Caring ethics and a Somali reproductive dilemma.

The use of traditional ethical methodologies is inadequate in addressing a constructed maternal-fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma.

International nursing exchange and collaboration with China: a perspective from the South and the East.

BACKGROUND: There are an imbalanced world power relationships and international knowledge system, as well as cultural differences across nations. RESULTS: Based on the author's international experiences, this article describes the needs and motivations of international exchange and collaboration in nursing from the perspective of both China and Western countries, examines the ethical and cultural issues involved, and suggests winning strategies. CONCLUSIONS: Western educators and scholars must keep these issues and strategies in mind in order to build a productive, mutually beneficial, and sustainable international exchanges and collaboration.

Principles for establishing trust when developing a substance abuse intervention with a Native American community.

This article traces the development of a research project with a Native American community. Four principles were used to guide the development of the "Community Partnership to Affect Cherokee Adolescent Substance Abuse" project using a community-based participatory research approach. The principles suggest that establishing trust is key when developing and conducting research with a Native American community.

Cultural safety and the socioethical nurse.

This article explores the social and ethical elements of cultural safety and combines them in a model of culturally safe practice that should be of interest and relevance for nurses, nurse educators and nurse ethicists in other cultures. To achieve this, the article briefly reviews and critiques the main underpinnings of the concept from its origins and development in New Zealand, describes its sociocultural and sociopolitical elements, and provides an in-depth exploration of the key socioethical elements. Finally, a model is presented to illustrate the strong connection between the social and ethical components of cultural safety that combine to produce culturally safe practice through the activities of a 'socioethical' nurse.

Utilitarian and common-sense morality discussions in intercultural nursing practice.

Two areas of ethical conflict in intercultural nursing - who needs single rooms more, and how far should nurses go to comply with ethnic minority patients' wishes? - are discussed from a utilitarian and common-sense morality point of view. These theories may mirror nurses' way of thinking better than principled ethics, and both philosophies play a significant role in shaping nurses' decision making. Questions concerning room allocation, noisy behaviour, and demands that nurses are unprepared or unequipped for may be hard to cope with owing to physical restrictions and other patients' needs. Unsolvable problems may cause stress and a bad conscience as no solution is 'right' for all the patients concerned. Nurses experience a moral state of disequilibrium, which occurs when they feel responsible for the outcomes of their actions in situations that have no clear-cut solution.

Ontologies of nursing in an age of spiritual pluralism: closed or open worldview?

North American society has undergone a period of sacralization where ideas of spirituality have increasingly been infused into the public domain. This sacralization is particularly evident in the nursing discourse where it is common to find claims about the nature of persons as inherently spiritual, about what a spiritually healthy person looks like and about the environment as spiritually energetic and interconnected. Nursing theoretical thinking has also used claims about the nature of persons, health, and the environment to attempt to establish a unified ontology for the discipline. However, despite this common ground, there has been little discussion about the intersections between nursing philosophic thinking and the spirituality in nursing discourse, or about the challenges of adopting a common view of these claims within a spiritually pluralist society. The purpose of this paper is to discuss the call for ontological unity within nursing philosophic thinking in the context of the sacralization of a diverse society. I will begin with a discussion of secularization and sacralization, illustrating the diversity of beliefs and experiences that characterize the current trend towards sacralization. I will then discuss the challenges of a unified ontological perspective, or closed world view, for this diversity, using examples from both a naturalistic and a unitary perspective. I will conclude by arguing for a unified approach within nursing ethics rather than nursing ontology.

Perspectives on transcultural care.

Culture has been defined as the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. A culture of nursing refers to the learned and transmitted lifeways, values, symbols, patterns, and normative practices of members of the nursing profession of a particular society. To serve the unique and diverse needs of patients in the United States, it is imperative that nurses understand the importance of cultural differences by valuing, incorporating, and examining their own health-related values and beliefs and those of their health care organizations, for only then can they support the principle of respect for persons and the ideal of transcultural care.

