Institutional Ethics Resources: Creating Moral Spaces

Since 1992, institutions accredited by The Joint Commission have been required to have a process in place that allows staff members, patients, and families to address ethical issues or issues prone to conflict. While the commission's expectations clearly have made ethics committees more common, simply having a committee in no way demonstrates its effectiveness in terms of the availability of the service to key constituents, the quality of the processes used, or the outcomes achieved. Beyond meeting baseline accreditation standards, effective ethics resources are requisite for quality care for another reason. The provision of care to the sick is a practice with profound moral dimensions. Clinicians need what Margaret Urban Walker has called “moral spaces,” reflective spaces within institutions in which to explore and communicate values and ethical obligations as they undergird goals of care. Walker proposed that ethicists needed to be concerned with the design and maintenance of these moral spaces. Clearly, that concern needs to extend beyond ethicists to institutional leaders. This essay uses Walker's idea of moral space to describe individuals and groups who are actual and potential ethics resources in health care institutions. We focus on four requisite characteristics of effective resources and the challenges to achieving them, and we identify strategies to build them. In our view, such moral spaces are particularly important for nurses and their colleagues on interprofessional teams and need to be expanded and strengthened in most settings

Advanced Practice Nursing: An Integrative Approach, 4th edition

Covering all advanced practice competencies and roles, this book offers strategies for enhancing patient care and legitimizing your role within today\u27s health care system. It covers the history of advanced practice nursing, the theory behind the practice, and emerging issues. Offering a comprehensive exploration of advanced practice nursing, this edition also adds a focus on topics including the APN scope of practice, certification, and the ethical and legal issues that occur in clinical practice.https://digitalcommons.usm.maine.edu/facbooks/1036/thumbnail.jp