Showing papers on "Nursing ethics published in 2023"

Ethics of care in technology-mediated healthcare practices: A scoping review.

Abstract: BACKGROUND Introducing new technologies into healthcare practices may challenge professionals' traditional care cultures. The aim of this review was to map how the 'ethics of care' theoretical framework informs empirical studies of technology-mediated healthcare. METHOD A scoping review was performed using eight electronic databases: CINAHL with full text, Academic Search Premier, MEDLINE, the Philosopher's Index, SocINDEX with Full Text, SCOPUS, APA PsycInfo and Web of Science. This was followed by citation tracking, and articles were assessed against the inclusion criteria. RESULTS Of the 443 initial articles, 18 met the criteria and were included. We found that nine of the articles used the concept of 'ethics of care' (herein used interchangeably with the terms 'feminist ethics' or 'relational ethics') insubstantially. The remaining nine articles deployed care ethics (or its equivalent) substantially as an integrated theoretical framework and analytical tool. We found that several articles suggested an expansion of ethics of care to encompass technologies as part of contemporary care. Furthermore, ethics of care contributed to the empirical research by recognising both new relationships between patients and healthcare professionals as well as new ethical challenges. CONCLUSION Ethics of care is sparsely used as a theoretical framework in empirical studies of technology-mediated healthcare practices. The use of ethics of care in technology-mediated care brings new dilemmas, relational tensions and vulnerabilities to the foreground. For ethics of care to be used more explicit in empirical studies, it is important that it is recognised by research community as an adequate, universal ethical theory.

Kode Etik Profesi Guru

Abstract: The code of ethics for the teaching profession is a guide as well as the moral basis for a teacher in professional behavior, including Guidance and Counseling teachers. The Importance of Professional Codes of Ethics Codes of ethics are a way to improve organizational ethics so that individuals can act ethically. Meanwhile, violations of the teaching professional code of ethics are violations of norms, values ​​and written professional rules that explicitly state what is right and good for a profession in a society that is influenced by misconceptions, lack of preparedness of teachers and students, and lack of inculcation of character. By using a literature study, in practice violations of the professional code are still found in the administration of education. To overcome violations of the teaching professional code of ethics, one of them is by taking firm action and imposing severe sanctions on individual teachers who commit cases of professional ethics because it is very detrimental to the teacher as a profession whose one of its duties is to set a good example towards students

