Tsaloglidou A, Rammos K, Kiriklidis K, Zourladani A, Matziari C
Department of Cardiothoracic Surgery, Faculty of Medicine, Aristotle University of Thessaloniki, Greece.
Br J Nurs. 2007;16(16):996-1001. doi: 10.12968/bjon.2007.16.16.27078.
This study provides an insight into the process of ethical decision-making regarding the initiation or withdrawal of artificial nutritional support of seriously ill patients and explores the nursing involvement in it. Fifteen health carers were recruited from a clinical nutrition unit in the UK and qualitative research methods were used to gather data. The findings of the study indicate that nursing contribution to decision-making appeared to be in the 'back room' as the nurses feel that the decisions about difficult ethical dilemmas are 'out of their hands' because of lack of knowledge, experience and confidence. The medical staff and the clinical nurse specialist appear to be primarily responsible for making important decisions. It is clear from the study that to become more effective in the process, nurses need to enhance their knowledge in nutritional support and to develop their practical skills in ethical decision-making through experience and research.
本研究深入探讨了关于重症患者开始或停止人工营养支持的伦理决策过程，并探究了护理工作在其中的参与情况。从英国一家临床营养科室招募了15名医护人员，并采用定性研究方法收集数据。研究结果表明，护士对决策的贡献似乎处于“幕后”，因为护士们觉得由于缺乏知识、经验和信心，有关棘手伦理困境的决策“不由他们掌控”。医务人员和临床护理专家似乎主要负责做出重要决策。从该研究可以清楚地看出，为了在这一过程中更有效地发挥作用，护士需要增强其在营养支持方面的知识，并通过经验和研究培养其在伦理决策方面的实践技能。
