Allmark Peter
Acute and Critical Care Nursing, University of Sheffield, Samuel Fox House/NGH, Sheffield, UK.
J Adv Nurs. 2005 Sep;51(6):618-24. doi: 10.1111/j.1365-2648.2005.03542.x.
The aim of this paper is to suggest that the study of ethics and ethical theories can enhance nursing practice.
Knowledge of ethical theories can be of practical use to nurses in at least three ways. First, it can help nurses uncover to what extent a problem is an ethical one. The questions faced in practice can be empirical, formal or philosophical. Very often, a practical decision requires us to tackle all three types. In the example of a 'Do not attempt resuscitation' order, deciding on whether such an order is appropriate requires us to answer empirical questions such as how likely any attempt is to achieve success. It also requires us to answer formal questions such as whether the law permits such an order in the present circumstance. Finally, it requires us to answer ethical/philosophical questions, such as how we should weigh up quality of life against quantity. Second, it can enable practitioners to develop skills and tools to tackle ethical/philosophical questions. In this paper I describe two such tools: Socratic questioning and Aristotelian dialectic. Third, it can help practitioners to develop the soundness of their ethical values and beliefs. All ethical reasoning requires us to use our values and beliefs, and attending to them enhances the quality of our reasoning.
The study of ethics can enhance nursing practice.
本文旨在表明，对伦理学及伦理理论的研究能够提升护理实践水平。
伦理理论知识至少能在三个方面对护士具有实际用途。首先，它能帮助护士发现一个问题在多大程度上属于伦理问题。实践中面临的问题可能是实证性的、形式性的或哲学性的。很多时候，一个实际决策要求我们应对所有这三种类型的问题。以“不要尝试复苏”医嘱为例，判定这样一个医嘱是否合适要求我们回答实证性问题，比如任何复苏尝试成功的可能性有多大。它还要求我们回答形式性问题，比如在当前情形下法律是否允许这样一个医嘱。最后，它要求我们回答伦理/哲学性问题，比如我们应该如何权衡生活质量与生命数量。其次，它能使从业者培养应对伦理/哲学性问题的技能和工具。在本文中，我描述了两种这样的工具：苏格拉底式提问和亚里士多德辩证法。第三，它能帮助从业者提升其伦理价值观和信念的合理性。所有伦理推理都要求我们运用我们的价值观和信念，关注它们能提升我们推理的质量。
伦理学研究能够提升护理实践水平。
