Valdosta State University, College of Nursing, Valdosta, GA 31698-0130, USA.
Nurs Outlook. 2009 Jul-Aug;57(4):185-93. doi: 10.1016/j.outlook.2008.10.006.
Ethics consultations are utilized in health care to identify and manage conflict, difficult decision-making, and ethical issues. In bioethics mediation, a more updated approach using interpersonal, mediative, conflict management, and dispute resolution skills is merged with ethical principles to manage dilemmas arising in healthcare settings. This article argues, based on a professional obligation to advocate for the good of the client, that nurses must assume leadership roles in mediation processes. Nurses can initiate and fully participate in formal bioethics mediation and other mediative interventions. Nurse administrators can work to evolve existing ethics consult models to mediation models. Nonetheless, mediative efforts of individual nurses must be grounded in realization of the multifactorial nature of conflict and dilemma in healthcare settings. Multidisciplinary mediative interventions, framed by sound institutional policies, may best serve the complex needs of ethically vulnerable clients. To best advocate for these at-risk clients, nurses must assume various leadership roles in mediation processes.
伦理咨询在医疗保健中被用于识别和管理冲突、困难的决策和伦理问题。在生物伦理调解中,一种更现代的方法将人际、调解、冲突管理和争端解决技能与伦理原则相结合,以管理医疗环境中出现的困境。本文认为,基于为客户利益辩护的职业义务,护士必须在调解过程中发挥领导作用。护士可以发起并充分参与正式的生物伦理调解和其他调解干预。护士管理人员可以努力将现有的伦理咨询模式转变为调解模式。然而,护士个人的调解努力必须基于对医疗环境中冲突和困境的多因素性质的认识。多学科调解干预,由健全的机构政策框架,可以最好地满足道德上脆弱的客户的复杂需求。为了最好地为这些处于风险中的客户辩护,护士必须在调解过程中扮演各种领导角色。