Toward a Moral Horizon: Nursing Ethics for Leadership and Practice

Abstract: This third edition of Toward a Moral Horizon: Nursing Ethics for Leadership and Practice will assist nurses and all health care providers to take up the challenge of embedding ethics in health care practice, education, research, and policy at all levels—from local to regional to global. In the current, complex health care environment, more nurses are engaging in graduate studies to enhance their knowledge and expertise in providing necessary leadership in all health care settings. As a result, there is a growing need for an advanced nursing ethics text, and so this book is targeted towards graduate-level and upper-level undergraduate nursing students, as well as nurses in leadership roles—providing a much-needed resource for these groups. This edition was written during a period when the COVID‑19 pandemic caused a health care crisis in Canada and around the world, provoking what the authors of one of the chapters called “a clarion call for change” in health care provision. The pandemic brought the fault lines of the Canadian health care system to the forefront of awareness, and profoundly affected patients, families, communities, as well as nurses and other health care providers. In addition to the influence of the pandemic, society is in the midst of rapid growth in science and technology. Now, more than ever, nurses need to use nursing ethics when developing their moral compasses for leadership. In this book, we focus on ethical knowledge for advanced practice nurse leaders to effect change and improve moral climates in nursing research, education, practice, and policy settings. We focus on social justice and equity as essential values of nursing ethics. Several chapter authors describe ways that nurses can press for improvements in the health care of vulnerable people who may be lacking access to quality health care: for example, Indigenous people, older adults, those who are coping with mental illness or substance use challenges, and those who have a disability. Social justice and equity issues are also explored in a chapter on global health. This book is structured in three sections, comprised of 22 chapters written by Canadian experts in ethics. In the book, we map the moral climate for health care and nursing ethics and describe the historical background of and theory related to nursing ethics. We illuminate the use of nursing ethics in diverse populations and with people at all stages of life; and we apply nursing ethics to new developments in health care issues and technologies. Instructors will be able to bring the content of this book alive with Ethics in Practice scenarios and reflective questions for students that are located in each chapter. Many chapters also include figures or appendices showing models and guidelines that can be used to assist with ethical decision making. This third edition includes several new chapters, including a chapter on nursing ethical theory as distinct from bioethics, as well as chapters related to people with disabilities, Indigenous health ethics, nursing leadership, and digital health technology. Many topics covered in previous editions are revised and updated. For example, the updated chapter about health care at the end of life now includes an in-depth discussion of medical assistance in dying (MAiD). Further updates are included in the areas of research ethics in nursing; the development of the Canadian health care system, and how the historical development has contributed to current deficiencies in health care delivery; nurses as moral agents, and the problem of moral distress; the application of nursing ethics in caring for patients at all stages of life; home health care ethics; ethical issues in biotechnology, and the broad areas of public health ethics and global health ethics. This edition is cutting-edge as the authors recognize the importance of inclusive language, since language affects attitudes towards people and the way they are treated. In particular, chapter authors in this text model the use of inclusive language in their writing as applied to gender diverse people and people with disabilities. This third edition is an open access, online publication, meaning that the book is accessible to all with no cost to the readers. This online publication also allows for new features, including two videos, with their accompanying transcripts, where listeners will gain a personal understanding of the contributors’ perspectives. In one video, Indigenous nurse scholars form a traditional circle online, as they discuss nursing ethics from their Indigenous perspectives. The other video showcases two nurses with expertise in digital health technologies in conversation with the book’s editors. Other features include access to additional resources on chapter topics and the inclusion of several chapters from the second edition of this textbook for readers’ reference. It is our hope that readers of this third edition will step boldly into shaping the future of health care by becoming more engaged in ethical practice, and becoming more confident in their leadership roles in health care. We believe that the content of this text can contribute to the knowledge needed for nurses to make ethical choices knowingly and wisely, so they can demonstrate moral imagination and moral courage in the face of challenges that confront them at all levels of the health care system.

Legal professional ethics education in chinese colleges and universities from the perspective of educational ethics

Abstract: To carry out legal professional ethics education for law students is the common requirement of social order, professional attributes and integrity of moral education. Meaningful legal professional ethics education is not simply the imposition of ethics, but the development of higher value goals and the teaching of ways to achieve ethical goals, and realize the coordination of the relationship between the internal and external value of the moral subject, the individual morality and the professional ethics, and the actualization of legal professional ethics education in legal professional ethics education rationalization.

Ethics in Nursing Research

Abstract: Nursing research ethics are the moral code that the researcher adheres to while carrying out research. Issues relating to ethics in nursing research and demonstrate how vital it is that exploitation of vulnerable groups is avoided. Vulnerable groups are defined as pregnant women, fetuses, children, people with mental disabilities, prisoners, and people from low socio-economic backgrounds (Horn et al., 2014). Informed consent, confidentiality, justice, anonymity, and beneficence are all significant when conducting research with vulnerable groups, as I will discuss.

Interdisciplinary ethics: Approaches

Abstract: Ethics/morality/professional ethics is a subject that can be discussed in many aspects in the field of health sciences and social sciences. Every social event that takes place in social life is also the subject of ethics. Ethics can be dealt with in every field from education to economy, from old age to media. In this book, experts from different fields of social sciences and health sciences have revealed their relations with the main theme of ethics. In terms of social sciences, education, economy, academic studies for disadvantaged groups, old age and ethics are discussed. In terms of health sciences, health problems in nursing, psychiatry, cancer and obesity were discussed ethically. The increasing importance of the interdisciplinary approach in all fields of science is valid in the main topic of ethics. For this purpose, it is aimed to reach the richness provided by the intersection sets of different perspectives.

