:,, M ir ia m * ** * Ca m e ro n *** **** *****..., (Salla dy & Mcdon n ell, 99 2 )., (Ket efia n, 98 8 ).,.., (Ca m er on, 2 ). (H a n & Ah n 9 9 5 ; Ah n et al, 99 5) (H a n & Ah n, 2 ). Cameron Sch affer (992 ), Pierce (997), Ca m er on (2 ). (von P ost, 996 ; Deca st er le et a l, 9 97 ), (Tu r n er, 99 ). (Ob er le, 99 5 ; DeCa st er le et a l, 99 7 ).. (H a n & Ah n, 99 5 ) * **** ** ***** *** Un iver sit y of Minn esot a College of Nur sing 2 5 2 2 6 2 2 9-8 4 6 -
3 5. 4.,. 2.. ). 2 )...,. Beau ch amp Ch ildr ess (994 ). 4,,,,,.. F r a n k en a (97 3 ),. Thiroux (986 ),,,,,,.. (et h ics of ca rin g).. (Taylor, 998 ).,..,.,,. (Ga st m a n s et a l, 998 ; Ga st m a n s, 999 )... (Lipp, 99 8 ; P ier ce, 99 7 ; Ton g, 99 9 ). (Cam er on, 993)...,,,,,,,. (vir t u e et h ics). (P ellegr in o, 99 5 ). Fr a nk en a (973 ) Bea u ch a m p (9 9 5).,... (Pellegrino, 995 ; Ben n er, 9 97 ; va n H ooft, 999 ). Valu e, Be, Do (Cam er on, 2 )., - 8 4 7 -
2,,. '? ', '? ', '? '.... 2. (H a n & Ah n, 99 5 ; Ah n et a l, 9 9 5). H a n Ah n (2 ) Ber gm a n (97 3 ).,.,,,,, 3 4. " " Ca m er on Sch affer (99 2 ) 5,,,, (m ana ged ca r e ).,,,, 4 %. Ca m er on Sch affer (9 92 ) 4 4... Cam er on (2 ),,. (F ry, 9 89 ; Ca llery, 99 ) (von P ost, 996 ; Deca st er le et a l, 9 97 ), (Bell, 984 ; Frisch, 987 ). (H a n et al, 999 ).... (con t ent a n alysis ). 2. 4 C 4 9 S 4 8 9 7. 3. ) (4 ). 5-8 4 8 -
3 5...,.. () Bea u ch a m p Ch ildr ess (994 ) (2) Fr a nk en a (973 ) (3 ) Th ir ou x (986 ) (4 ) (car in g a n d j u st ice ) (Ca m er on, 9 93 ) (5) - Va lu e, Be, Do (Ca m er on, 2 ) 2 ) () A :?,,. (2 ) B : 5 A.. 4. A. B A, B. 5.,. Ca m er on (2 ) 5, (cont ent a n a lysis ). A, 3,. B. a.. b.. c.... 97 <T a b le > Co nt e nt Cate g o rie s a n d Pe rc e nt ag e o f Et h ic a l P ro b le m s Cont en t F r equ en cy of Et h ical pr oblem s (% ) Et h ica l Pr oblem s In volving H ealt h Pr ofession als N u r sin g St a ff Ph ysicia n s Et h ica l Pr oblem s In volving Qu alit y of Life/ Dea t h & Dyin g Et h ica l Pr oblem s In volving Disa gr eem en t wit h a Clint ' s Beh a vior Et h ica l Pr oblem s In volving P er son s wit h H IV/ AIDS a n d Ot h er Con t a giou s Disea ses Ot h er s 67 (69. ) 4 7 2 6 (7. ) 2 ( 2 ) 5 ( 5 ) 7 ( 7 ) Tot a l 97 (. ) - 8 4 9 -
2 5,, /,, H IV/ AIDS, <Ta ble >.. A. (,,, )..,.... (8 ) MRSA.,,....,,,, ( ),,.,,.. 2.,.. 38.... 8. 6.... B.. cm., 5... 2. /.. %.,,. - 8 5 -
3 5 3.. (5 ),. 4. H IV / A ID S,..? 5.,.,.,,.,,? <Table 2 >. VBD (Va lu e, Be, Do) 4 2, BC (Bea u ch a m p & Ch ildr ess ) TH (Th ir ou x ' s ) 7, CJ (Ca rin g & J u st ice ) 5, F R (F r a nk en a ' s) 6. 2. ),...... <T a b le 2 > F req u e ncy of Et h ica l De c is io n Ma king Mo d e ls * Us e d to Res o lv e Et h ic a l P ro b le m s in Fiv e Co nt e nt Cat eg o rie s Et h ica l Decision Mak in g Models Con t ent Ca t egories BC CJ F R TH VBD H ealt h Pr ofession als Qu alit y of life/ Dea t h Clien t ' s Beh a vior Con t a giou s Disea se Ot h er s 2 3 4 4 3 3 24 8 2 2 6 Tot a l Et h ical Pr oblem s/ St u d en t s N (% ) 67 ( 69. ) 6 ( 6.5 ) 2 ( 2.) 5 ( 5.2 ) 7 ( 7.2 ) Tot al for Models 7 (7.5 ) 5 (5.5 ) 6 (6.2 ) 7 (7.5 ) 4 2 (4 3.3 ) 9 7 (. ) * A b b r e v i a t i o n f o r E t h i ca l D e ci s i o n M a k i n g M o d e l s B C : Act ion Gu id es of Beau ch a m p a n d Ch ildr ess Model CJ : Car ing & J u st ice Et h ica l Decision- Ma k ing Model F R : F r a nk en a ' s Mixed Deont ologica l Th eor y of Obliga t ion T H : Th ir ou x ' s U n iver sal Et h ica l Prin ciples V B D : Va lu e, Be, Do : Gu id elin es F or Resolving Et h ica l Con flict - 8 5 -
