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Nurses play a role as advocates to assist patients and families struggling with complex information and difficult decisions. In particular, the fact that nurses encounter clinical situations that require ethical judgment highlights the need for nursing staff to gain knowledge and expertise in delivering care in an ethical manner. In this study, through reviewing empirical studies of hospital-based nurses' experiences, the author identified the ethical issues that nurses frequently face and the approaches that they have taken to solving them. The findings can serve to intensify the awareness of the ethical issues in both clinical and educational areas.
Keywords: ethical issues; nursing practice; education; hospitals
Advances in medical technology allow for better recovery for critically ill patients and dramatically extend the human life span. However, while advances bring benefits to patients and families, they simultaneously raise moral and ethical issues regarding respect for patient integrity and autonomy, soaring medical costs, quality care, and end-of-life decision making (Scanlon & Fleming, 1990; Wright, Cohen, & Caroselli, 1997). As the largest group of health care providers, nurses are frequently placed in unique positions to assist patients and families struggling with complex information and difficult decisions (Briggs & Colvin, 2002). The fact that nurses encounter clinical situations that require ethical judgment highlights the need for nursing staff to gain knowledge and expertise in delivering care in an ethical manner.
Reporting the lack of ethical confidence among newly graduated nurses, nursing ethics researchers have emphasizes the importance of having welleducated and well-qualified nurses who know how to find feasible solutions to ethical problems (Bunch, 2001; Woods, 2005). Although nursing schools have become more concerned with the ethical development of their students, researchers point out that education has not reflected reality and does not prepare newly qualifying nurses to deal effectively with a variety of ethical situations in the health care setting ( Woods, 2005). The traditional ethics education has tended to emphasize the acquisition of philosophical and theoretical knowledge and has created a gap between theory and practice ( Woods, 2005). New approaches are needed for teaching nursing ethics pragmatically.
The nursing ethic as a dynamic standard for nurses' professional moral behavior should address ethical issues confronted by nurses (Omery, Henneman, Billet, Luna-Raines, & Brown-Saltzman, 1995). Therefore, knowledge about...