Abstract
Forty cases of ethical dilemmas of pediatric nurses reported in 1983 were analyzed in terms of the type of bioethical problems, the Japanese Nurses' Association Code for Nurses, and the conditions of patients. 29 cases had the problems of medical decision for serious congenital malformations and handicap, and 27 cases were against the Code : the nurse provides the highest level of nursing care and is responsible for the care she gave. Parental refusals were found among 22 cases with congenital problems, and physician's medical decisions were dominant in 18 cases with acquired problems. Most nurses in both cases were not participating in decision-making and giving much direct care to those with serious conditions, with confused feelings of doubt, angry, agony, and withdrawal. From these findings, respect for children's rights, sharing thoughts and feelings among professionals, and clarifing nurses' roles in ethical decision-making were emphasized.