2...,. 2 ).......,..,........ 3 ).....,......... <T a b le 3 > N u rs ing S t u d e nts Re a ct io ns to Us in g Et h ic a l De c is io n Ma kin g Mo d e ls Rea ct ion s BC CJ F R TH VBD N (%) Model H elped 6 5 6 6 38 9 (93.8 ) - Mod el Sim ply h elped. - Mod el h elp ed, bu t m y r esolu t ion r em a in ed t h e sam e - Mod el h elp ed, bu t didn 't r esolved m y conflict. - Mod el h elp ed, bu t it h a s sa m e disa dva n t a ges. Model Did N ot H elp 3 4 (4. ) St u d en t Did N ot Addr ess Rea ct ion 2 (2. ) 2 2 2 Tot al 7 5 6 7 4 2 97 ( ) 2 2 5 2 3 29 3 3 3 7 7 7 7-8 52 -
3 5 3. <Table 3 >. 9 (9 3.8 % ), 4. ). 7,...,....,.,,? 2 ). 2. 7... 7.,. 7. Th ir ou x,,.. 3 ). 4,..,,... 69 % Cam er on (2 ) 44 %. 2 % Ca m er on (2 ) ( 4 % ). Cam er on (2 ),,,,. Cam er on (2 ). H a n Ah n (2 ),,,. - 8 5 3 -
2.......... (de Ca st erle, et a l, 99 7 ).,,. 2. VBD (Va lu e, Be, Do) (4 3 %) Ca m er on (2 ) CJ (26 %). VBD. Cam er on (2 ) CJ F R (F r a nk en a, 973 ) BC 2 CJ. 4 (4 %) 3 Ca m er on (2 ) 52 %. 3. Ca m er on (2 ) (6 ) 2/ 3,..,.,.,,.,,.,. (Riley & F ry, 2 ; va n der Ar en d & Rem m er s- va n den Hu rk, 999 ; von P ost, 99 6 ; Wa gn er & Ron en, 996 ; Gold, Ch am ber s, Dvor ak, 9 9 5)..,, (de Cast erle, et a l, 9 97 )., (Cam er on & Moch, 2 ; Mysak, 99 7 ) - 8 54 -
3 5.. 2 4 9 7, 5,...,,,.. VBD (Va lu e, Be, Do) 42, BC(Beauchamp & Ch ildr ess ) TH (Th ir ou x s) 7, CJ (Car in g & J u st ice ) 5, F R (Fr a nk en a s ) 6. 9., /,, H IV/ AIDS, 5. 69 % (67 ) 4 7 % (4 7 ), 2 % (2 ). / 7 %. 2 %. H IV/ AIDS 5%. 7 %.,,,...., Re fe re nce Ah n, S. H., H a n, S. S., Kim, C. H. (99 5). A st u dy of m or al r ea son in g by t h e Definin g Issu es Test a m on g m edica l st u dent s. J of Korean N u rsing A dm in. A cad S ociety, 2 (2 ), 8 5-9 5. H a n, S. S., Ah n, S. H. (99 5 ). Mor a l r ea sonin g a n d et h ica l decision m ak in g a m on g st u den t nu r ses in m or a l dilem m a s. J of Korean N u rsing A dm in. A cad S ociet y.feb. (), 5-2. H a n, S. S., Kim, Y. S., U m, Y. R., Ah n, S. H. (99 9 ). Th e St at u s of N u r sin g Et h ics Edu cat ion in Kor ea 4 -Yea r- College of Nu r sin g. J of Korean A cad S ociety of N u rsing E du Dec. 5 (2 ), 376-386. Beau ch amp, T., Childress, J. (994 ). Principles of biom edical et h ics (4 t h E d.). N ew Yor k. Oxfor d U niver sit y Pr ess. Beau ch am p, T. L. (99 5 ). Prin ciplism a n d it s alleged com p et it or s. Ken n edy In st it u t e of Et h ics J ou rn al, 5, 8-98. Bell, S. K. (984 ). Effect s of a Biom edica l Et h ics Cou r se on Sen ior N u r sin g St u dent s' Level of Mor a l Developm ent.(doct or a l Disser t a t ion, West Vir ginia U niver sit y, 984 ). Dissert at ion A b st ract s Int ern at ion al, 4 5, 32 5 B. Ben n er, P. (99 7 ). A Dia logu e b et ween virt u e et h ics a n d car e et h ics. T h eoret ical M edicin e, - 8 5 5 -