Ethics positions of nursing students in clinical decision-making.

Abstract: BACKGROUND Ethics positions, consisting of the two fundamental dimensions of idealism and relativism, influence individuals' decision-making significantly. Particularly in an applied field such as nursing, the ethics positions of nurses can play a significant role in clinical decisions. Therefore, it is important to know the factors affecting the ethics positions of nurses in clinical decision-making. AIM The aim of the study is to examine the factors affecting the ethics positions of nursing students in clinical decision-making. RESEARCH DESIGN This is a two-phase sequential explanatory mixed methods study designed in accordance with the COREQ criteria. A participant Information Form and the Ethics Position Questionnaire were used to collect quantitative data. Qualitative data were obtained through focus group interviews. ETHICAL CONSIDERATIONS This study was conducted after receiving written permission from X University Ethics Board. Additionally, permission was obtained from the participating nursing faculty. PARTICIPANTS Among the fourth-year nursing students, 180 students participated in the quantitative phase and 30 students in the qualitative phase of the study. RESULTS The quantitative data analysis showed that the idealism sub-dimension mean scores of the participants were higher than the relativism sub-dimension mean scores. The analysis of the qualitative data resulted in four main themes that influence participants' ethics positions in clinical decision-making: (1) attitudes of role models in clinical practice (staff nurses/mentors/lecturers), (2) resources related to clinical practice (labs, hospitals/classrooms), (3) health system (hospital policies/school policies), and (4) personal differences (act with emotion/act with logic). CONCLUSION The results showed that the health system, role models in the clinic, personal differences, and skill-related resources affect the ethics positions of nursing students in clinical decision-making. In this regard, awareness can be raised by providing training to nursing students by academic instructors on ethics positions and the factors that are determined to affect ethics positions in clinical decision-making.

Moral Sensitivity, Ethical Experiences, and Promotion of the Civility of Staff Nurses: A Review

Abstract: The nursing construct is an extensive idea and an ethical responsibility to uphold and protect a patient's integrity and dignity. Healthcare is, however, quickly changing as a result of technological advancements and medical advancements. Nurses play a significant role in health care research, support of patients, management, policy writing, and decision making. Working under time constraints and with a lot of responsibility causes nurse burnout and ethical violation, which limits their ability to behave morally and ethically in situations requiring effective patient care. For "carrying out nursing responsibilities with an attitude coherent with quality in care for patients and the ethical standards of the profession," refer to the nursing code of ethics. The review argument that follows discusses moral sensitivity, ethical experiences, and the promotion of staff nurses' civility. The paper presents an overview of other research studies on this topic. Both historic and contemporary authors argue for a variety of ethical experiences, such as privacy and data protection as well as nurses' capacity for moral judgment.

Healthcare Ethics Consultation in Austria: Joining the International Path of Professionalization

Abstract: Healthcare ethics consultation has been developed, practiced, and analyzed internationally. However, only a few professional standards have evolved globally in this field that would be comparable to standards in other areas of healthcare. This article cannot compensate for this situation. It contributes to the ongoing debate on professionalization by presenting experiences with ethics consultation in Austria, though. After exploring its contexts and providing an overview of one of its primary ethics programs, the article analyzes the underlying assumptions of “ethics consultation” as an essential effort on the path to professionalize ethics consultation.

