Showing papers on "Nursing ethics published in 2018"
TL;DR: An analysis of the available evidence regarding ethical dilemmas in acute care, identifying themes, limitations and gaps in the literature is offered to develop strategies to help nurses resolve ethical dilemma and to avoid moral distress and burnout.
Abstract: Aims To identify themes and gaps in the literature to stimulate researchers to develop strategies to guide decision-making among clinical nurses faced with ethical dilemmas. Background The concept of ethical dilemmas has been well explored in nursing because of the frequency of ethical dilemmas in practice and the toll these dilemmas can take on nurses. Although ethical dilemmas are prevalent in nursing practice, frequently leading to moral distress, there is little guidance in the literature to help nurses resolve them. Design This study is an integrative review of published research from 2000 to 2017. Methods The keywords ethics, ethical dilemmas and nurs* were searched in CINAHL, PubMed, OVID and SCOPUS. Exclusion criteria were sources not available in English, not in acute care, and without an available abstract. Seventy-two studies were screened; 35 were retained. Garrard's matrix was utilised to analyse and synthesise the studies. Results Ethical dilemmas arose from end-of-life issues, conflict with physicians or families, patient privacy concerns and organisational constraints. Differences were found in study location, and yet international research confirms that ethical dilemmas are universally prevalent and must be addressed globally to protect patients and nurses. Conclusions This review offers an analysis of the available evidence regarding ethical dilemmas in acute care, identifying themes, limitations and gaps in the literature. The gaps in quantitative intervention work, US paucity of research, and lack of comparisons across practice settings/nursing roles must be addressed. Further exploration is warranted in the relationship between ethical dilemmas and moral distress, the significance patient physical appearance plays on nurse determination of futility, and strategies for pain management and honesty. Relevance to nursing practice Understanding and addressing gaps in research is essential to develop strategies to help nurses resolve ethical dilemmas and to avoid moral distress and burnout.
70 citations
TL;DR: In this article, a more accurate and comprehensive application of MacIntyre's After Virtue scheme to accounting is presented, where the key concepts of practices, institutions, internal and external goods, the narrative unity of a human life and tradition, and the virtues associated with these concepts are considered.
Abstract: Alasdair MacIntyre’s After Virtue presented a reinterpretation of Aristotelian virtue ethics that is contrasted with the emotivism of modern moral discourse, and provides a moral scheme that can enable a rediscovery and reimagination of a more coherent morality. Since After Virtue’s (AV’s) publication, this scheme has been applied to a variety of activities and occupations, and has been influential in the development of research in accounting ethics. Through a ‘close’ reading of Chaps. 14 and 15 of AV, this paper considers and applies the key concepts of practices, institutions, internal and external goods, the narrative unity of a human life and tradition, and the virtues associated with these concepts. It contributes, firstly, by providing a more accurate and comprehensive application of MacIntyre’s scheme to accounting than that available in the existing literature. Secondly, it identifies areas in which MacIntyre’s scheme supports the existing approach to professional accounting ethics as articulated by the various International Federation of Accountants pronouncements as well as areas in which it provides a critique and challenge to this approach. The application ultimately provides an alternative philosophical perspective through which accounting can be examined and further research into accounting ethics pursued.
43 citations
TL;DR: This essay presents an “ethics of care” approach as well as an empirical pilot project—“Ethics from the bottom up”—which organizes ethics consultation based on this focus and findings will be discussed as far as relevant for ethics consultation in the healthcare system.
Abstract: Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an "ethics of care" approach as well as an empirical pilot project-"Ethics from the bottom up"-which organizes ethics consultation based on this focus. Findings and philosophy of the project will be discussed as far as relevant for ethics consultation in the healthcare system.
42 citations
TL;DR: In this article, the authors define design ethics in relation to the distinction between 'ethics' and'morality' and draw out new issues and questions by examining three commonly encountered categories in design, namely, technology, sustainability, and responsibility.
39 citations
Journal Article•
TL;DR: Overall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge.
Abstract: Background Moral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela. Objective The purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants' MD, clinical ethics knowledge, work satisfaction, and patient care among ICU nurses. Sample and setting The sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period. Methods Alvita K. Nathaniel's Theory of Moral Reckoning guided development of the nursing ethics huddle process. The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects' level of MD. Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects' perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions. Results Overall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant.
