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Biomedical subjects

Elizabeth Peter

Publications and source records attributed to Elizabeth Peter.

16 recordsLinked to original sources
PubMed2006

The interplay between the abstract and the particular: research ethics standards and the practice of research as symbolic.

Ethical standards for research with human participants are increasingly important. With respect to nursing research these standards are symbolic of the interplay between the abstract theoretical aspects of bioethical standards and the particulars of nursing practice. In this column, this interplay is symbolized as a reflective equilibrium. These standards are argued to symbolize not only the dialectic relationship between the abstract and the particular in ethics, but also the general lack of a nursing specific articulation of ethical standards. Further understanding of the distinctiveness of nurses' moral judgments and knowledge is presented as necessary in strengthening the reflective equilibrium.

Codes of Ethics↗
PubMed2004

Nursing resistance as ethical action: literature review.

BACKGROUND: Much has been written about nursing as a predominantly female profession whose members display passivity, submission, obedience and powerlessness. Alternatively, some authors have presented evidence of nurses' capacity to exercise power, revealing the possible relationship between powerlessness and ethical compromise. Thus, empowerment strategies for nurses can yield ethical action. AIM: The aim of this paper is to use analysis of the literature to demonstrate how the actions and responses of nurses to ethical concerns are examples of nurses exercising power. METHOD: Empirical studies published in the nursing literature between 1990 and 2003 have been analysed to illustrate how nurses' actions of resistance can ensure that moral values are realized in practice. Foucauldian notions of power relations and feminist ethics provide the theoretical framework. CONCLUSIONS: Nurses were found to resist in situations where they experienced moral conflicts in relation to the actions of health professionals; however, instances were cited where they did not. Consequently, strategies for nursing education and management are proposed to increase nurses' understanding of the potential acts of resistance that they could employ in situations of moral conflict or concern.

Attitude of Health Personnel↗
PubMed2004

Nursing ethics and conceptualizations of nursing: profession, practice and work.

BACKGROUND: Nursing has been understood as a calling, vocation, profession, and most recently, a practice. Each of these conceptualizations has associated with it an ethics that has emphasized particular aspects of nursing reflecting the social position of nursing in a given historical period. The ethics associated with current understandings of nursing as a profession and a practice are, we believe, no longer adequate to address the social realities and moral challenges of health care work. AIM: The aim of this paper is to discuss the limitations of the ethics associated with profession and practice and to show why the concept of work can contribute to a nursing ethics. DISCUSSION: The characteristics that have socially defined professionals, among them the possession of a unique body of knowledge, provision of an altruistic service to society, and autonomy in the sense of control over their work and work conditions, only partially reflect the realities of contemporary health care work. This is true even for physicians, an exemplar of a professional group. The ethics associated with the professions has tended to limit what counts as a moral concern and who is authorized to label them as such. More recently, the idea of a practice has been used to argue for an ethics in which professional activities of a certain kind and understood in a specific way are inherently moral. However, this approach is limited for similar reasons. Because morality cannot be separated from the social organization of health care, we argue that considering nursing primarily as work, in contrast to a profession or a practice, offers the possibility of an ethics that more completely reflects the complexity of contemporary health care. CONCLUSION: Beyond the obvious conclusion that nursing is work, conceptualizing nursing as work points to changing social realities that are raising significant ethical issues. As a concept, work inherently conveys value, connects intellectual and manual labour, and recognizes social divisions of labour. At the moment an ethics of work is merely an idea, but we believe that such an ethics would lead nurses to ask different questions and propose different answers to the moral challenges of the present and near future.

Codes of Ethics↗
PubMed2004

Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity.

The physical nearness, or proximity, inherent in the nurse-patient relationship has been central in the discipline as definitive of the nature of nursing and its moral ideals. Clearly, this nearness is in service to those in need of care. This proximity, however, is not unproblematic because it contributes to two of the most prolonged difficulties, both for individual nurses and the discipline of nursing--moral distress and moral ambiguity. In this paper we explore proximity using both a moral and geographical lens and offer some insights regarding this practice reality. We examine the effect of proximity to patients on nurses' moral responsiveness, particularly as it affects nurses' moral distress. Proximity is paradoxical in this regard because, while it propels nurses to act, it can also propel nurses to ignore or abandon. Likewise, we argue that nursing's tendency to define itself in relation to the closeness of the nurse-patient relationship leads to problems of moral ambiguity. Our recommendations include moving others closer to the bedside and thus to the work of nursing in the literal and theoretical sense.

Adaptation, Psychological↗
PubMed2003

Receiving money for medicine: some tensions and resolutions for community-based private complementary therapists.