Research ethics and organizations: the neglected ethics of organizational ethnography

Abstract: PurposeWorking with organizations is central to organizational ethnography. However, while research ethics relating to individual participants is widely discussed, research ethics relating to the organizations has been neglected. The purpose of this article is to address this shortcoming and introduce the concept and domain of “meso-ethics” in research ethics. Meso-ethics pertains to organizations as research participants and thus allows for the explicit inclusion of organizations in ethical considerations and practice. Meso-ethics complements the known domains of micro-ethics and macro-ethics in research ethics.Design/methodology/approachThe concept of meso-ethics takes point of departure in the micro-ethical principles of “respect, and avoiding harm” and adjusts these to apply to organizations. The organizations are first defined as a distinct type of research participants, which differs from individual participants. The organizations are formally organized units that possess resources to assert power and stakeholders with a vested interest in the research. Second, the relationship between researchers and organizations is related to issues of power, allowing for a view of the power relations as flexible and relational. Moreover, this includes a potential vulnerability to harm on both sides.FindingsThe new concept and domain meso-ethics allows for explicit reflections and practice of research ethics in relations to organizations, a central participant in organizational ethnography. There is a discussion that meso-ethics should be combined with micro-ethics and macro-ethics in future practice to allow for comprehensive reflections and practice of research ethics.Originality/valueThe article contributes a new concept and domain of research ethics, meso-ethics, in organizational ethnography and related research to explore and practice research ethics in relation to organizations participating in our research. Meso-ethics complements the known domains of micro-ethics and macro-ethics in research ethics.

Rising to “The Highest Morals”—The Rich History of Nursing Ethics

Abstract: Modern nursing is supported by a rich ethical tradition dating back to the mid-19th century. Moving illustrations of nursing practice and "the highest morals" (McIsaac, 1901) relay the distinguished history and distinctives of nursing ethics from the 1860s to the present day. Of note is that nursing ethics is relationally focused, virtue-based, preventative, and central to the identity of nursing. A brief history of how bioethics emerged in the mid-20th century and an overview of the development of nursing ethics unveils differences between the two ethical paradigms.

The Ethical Disposition, Professional Self-Concept, and CPR Attitude of Nursing Students Effects on Bio-medical Ethics

Abstract: Purpose : The purpose of this study is a descriptive study to identify the factors that influence nursing students’ ethical disposition, professional self-concept, and cardiopulmonary resuscitation attitude on bio-medical ethics. Method : This study identifies the factors that affect bio-medical ethics by convenience sampling. Data were collected using a questionnaire from 257 students participating in bio-medical ethics education from December 15, 2019 to January 15, 2020. Results : The subjects’ ethical disposition were 42.21±5.18 for idealism and 38.91±5.96 for relativism. The average professional self-concept was 3.72±0.43, and the CPR attitude was 3.83±0.47. The overall average of bio-medical ethics was 3.17±0.44. The relationship between idealism (r＝.54), relativism (r＝.28), professional self-concept (r＝.39), CPR attitude (r＝.26), and bio-medical ethics of nursing students showed a statistically significant positive correlation. The significant predictors of bio-medical ethics were idealism (β＝.04) and professional self-concept (β＝.18). Conclusion : Based on the research results, the development of various types of educational programs that can improve bio-medical ethics capabilities should be developed. First, comprehensive education on ethical principles and concepts should be provided in ethical decision-making situations. Second, educational content that can foster professional self-concept and idealistic ethical disposition should be included to understand ethical beliefs. It is necessary to apply educational programs, such as simulation, discussion, and problem-solving teaching and learning methods, so nursing students can actively participate in and judge bio-medical ethics situations.

Ethics education: Nurse educators' main concern and their teaching strategies.

