Fowler M D
School of Nursing, Azusa Pacific University, California.
Nurs Clin North Am. 1989 Dec;24(4):955-65.
Contemporary nursing ethics education focuses on the use of an analytical model of ethical decision making for both its process and its content. Perhaps this is the case because it bears some resemblance to the nursing process, which is taught in a similar fashion. Thus, a deductivist method of ethical decision making fits within the same general schema of the hypotheticodeductive method of decision making that is taught for nursing diagnosis. Ethics requires that nurses respect persons, inform patients and secure their consent, not inflict harm, preserve the patient's quality of life, prevent harm and remove harmful conditions, do good for patients, and minimize risk to themselves. These are among the norms of obligation that guide ethical analysis and judgment in nursing practice and are the substance of the analytical model of ethical decision making. Nursing's ethics has established high ideals and strong demands for nurses. These are demands which nurses have met and ideals which have often been realized. Whatever the strength of our science, nursing is an inherently moral endeavor and is only as strong as its commitment to its ethical obligations and values. Between the grinding edges of the forces that affect it, nursing must establish its priorities among the aspects of its environment that it attempts to control. Ethics must be chief among those priorities.
当代护理伦理教育在其过程和内容方面都侧重于使用一种伦理决策分析模型。或许如此是因为它与以类似方式教授的护理程序有一些相似之处。因此，伦理决策的演绎主义方法符合为护理诊断所教授的假设演绎决策方法的相同总体模式。伦理学要求护士尊重人，告知患者并获得他们的同意，不造成伤害，维护患者的生活质量，预防伤害并消除有害状况，为患者做好事，并将自身风险降至最低。这些是指导护理实践中伦理分析和判断的义务规范，也是伦理决策分析模型的实质内容。护理伦理为护士确立了崇高的理想和严格的要求。这些要求护士已经满足，理想也常常得以实现。无论我们的科学力量有多强大，护理本质上都是一项道德事业，其强大程度仅取决于它对伦理义务和价值观的承诺。在影响它的各种力量的磨砺边缘之间，护理必须在其试图控制的环境方面确定其优先事项。伦理必须在这些优先事项中占据首要地位。