2 8, 4 7-6. Ca m er on, M. E., Sch affer, M. A. (99 2 ). Tell m e t h e r igh t a n swer : A m odel for t ea ch in g nu r sin g et h ics. J of N u rsing Edu cat ion. 3 (8 ), 37 7-38. Ca m er on, M. E. (9 93 ). Liv ing wit h A IDS : Ex p erien cing Et h ical Program s. N ewbu ry P ar k, CA : Sa ge Pu blica t ion s. In c. Ca m er on, M. E. (996 ). Virt u e et h ics for nu r ses a n d h ea lt h car e. J of N u rs L aw, 3 (4 ), 27-39. Cameron, M. E. (2). Valu e, Be, Do: Guidelines for r esolvin g et h ical conflict. J of N u rs L aw, 6 (4 ), 5-24. Ca m er on, M. E., Moch, S. D. (2 ). Et h ical r ela t ion sh ips a m on g nu r ses. J of N u rs L aw, 7 (), 3-2. Ca m er on, M. E., Sch affer, M., P ark (2 ). N u rsing st u dent s ' ex p erien ce of et h ical problem s an d u se of et h ical decision -m ak ing m od els. N u rsing Et h ics.8 (5), 4 3 2-44 7. DeCa st er le, B. D., Gryp don ck, M., Vu ylst ek e- Waut ers, M., J a nssen, P. J. (997). Nur sing st u dent s ' Respon ses t o Et h ica l Dilem m a s in Nu r sin g Pr a ct ice. N u rsing Et h ics, 4 (), 2-2 8. F r a nk en a, W. K. (9 73 ). Et h ics (2 n d E d.). En glewood Cliffs, N J : Pr ent ice- H all. F risch, N. C. (987 ). Valu e a n alysis : A m et h od for t ea ch in g n u r sin g et h ics a n d pr om ot in g t h e m or a l developm ent of st u dent s. J of N u rs Edu cat ion, 24 (4 ), Dec. 9 56-9 57. F ry, S. T. (989 ). Towa r d a t h eor y of nu r sin g et h ics. A dv an in N u rs S cien ce, (4 ), 9-2 2. Ga st m a n s, C. (99 9 ). Car e a s a m or a l a t t it u de in nu r sin g. N u rsing Et h ics, 6, 2 4-2 23. Ga st m a n s, C., Dier ck x, de Ca st erle, B., & Sch ot sm a n s, P. (9 98 ). N u r sin g con sider ed a s m or a l pr a ct ice : A Ph ilosoph ical et h ical int er pr et a t ion of nu r sin g. Ken n edy In st it u t e of Et h ics J ou rn al, 8, 4 3-69. Gold, C., Ch am b er s, J., Dvor a k, E. M. (99 5 ). Et h ica l dilemm a s in t h e lived exp er ien ce of nu r sin g pr a ct ice. N u rsing Et h ics, 2 (2 ), 3-4 2. H a n, S. S., Ah n, S. H. (2 ) An An a lysis a n d Eva lu a t ion of St u d ent N u r se ' P a rt icipa t ion in Et h ical Decision Ma k in g. N u rsing Et h ics, 7 (2 ), 3-23. Ket efia n, S. (9 88 ). M oral R easoning an d Et h ical Pract ice in N u rsing ; An Int egr a t ive Review. N ew York : N LN. Lipp, A. (99 8 ). An in qu iry int o a com bin ed a p pr oa ch for nu r sin g et h ics. N u rsing Et h ics, 5, 22-38. Mysak, S. (9 97 ). St r at egies for pr om ot in g et h ica l decision- m ak in g. J Geront o N u r, 23 (), 2 5-3. Oberle, K. (99 5). Mea su rin g nu r ses m or al r ea sonin g. N u rsing Et h ics, 2 (4 ), 3-3 3. P ellegrin o, E. D. (9 9 5). Towa r d a virt u e-b a sed n orm at ive et h ics for t h e h ea lt h pr ofession s. Ken n edy In st it u t e of Et h ics J ou rn al, 5, 2 53-277. Pier ce, S. F. (997). A model for conceptu alizing t h e m or al dyn a m ic in h ea lt h car e. N u rsin g Et h ics, 4, 4 83-4 9 5. Riley, J. M., F ry, S. T. (2 ). N u r ses r epor t widespr ead et hical conflict s. Reflect ion s N urs L eadersh ip, 26 (2 ), 3 5-36. Sa lla dy, S. A., Mcdon n ell, M. M. (99 2 ). Fa