Bunch Eli Haugen
Institute of Nursing Science, University of Oslo, Oslo, Norway.
Nurs Inq. 2002 Sep;9(3):187-95. doi: 10.1046/j.1440-1800.2002.00143.x.
Results from two studies of ethical dilemmas nurses and doctors experience on two high-technology units are compared and discussed. The qualitative comparative methodology of grounded theory was used to generate theoretical frameworks grounded in the empirical realities of the units. The ethical dilemmas they faced were related to: treating the one vs. the common good; end of life questions; and resource allocations with inadequate staffing. Similarities were related to intensity and urgency of nursing care and patient treatment, clear nursing ideologies based on treating humans within a framework of hope, embracing technology and scarce resources. Differences between the two study units were patient diagnosis, hierarchical structure on one unit while one had a vertical structure and decision-making processes, and finally how nursing knowledge and autonomy were used. The two studies demonstrated that clinical, ethical and administrative interactions and decisions are highly compounded, stressful and intertwined.
对两项关于护士和医生在两个高科技科室所经历的伦理困境的研究结果进行了比较和讨论。采用扎根理论的定性比较方法来生成基于科室实证现实的理论框架。他们所面临的伦理困境与以下方面有关：治疗个体与公共利益；生命末期问题；以及人员配备不足情况下的资源分配。相似之处与护理和患者治疗的强度及紧迫性、基于在希望框架内对待患者、接受技术和稀缺资源的明确护理理念有关。两个研究科室之间的差异在于患者诊断、一个科室的层级结构（而另一个具有垂直结构）和决策过程，以及最后护理知识和自主权的运用方式。这两项研究表明，临床、伦理和行政互动及决策高度复杂、压力巨大且相互交织。