La relación transcultural en los cuidados / Trans-cultural relationships in treatment situations

Este artículo forma parte del marco teórico del proyecto "La relació intercultural en les cures infermeres. Una mirada qualitativa" defendido en junio de 2008 en la Universitat Internacional de Catalunya, en el marco del Màster Oficial d'Infermeria. Los efectos de las corrientes migratorias en un determinado territorio activan a su vez nuevos fenómenos en las relaciones humanas prácticamente en todas las esferas. La enfermería no es ajena a este cambio. Este nuevo escenario incrementa la tangencia de distintas maneras de ver el mundo según los diferentes valores y creencias, lo que puede afectar a la calidad de los cuidados enfermeros. Las dos teorías que aquí se presentan, la humanista de Paterson y Zderad y la de los cuidados culturales de Leininger, proponen una reflexión sobre cada uno de nosotros y sobre los cuidados que ofrecemos; así mismo alientan a la intervención desde los diferentes ámbitos enfermeros(AU)

This article comprises part of the theoretical format for the project "The intercultural relationships in nursing cures, a qualitative look", defended in June 2008 at the International University of Catalonia under the auspices of the Official Masters Program for Nursing.The effects of migratory movements inside a specific territory activate as they develop new phenomena among human relationships in practically all spheres. Nursing is not unaffected by these changes. This new scene increases the different number of ways to see the world according to different values and beliefs which can affect the quality of nursing care. The two theories described in this report, a humanistic theory by Paterson and Zderad and Leninger's cultural cares theory, propose a reflection about each one of us and about the care we offer; and at the same time foment interventions from various nursing perspectives(AU)

Religion, bioethics and nursing practice.

This article calls nursing to engage in the study of religions and identifies six considerations that arise in religious studies and the ways in which religious faith is expressed. It argues that whole-person care cannot be realized, neither can there be a complete understanding of bioethics theory and decision making, without a rigorous understanding of religious-ethical systems. Because religious traditions differ in their cosmology, ontology, epistemology, aesthetic, and ethical methods, and because religious subtraditions interact with specific cultures, each religion and subtradition has something distinctive to offer to ethical discourse. A brief example is drawn from Native American religions, specifically their view of ;speech' and ;words'. Although the example is particular to an American context, it is intended to demonstrate a more general principle that an understanding of religion per se can yield new insights for bioethics.

Lived religion: implications for nursing ethics.

This article explores how ethics and religion interface in everyday life by drawing on a study examining the negotiation of religious and spiritual plurality in health care. Employing methods of critical ethnography, namely, interviews and participant observation, data were collected from patients, health care providers, administrators and spiritual care providers. The findings revealed the degree to which 'lived religion' was intertwined with 'lived ethics' for many participants; particularly for people from the Sikh faith. For these participants, religion was woven into everyday life, making distinctions between public and private, secular and sacred spaces improbable. Individual interactions, institutional resource allocation, and social discourses are all embedded in social relationships of power that prevent religion from being a solely personal or private matter. Strategies for the reintegration of religion into nursing ethics are: adjusting professional codes and theories of ethics to reflect the influence of religion; and the contribution of critical perspectives, such as postcolonial feminism, to the understanding of lived ethics.

Incorporating patients' spirituality into care using Gadow's ethical framework.

Incorporating patients' spiritual beliefs into health care decision making is essential for ethically good care. Gadow's three-level ethical framework of ethical immediacy, ethical universalism, and relational narrative is presented as a tool for enhancing nurses' ability to explore and deepen understandings of patients' spiritual beliefs, given that these and their experiences are often expressed in a language that seems foreign to nurses. The demographic and cultural shifts that lead to the necessity to understand patients who use principles and metaphors that, while commonly understood within their spiritual tradition, may seem incomprehensible to outsiders, are here set in the Canadian context. A case study on palliative sedation is used to illustrate how the ethical framework can help to reveal the spiritual certainties, principles and narratives patients bring to their health care experiences.

The ethics of nursing student international clinical experiences.

This article explores the motivations for offering international nursing student experiences and the reasons students choose to participate. Students should prepare by learning cultural humility rather than cultural competency, and they should be oriented to the ethical responsibility implicit in caring for those in developing countries. Programs that provide these experiences need to be developed with an eye to sustainability so the lives of those receiving care will be enriched after the students go home.