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Cited by 213Ethics in medical practiceEthics and bioethics in healthcareEthics in Business and Education

Nurses’ ethical reasoning and behaviour: A literature review

Goethals, Sabine, Gastmans, Chris, de Casterlé, Bernadette Dierckx·2010·International Journal of Nursing Studies
DOI 10.1016/j.ijnurstu.2009.12.010
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Abstract

Background Today's healthcare system requires that nurses have strong medical-technical competences and the ability to focus on the ethical dimension of care. For nurses, coping with the ethical dimension of care in practise is very difficult. Often nurses cannot act according to their own personal values and norms. This generates internal moral distress, which has a negative impact on both nurses and patients.Objectives The objective of this review is a thorough analysis of the literature about nurses' ethical practise particularly with regard to their processes of ethical reasoning and decision making and implementation of those decisions in practise.Design We conducted an extensive search of the electronic databases Medline, Embase, Cinahl, and PsycInfo for papers published between January 1988 and September 2008. A broad range of search keywords was used. The 39 selected articles had a quantitative, qualitative, or mixed-method design.Findings Despite the conceptual difficulties that the literature on the ethical practise of nurses suffers, in this review we understand nurses' ethical practise a complex process of reasoning, decision making, and implementation of the decision in practise. The process of decision making is more than a pure cognitive process; it is influenced by personal and contextual factors. The difficulties nurses encounter in their ethical conduct are linked to their difficult work environment. As a result, nurses often capitulate to the decisions made by others, which results in a conformist way of acting and less individually adapted care.Conclusions This review provides us with a more nuanced understanding of the way nurses reason and act in ethically difficult situations than emerged previously. If we want to support nurses in their ethical care and if we want to help them to change their conformist practises, more research is needed. Especially needed are in-depth qualitative studies that explore the experiences of nurses. Such studies could help us better understand not only how nurses reason and behave in practise but also the relationship between these two processes.

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Authors
Goethals, S., Gastmans, C., & de Casterlé, B. D.
Affiliations
UCLouvain (BE)
Corresponding author
Goethals, Sabine
ORCID
Gastmans, Chris
Venue
International Journal of Nursing Studies
Publisher
Elsevier BV
Published
2010-05
Volume
47
Issue
5
Pages
635-650
ISSN
0020-7489 (ISSN-L)
DOI
10.1016/j.ijnurstu.2009.12.010
OpenAlex
W2048543971
Cited by
213
References
87
Citations by year
2026: 6 · 2025: 14 · 2024: 19 · 2023: 13 · 2022: 18 · 2021: 12 · 2020: 11 · 2019: 8 · 2018: 14 · 2017: 13 · 2016: 13 · 2015: 10 · 2014: 20 · 2013: 14 · 2012: 10
FWCI
2.49
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • International Journal of Nursing Studies (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Social Sciences › Decision Sciences › Information Systems and Management › Ethics in Business and Education
Keywords
ethical decision-making, moral distress, ethical dilemmas, nursing work environment
MeSH terms
Decision Making, Ethics, Nursing, Nurses

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