Kearns Alan J
School of Theology, Philosophy, and Music, Dublin City University, Dublin, Ireland.
Nurs Outlook. 2022 Nov-Dec;70(6):807-819. doi: 10.1016/j.outlook.2022.09.001. Epub 2022 Nov 16.
Nurses are generally expected to raise concerns when a harm or wrongdoing is committed against patients. Should their concerns not be adequately addressed, then nurses may take the decision to engage in external whistleblowing. Given that it could have a negative effect on the health care organization or service, nurses may question whether they should engage in external whistleblowing. Consequently, is there an ethical criterion to discern whether the negative effect on the health care organization or service is ethically permissible? This paper argues for the suitability of the Principle of Double Effect as an ethical criterion. The position of this paper is that external whistleblowing by a nurse when understood as an advocacy act with two effects (i.e. the effect of defending a patient and the further negative effect on the health care organization or service) can be ethically permissible through meeting the conditions of the Principle of Double Effect.
一般而言，当患者遭受伤害或不当对待时，护士应提出关切。若他们的关切未得到充分解决，那么护士可能会决定进行外部举报。鉴于这可能会对医疗保健机构或服务产生负面影响，护士可能会质疑自己是否应进行外部举报。因此，是否存在一种伦理标准来辨别对医疗保健机构或服务的负面影响在伦理上是否可允许呢？本文主张双重效应原则作为一种伦理标准是合适的。本文的立场是，护士的外部举报若被理解为一种具有两种效应（即保护患者的效应以及对医疗保健机构或服务的进一步负面影响）的维权行为，通过满足双重效应原则的条件，在伦理上可能是可允许的。
