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- Bremer, Anders, 1957-, et al.
(författare)
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Ethical values in emergency medical services : A pilot study
- 2015
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 22:8, s. 928-942
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ambulance professionals often address conflicts between ethical values. As individuals’values represent basic convictions of what is right or good and motivate behaviour, research is neededto understand their value profiles.Objectives: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure thepresence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles inSpain and Sweden.Methods: The instrument was translated and culturally adapted. A content validity index was calculated.Pilot tests were carried out with 46 participants.Ethical considerations: This study conforms to the ethical principles for research involving humansubjects and adheres to national laws and regulations concerning informed consent and confidentiality.Findings: Spanish professionals favoured justice and Swedish professionals’ rights in their ambulanceorganizations. Both countries favoured utilitarianism least. Gender differences across countries showedthat males favoured rights. Spanish female professionals favoured justice most strongly of all.Discussion: Swedes favour rights while Spaniards favour justice. Both contexts scored low onutilitarianism focusing on total population effect, preferring the opposite, individualized approach of therights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardizeambulance professionals’ moral right to make individual assessments based on the needs of the patientat hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justiceand rights perspectives portrayed in the survey mainly concern relationship to the organization and peerswithin the organization, this relationship might at worst be given priority over the equal treatment andmoral rights of the patient.Conclusion: A balanced view on ethical perspectives is needed to make professionals observant and readyto act optimally – especially if these perspectives are used in patient care. Research is needed to clarify howjustice and rights are prioritized by ambulance services and whether or not these organization-related valuesare also implemented in patient care.
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| 2. |
- Jiminez Herrera, Maria F, et al.
(författare)
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Some ethical conflicts in emergency care
- 2015
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Ingår i: Nursing Ethics. - : Sage Publications Ltd.. - 0969-7330 .- 1477-0989. ; 22:8, s. 928-942
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals. Aim: To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations. Methods: Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group. Ethical considerations: Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research. Result/conclusion: Two categories emerged: one in ‘ethical issues’ and one in ‘emotions and feelings in caring’. The four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse’s ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients’ care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with ‘end-of-life’ care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient’s ‘previous wishes’ in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient’s advocate. The nurses express feelings of distress, suffering, anger and helplessness.
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