Abstract: BACKGROUND To practice nursing ethics, students must first understand the ethical concepts and principles of their profession, but despite this knowledge, students face challenges in implementing ethical principles in clinical settings. The educational performance of nurse educators is critical in resolving these challenges. This study focused on the lived experiences of nurse educators. OBJECTIVE To address the main concern of educators when teaching ethics to undergraduate nursing students and how they deal with it. RESEARCH DESIGN We conducted this qualitative content analysis in Iran in 2020. We used individual semi-structured interviews to collect, record, and transcribe data, as well as Graneheim and Lundman method to analyze them. PARTICIPANTS and research context: We used purposive sampling to select 11 nurse educators who either were currently in the position of ethics educators or had taught ethics from Iranian universities of medical sciences. ETHICAL CONSIDERATIONS The present study received the code of ethics No. IR.MODARES.REC.1399.036. Participants were aware of the study's purpose and signed a consent form to participate in the study. We considered data confidentiality and the voluntary principle in data collection. FINDINGS Nurse educators' main concern was how to sensitize students to ethical principles in clinical settings, so they tried to involve students in the teaching process, to repeat and practice ethical principles and concepts, simplify and simulate ethical principles and concepts, and provide opportunities for students to gain clinical experiences. DISCUSSION To sensitize students to ethical nursing care, nurse educators try to institutionalize ethical principles using different teaching methods, including students' involvement in teaching, experiential learning through simulated situations, practice, repetition, and provision of opportunities for practice and experience. CONCLUSION Improving students' cognitive ability and objectifying moral concepts and principles for students will institutionalize moral values in them that are fundamental for their moral sensitization.

Ethics and frontline nursing during COVID-19: A qualitative analysis

Abstract: Background Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. Research aim To analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic. Research design Qualitative analysis using a directed content methodology. Participants and research context The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. Ethical considerations Participant privacy and data confidentiality were addressed. Findings Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. Discussion This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. Conclusions Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available.

Normative Ethical Theorizing

Abstract: Ethical issues are ubiquitous in nursing, yet there is a dearth of scholarship in normative ethics and ethical inquiry in nursing. In a concern to motivate interest in normative ethics and inquiry to build ethical knowledge, this article highlights some of the conceptual resources of normative ethics after describing the different types of ethics, including normative ethics. These conceptual resources of normative ethics include moral theories and the method of wide reflective equilibrium.

Professional Ethics in Higher Education

Abstract: In higher educational institutions, the concept of professional ethics is regarded to be of utmost significance in achieving the desired goals and objectives. The paper discusses the significance, relevance, and usefulness of professional ethics in the context of higher education. It highlights the pivotal role of professional ethics in offering teachers a better understanding of their responsibilities, duties, rights, and institutional obligations as they work to provide quality education. As the individuals grow, they are provided with information in terms of professional ethics. When the individuals are able to understand the meaning and significance of professional ethics and implement them, they are able to bring about improvements in their lives and achieve personal and professional goals. Within the course of pursuance of higher education, it is necessary for the students to take into account professional ethics. This concept is vital not only for students, but also for other members of the educational institutions as well, including directors, heads, professors, and staff members. In the effective implementation of professional ethics, it is vital for the individuals to ensure that they communicate effectively, form good terms and relationships with others, depict honesty and righteousness and carry out their job duties in a well-organized manner. The paper discusses meaning and significance of professional ethics, objectives of professional ethics, types of professional ethics, and measures to improve professional ethics.

Walking the Walk of AI Ethics: Organizational Challenges and the Individualization of Risk among Ethics Entrepreneurs

Abstract: Amidst decline in public trust in technology, computing ethics have taken center stage, and critics have raised questions about corporate “ethics washing.” Yet few studies examine the actual implementation of AI ethics values in technology companies. Based on a qualitative analysis of technology workers tasked with integrating AI ethics into product development, we find that workers experience an environment where policies, practices, and outcomes are decoupled. We analyze AI ethics workers as ethics entrepreneurs who work to institutionalize new ethics-related practices within organizations. We show that ethics entrepreneurs face three major barriers to their work. First, they struggle to have ethics prioritized in an environment centered around software product launches. Second, ethics are difficult to quantify in a context where company goals are incentivized by metrics. Third, the frequent reorganization of teams makes it difficult to access knowledge and maintain relationships central to their work. Consequently, individuals take on great personal risk when raising ethics issues, especially when they come from marginalized backgrounds. These findings shed light on complex dynamics of institutional change at technology companies.

[Evoking ethics in care: a pentagram of modalities.]

