Moral dilemmas involving anthropological and ethical dimensions in healthcare curriculum

Nurs Ethics. 2020 Aug;27(5):1238-1249. doi: 10.1177/0969733020914382. Epub 2020 Apr 29.

Abstract

Background: Currently a variety of novel scenarios have appeared within nursing practice such as confidentiality of a patient victim of abuse, justice in insolvent patients, poorly informed consent delivery, non-satisfactory medicine outputs, or the possibility to reject a recommended treatment. These scenarios presuppose skills that are not usually acquired during the degree. Thus, the implementation of teaching approaches that promote the acquisition of these skills in the nursing curriculum is increasingly relevant.

Objective: The article analyzes an academic model which integrates in the curriculum a series of specific theoretical concepts together with practical skills to acquire the basic ethic assessment competency.

Research design: The project includes designing two subjects, General Anthropology and Ethics-Bioethics, with an applied approach in the nursing curriculum. The sequential structure of the curriculum in both subjects is constituted by three learning domains (theoretical, practical, and communicative) with different educational strategies.

Ethical considerations: No significant ethical considerations as this is a discussion paper.

Findings: The model was structured from the anthropology's concepts and decision-making process, applied to real situations. The structure of the three domains theoretical-practical-communicative is present in each session.

Discussion: It is observed that theoretical domain fosters the capacity for critical analysis and subsequent ability to judge diverse situations. The practical domain reflected two significant difficulties: students' resistance to internalizing moral problems and the tendency to superficial criticism. The communicative domain has frequently shown that the conflicting points are in the principles to be applied.

Conclusion: We conclude that this design achieves its objectives and may provide future nursing professionals with ethical competences especially useful in healthcare practice. The three domains of the presented scheme are associated with the same process used in decision making at individual levels, where the exercise of clinical prudence acquires particular relevance.

Keywords: Case study methods; ethics education; moral dilemmas; moral sensitivity; moral/ethical climate of organizations; virtue ethics.

MeSH terms

  • Anthropology / education
  • Curriculum / standards*
  • Curriculum / trends
  • Education, Nursing, Baccalaureate / ethics*
  • Education, Nursing, Baccalaureate / trends
  • Ethics*
  • Humans
  • Stress Disorders, Post-Traumatic / etiology*
  • Stress Disorders, Post-Traumatic / psychology
  • Students, Nursing / psychology*
  • Students, Nursing / statistics & numerical data