Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
Department of Psychiatry, Region Östergötland, Linköping, Sweden.
Nurs Ethics. 2024 Mar-May;31(2-3):256-267. doi: 10.1177/09697330231185944. Epub 2023 Aug 19.
Two ethical challenges of nursing home nurses during the COVID-19 pandemic in Sweden are discussed in this paper.
Historically, the nurse's primary concern is for the person who is ill, which is the core of nurses' moral responsibility and identity. In Sweden, person-centered care is generally deemed important in nursing older nursing home residents.
To chart moral responsibilities of nursing home nurses in two cases involving older residents during the COVID-19 pandemic in Sweden.
We used Margaret Urban Walker's framework for moral responsibilities and the International Council of Nurses (ICN) code of ethics for nurses (2021) for our normative analysis.
Written and verbal consent was obtained before the interviews, and information was given that participation was entirely voluntary and possible to cancel at any time before the work was published. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to this research project (Dnr. 2020-05649).
Case #1: a palliative older nursing home resident who was coercively tested for COVID-19, and case #2: a COVID-19-infected resident with dementia who was isolated using sedation. The decision that was finally made in the respective case was analyzed in the light of either consequentialist/utilitarian or non-consequentialist/deontological reasons.
Empowerment of nurses as moral agents is required for the application of practical wisdom in the balancing of different care relationships (responsibilities), moral identities (professional virtues), and competing moral values. This requires resources and opens possibilities for profound ethical reflection in nursing education and at work.
During the COVID-19 pandemic, the moral and professional responsibility of nursing home nurses to deliver person-centered care was sometimes problematically abandoned in favor of a more utilitarian manner of ethical decision-making.
本文讨论了瑞典在 COVID-19 大流行期间养老院护士面临的两个伦理挑战。
从历史上看，护士的首要关注点是病人，这是护士道德责任和身份的核心。在瑞典，普遍认为以人（person-centered care）为本的护理对老年养老院居民很重要。
在瑞典 COVID-19 大流行期间，以两名老年居民为例，阐明养老院护士的道德责任。
我们使用玛格丽特·厄本·沃克（Margaret Urban Walker）的道德责任框架和国际护士理事会（ICN）护士伦理准则（2021 年）进行规范分析。
在访谈之前获得了书面和口头同意，并告知参与者，他们的参与完全是自愿的，并且在工作发表之前随时可以取消。瑞典伦理审查局发表了一项咨询意见，称该研究项目不存在伦理问题（编号：2020-05649）。
案例#1：一名接受 COVID-19 强制性检测的姑息治疗老年养老院居民；案例#2：一名患有痴呆症的 COVID-19 感染居民，使用镇静剂进行隔离。分别对各自案例中的最终决定进行了分析，分析结果依据的是结果主义/功利主义或非结果主义/义务论的理由。
赋予护士作为道德代理人的权力，对于在平衡不同护理关系（责任）、道德身份（专业美德）和相互竞争的道德价值观方面应用实践智慧是必要的。这需要资源，并为护理教育和工作中的深刻伦理反思提供了可能性。
在 COVID-19 大流行期间，养老院护士提供以人为本的护理的道德和职业责任有时会被抛弃，转而采用更功利的伦理决策方式。
