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Biomedical subjects

J H Penticuff

Publications and source records attributed to J H Penticuff.

12 recordsLinked to original sources
PubMed1998

Defining futility in neonatal intensive care.

This article presents an initial conceptualization of futility in neonatal intensive care in an attempt to stimulate thoughtful debate an further development of the concept. Futility is defined within the context of the infant's response to a trial of therapy for extreme prematurity. Substantial criteria for determining whether futility has been reached focus on whether the infant has sustained physiologic complications that have been shown in follow-up studies to be related to mortality and significant morbidity.

Decision Making↗
PubMed1991

Conceptual issues in nursing ethics research.

Empirical studies that have attempted to describe nurses' ethical practice have used conceptual frameworks derived primarily from the disciplines of bioethics and psychology. These frameworks have not incorporated important concepts developed by nursing theorists over the past two decades. This article points out flaws in the past research frameworks and proposes a synthesis of ethical theory, nursing practice contexts, and empirical research methods to enrich theoretical development in nursing ethics.

Ethical Analysis↗
PubMed1990

Ethical issues in redefining death.

This discussion has presented an introduction to a philosophic debate about definitions of death. It is not intended to provide concrete answers to dilemmas confronting neuroscience nurses, but perhaps will spark further thoughts about the arguments described.

Awareness↗
PubMed1989

Infant suffering and nurse advocacy in neonatal intensive care.

This discussion of nurse advocacy and infant suffering in neonatal intensive care was based on content analysis of interviews of 20 neonatal nurses in three NICUs over a period of 6 years. Throughout that span of time, nurses experienced significant emotional distress when they believed that therapies resulted in infant suffering without proportional benefit. In all of the nurses interviewed, infant suffering triggered a variety of acts of advocacy, ranging from changes in nursing care to decrease infant distress to formal requests that the medical plan of care be reviewed. Characteristics of infants, nurses, and the NICU organization were described as possibly influential to nurse advocacy. Finally, some thoughts about an ethic of the good were presented. Gajardo-Velasquez noted, "Nothing really great and important can be obtained without a certain amount of sacrifice; therefore, suffering is present in every human action that tends to transform and create new conditions for life." Our technology in the NICU has saved many lives and prevented much suffering and avoidable disability. It has also, for some, been a source of profound suffering. It is hoped that nurses in neonatal intensive care will use the ideas presented here as a starting point for their individual and collective examination of what constitutes an ethic of the good. Perhaps such an ethic can minimize the cost in suffering of the powerful technology of neonatal intensive care.

Child Advocacy↗
PubMedDate not supplied

Influence of practice environment and nurse characteristics on perinatal nurses' responses to ethical dilemmas.

BACKGROUND: Previous research on nurses' responses to ethical dilemmas has focused either on nurse characteristics or on practice environment characteristics, but has not examined both influences concurrently. OBJECTIVE: To explore the relative contributions of practice environment characteristics and nurse personal and professional characteristics to perinatal nurses' willingness to be involved in activities to resolve clinical ethical dilemmas. METHODS: A descriptive correlational design and hierarchical multiple regression were used to examine responses of 127 perinatal nurses to three instruments: the Nursing Ethical Involvement Scales (NEIS), Perinatal Values Questionnaire (PVQ), and Demographic Data Sheet (DDS). RESULTS: The organizational variable, nursing influence, accounted for the greatest amount of variance in nurses' reported resolution actions, with nurses' concern about ethics and consequentialist values also contributing significantly. The three predictors together accounted for 31% (24% adjusted) of the variance in actions to resolve clinical ethical dilemmas. Level of nursing education was not a statistically significant influence. CONCLUSIONS: These results suggest that nurses are more likely to be involved in dilemma resolution activities when they perceive themselves to have higher levels of influence in their practice environments and higher levels of concern about the ethical aspects of clinical situations. Nurses who emphasize consideration of morally relevant aspects of individual patient situations (consequentialist value orientation) and deemphasize adherence to abstract standards, rules, and policies also are more likely to be involved in dilemma resolution.

Adult↗
PubMedDate not supplied

Ethical dimensions in genetic screening: a look into the future.

The ethical dimensions of four areas of genetic screening, prenatal screening and diagnosis, newborn screening, carrier detection, and presymptomatic genetic testing, are discussed. Ethical analysis of genetic technologies focuses on the goals, values, and professional obligations that underlie the development and use of these technologies. We live in a complex, diverse society, in which there are multiple, often contradictory, values and belief systems that influence public and personal views about the morality of genetic technologies. Some of these prevailing views are presented to highlight the ethical issues nurses may encounter in reproductive health care, an area in which genetic information and services are increasingly important aspects of care.

Civil Rights↗
PubMedDate not supplied

Ethics in pediatric nursing: advocacy and the child's "determining self".

This article examines the evolving role of the nurse as patient advocate, building on Gadow's framework of "existential advocacy" (9) and Cooper's description of "covenantal relationships." (6) A new conception of advocacy relevant to pediatric nursing is proposed, based not on protection of patient autonomy, but instead emphasizing protection of the child's potential "determining self". This potential for self-determination is seen as an affirmation of the child's understanding and goals in his or her immediate circumstances which counters learned helplessness. Protection of the child's potential "determining self" is accomplished through the following nursing interventions: (1) alleviation of pain and discomfort, (2) thorough preparation of the child for procedures, (3) careful explanation to child and family about what will happen, how it will feel, and how child and family will be helped to cope, (4) inclusion of the family in planning care, and (5) safeguarding the family's decision-making prerogatives. A promise to care for the hospitalized child, based on Stenberg's notions of covenantal relationship, is seen as involving a commitment to the mastery of technical skills, an agreement to safeguard the patient, a promise to provide unqualified care, and a promise to free the patient from the fear of abandonment and unnecessary pain. It is argued that ethical practice in pediatric nursing may at times require that the nurse fulfill all of these commitments. It is also recognized, however, that certain organizational characteristics powerfully influence the ability of pediatric nurses to act in this new advocacy role. Characteristics of practice settings which are thought to facilitate or inhibit advocacy, such as staff nurse influence and nursing resources, are described.

Child↗