Legal and ethical aspects of informed consent: a nursing research perspective

Patient autonomy in care: a theoretical framework for nursing

Patient autonomy has increasingly become an issue in a health care system that often promotes dependence in decision making. The complex technology of health care creates situations in which difficult decisions need to be made by patients and their families. Nurses are important participants in that decision-making process. Models available for developing a theoretical approach to patient autonomy traditionally have been limited to ethics literature. A more recent approach to personal autonomy is Meyer's philosophical feminist perspective. Any philosophical approach to patient autonomy must be congruent with other critical nursing concepts. In addition, a model of patient autonomy for nursing must be useful for persons who operate at various functional levels. The model, Patient-Autonomy in Care, based on the Meyer's model, was developed to incorporate the special vulnerability and functional needs of patients in the health care system.

Hospice research: the importance of program participation

Hospice research is needed in order to understand the complex phenomena of holistic care for terminally ill persons and their families. Hospice program participation is key to future hospice research efforts. The purpose of this article is to encourage hospice programs to participate in hospice research. The discussion includes why research is done, who undertakes a research project, the role of institutional review boards in assuring rights of human subjects and potential strategies for recruitment of research subjects. The authors use their experiences with conducting hospice research to illustrate potential recruitment strategies.

Nursing research in the United States: the protection of human subjects

In the United States the protection of the rights of human subjects in experimentation has evolved at three levels: professional, public, and private. At the professional level, codes, guidelines and the Patient's Bill of Rights address the issues of protecting the dignity, privacy and autonomy of individuals who serve as research subjects. At the public level, regulations promulgated by the Food and Drug Administration and the Department of Health and Human Services have become the standard for protecting human subjects. At the private level, United States common law regulates the conduct of individual researchers by requiring them to act in a manner consistent with generally accepted standards of care. As professionals, nurses must be actively involved in the formation of public policy regarding the conduct of research and strive to formulate a research agenda that will ensure that the ethics of research in nursing is above question.

Ethical dilemmas and AIDS: nursing issues regarding rights and obligations

Nurses and other health professionals deal with many ethical dilemmas daily. The AIDS epidemic has generated enormous controversy affecting the care and treatment of persons with HIV infections. As the epidemic spreads, the ethical issues become more apparent. The AIDS situation highlights the precarious balance between individual rights and the public welfare, patients' rights, and the rights of nurses and their professional obligations. Ethical questions have also been raised concerning equal rights to healthcare resources. The AIDS epidemic has caused hysteria among members of our society, including some people in the nursing profession. Implications for nursing practice and education are outlined to help nurses to make ethical rather than emotional decisions.