32 citations
TL;DR: The authors examined the impact of two types of ethics instruction, traditional ethics instruction and giving voice to values instruction, across four classes in an accounting curriculum, and found consistent unethical behavior in the traditional cohort but not in the GVV cohort.
Abstract: While there is considerable support for integrating ethics education in accounting curricula, research presents conflicting evidence on how best to incorporate it. A review of accounting ethics scholarship highlights criticisms of the literature, including limited research into actual behavior and a lack of theory. We report the results of a study that is theory based, captures behaviors rather than attitudes, and explores the effect of repeated practice to develop voice efficacy. We examine the impact of two types of ethics instructions. Across four classes in an accounting curriculum, one student cohort participated in traditional ethics instruction, while the other cohort participated in Giving Voice To Values (GVV) instruction. We collected student responses to an ethical challenge and conduct a between-subject analysis. The results reveal consistent unethical behavior in the traditional cohort but not in the GVV cohort, indicating that faculty should consider the use of this pedagogy in accounting ethics education.
30 citations
TL;DR: Common, mutual, interdependent bonds between social workers and service users are highlighted, with a focus on caring practices and activities, accompanied by a potential reduction in professional power and role distance.
Abstract: Definitions of ethics of care are provided and key features outlined. Critical perspectives on ethics of care are explored such as ambiguous meanings, the neglect of surveillance roles in statutory...
26 citations
TL;DR: The authors argue that current research ethics processes, based on the mantra of privacy and institutional protection, take a paternalistic approach to research participants that leaves them open to harm and argue for fundamental changes to the modern research ethics process.
Abstract: Current research ethics processes, based on the mantra of privacy and institutional protection, take a paternalistic approach to research participants that leaves them open to harm. Reflecting on our own research/consultancy as a case study to illustrate the current flaws, we explore our and our subjects’ experiences within the wider political context of institutional ethical rules and the Australian NHMRC guidelines. In doing so we argue for fundamental changes to the modern research ethics processes – a system that treats participants more as research collaborators rather than victims in waiting. A complete review of ethics processes is needed to empower participants and researchers to recognize the reality of the process as co-created and negotiated. This includes changes at the top level of research administration – a shift in ethics policies and procedures as well as greater education in ethics with commensurate trust for active researchers.
25 citations
TL;DR: It is hoped that the history of collaboration between philosophers and physicians about clinical dilemmas and the different venues that have developed at one children’s hospital to address ethical issues will stimulate research in other hospitals analyzing the various ways ethicists and ethics committees can build an ethical environment in hospitals.
Abstract: In most children’s hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children’s hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of “core competencies” than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple “moral spaces” in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set out to do than in the role of the typical hospital ethics consultant today.
23 citations
TL;DR: This study presents the current state of affairs regarding empirical research published nine bioethics journals and finds no significant difference between the proportion of empirical papers published in 2004–2009 and 2010–2015, however, the increasing empirical trend has continued in these journals.
Abstract: A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is changing, that is, what are the characteristics of the empirical works published in these nine bioethics journals. A review of the same nine journals (Bioethics; Journal of Medical Ethics; Journal of Clinical Ethics; Nursing Ethics; Cambridge Quarterly of Healthcare Ethics; Hastings Center Report; Theoretical Medicine and Bioethics; Christian Bioethics; and Kennedy Institute of Ethics Journal) was conducted for a 12-year period from 2004 to 2015. Data obtained was analysed descriptively and using a non-parametric Chi-square test. Of the total number of original papers (N = 5567) published in the nine bioethics journals, 18.1% (n = 1007) collected and analysed empirical data. Journal of Medical Ethics and Nursing Ethics led the empirical publications, accounting for 89.4% of all empirical papers. The former published significantly more quantitative papers than qualitative, whereas the latter published more qualitative papers. Our analysis reveals no significant difference (χ2 = 2.857; p = 0.091) between the proportion of empirical papers published in 2004–2009 and 2010–2015. However, the increasing empirical trend has continued in these journals with the proportion of empirical papers increasing from 14.9% in 2004 to 17.8% in 2015. This study presents the current state of affairs regarding empirical research published nine bioethics journals. In the quarter century of data that is available about the nine bioethics journals studied in two reviews, the proportion of empirical publications continues to increase, signifying a trend towards empirical research in bioethics. The growing volume is mainly attributable to two journals: Journal of Medical Ethics and Nursing Ethics. This descriptive study further maps the still developing field of empirical research in bioethics. Additional studies are needed to completely map the nature and extent of empirical research in bioethics to inform the ongoing debate about the value of empirical research for bioethics.
