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Open Access Navigating Towards a Moral Horizon: A Multisite Qualitative Study of Ethical Practice in Nursing Vers un horizon déontologique: une étude qualitative multicontextuelle des pratiques déontologiques au sein de la profession infirmière

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This paper reports the results of a qualitative study of nurses' ethical decision-making. Focus groups of nurses in diverse practice contexts were used as a means to explore the meaning of ethics and the enactment of ethical practice. The findings centre on the metaphor of a moral horizon — the horizon representing "the good" towards which the nurses were navigating. The findings suggest that currents within the moral climate of nurses' work significantly influence nurses' progress towards their moral horizon. All too often the nurses found themselves navigating against a current characterized by the privileging of biomedicine and a corporate ethos. Conversely, a current of supportive colleagues as well as professional guidelines and standards and ethics education helped them to move towards their horizon. The implications for nursing practice and for our understanding of ethical decision-making are discussed.

Cet article rapporte les résultats d'une étude qualitative portant sur la prise de décision axée sur des principes déontologiques chez les infirmières. Des groupes de discussion rassemblant des infirmières travaillant dans divers contextes professionnels ont été mis sur pied pour explorer la signification du concept d'éthique et la mise en æuvre d'interventions fondées sur des principes déontologiques. Les résultats s'appuient sur la notion d'horizon déontologique (moral horizon) — l'horizon représentant « le bien », l'objectif que les infirmières ciblent dans leur pratique. Les résultats indiquent que les courants du climat moral dans lequel æuvrent les infirmières influencent de façon importante le cheminement de celles-ci vers l'horizon déontologique qu'elles visent. Bien trop souvent, les infirmières ont été forcées à naviguer contre un courant qui privilégie la biomédecine et la culture corporative. Par ailleurs, un courant favorisant le soutien entre collègues, la présence de lignes directrices et de normes professionnelles, et l'éducation déontologique les a aidées à cheminer vers cet objectif. Les implications quant à la pratique infirmière et une compréhension d'une prise de décisions fondées sur des principes déontologiques font l'objet d'une discussion.

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Document Type: Research Article

Publication date: 2009-03-01

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