Principlism or narrative ethics: must we choose between them?

This paper addresses a current debate in the bioethics community between principlists, who consider that principles are at the heart of moral life, and narrativists, who see communication at its core. Using a case study entitled "The forgetful mourner" to introduce the tensions between each of these positions, I go on to explain the central tenets of both principlism and narrative ethics. Rather than focus on their respective weaknesses, which many theorists do, I emphasise instead, the contribution that each approach can make to understanding moral life and the process of ethical decision making in health care situations. My ultimate aim is to identify the, sometimes overlapping, skills that both principlism and narrative ethics require on the part of health professionals who deploy them. I conclude that a good principlist has narrativist tendencies and a good narrativist is inclined toward principlism

A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress

Purpose: The purpose of this study was toinvestigate moral distress in Irish psychiatric nurses. Design: A qualitative descriptive methodology was used. Findings: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings. Practice Implications: The findings indicate that while multidisciplinary teams appear to function well on the surface, situations that give rise to moral distress are not always acknowledged or dealt with effectively. Furthermore, unresolved moral conflict impacts upon the quality of clinical decision-making by not allowing open and transparent discussions that allow clinicians the opportunity to address their concerns adequately

Moral distress: Feeling compelled to do the wrong thing

Moral distress is a conceptual tool that brings the emotional landscape of the moral realm to the fore and draws attention to the socio-political and contextual features of moral agency. This essay gives a brief history of the development of the normative and empirical research on moral distress. It pays special attention to the standard definition of moral distress originally delineated by Andrew Jameton in 1984 and the early empirical research that operationalized this definition. Finally, it summarizes some of the lenses through which moral distress is currently perceived, articulated, and critiqued

A woman's right to choose – the moral arguments

Final Report on the Eighth Amendment of the Constitution. Paper by Dr. Joan McCarthy, University College Cork, presenting the pro-choice perspective delivered to The Citizens' Assembly on 05 Feb 2017

Right of freedom of conscience is not absolute

In the course of my work as a lecturer in healthcare ethics in the School of Nursing and Midwifery, University College Cork, I have met with a number of Irish health professionals – nurses, midwives and doctors – who are uncertain and confused about their obligations in relation to the provision of abortions services in post-2018 Ireland. Their questions have prompted me to explain and defend the standard account of conscientious objection that is articulated in the Health (Regulation of Termination of Pregnancy) Act 2018. To do so, I will define and discuss some of the key terms that are at the centre of debates about conscientious objection: “conscience”, “freedom of conscience”, “right of freedom of conscience”, and “conscientious objection” itself

Making tough decisions at the end of life

In end-of-life situations, health professionals, patients and families must often make difficult decisions in tense, demanding, emotionally fraught and constrained circumstances. Every day, caring for dying patients, nurses and doctors find themselves faced with moral questions and challenges: What is good care in this case? How can I be a good nurse or doctor? What do I say if this patient asks “Am I dying?” Should we start or stop treatments such as dialysis, ventilation or nutrition and hydration? Will treatment prolong life or hasten death? Should I document a Do Not Attempt Resuscitation Order (DNAR)? What should I do if there is no DNAR order? How much involvement should this patient and/or family have? How far do my professional and legal responsibilities extend? With medical technology we gain greater control over how and when we die. With greater control comes greater responsibility for the range of complex decisions medical technology makes available. The recently launched Ethical Framework for End-of-Life Care (McCarthy, Donnelly, Dooley, Campbell, Smith [2010] Dublin: Irish Hospice Foundation) is a set of educational resources that offers a constructive response to the challenges of such decision-making. The overall aim of the Framework is to foster and support ethically and legally sound clinical practice in end-of-life treatment and care in Irish hospitals and healthcare settings. It has emerged as part of a larger initiative, the Hospice Friendly Hospitals Programme (HfHP), of the Irish Hospice Foundation in collaboration with the Health Services Executive and with the support of The Atlantic Philanthropies

Problems in using social work records in assessing change

Thesis (M.S.)--Boston Universit