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[护理伦理与护理服务的可及性]

[Nursing ethics and the access to nursing care].

作者信息

Monteverde Settimio

机构信息

Institut für Biomedizinische Ethik, Universität Zürich, Zürich, Switzerland.

出版信息

Pflege. 2013 Aug;26(4):271-80. doi: 10.1024/1012-5302/a000305.

Abstract

The increasing number of ethical issues highlighted in everyday nursing care demonstrates the connectedness between nursing ethics and nursing practice. However, what is the role of ethical theories in this context? This question will be examined in this article by analysing the contribution made by the ethics of care, in particular in understandings of gender roles, asymmetries of power, professional knowledge and experience. The adoption and criticism of an emergent nursing ethics is discussed and stated from different viewpoints. The actuality of the caring approach is affirmed by a new reading of the given situation. This article first describes the traditional perception of nurses as marginalised actors in the health sector. By making reference to the current and growing global scarcity of nursing care, it contends that nursing will no longer be marginalised, but instead at the centre of public health attention and reputation. Nevertheless, marginalisation will persist by increasingly affecting the care receivers, especially those groups that are pushed to the fringes by the consequences of the healthcare market, such as persons of extreme old age, suffering from multiple morbidities, or with poor health literacy. Whereas the "classical" understanding of the ethics of care focuses on the nurse-patient relationship and on individual care and understanding of ethics, the new understanding confirms the classical, but adds an understanding of social ethics: caring for the access to care is seen as a main ethical goal of social justice within a nursing ethic.

摘要

日常护理中凸显的伦理问题日益增多,这表明护理伦理与护理实践之间存在着联系。然而,在这种背景下,伦理理论的作用是什么呢?本文将通过分析关怀伦理学所做出的贡献来探讨这个问题,尤其是在对性别角色、权力不对称、专业知识和经验的理解方面。文中将从不同观点讨论并阐述一种新兴护理伦理的采纳与批判。通过对给定情境的全新解读,肯定了关怀方法的现实意义。本文首先描述了传统观念中护士在卫生部门被边缘化的角色。鉴于当前全球护理资源日益稀缺的现状,文章认为护理将不再被边缘化,而是会成为公共卫生关注和声誉的核心。然而,边缘化仍将持续,且会越来越多地影响到护理接受者,特别是那些因医疗市场的后果而被推向边缘的群体,比如高龄老人、患有多种疾病的人或健康素养低下的人。“经典”的关怀伦理学理解侧重于护患关系以及对个体关怀和伦理的理解,而新的理解在确认经典理解的基础上,增加了对社会伦理的理解:在护理伦理中,关注护理的可及性被视为社会正义的一个主要伦理目标。

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