Nursing Ethics

IntroductionWisdom is frequently invoked as a hallmark of good nursing, yet its meaning and practical implications remain conceptually under-specified. Grounded in virtue ethics and the Aristotelian notion of phronesis, this paper aims to clarify the concept of "wisdom in nursing care" to support ethically grounded nursing practice.MethodsA concept analysis was conducted using the Walker and Avant method. The literature search was carried out in January 2026 using the PubMed and CINAHL...

BackgroundRepeated exposure to ethically challenging situations may lead to moral injury (MI). Though MI among healthcare professionals has attracted increasing attention, studies on the process of MI are limited.AimTo elucidate the entire process that psychiatric nurses in Japan undergo from before experiencing MI to their subsequent recovery. Core values in psychiatric nursing, what mitigate MI, and what is important to prevent MI are discussed.Research designA descriptive, qualitative design...

BackgroundNurses, as the most frequent providers of healthcare services, play a key role in nursing research. Their knowledge of ethics ensures scientific quality and respect for human rights.ObjectivesTo identify nurses' knowledge of Research Ethics Committees (REC) and to explore barriers and facilitators to access.Research designDescriptive cross-sectional study of nurses from two Spanish hospitals, conducted in March-April 2025, using ad hoc questionnaire.Ethical considerationsParticipants'...

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CONCLUSION: XAI should be understood not simply as a technical enhancement, but as a professional and ethical requirement for the responsible use of AI in critical care nursing. When implemented thoughtfully, XAI can strengthen clinical reasoning, transparency and accountable care.

This concept analysis aims to clarify the definition and key components of nurses' guilt associated with patient death. Walker and Avant's methodological approach was employed to identify defining attributes, antecedents, and consequences. A comprehensive literature review was conducted using PubMed, CINAHL, MEDLINE, PsycArticles, Scopus, and the Cochrane Library, focusing on articles published between 2015 and 2025. The literature search and selection process are reported in accordance with...

Digital infrastructures such as platforms, algorithms, and artificial intelligence (AI) are rapidly reshaping the conditions under which nursing care is enacted, raising ethical concerns that extend beyond efficiency. Indeed, as nursing becomes increasingly embedded within platformized and AI-mediated ecosystems, the discipline is confronted with new forms of harm arising from the disruptions to the relational foundations that make ethical nursing possible. Despite this, the discipline lacks a...

BackgroundReturn-to-play decisions are usually framed as matters of medical clearance, functional recovery, risk management, and athlete welfare. Although sports medicine ethics already addresses athlete health, professional autonomy, and third-party pressure, return-to-play can also be examined through nursing ethics where sustained caregiving responsibility coexists with limited procedural influence.Research aimThis article clarifies how return-to-play decisions may generate moral distress and...

BackgroundFinancial toxicity imposes a heavy burden on older cancer patients and their families. In Confucian societies, cultural norms fundamentally shape how financial burden is experienced, communicated, and managed-caregivers feel duty-bound to bear treatment costs, while older patients often conceal financial concerns to avoid burdening their families. This renders financial toxicity a dyadic, relational phenomenon rather than a purely individual economic stressor. Yet how patients and...

CONCLUSION: The results of this study indicated that the level of adherence to professional ethics among nurses at Imam Khomeini Hospital in Saqqez is mostly moderate. This can be considered a warning sign regarding the quality of nursing care and patient satisfaction. Despite relatively favorable performance in the area of professional commitment, weaknesses in interpersonal communication, especially in the nurse-colleague domain, require special attention. It is therefore recommended that...

CONCLUSIONS: Historical trauma-based education may provide a meaningful reflective space for professional identity work in graduate nursing education. The findings suggest that, when supported by trauma-informed pedagogy and reflective writing, difficult historical content can help students articulate ethical commitments and anticipated nursing responsibilities. Future studies should examine whether these immediate reflective commitments are sustained over time and translated into practice.

CONCLUSION: Professional values are a strong determinant of moral courage among nurses. Individual and professional characteristics are key moderators of this relationship. Together with professional values, they influence nurses' ethical decision-making, risk-taking, and professional identity, thereby strengthening moral courage. Developing educational programs and organizational environments that support professional values while considering individual differences is crucial for promoting...