Abstract: The ways in which ethics is evoked in care and more generally in health policy decision-making are many and very different. Ideological ethics is based on the conviction that we know what is desirable and what is ethically reprehensible in health care. Legal-administrative ethics tends to seek legitimisation of behaviours. Exhortative ethics acts as a kind of moral suasion, while ethics of consultation tends to delegate decisions and choices on matters about which there is perplexity or uncertainty to committees of 'experts'. Finally, the author dwells on counselling ethics, which, with a three-dimensional view, calls for decisions to be made not about the sick person, but with the sick person, taking into account his or her values and conception of the quality of life, as well as the community's ability to use resources fairly and to respond to the needs not only of the wealthy, but of all those in need of care. Its starting point is listening, rather than rigid application of principles. Rather than importing ethics into clinical practice from outside, it encourages its explication by those involved, particularly clinicians.

Professional responsibility, nurses, and conscientious objection: A framework for ethical evaluation.

Abstract: Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of the nurse and of those who must evaluate such claims. We synthesized the framework using Rest's Four Component Model of moral reasoning along with tenets of the International Council of Nursing's (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action.

Effective interventions for improvement of moral sensitivity among nursing students: A systematic review

Abstract: The present research was carried out to look into the optimal interventions for raising moral sensitivity in nursing students. International electronic databases like Scopus, PubMed, and Web of Science were searched systematically from the earliest date to August 2, 2022, via keywords like "Morals", "Moral sensitivity", "Ethical sensitivity", and "Nursing students". Additionally, Iranian databases like Iranmedex were looked up. Randomized control trials (RCTs) and quasi-experimental studies' quality was evaluated using the Joanna Briggs Institute's (JBI) critical assessment checklist. A total of 756 nursing students were enrolled in nine studies. Of the nursing students, 54.87% were female and 70.63% were in the intervention group. The mean age of participants was 22.83 (SD=1.31) years. Mean study duration, intervention, and follow-up were 10, 5.41, and 6.68 weeks, respectively. It was shown that “education based on the visual, auditory, kinaesthetic (VAK) model”, “the spirituality training sessions”, “case-based method of education”, “the spirituality training sessions”, “nursing codes of ethics lecture”, and “the spiritual care training sessions” were enhanced moral sensitivity. Additionally, the “professional nursing practice course”, “nursing ethics education”, and “debate-based ethics education”, did not affect the nursing students' moral sensitivity. It is recommended that university administrators and policymakers plan and implement appropriate educational initiatives with moral and spiritual content in the form of educational workshops.

Nurses’ Ethical Experience and the Needs of Nursing Ethics Education in South Korea

Abstract: Nursing ethics, which is an ethical norm of nursing practice, is basic to the professionalism of nurses, and ethical education is important in building the professional virtues. The study aimed to identify the needs of nursing ethics education targeting a group of nursing professionals in South Korea. This study adopted descriptive survey design via online survey. The questionnaire items consisted of the experience of ethical issues and the needs related to the subject of ethics education in nursing. 53 questionnaires were finally analyzed by descriptive statistics and correlation coefficients. The results showed that 40 of the study participants had more than 5 years of total clinical experience(69.8%). 48 of them previously participated in nursing ethics education(90.6%). The most frequently experienced ethical issues were ‘conflicts between colleagues’, ‘protecting of patient rights’ and ‘informed consent’. In relation to nursing ethics education, ‘ethical decision making and moral distress’, ‘shared decision making’ and ‘end-of-life care’ showed high needs for education. Overall, the higher the level of experience on ethical issues, the more educational needs for nursing ethics education(r=.360, p<.01). In addition, satisfaction with previous nursing ethics education was statistically significant positive correlation with the needs for the overall nursing ethics education topic(p.<01). In conclusion, the high level of experience on ethical issues shows the demands for continuity of ethical education and systematic improvement to improve the working environment of clinical nurses, and to meet the needs of nursing ethics education, a venue for discussion and education using case-based method should be provided.