Faculty of Humanities, International University of Catalonia, Spain.
Pharmacokinetics, Patient Care and Translational Bioethics' Research Group, Spain.
Nurs Ethics. 2024 Dec;31(8):1646-1660. doi: 10.1177/09697330241230684. Epub 2024 Feb 14.
During the most critical phases of COVID-19 pandemic, dramatic situations were experienced in hospitals and care centers that nurses could hardly verbalize. Especially relevant were deep challenges related to terminal illness, situations of extreme sacrifice, as well as reflections on protective measures mixed with beliefs. We intend to analyze which problems had the greatest impact on professionals.
The aim is to explore the ultimate basis for action when making decisions and the orientation of their behavior in the face of moral conflicts.
The methodological strategy is an interpretive synthesis. Narrative review of academic articles that analyzed ethical dilemmas during the pandemic was carried out by searching five databases (Pubmed, Scopus, Psycinfo, CINHAL, and WOS) between January 2020 and December 2022. Finally, 43 articles were selected.
Ethical requirements were respected in all study phases.
The reading and review of the 43 articles initiated the first phase of inductive coding which resulted in 14 initial sub-themes. Based on this structure, a second phase of coding was carried out, giving rise to six categories or emerging themes. To facilitate the process of identifying the central category, the authors agreed to carry out a phase of synthesis, grouping the six themes into three meta-themes: the identification and acceptance of human vulnerability; the discovery of positive paradigms in traumatic situations in society; the prevalence of the common good over the particular interest, as the core structure of any society.
The study has shown the need to consider healthcare benevolence as a new dimension of health care upon global vulnerability. Responsibility is required to ensure the well-being of a global society, prioritizing the common good over particular interests and building solutions on solid moral structures. A new ethical landscape is essential, starting with a humanistic curricular training of all healthcare professionals.
在 COVID-19 大流行的最关键阶段，医院和护理中心经历了护士难以用言语表达的戏剧性情况。特别相关的是与绝症、极端牺牲情况有关的深刻挑战，以及对保护措施与信仰的混合反思。我们旨在分析对专业人员影响最大的问题。
旨在探讨在做出决策时行动的最终基础以及在面对道德冲突时行为的方向。
方法策略是解释性综合。通过在 2020 年 1 月至 2022 年 12 月期间在五个数据库（Pubmed、Scopus、Psycinfo、CINHAL 和 WOS）中搜索，对分析大流行期间伦理困境的学术文章进行了叙述性综述。最终选择了 43 篇文章。
在所有研究阶段都尊重伦理要求。
对 43 篇文章的阅读和回顾引发了第一个阶段的归纳编码，产生了 14 个初始子主题。基于这个结构，进行了第二个阶段的编码，产生了六个类别或新兴主题。为了便于确定中心类别的过程，作者同意进行一个综合阶段，将六个主题分为三个元主题：识别和接受人类脆弱性；在社会创伤性情况下发现积极的范例；将共同利益置于特殊利益之上，作为任何社会的核心结构。
该研究表明，有必要考虑医疗保健慈善作为全球脆弱性背景下医疗保健的一个新维度。有责任确保全球社会的福祉，优先考虑共同利益而不是特殊利益，并在坚实的道德结构上构建解决方案。必须建立一个新的伦理景观，从对所有医疗保健专业人员进行人文课程培训开始。