TL;DR: In this paper, a comprehensive review of recent developments in hospitality ethics research articles published in major hospitality journals as well as in other fields in the period from 2006 to 2015 is presented with the results of research articles by journal and period, geographical locations of study, research method and data analysis, and research subject areas.
Abstract: This study presents a comprehensive review of recent developments in hospitality ethics research articles published in major hospitality journals as well as in other fields in the period from 2006 to 2015. A total of 62 articles were analyzed and the results were presented with the discussion of research articles by journal and period, geographical locations of study, research method and data analysis, and research subject areas. Conclusions and implications for future research are offered.
TL;DR: This paper seeks to construct a concept of informed consent from the perspective of ethics of care which is here called relational autonomy-in-informed consent (RAIC), providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western.
Abstract: The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept of informed consent from the perspective of ethics of care which is here called relational autonomy-in-informed consent (RAIC). Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism.
TL;DR: Level at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system in Iran.
Abstract: Background:Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values.Objectives:The present research sought to explore aspects of rationing nursing care in Iran.Research design:This study applied qualitative content analysis, a method to explore people’s perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions.Participants and research context:The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities ...
01 Jul 2018
TL;DR: For researchers in Aotearoa New Zealand who intend to conduct research with people, it is common practice to first ensure that their proposals are approved by a Human Research Ethics Committee (HRE) as mentioned in this paper.
Abstract: For researchers in Aotearoa New Zealand who intend to conduct research with people, it is common practice to first ensure that their proposals are approved by a Human Research Ethics Committee (HRE...
TL;DR: In this article, the impact of virtue at the level of the organisation and the extent to which organisational virtue impacts on moral attentiveness and the perceived role of ethics and social responsibility in creating organisational effectiveness is examined.
Abstract: Examination of the application of virtue ethics to business has only recently started to grapple with the measurement of virtue frameworks in a practical context. This paper furthers this agenda by measuring the impact of virtue at the level of the organisation and examining the extent to which organisational virtue (OV) impacts on moral attentiveness (MA) and the perceived role of ethics and social responsibility in creating organisational effectiveness (PRESOR). It is argued that people who operate in more virtuous organisational contexts will be expected to be more attentive to ethical issues and in turn perceive a greater role for ethics and social responsibility in business. Analysis of results based on a sample of 137 HR professionals shows that where people report that their organisation provides meaningful work, they are more likely to display reflective MA and the belief that ethics and social responsibility are compatible with business objectives, suggesting that organisations who are interested in promoting an ethical culture should focus on their work structures and practices. More generally, OV is shown to have a more complex relationship with PRESOR than hypothesised pointing towards a more nuanced view of OV. The paper examines the implications of the results for organisations and research.
TL;DR: This study shows that ethics initiatives can be both sustainable and significant for practice and it is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale.
Abstract: Background:Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities.Objectives:To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities.Research design:Two online questionnaires about the municipal ethics activities.Participants and research context:A total of 137 municipal contact persons for the ethics project answered the first survey (55% response rate), whereas 217 ethics facilitators responded to the second survey (33% response rate).Ethical considerations:Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services.Findings:Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations ...
TL;DR: The results suggest the Ethical Awareness Scale is a psychometrically sound, reliable and valid measure of ethical awareness in critical care nurses.
