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NursingValuesandEthicsA)Thenursingprofession,today,hasbuiltforitsmembersahighlevelofacademicexcellenceleadingthemtoastatewheretheyhaveanabilitytoprovidespecificserviceandcompleteprofessionalautonomytomakedecisions.Professionalautonomymeansthatanurseisindependentreasonablyandself-governinginmakingdecisionsinpractice.Thereareindependentmeasuresanursecaninitiatewithoutmedicalorders.B)Thenurseisaclientadvocate.Shehastoprotectthehumanandlegalrightsofthepatientunderhercare,basedonhisculturalandreligiousaffiliations.ThenurseisaCaregiverhelpingthepatientregainhealththroughtheprocessofhealing.Thenurseisalsothepivot(中心)ofallcommunicationsinthehealthcaredeliverysystem.Thus,itisimportantthatthisprofessionalautonomyisalwaysgovernedbyacodeofethicsandvalues.C)Patientcareshouldbebasedontheuniversalprinciplesofbeneficence,justiceandautonomy.Beneficenceistheconceptwherehumanparticipantsaretreatedinanethicalmannerbymaximizingbenefitsandminimizingpossibleharm.Justiceisallabouttheethicalconsiderationsorrisksversusbenefitsleadingtothequestionoflaw.Respectforautonomyisallaboutrespectingtheindividualdecisions.Butthereseemstobeagapandsignificantperceptiondifferencesamongnursesbetweenalearningenvironmentandactualprofessionalsituations.Hence,teachingethicsandnursingvaluesisimportanttobridgethisgap.D)Thereisnodoubtthatethics,asafieldofstudy,hasitsowntheoriesofmoraldevelopment.Teachingethicsthatisexclusivelyforthenursesrequiresuniquetheoriesandcurriculummodels.Ethicslearningisapersonalprocessthatalwaysgoeswitheverydaynursingwork.Hence,thereisalsoaneedfordevelopmentofapedagogy(教学法)thatintegratesthisselflearningexperiencealongwithprofessionaltrainingwheretheyseeethicsasanaturalcomponentoftheirbeinginsteadofarulethattheyshouldfollowasprofessionals.E)Thenursingprofessionconstantlyinvolvestheethicalandmoralconflict.Therearesomecoresituationsinnursingpracticethatdemandsethicaldecision-makingwithregardstothepatient'srighttolife,righttochoose,rightandabilitytogiveconsenttotreatment,end-of-lifetreatmentoptionsandtherighttoendlife.F)DorotheaOremdefinednursingwithemphasisonclient'sself-careneedswhichisalearned,goal-orientedactivitydirectedtowardtheselfintheinterestofmaintaininglife,health,developmentandwell-being.Therighttolifeisthecornerstoneofanyhumanrightslawandhence,anurse,byduty,hastostrivetosafeguardthelifeofeverypatient.G)AsperUSlaws,apatientorhishealthattorneyshouldgiveawell-documented,informedconsentbeforeanytreatmentproceduresarecarriedout.Informedconsentreferstolegalrulesthatprescribe(法律规定)behaviorsformedicalprofessionalsintheirinteractionswithpatientsbasedontheethicaldoctrinerootedinthevalueofautonomythatfacilitatespatients'righttoself-determination.Itisaninterpersonalprocesswherebyprofessionalsinteractwithpatientstoselectanappropriatecourseofaction.Informedconsentmeansthattests,treatmentsandmedicationshavebeenexplainedtotheperson,aswellasoutcomes,possiblecomplications(并发症)andalternativeproceduresbeforethetreatmentandhisconsentisdocumented.H)ProblemsrelatedtoEnd-of-lifeareontheriseespeciallywhenconceptsofeuthanasia(安乐死)andphysician-assisteddeathsaretryingtofindlegitimatepositionsinthesociety.ThestateofOregonintheUSalreadyhasalegalbackingandthebillintroducedbyLordJoffeinUKParliamentrecentlyhasstirredachainofdebatesontheethicalaspectsofassisteddeathoftheterminallyill.I)Researchstudieshaveconfirmedthatpatientswantinformationabouttheirillnessandend-of-lifechoices.AccordingtoCardozo,thedecisiontolimitcareforcriticallyillpatientsisnotuncommon,whichisregardedbysomeasawaytomakedeathmorehumaneandrespectpatientautonomy.J)RosaliaHamiltonadvocatessimpleinsteadofcomplexapproachesforteachingethicstonursingstudents.Sherecommendsanursingpedagogythatwillhelpstudentsinlearningbasicprinciplesinvolvedinethicaldecision-makingandtraintheminapplyingthoseprinciplesintheanalysisandinterpretationofclinicalevents.Shedescribesspecificteachablemomentsinclinicalpracticethatallowstheintegrationoftheclinicalapplicationofethicsandvaluesinthecurriculum.Sheviewsethicsasacontinuingandrecurringcurricularthemethatwillpermittheteachingofcoreprinciplesandvalues,suchas,criticalthinking,analysisofmanagementprinciples,powerandpracticeissuesandanalysisofclienteducationalneeds.Shealsostressestheneedforreviewingthecurriculumonaregularbasistoensurethatnurseeducationreflectscurrenthealthcarepractices.Thus,itisimportanttoteachcorenursingvaluesandethicswithregardstovariouscomplexnursesituationsdiscussedthatdemandethicaldecision-making.(1)Itiscommontolimitcarefordyingpatientstorespecttheirdignityandself-determination.(2)Intermsofpatientcare,instructionsshouldbegivenonethicsandnursingvaluestoshortenthedistancebetweenthetaughtknowledgeandactualworkexperience.(3)Regardingthefactthatnursesareexposedtosituationsaboutethics,coremoralprinciplesshouldbetaughtinthecurriculum.(4)Nowadaysnurses'academicexcellenceenablesthemtoofferrequiredserviceandindependentlydecideonmedicalissues.(5)Aspeopleattempttomakedoctor-aideddeathlegal,morerelevantquestionscomealong.(6)Anapproachtonursingteachingisrecom