Leg& md E thick lssnes The Future and Law
URSING SCIENCE’S GOALS in ethics and law are to incorporate abstract ethical values and obligations and legal principles into clinical practice, specifically into clinical decision making. The ultimate goal is to assure that nursing practice falls within both legal and ethical parameters so that those who seek nursing care receive both safe and respectful care. At present, there is a lack of consensus on what constitutes ethical practice in nursing. This lack of clarity makes it difficult to understand the direction in which legal aspects of nursing practice should evolve. In order to gain consensus and develop theory in nursing ethics, research must include comprehensive attention to variables that affect ethical practice. Past ethics research has used a fragmented approach that has not adequately described factors that bear on ethical practice (Penticuff, 199 1). Nursing ethics is currently undergoing theoretical development (Benner, 1990; Fry, 1989; Ketefian, 1987; Yeo, 1989). Likewise, nursing law research is evolving as it relates to nursing science (Kjervik & King, 1990; Weiler & Rhodes, 199 1). Nursing research in law and ethics requires conceptual frameworks specifically designed to incorporate the variables that affect ethical and legal practice. Research that provides necessary data for descriptive and normative ethics in nursing must employ frameworks that take into account the intricacy of the nursing role within practice environments and the goals and values of nursing as these relate to human needs (Penticuff, 1991). As with other areas of nursing science, the development of science in nursing law and ethics requires a distinct perspective that includes the phenomena of interest, the context in which such phenomena are to be viewed, the questions to be raised, and the methods of study (Donaldson & Crowley, 1978). Programs of research in nursing ethics and law should be coherent and build on each other. Due to the multivariate nature of legal and ethical practice, research frameworks that place legal and ethical variables on the periphery are likely to result in distorted views of practice. Careers in ethics and law research are unlikely to be developed if this
DIANE K. KJERVIK, JD, RN, FAAN Professor and A.rsociateDean for Academic Program JOY PENTICUFF, PHD, RN, FAAN Associate Professor The Univwsity of Texas at At&in Srhool of Numng 1700 Red River Austin, TX 78701-1499 Copyright 0
1990 by W.B. Saunders Company 8755-7223/92/0802-0003$03.00/O
Journal of Professional Nursing,
Vol 8, No 3 (May-June),
research is not seen as a primary area of study independent of other areas. Nurse researchers must have adequate preparation in methods that properly address the complexity of the ethical and legal dilemmas confronted in practice. Funded ethics and law research is necessary so that researchers can have mechanisms for support of this research area. The conceptual constriction of past nursing ethics research has impeded theory development in nursing ethics and has been unsuccessful in explaining ethical practice (Penticuff, 1991). Participants in a national workshop noted that there is insufficient research-based information available for clinical ethical decision making. “This scarcity is primarily due to the apparent lack of systematic observation, analysis, and description that lead to the generation of hypotheses” (Faden & Murphy, 1990, p. 11). Participants also noted the difficulty that nurse researchers have in working within current theoretical frameworks that do not fit the realities of the nurse-patient relationship and do not mirror essential aspects of the clinical practice of nursing (Faden & Murphy, 1990). For clinical ethical decision-making to benefit from nursing research in ethics and law, research must employ a holistic-as opposed to a piecemeal--depiction of the realities of nurse-patient transactions within health care systems. Only then can the goals of research in ethics and law be achieved. References Benner, P. (1990). The moral dimensions of caring. In J. S. Stevenson & T. Tripp-Reimer (Eds.), Knowledge about care and caring (pp. 5-17). Kansas City, MO: American Academy of Nursing. Donaldson, S. K., & Crowley. D. M. ( 1978). The discipline of nursing. Nursrng Outlook, 26, 113-120. Faden, R. R., & Murphy, E. K. (1990). Proceedings of the Workshop, Btoethtcs and Clinical Practice: Examznrng Research OutcomeJ and Methods, Januav 12-13, 1989. National Center for Nursing Research. Fry, S. T. (1989). Toward a theory of nursing ethics. Advancer rn Nursing Science, I l(4), 9-22. Kerefian, S. (1987). A case study of theory development: Moral behavior in nursing. Advances in Nursing Science, 9(2), 10-19. Kjervik, D. K., & King, F. E. (1990). The legal research method: An approach to enhance nursing science. Journal of Professional Nurstng, 6, 2 13-220. Penticuff, J. H. (1991). Conceptual issues in nursing ethics research. The Journal of Medicine and Philosophy, lb, 235-258. Weiler, K., & Rhodes, A. M. (1991). Legal methodology as nursing problem solving. Image: Journal of Nursing Scholarship, -73(4), 241-244. Yeo, M. (1989). Integration of nursing theory and nursing ethics. Adlunces in Nursing Scjencr, I l(3), 33-42.