The contribution of professional autonomy in advancing ethical behaviour: A narrative review of studies in nursing.

AIM: This article explores moral disagreements between nurses and physicians; specifically, we aim to analyse professional nurses' practice in navigating these conflicts. BACKGROUND: Nurses face morally challenging situations while caring for patients when their views on treatments and care may contradict those of physicians. It is important that nurses represent patients' perspectives and are partners in the care decision-making process. EVALUATION: A narrative review was conducted by including peer-reviewed articles in English. A literature search was conducted using the Web of Science database and Google Scholar search engine from 1 December 2021 to 10 February 2022. KEY ISSUES: A total of 27 articles published between 2009 and 2021 were included in the analysis. The following themes were explored in this article: areas in which moral disagreements occur and how these disagreements shape physician-nurse relationships, differences in the status of professional autonomy in nursing in the Baltic states and Nordic countries, and potential directions for nurses' involvement in the decision-making process regarding moral disagreements in nursing practice. CONCLUSIONS: Moral disagreements between nurses and physicians most often occur in situations related to treatment and/or care strategies as well as end-of-life decisions. Nurses' participation in the decision-making process and physicians' willingness to consider nurses' perspectives play a fundamental role in navigating moral conflicts because nurses possess a body of knowledge about their patients that differs from that of physicians. This knowledge is just as worthy as physician knowledge. Considering the level of professional autonomy in specific regions, nurses' involvement in decision-making regarding particular patients' care in the Baltic states seems to be relatively low compared to that in the Scandinavian countries, where nurses have a much wider space for independent decision-making. IMPLICATIONS FOR NURSING MANAGEMENT: Complex moral situations that require the input of both physicians and nurses must be examined and addressed. Several processes may assist in fostering nurses' contributions to decision-making, among which training to effectively deal with morally complex situations and creating an atmosphere conducive to collaboration between physicians and nurses are particularly important.

Perish or Publish Dilemma: Challenges to Responsible Authorship.

Controversies related to the concept and practice of responsible authorship and its misuse have been among the most prominent issues discussed in the recent literature on research integrity. Therefore, this paper aims to address the factors that lead to two major types of unethical authorship, namely, honorary and ghost authorship. It also highlights negative consequences of authorship misuse and provides a critical analysis of different authorship guidelines, including a recent debate on the amendments of the International Committee of Medical Journal Editors (ICMJE) authorship definition. Empirical studies revealed that honorary authorship was the most prevalent deviation from the responsible authorship standards. Three different modalities of honorary authorship were distinguished: gift authorship, guest authorship, and coercive authorship. Prevalence of authorship misuse worldwide and in Europe was alarmingly high, covering approximately one third of all scientific publications. No significant differences were reported in authorship misuse between different health research disciplines. The studies conducted in North America highlighted the most effective means to cope with unethical authorship. These were training in publishing ethics, clear authorship policies developed by medical schools, and explicit compliance with the authorship criteria required by the medical journals. In conclusion, more empirical research is needed to raise awareness of the high prevalence of authorship misuse among scientists. Research integrity training courses, including publication ethics and authorship issues should be integrated into the curricula for students and young researchers in medical schools. Last but not least, further discussion on responsible authorship criteria and practice should be initiated.