CONCLUSIONS: These findings indicate that dignity is crucial in shaping nursing students' professional identity and ethical awareness throughout their education. Reinforcing ethical values and dignity in nursing education is essential for high-quality care.

BackgroundIn contrast to legally mandated coercive care in psychiatry, there is a paucity of studies on the use of coercive practices within somatic healthcare.AimTo gain an in-depth understanding of the practices used by nurses and other staff to provide somatic healthcare interventions to ill patients in the absence of informed consent.Research designFocus-group interviews were held, and the collected data were analyzed qualitatively using Reflexive Thematic Analysis.Participants and research...

The meteoric rise of nurse influencers on social media platforms like Instagram and TikTok represents a paradigm shift in the history of the nursing profession, transforming care from a private, clinical interaction into a public, performative spectacle. While this digital visibility offers opportunities for global advocacy, it creates a complex dialectic between the democratization of health knowledge and the commodification of professional identity. This integrative narrative review explores...

CONCLUSIONS: Nursing students observed violations of patient autonomy, informed consent, privacy, and equality, and experienced moral distress. Ethics education should emphasize core values, strengthen ethical decision making, and foster moral courage. In addition, academic and clinical settings need to provide emotional and professional support, to help students manage distress, and develop resilience as future professionals.

CONCLUSIONS: Conscious justification bridges technical explainability and ethical accountability, essential for responsible AI deployment in nursing globally. Implementation requires coordinated attention to technical systems, normative frameworks, institutional structures, and professional competencies, with particular attention to cultural context and resource variations across healthcare systems.

CONCLUSION: The PAMSS Model offers implications for nursing leadership, clinical practice, institutional decision-making, and ethics consultation by providing a structured ethical framework for addressing requests involving patients' own companion animals during healthcare institutionalization.

BackgroundPsychiatric inpatients in China may experience threats to dignity and self-expression within ward environments shaped by stigma, safety concerns, and institutional routines. However, how they navigate these challenges and restore dignity through everyday interactions during hospitalization remains underexplored in psychiatric nursing.AimTo develop a substantive theoretical framework explaining how Chinese psychiatric inpatients experience dignity challenges and navigate pathways toward...

Nursing is a profession grounded in a vocation of caring, altruism and moral responsibility. However, contemporary nursing practice occurs largely within a healthcare system structured by neoliberal, productivity-driven imperatives-commonly described as the healthcare-industrial complex. As market-oriented logics continue to shape healthcare delivery and access to care, tensions emerge between the moral foundations of nursing and the economic rationalities that govern healthcare institutions....

CONCLUSION: Latent profile analysis was applied in this study. The moral resilience of clinical nurses was divided into three categories. The moral resilience of different profiles is closely related to the level of ethical behavior of clinical nurses. Based on these findings, healthcare institutions should implement targeted intervention strategies tailored to the heterogeneous characteristics of nurses' moral resilience, enhancing their moral resilience levels by optimizing organizational...

BackgroundEthical dilemmas in pediatric oncology represent a major challenge for nurses, significantly impacting their well-being and motivation at work.Research aimThe objective of this study was to identify the ethical dilemmas experienced by nurses through a sample recruited from two pediatric cancer treatment units.Research designThis study adopts an interpretative phenomenological qualitative approach based on interviews conducted with nurses working in pediatric oncology.Ethical...

Diversity, equity, and inclusion (DEI) are essential principles in the healthcare landscape, particularly in the nursing profession, aimed at reducing systemic inequities, improving representation, and strengthening fair opportunities across nursing education, workforce development, and clinical practice. However, the current U.S. political climate has posed challenges to the value of DEI by dismissing its ethical imperatives and disavowing the evidence that equity initiatives function as...

CONCLUSION: The Chinese version of the BPAPS has good reliability and validity. It can be used as an effective tool to assess barriers to PA in Chinese pregnant women.

In elder care, "safety" is frequently accorded overriding moral priority. As a result, restrictive measures introduced under the banner of risk prevention are readily treated as "reasonable protection," while, under the guise of care, they can encroach on older persons' freedom, privacy, and dignity. The expansion of digital care technologies reinforces logics of continuous monitoring and alerting, thereby intensifying this tension. Existing debates often remain confined to an "autonomy versus...

