看護実践における倫理的問題解決のための概念を見出す試み : 事例分析から

抄録

The purpose of this study was to attempt to determine general ideas for addressing ethical issues in nursing practice. The author interviewed nurses who had experienced cases involving care and related ethical issues. The interview data were analyzed using qualitative research methods. The subjects of analysis were the following three cases: 1. A client who was transferred to the hospital for reoperation but died shortly before operation; 2. A client who was in and out of the hospital for more than 10years because of incurable illness; and 3. A client whose last wish was fulfilled in the form of a Christmas party. Analysis showed that ideas for addressing ethical issues converged into two categories. The first included ethical issues, including "role as the client's advocate," "coordination between the client's wishes and the doctor's policy," and "paternalism and maternalism". The other category included issues related to caring, including "learning from the client," "formation of a strong bond resulting from mutual relationship," "involvement as a team," and "departure from medical rules". There were, in addition, three keys to addressing ethical issues that did not fit into either category: "hope for peaceful settlement of affairs," "hope for successful communication," and "wish to be treated indulgently". These three keys are useful both in care for patients and addressing ethical issues.