IDENTIFICATION OF JUSTICE AND CARE MORAL ORIENTATIONS FROM REAL-LIFE MORAL CONFLICTS OF CRITICAL CARE NURSES (NURSES).
Contributors: University of South Carolina.
Published: 1992
Number of pages: 163
Subjects: Health Sciences, Nursing.; Psychology, Industrial.
Description: A highly technological and depersonalized health care system poses a threat to the preservation of humanistic concerns in the delivery of care. This factor coupled with the rapidly growing number of elderly clients and increasing population of poor and near poor with limited access to health care, has resulted in an environment where patients, families and health care providers are forced to make decisions which have complex moral and ethical ramifications.

Nurses, as patient advocates and direct care givers, must be able to confront complex ethical dilemmas and sort out the conflicting moral principles if they are to be effective practitioners. Emerging theories indicate that morality is neither unitary nor exclusively related to the justice orientation and that an orientation of care equally preoccupies an individual's construction and resolution of a moral conflict.

The purpose of this study was to examine the moral orientations used by critical care nurses to frame, resolve and evaluate situations involving issues of moral conflict and choice. A qualitative/descriptive study was conducted to answer the questions: (1) What are the moral issues which characterize the conflicts described by critical care nurses? (2) What are the contextual factors which influence the moral conflict and choice? (3) To what extent do critical care nurses use orientations of care and justice to frame, resolve, and evaluate moral conflicts? (4) What is the relationship between self and moral orientation? (5) What are the contextual factors that influence the nurses' moral conflict and choice?.

The sample included 25 registered nurses who had practiced at least one year in a critical care setting. The nurses participated in a focused interview and were encouraged to tell their stories bringing out the detail, variety, ambiguities, and subtleties which they believed to be important to the conflict. The narratives were taped, transcribed, and a content analysis was carried out using an interpretive guide.

The 25 participants identified 43 different moral issues with the most frequently identified as (1) prolonging life versus quality of life and (2) patient/family's right to choose. The results indicated that the majority of the nurses used both justice and care orientations in the framing, resolution, and evaluation of moral conflicts. Self was most frequently found to align with both orientations. The findings suggest that both justice and care perspectives are important in the framing of an ethic of nursing.
Notes: Source: Dissertation Abstracts International, Volume: 53-04, Section: B, page: 1782.

Thesis (PH.D.)--UNIVERSITY OF SOUTH CAROLINA, 1992.

School code: 0202.