During recent years, private complementary medicine has grown as a significant provider of healthcare in the UK and much of this provision is through small private businesses financed by out-of-pocket payments made by privately paying clients. Using a combined questionnaire (n = 426) and interview survey (n = 49), the present paper considers the potential tensions and dilemmas which therapists face and the resolutions which they come to in being carers, but in market terms, also profit makers. Therapists generally identified with being carers first and business people second, and this was reflected in their caring decisions. Indeed, under circumstances where the roles potentially conflicted (e.g. when clients could no longer afford to pay for their treatments), most therapists claimed that they continued to provide care, either by providing their services free-of-charge, at a reduced rate, by deferring payment or by accepting alternative forms of compensation. There is a relative lack of dedicated research literature on complementary therapists, their attitudes and actions, and this paper provides some important data on their specific management and caring decisions. At the same time, the evidence also provides some initial food-for-thought and indicates some potential research directions for exploring ethical issues in the private practice of complementary medicine.

Adult↗
PubMed2003

Media portrayal of nurses' perspectives and concerns in the SARS crisis in Toronto.

PURPOSE: To describe nursing work life issues as portrayed in the media during the SARS crisis in Toronto. METHODS: Content analysis of local and national news media documents in Canada. Media articles were sorted and classified by topic, and themes were identified. FINDINGS: Themes were: (a) changing schemas of nursing practice: the new normal; (b) barriers to relational nursing work; (c) work life concerns: retention and recruitment; (d) nursing virtue: nurses as heroes and professionals; (e) paradoxical responses to nurses from the community; and (f) leadership in nursing during the SARS crisis. CONCLUSIONS: This analysis enhanced understanding of how nurses are portrayed in the media, but it indicated the significance of quality of work life and issues about work-home life. Some descriptions of the care and caring of nurses have made nursing seem like an important and influential profession to potential applicants who might previously have dismissed nursing as a career.

Anxiety↗
PubMed2002

The history of nursing in the home: revealing the significance of place in the expression of moral agency.

The history of nursing in the home: revealing the significance of place in the expression of moral agency The relationship between place and moral agency in home care nursing is explored in this paper. The notion of place is argued to have relevance to moral agency beyond moral context. This argument is theoretically located in feminist ethics and human geography and is supported through an examination of historical documents (1900-33) that describe the experiences and insights of American home care/private duty nurses or that are related to nursing ethics. Specifically, the role of place in inhibiting and enhancing care, justice, good relationships, and power in the practice of private duty nurses is explored. Several implications for current nursing ethics come out of this analysis. (i) The moral agency of nurses is highly nuanced. It is not only structured by nurses' relationships to patients and health professionals, i.e. moral context, it is also structured by the place of nursing care. (ii) Place has the potential to limit and enhance the power of nurses. (iii) Some aspects of nursing's conception of the good, such as what constitutes a good nurse-patient relationship, are historically and geographically relative.

Ethics, Nursing↗
PubMed2002

Client-centred care: making the ideal real.

Providing quality care in a timely manner is a key goal of the healthcare system. Who defines quality care is a pivotal question to be answered in an era of well-informed clients. The Registered Nurses Association of Ontario's (RNAO) Client-Centred Care Best Practice Guideline puts patients where they belong--at the centre of care. This guideline recommends that nurses embrace as foundational to their practice a set of values and beliefs. These include: respect, human dignity and the belief that clients are the experts regarding their own lives. Clients must be provided the opportunity to lead their care as much as they choose. Moreover, the guideline recommends that nurses advocate for their clients' goals within the entire healthcare team. Recommendations regarding the organization of nursing care emphasize continuity and consistency of care and caregiver as paramount to providing timely and responsive client-centred-care. This article presents the rationale for the development of a CCC-BPG and highlights its key recommendations. It also discusses the responsibilities of healthcare practitioners and administrators in working together to ensure that these recommendations are incorporated into every aspect of client care and services.

Benchmarking↗
PubMed2002

Unrelieved pain: an ethical and epistemological analysis of distrust in patients.

Unrelieved pain is a serious clinical problem that has received little attention in bioethics. This paper contends that unrelieved pain is the result of distrust in patients that reveals both an ethical and epistemological failure on behalf of nurses and physicians. The analysis is conceptually framed in previous work on the articulation of trust in nursing. Specifically, an argument is made that clinicians do not trust patients' subjective experiences, distrust patients from marginalized and relatively less powerful groups, and resist entrusting themselves or becoming vulnerable to patients' pain and suffering. The authors discuss the need for awareness and critical examination of deeply entrenched societal beliefs and values that influence everyday decision-making in pain management.

Ethics, Nursing↗
PubMedDate not supplied

Are submissive nurses ethical?: reflecting on power anorexia.

We believe that the notion of power anorexia, which we define as a lack of desire to exercise power, is central to reflections about nursing ethical concerns. Questioning the assumption that nurses are powerless, we argue that nurses can and do exercise power and that their actions and inactions have consequences not only for themselves, but also for those for whom they care. We propose that a feminist ethics perspective be used both to understand and to overcome nurses' power anorexia. Feminist thinkers remind us not only of oppression's psychological impact, but that stereotypical views about women are socially constructed and, therefore, can be changed. Nurses using this framework should explore the implications of a centralized notion of caring to the way we conceive of power relations in health care. Perhaps deconstructing caring by focusing on how nurses exercise power could help us to re-conceptualize nursing and promote new agendas for health and health care.

Brazil↗