological ethical theories – focus on ends, goals and consequences 350
Moral theory and the structure of moral action 356
Moral theory and the goal of social consensus 357
Further reading 359
References 361
Glossary 379
Author Index 399
Subject Index 403