Cameron M E, Crisham P, Lewis D E
School of Nursing, University of Minnesota, Minneapolis.
J Prof Nurs. 1993 Nov-Dec;9(6):327-35. doi: 10.1016/8755-7223(93)90007-y.
The purpose of this research was to describe and examine the basic nature of ethical problems that are experienced by persons with acquired immunodeficiency syndrome (AIDS). The participants were 25 persons with AIDS and 5 significant persons, not infected with the human immunodeficiency virus, who provided contextual understanding. The conceptual framework and method combined ethical inquiry and phenomenology. During an in-depth audiotaped interview, each participant answered the question, "What situation involving AIDS has caused you the most conflict about the right thing to do?" To assure scientific adequacy, the participant validated the analysis of the first interview in a second interview 2 weeks later, and five experts and two independent judges validated the combined analyses. From 117 ethical problems emerged a basic nature consisting of (1) conflict of values about what to believe, who to be, and what to do; (2) resolutions based on intuitive beliefs, desire to be a good person, and rational choice; and (3) rationale revolving around a desire for integrity and meaning. The findings suggest strategies for improving nursing ethics education and, ultimately, nursing practice: (1) base content on ethics research and philosophical analysis, (2) address real-life ethical problems, (3) discuss virtue ethics in addition to principled thinking and ethical caring, and (4) teach ethical listening.
本研究的目的是描述和审视获得性免疫缺陷综合征（艾滋病）患者所经历的伦理问题的基本性质。研究参与者为25名艾滋病患者以及5名未感染人类免疫缺陷病毒的重要他人，后者提供背景理解。概念框架和方法将伦理探究与现象学相结合。在一次深度录音访谈中，每位参与者回答了这样一个问题：“涉及艾滋病的哪种情况让你在做正确之事时产生了最大的冲突？”为确保科学充分性，参与者在两周后的第二次访谈中对第一次访谈的分析进行了确认，并且有五位专家和两位独立评判者对综合分析进行了确认。从117个伦理问题中浮现出一种基本性质，包括：（1）在相信什么、成为什么样的人以及做什么方面的价值观冲突；（2）基于直观信念、想成为好人的愿望以及理性选择的解决方式；（3）围绕对完整性和意义的渴望的基本原理。研究结果提出了改善护理伦理教育以及最终改善护理实践的策略：（1）将内容建立在伦理研究和哲学分析的基础上；（2）处理现实生活中的伦理问题；（3）除了原则性思维和伦理关怀之外，还要讨论美德伦理学；（4）教授伦理倾听。
