School of Nursing, University of Texas Health Science Center at Houston, TX 77030, USA.
J Clin Nurs. 2012 Aug;21(15-16):2099-107. doi: 10.1111/j.1365-2702.2012.04168.x.
The aim of this article was to analyse the scholarly discourse on the ethical issues of incorporating spirituality and religion into clinical practice.
Spirituality is an important aspect of health care, yet the secularisation of health care presents ethical concerns for many health providers. Health providers may have conflicting views regarding if and how to offer spiritual care in the clinical setting.
Discursive paper.
The discourse analysis uncovered four themes: ethical concerns of omission; ethical concerns of commission; conditions under which health providers prefer to offer spiritual care; and strategies to integrate spiritual care. Ethical concerns of omission of spiritual care include lack of beneficence for not offering holistic care. Ethical concerns of commission are coercion and overstepping one's competence in offering spiritual care. Conditions under which providers are more likely to offer spiritual care are if the patient has a terminal illness, and if the patient requests spiritual care. Strategies for appropriate spiritual care include listening, and remaining neutral and sensitive to spiritual issues.
Health providers must be aware of both the concerns of omission and commission. Aristotle's golden mean, an element of virtue ethics, supports a more moderate approach that can be achieved by avoiding the imposition of one's own personal beliefs of a religious persuasion or beliefs of extreme secularisation, and focusing on the beneficence to the patient. Relevance to clinical practice. Key components for health providers in addressing spiritual concerns are self-reflection, provision of individualised care, cultural competency and communication.
本文旨在分析将灵性和宗教纳入临床实践的伦理问题的学术论述。
灵性是医疗保健的一个重要方面，但医疗保健的世俗化给许多医疗保健提供者带来了伦理问题。医疗保健提供者对于在临床环境中是否以及如何提供精神关怀可能存在不同的看法。
论述性论文。
话语分析揭示了四个主题：忽视的伦理问题；违背伦理的行为的伦理问题；提供者愿意提供精神关怀的条件；以及整合精神关怀的策略。忽视精神关怀的伦理问题包括不提供整体关怀而缺乏善行。违背伦理的行为的伦理问题是强迫和超越提供精神关怀的能力。提供者更有可能提供精神关怀的条件是患者患有绝症，以及患者要求精神关怀。适当的精神关怀策略包括倾听，以及对精神问题保持中立和敏感。
医疗保健提供者必须意识到忽视和违背伦理的行为的问题。亚里士多德的中庸之道，是美德伦理学的一个要素，支持一种更温和的方法，可以通过避免强加自己的个人宗教信仰或极端世俗化的信仰，以及关注对患者的善行来实现。与临床实践的相关性。医疗保健提供者在解决精神问题时的关键组成部分是自我反思、提供个性化护理、文化能力和沟通。
