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Showing 5 results for Ethical Decision-Making
Evaluation and comparison of conventional ethical decision-making models in medicine
Mansoure Madani, Saeedeh Saeedi Tehrani,
Volume 9, Issue 1 (5-2016)
Abstract

Moral dilemmas are among the most important challenges in medical ethics. Dilemmas can occur frequently during a physician’s career and if physicians lack the ability and skills to solve them, they may be pushed to unethical behavior. Bioethics experts have always been concerned with solving ethical dilemmas in the medical profession and facilitating physicians’ decision-making process. Therefore, they often try to find useful and practical solutions by combining the views of different schools of ethics. Designing decision-making models is part of their effort to apply ethics in medicine. It is impossible to solve dilemmas without acquiring the necessary skills, and the ability to apply a decision-making model can be part of the training process.

These models aim to facilitate ethical decision-making in the field of health care by providing various frameworks. This article aims to introduce and evaluate the popular models of ethical decision-making in medicine in the hope of helping physicians choose appropriate solutions when faced with moral challenges. By presenting the advantages of applying the model approach and offering a brief introduction to popular models, the article recommends applying the approach in analyzing and resolving ethical dilemmas. Although the models each have their advantages and disadvantages, becoming proficient in their application will facilitate ethical decision-making for physicians.


A review of the evolution and challenges in nursing role development
Shamsa Ahmadian, Jamileh Mokhtari,
Volume 9, Issue 6 (3-2017)
Abstract
Nursing role development was created to response to the challenge of balancing supply and demand in healthcare system. The aim of this study is to examine the evolution in nursing role development and subsequent experience in dealing with the challenges in the world. In this study, electronic resources were searched till to 2015 by English keywords contain 'Role development' and 'Nursing role' in combination and individually. Data were extracted from articles that were more relevant. This study found two approaches regarding nursing role development. First, the role extension that relates to progressing in the field of medicine and the traditional functions of physicians, and the role expansion that implies any enlargement of the nurse's role within the boundaries of nursing education, theory and practice. In many countries that seek to expansion/extension of the nurses’ role. However, despite the shortage that exist in nursing and also because of the increased workload of nurses, caused employment of workers with lower skills and in result multiple significantly challenges have been experienced.  In our country, nursing role development has not considerable progress. The current situation does not provide enough infrastructures such as the licensing professional qualification and data-based decision-making from monitoring the effect of changes on the quality of care. Therefore, decision-making about the implementation of any changes in the nursing profession and its role development, must be accomplished very prudential with regard to all aspects of the professional Ethics.
 

Evaluating the Level of Ethical Decision Making of Nurses and Its Relationship with the Attitudes of End-Of-Life Care of Patients with COVID-19
Mohammad Torabi, Mahsa Eslamipanah,
Volume 14, Issue 0 (3-2021)
Abstract
Nurses are among the members of the treatment team who have the most contact with Corona Virus Disease- 2019 (COVID-19) patients and their ethical decision-making is inevitable during patient care. On the other hand, nurses' motivation to implement end-of-life care is influenced by their attitude, awareness, and moral reasoning. The aim of this study was to investigate the level of ethical decision making of nurses and its relationship with the attitudes of end-of-life care of patients with COVID-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2021. In this study, 180 nurses working in hospitals affiliated to Hamadan University of Medical Sciences were selected by convenience sampling method. Data collection tools included: demographic Information questionnaire, Nursing Dilemma Test (NDT) questionnaire, and Frommelt Attitudes towards End-of-Life Care questionnaire. According to the results, there is a direct relationship between nurses' ethical decisions and the attitude of end-of-life care (<0.05, r=0.819). The mean score of nurses' ethical decision-making indicates the low level of ethical decision-making (39.19 (5.3)) and the mean score of nurses' practical considerations (20.62(4.2)) showed that the process of nurses' ethical decision-making is relatively influenced by environmental factors. Also, the average score of nurses' exposure to moral challenges indicates that nurses are familiar with similar situations. The mean score of nurses' attitudes toward end-of-life care was reported at an undesirable level (81.58(7.8)). According to the results, by identifying the factors affecting nurses' ethical decision-making and educational planning to improve their decision-making level, it is possible to improve the quality of patients care while improving nurses' attitudes toward end-of-life care.

Moral Sensitivity Among Pre-Hospital Emergency Personnel: A Cross-Sectional Multicenter Study
Mostafa Ghasempour, Abbas Dadashzadeh, Majid Purabdollah, Fezeh Hoseini Lilab,
Volume 17, Issue 0 (12-2024)
Abstract
Moral sensitivity is a crucial attribute for pre-hospital emergency personnel, significantly impacting their ethical decision-making and patient care in urgent and often complex situations. Defined as the capacity to recognize ethical dilemmas and comprehend their implications, moral sensitivity empowers personnel to navigate challenges such as resource limitations, critical patient conditions, and the imperative for rapid, independent decision-making. This study aimed to evaluate the level of moral sensitivity among Emergency Medical Technicians (EMTs) and identify key influencing factors. A cross-sectional study was conducted in 2023, encompassing 245 EMTs selected through cluster random sampling. Data were collected using the Moral Sensitivity Questionnaire (MSQ) and analyzed employing correlation tests and regression analysis. The findings revealed a mean moral sensitivity score of (39.45 ± 7.13) among participants, indicating a moderate-to-high level of ethical awareness. A significant correlation was observed between moral sensitivity and specific demographic and professional characteristics. Notably, work experience emerged as a key determinant (P < 0.001). Regression analysis further emphasized work experience (β = 0.08, P < 0.001) as a strong predictor, demonstrating that increased exposure to clinical and ethical challenges over time enhances moral sensitivity. Enhancing ethical sensitivity among pre-hospital emergency personnel is paramount to improving their ability to identify and address complex ethical challenges and deliver high-quality patient care. Given the unique demands of emergency situations, including time constraints, resource limitations, and the need for immediate action, it is crucial to equip personnel with the tools necessary to recognize and navigate ethical dilemmas. Implementing comprehensive training programs that emphasize ethical awareness and reasoning can empower EMTs to make more informed and empathetic decisions. Furthermore, cultivating a supportive organizational culture that prioritizes ethical performance and provides ongoing training can further enhance their confidence and competence in managing ethically sensitive situations.

The Strategy of Nursing Managers in Ethical Decision-Making: A Qualitative Content Analysis
Mostafa Roshanzadeh, Ali Taj, Somayeh Mohammadi,
Volume 17, Issue 1 (3-2024)
Abstract
In the current health system conditions, the strategies adopted by nursing managers in their ethical decision-making can lead to different results for patients, nurses, and health systems. Therefore, the present study aimed to explain ethical decision-making strategies implemented by nursing managers. The present study was conducted using qualitative content analysis in 2022 at Shahrekord University of Medical Sciences. A total of 18 nursing managers were selected through purposive sampling and were interviewed using in-depth unstructured individual interviews. Data were analyzed using the method proposed by Graneheim and Lundman. The results revealed one main category (human-centeredness) and three subcategories (customer-centeredness, valuing employees’ dignity, and the conflict between respecting the rights of patients and employees and adhering to organizational policies). Nursing managers attempted to make their ethical decisions based on the principle of humanism by using customer-centeredness strategies, valuing employees’ dignity, and prioritizing the rights of individuals and employees over organizational rules. The results of the present study showed nursing managers make decisions in line with respecting the rights of patients and employees. However, sometimes these decisions conflict with the interests of organizations. In this regard, the existing obstacles that create the conditions for such conflicts should be identified. Increasing organizational commitment in managers can also be effective in decisions that benefit different groups of customers, personnel, and health organizations.

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