Nursing ethics today is often guided by policies, professional codes, and principle-based frameworks. These structures are essential for protecting patients and ensuring professional accountability. However, ethical practice cannot be reduced to following rules alone. Many nurses continue to experience moral distress, emotional strain, and loss of professional meaning, even when they comply with institutional guidelines. This suggests that ethical principles, while necessary, are not sufficient...

BackgroundEthical sensitivity is a foundational competency that enables nursing interns to recognize and respond to ethical issues in clinical practice. Understanding its heterogeneity is essential for designing tailored educational interventions.AimThis study aimed to identify distinct latent profiles of ethical sensitivity among nursing interns and to examine their associations with critical thinking and readiness for artificial intelligence (AI) in healthcare.Research designA cross-sectional...

Nursing scholarship has extensively documented the harms of inequity within healthcare systems, including racism, bias, and structural exclusion affecting patients and the nursing workforce. Less examined, however, is a foundational ethical question: what does ethical care require of the caregiver within inequitable systems? This paper argues that wellbeing should be understood not merely as an outcome shaped by justice, but as a professional and organizational capacity necessary for ethical,...

Moral distress has become one of the most prominent ethical constructs in contemporary nursing, widely used to describe nurses' experiences of constraint, frustration and ethical unease. While moral distress scholarship continues to retain important ethical and structural dimensions, the broader operationalisation of moral distress within healthcare organisations and professional discourse may influence how ethical conflict is understood and managed within healthcare organisations. This paper...

CONCLUSIONS: Our findings demonstrate that the German adaptation of the MMD-HP shows potential for measuring moral distress among intensive care nurses in Germany. In addition, its psychometric properties preliminarily support its reliability and validity in this cultural context. Further independent validation studies are needed to provide support for the proposed four-factor model.

CONCLUSIONS: The findings indicate that strengthening moral resilience depends not only on individual attributes but is deeply influenced by workplace relationships, institutional ethical climate, and organizational conditions. These results underscore the importance of educational and institutional strategies that promote dialogue, ethical reflection, interprofessional collaboration, and professional support in daily clinical practice, contributing to quality of care, patient safety, and...

CONCLUSIONS: Intensive care nurses sensitive to their patient's physical and emotional needs often experience moral distress for many reasons during the advanced cardiopulmonary life support process. Intensive care nurses experience moral distress during advanced cardiopulmonary life support due to lack of knowledge, legal obligations, organizational problems, inadequate teamwork and equipment and inadequacies in person-centred care.

Nurses, frontline providers, must ethically adopt AI in care, but no validated tool exists to assess their ethical acceptance. This study aims to develop and evaluate the Nurses' Ethical Acceptance of Artificial Intelligence Scale (NEAIS). A methodological study was conducted in 2 phases between August 2024 and May 2025. In phase I, an item pool was developed based on ethical awareness theory and the Unified Theory of Acceptance and Use of Technology. Content validity was confirmed through...

BackgroundTransgender youth face multiple ethical and social challenges that significantly impact their mental health, dignity, and overall well-being. These challenges are influenced by social, cultural, and religious norms in a middle eastern country, and little is known about the ethical dimensions of their lived experiences.Research question/aim/objectivesThis study aimed to explore the ethical challenges and human vulnerability experienced by transgender youth in a middle eastern country,...

CONCLUSIONS: This study suggests that a low-resource, immersive role-play format may help nursing students engage with bioethical principles in context, consider multiple stakeholder perspectives, and reflect on their future professional responsibilities. The findings support IERS as a feasible complement to didactic ethics teaching, while also indicating the need for longitudinal and comparative research to assess sustained educational impact.

Aim: To report an analysis of the concept of moral distress among nurses caring for undocumented immigrants (UIs). Design: Concept analysis is the study design. Data Sources: Data sources included nursing and health care databases searched from 2015 to 2025. Eight articles were identified that addressed moral distress in the context of nursing care for UIs. Review Methods: Walker and Avant's method was used to identify definitions, antecedents, consequences, and empirical referents of the...

CONCLUSION: Nursing management competency performance among nurses in national specialized hospitals was associated with the nursing work environment, including organizational conditions. These findings underscore the importance of organizational support and suggest that competency-based education should be redesigned to prioritize high-need competency areas. This study provides a foundation for developing educational interventions and programs to enhance nursing management capacity.

