Sofaer B
University of Brighton.
J Med Ethics. 1995 Feb;21(1):31-4. doi: 10.1136/jme.21.1.31.
An outstanding feature of the study of nursing ethics is that it raises questions concerning moral virtue, conscience, consistency and character. A considerable section of the literature is devoted to ideas of how best to teach ethics to health professionals. It has been shown that when faced with ethical dilemmas nurses tended to rely on intuition and instinct to resolve them, with little systematic analysis to help the process. Nurses who have been in practice for a number of years may experience particular difficulties in resolving ethical dilemmas, for although they may be able easily to identify ethical problems they may feel powerless to behave appropriately through lack of theoretical background and/or confidence in participating in informed debate. An educational programme was designed to meet the needs of mature registered nurses who were undertaking a post-qualification part-time honours degree in nursing studies. A variety of teaching methods were employed in teaching the nurses. These included discussion, student-led seminars, structured debate and role play. A session which dealt with sudden death and organ donation is described in some detail. Because the topic involved communication between professionals and patients and/or relatives and was linked with ethics, role play was used to explore the dynamics in these areas. The participants were invited to act out the situation as they felt it might occur. Role play highlighted the stress and shock attached to such an experience. Before working through the dynamics of a situation the nurses were conscious of being part of decision-making 'in the cold' and 'in isolation'. As a result of the experiential learning they felt more able to reflect analytically and to participate in discussions in an informed and articulate way.
护理伦理学研究的一个突出特点是它提出了有关道德美德、良知、一致性和品格的问题。相当一部分文献致力于探讨如何以最佳方式向健康专业人员传授伦理学。研究表明，面对伦理困境时，护士往往倾向于依靠直觉和本能来解决问题，很少有系统分析来辅助这一过程。从业数年的护士在解决伦理困境时可能会遇到特别的困难，因为尽管他们可能很容易识别伦理问题，但由于缺乏理论背景和/或参与明智辩论的信心，他们可能会觉得无力采取恰当行动。设计了一个教育项目，以满足正在攻读护理学兼职资格后荣誉学位的成熟注册护士的需求。在教授护士时采用了多种教学方法。这些方法包括讨论、学生主导的研讨会、结构化辩论和角色扮演。详细描述了一个关于猝死和器官捐赠的环节。由于该主题涉及专业人员与患者和/或亲属之间的沟通，且与伦理学相关，因此采用角色扮演来探究这些领域的动态情况。邀请参与者按照他们认为可能发生的情况来演绎情景。角色扮演凸显了此类经历所带来的压力和冲击。在梳理情景动态之前，护士们意识到自己是在“冷静”且“孤立”地参与决策。通过体验式学习，他们感觉更有能力进行分析性反思，并以明智且清晰的方式参与讨论。