Abstract: Aim To develop and psychometrically assess the Ethical Awareness Scale using Rasch measurement principles and a Rasch item response theory model. Background Critical care nurses must be equipped to provide good (ethical) patient care. This requires ethical awareness, which involves recognizing the ethical implications of all nursing actions. Ethical awareness is imperative in successfully addressing patient needs. Evidence suggests that the ethical import of everyday issues may often go unnoticed by nurses in practice. Assessing nurses' ethical awareness is a necessary first step in preparing nurses to identify and manage ethical issues in the highly dynamic critical care environment. Design A cross-sectional design was used in two phases of instrument development. Method Using Rasch principles, an item bank representing nursing actions was developed (33 items). Content validity testing was performed. Eighteen items were selected for face validity testing. Two rounds of operational testing were performed with critical care nurses in Boston between February-April 2017. Results A Rasch analysis suggests sufficient item invariance across samples and sufficient construct validity. The analysis further demonstrates a progression of items uniformly along a hierarchical continuum; items that match respondent ability levels; response categories that are sufficiently used; and adequate internal consistency. Mean ethical awareness scores were in the low/moderate range. Conclusion The results suggest the Ethical Awareness Scale is a psychometrically sound, reliable and valid measure of ethical awareness in critical care nurses.
TL;DR: In this paper, a content analysis of the series indicates that more than 35% of the episodes contain ethical content, much of which may be beneficial for the classroom, and three episodes are explained in depth and the utility of the show for ethics education is explored.
Abstract: Codes of ethics seek to inspire public servants to work ethically, yet ethical misbehavior by public officials appears often in the news. While there exists a lack of consensus about whether ethics education leads to behavioral changes, public administration programs typically include ethics instruction anyway, as either a separate course or sprinkled throughout the curriculum. Student engagement is critical for ethics education, and audiovisual media are known to increase engagement and active learning. Parks and Recreation, a popular NBC sitcom, is proposed here as a useful source of ethics case studies and scenarios that instructors can use to supplement their ethics instruction. A content analysis of the series indicates that more than 35% of the episodes contain ethical content, much of which may be beneficial for the classroom. Three episodes are explained in depth and the utility of the show for ethics education is explored.
TL;DR: In this paper, a conceptual proposal to analyse the ethics of resistance in organisations, drawing on Foucault's practising self as a refusal and Schaffer's ethics of freedom in opposition to the legitimacy of managerial control and the ethical of compliance, is presented.
Abstract: This study suggests a conceptual proposal to analyse the ethics of resistance in organisations, drawing on Foucault’s practising self as a refusal and Schaffer’s ethics of freedom in opposition to the legitimacy of managerial control and the ethics of compliance. We argue that ethics is already part of such politics in the form of ethico-politics on the basis of participation in political action in organisations. Hence, the practising self as resistance in the face of the status quo of managerial power in an ongoing dialectical process with others and for others comprises our conceptual proposal as an ethics of resistance. Acknowledging dialectics as the driver of the continuous reconstruction and co-construction of politics and praxis, we propose an ethics from the bottom up with a critical and radical perspective. Our contribution is based on opening up an ethico-political space for those who are ignored or suppressed in the ethics and organisations literature.
TL;DR: This quality assessment project explores consultation requests and follow-up questionnaire responses voluntarily submitted from nurses who requested clinical ethics consultation to identify key concerns that prompted requests as well as common themes among nurse requestors’ evaluations of what was most important in clinical ethics consultations.
Abstract: Background:An ongoing challenge for clinical ethics consultation is learning how colleagues in other healthcare professions understand, make use of, and evaluate clinical ethics consultation services.Aim:In pursuing such knowledge as part of clinical ethics consultation service quality assessment, clinical ethics consultation services can learn important information about the issues and concerns that prompt colleagues to request ethics consultation. Such knowledge allows for greater outreach, education, and responsiveness by clinical ethics consultation services to the concerns of clinician colleagues.Design:This quality assessment project explores consultation requests and follow-up questionnaire responses voluntarily submitted from nurses who requested clinical ethics consultation. We present qualitative data analyzed using content analysis and constant comparison methods to identify key concerns that prompted requests as well as common themes among nurse requestors’ evaluations of what was most importa...
TL;DR: A literature review was conducted to evaluate existing knowledge of incivility in the nursing workplace through the lens of nursing ethics and spirituality to suggest a positive correlation between spirituality and more civil environments in nursing workplaces.