CONCLUSIONS: These findings underscore the bidirectional yet distinct relationships between specific insomnia symptoms and depression in older adults. DIS shows consistent bidirectional associations with depressive symptoms, while DMS is only concurrently associated. Understanding the specific interplay between these conditions may enable the development of more targeted and effective prevention and treatment strategies.

BackgroundIn Residential Aged Care Homes (RACHs), medication administration is typically carried out by aged care workers, rather than being under the control of older adults. Very little empirical qualitative evidence exists around situations where medication is refused by older adults.Research aimTo explore aged care workers', older adults', and family members' perspectives and experiences of medication refusal in RACHs.Research designA qualitative exploratory study design. Participants and...

CONCLUSION: The Chinese version of the EDM-CS demonstrates robust psychometric properties and provides a standardized, theoretically grounded instrument for assessing ethical decision-making competence among nursing students in mainland China. The findings support the cross-cultural applicability of Rest's Four-Component Model and provide empirical support for nursing ethics education and evaluation in mainland China.

BackgroundNurses frequently encounter ethical dilemmas, moral distress, and situations in which they must balance professional duties, personal values, and organizational constraints. Deontological ethics, particularly Kant's ethics of duty, offers a normative framework that emphasizes moral action grounded in duty rather than consequences. However, limited empirical research explores how nurses understand and enact Kantian principles in everyday clinical practice.Research aimTo explore how...

BackgroundPrevious studies have confirmed a connection between nurses' professional autonomy and their attitudes toward patient safety. However, no research has investigated the indirect mediating role of moral sensitivity in this relationship. It is crucial to address this gap to enhance nursing care outcomes.Research aimTo investigate the mediating role of moral sensitivity in the relationship between professional autonomy and patient safety attitudes among ICU nurses.Research...

CONCLUSION: AI can assist nurses with their tasks, but it cannot currently replace the compassionate, humanistic patient care delivered by nurses. Nurses must serve as moral arbiters of AI, ensuring that technology augments rather than supplants the profession's ethical core.

Endoscopy departments tend to prioritize task efficiency, which may sometimes limit individualized and patient-centered nursing care. Structured workflows and time constraints can make it challenging for nurses to fully address patients' needs and ethical concerns. However, the ethical issues specific to endoscopic nursing remain largely unexplored. This study aims to clarify ethical issues perceived by nurses involved in endoscopic practices. A qualitative study was conducted with 14 nurses...

BackgroundThe healthcare system is characterized by increasing complexity. As moral challenges in healthcare become increasingly frequent, healthcare professionals, patients, and families turn to Clinical Ethics Consultants (CECs) for support. This evolving scenario highlights the importance of establishing clear professional standards and competencies for consultants to ensure qualified, transparent, and ethically rigorous support.Research aimTo define a repertoire of technical-professional and...

A review of the new American Nurses Association Code of Ethics for Nurses and workplace violence application case example.

BackgroundJapan has been promoting the use of medical and long-term care robots to reduce the workload of healthcare professionals. In home-visit nursing, where the number of older adults and patients with dementia is increasing, robots may provide benefits, such as supporting infection control and physically demanding care. However, implementing these technologies may also generate new ethical challenges.ObjectiveTo clarify home-visiting nurses' perceptions and the ethical issues regarding the...

BackgroundOrgan procurement following death by neurological criteria can pose ethical challenges for transplant teams, yet the lived experiences of these professionals - particularly nurses - remain poorly understood, especially where donation rates are low.Research question/aim/objectivesTo explore ethical issues experienced by transplant team members during deceased donor organ procurement and examine coping strategies for morally and emotionally challenging experiences, with attention to...

Moral resilience plays a key role in providing quality care to patients. The way nurses view ethical issues directly affects their decision-making. This study aimed to investigate the relationship between the ethical ideology and moral resilience of nurses working in critical care units. The present study is a cross-sectional, correlational study. The study sample included 196 nurses working in critical care units. In addition to the demographic questionnaire, Forsyth's Ethics Position...

CONCLUSIONS: National and organisational support for the ACP process, cultural competency in ACP and engagement efforts to raise awareness and address barriers to ACP are important considerations in ACP implementation in the Asia Pacific.