cing et hical conflict s. N ursing, F eb. 44-47. Ta ylor, C. R. (998 ). Reflect ion s on "N u r sin g con sider ed a s m or al pr a ct ice." Ken n edy In st it u t e of Et h ics J ou rn al, 8, 7-8 2. Ton g, R. (9 99 ). F eminist a ppr oa ch es t o bioet h ics. M edical Et h ics, Wint er., 2, 8. Th ir ou x, J. P. (98 6 ). Et h ics : T h eory an d pract ice (3r d Ed.). N ew Yor k : Ma cm illa n Pu blish in g Com pa ny. Tu r n er, S. L. (99 ). A n ev alu at ion of t h e effect iv en ess of a gu ided design in st ru ct ion al p ack age on et h ical decision m ak ing of senior nu rsing st u den t s. Disser t a t ion Ab st r a ct s Int ernational. Health Science Nursing University - 8 56 -
3 5 of Geor gia. va n d er Ar en d AJ G, Rem m er s- va n den Hu rk CHM. (999 ). Mor a l pr oblem s am on g Du t ch nu r ses : A su rvey. N u rsing Et h ics, 6 (6 ), 4 68-4 82. va n H ooft, S. (9 99 ). Act in g fr om t h e virt u e of car in g in nu r sin g. N u rsing Et h ics, 6, 89-2. von P ost, I. (99 6 ). Explorin g et h ica l dilem m a s in p er ioper a t ive nu r sin g pr a ct ice t h r ou gh crit ica l in cident s. N u rsing Et h ics, 3 (3 ), 236-24 9. Wa gner, N., Ronen, I. (996). Et hical dilemm as exp er ien ced by h ospit al a n d com mu nit y nu r ses : An Isr a eli su rvey. N u rsing Et h ics, 3 (4 ), 294-3 4. - Ab st r a ct - Kor e a n Nu r s in g St u d en t s ' Ex p er ien ce of Et h ic a l Pr ob lem s a n d Us e of Et h ic a l De cis ion - Ma k in g Mo d els Han, S u n g -S u k * Park, Hy e ou n -Ae ** A h n, S u n g -Hee * Cam e ron, Miriam E. *** Oh, Hy o -S ook **** Kim, Ky e on g -Uoon ***** P u r p o s e : Th is st u dy w a s con du ct ed t o st u dy on ) Wh at is nu r sin g st u d ent s' exp er ien ce of et h ical pr oblem s involvin g nu r sin g pr a ct ice? 2 ) Wh a t is nu r sin g st u den t s ' experien ce of u sin g et h ical d ecision- m a kin g m odels? Me t h o d : In or der t o a n swer t h ese t w o qu est ion s, we select ed 97 senior b a ccala u r ea t e nu r sin g st u den t s fr om t wo Kor ea n u n iver sit ies u sin g a con cept u al fr am ework a n d m et h od of cont en t a n a lysis. Re s u l t : F r om 97 et h ica l pr oblem s em er ged five cont ent ca t egor ies, t h e lar gest bein g et h ica l pr oblem s involvin g h ea lt h pr ofession a ls (69 % ) ; t h e ba sic n a t u r e of t h e nu r sin g st u dent s ' experien ce of et h ical pr oblem s con sist ed of conflict, r esolu t ion, a n d r at ion ale ; 94 % of t h e st u d ent s st a t ed t h at u sin g a n et h ical decisionm a kin g m odel wa s h elpfu l. Co n c lu s i o n : Alt h ou gh a ddit ion al r esea r ch is needed, these findings h ave import ant for nu r sin g et h ics edu ca t ion a n d pr a ct ice. implicat ions Key w o rds : Nursing St udent s, Ethical Problems, Et h ical Decision Mak in g Model * Th e Ca t h olic Un iver sit y College of N u r sin g ** S eou l N a t ion a l U n iv er sit y C oll ege of N u r sin g *** Universit y of Min n esot a College of Nursing **** S eou l N a t ion a l U n iv er sit y C oll ege of N u r sin g P h.d C a n di d a t e ***** Kor ean Nu r ses Associa t ion Man ager of E d u ca t i on D ep a r t m en t - 8 5 7 -