Abstract: A literature review was conducted to evaluate existing knowledge of incivility in the nursing workplace through the lens of nursing ethics and spirituality. Study articles presented a consistent theme of improved organizational commitment and job satisfaction when spirituality was injected into the workplace. It seems plausible to suggest a positive correlation between spirituality and more civil environments in nursing workplaces.
Journal Article•
TL;DR: Sunstein's "The Ethics of Influence" as mentioned in this paper argues that, in addition to welfare, autonomy, dignity, and self-government, agents of the ethical state should also consider a fifth value, distributive justice.
Abstract: This Book Review of Cass Sunstein's "The Ethics of Influence" (2016) argues that, in addition to welfare, autonomy, dignity, and self-government, agents of the ethical state should also consider a fifth value, distributive justice.
TL;DR: It is found that building an ethical climate in all the hospitals that provide health care will result in a high moral sensitivity of nurses when giving health care.
Abstract: Objectives: The study determines the effects of the hospitals ethical climate on the moral sensitivity of nurses Methods: T he study design is descriptive and correlational The data was obtained from 99 nurses who voluntarily accepted to fully participate in the surveys conducted The data was analysed using descriptive statistics and Pearson correlations Results: As a result of the study, the ethical climate perception of nurses and their moral sensitivity level was found to be above average A positive, meaningful and medium relationship was found between the moral sensitivity level of nurses and ethical climate perceptions of nurses Conclusions: Our findings support that the ethical climate perception of nurses is an important factor in determining the moral sensitivity Consequently, building an ethical climate in all the hospitals that provide health care will result in a high moral sensitivity of nurses when giving health care
TL;DR: There is inadequate teaching and implementation of the code of nursing ethics and values which calls for urgent reforms in nursing education and practice to improve the standard and image of the Nursing Profession in the Gambia.
TL;DR: The propensity to ask for ethics consultations to address ethical issues was found to be significantly associated with the degree to which ethical issues have deepened (and the level of experience acquired in this field).
Abstract: Background:Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in ...
TL;DR: The findings suggest that narrative writing in nursing ethics education could lead to ethical practice and indicate that narrativeWriting in research may be helpful as a strategy to clarify ethical issues and the awareness of nurses in clinical settings.
Abstract: Objectives The purpose of this study was to explore the effectiveness of learning ethics of nursing practice using narrative writing. Methods Study design was qualitative descriptive research. The participants were 90 graduate students who took nursing ethics classes, of whom 86 graduate students (4 males and 82 females) agreed to this study. The data gathered for analysis were their narratives described as feeling uncomfortable in clinical settings and their comment sheets after narrative group work in nursing ethics classes. We used qualitative content analysis to identify graduate students' awareness gained through narrative writing and narrative group work. Results As a feature of the scenes described by graduate students, there were often conflicts that patients' autonomy were not respected, or that they were not able to engage in sincere engagement. The narrative writing was effective to make graduate students aware of the following two aspects: 1) habits and trends in one's own thoughts and 2) organizational and administrative issues related to ethical issues. Conclusions Learning ethics of nursing practice using narrative writing that focused on nurses' sentiments helped reveal nurses' thoughts as well as their attitudes and approaches to patients. These findings suggest that narrative writing in nursing ethics education could lead to ethical practice. Additionally, our results indicate that narrative writing in research may be helpful as a strategy to clarify ethical issues and the awareness of nurses in clinical settings.
TL;DR: It is concluded that the Code of Ethics for Nurses in Italy can be a valuable aid in daily practice in most clinical situations that can give rise to ethical problems.
Abstract: Background:The research question for this study was as follows: Is the Code of Ethics for Nurses in Italy (Code) a valid or useful decision-making instrument for nurses faced with ethical problems in their daily clinical practice?Method:Focus groups were conducted to analyze specific ethical problems through 11 case studies. The analysis was conducted using sections of the Code as well as other relevant documents. Each focus group had a specific theme and nurses participated freely in the discussions according to their respective clinical competencies.Ethical considerations:The executive administrative committee of the local nursing licensing council provided approval for conducting this project. Measures were taken to protect the confidentiality of consenting participants.Findings:The answer to the research question posed for this investigation was predominantly positive. Many sections of the Code were useful for discussion and identifying possible solutions for the ethical problems presented in the 11 c...