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Issue 177 - 13 April 2011

Articles from Nursing Ethics

1. Guest editorial
By Nortvedt, Per. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p147-148
The author discusses the normative challenges in ethics of care, and refers to the 2010 interdisciplinary workshop on 'Ethics of care' organized by the Center for Medical Ethics, University of Oslo, Norway. He explores questions pertaining to the concept of deep caring, and reflects on the moral and relational ontology of care. The author also focuses on the themes of moral reasoning and epistemology, the status of ethics of care, and the relationship between normative and empirical issues..

2. Caring, objectivity and justice: An integrative view
By Van Hooft, Stan. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p149-160
The argument of this article is framed by a debate between the principle of humanity and the principle of justice. Whereas the principle of humanity requires us to care about others and to want to help them meet their vital needs, and so to be partial towards those others, the principle of justice requires us to consider their needs without the intrusion of our subjective interests or emotions so that we can act with impartiality. I argue that a deep form of caring lies behind both approaches and so unites them. In the course of the argument, I reject Michael Slote’s sentimentalist form of an ethics of care, and expound Thomas Nagel’s moral theory, which seems to lie at the opposite end of a spectrum ranging from moral sentiments to impersonal objectivity. Nevertheless, Nagel’s theory of normative realism provides unexpected support for the thesis that a deep and subjective form of caring lies at the base of even our most objective moral reasons. [ABSTRACT FROM PUBLISHER].

3. A personalist approach to care ethics
By Vanlaere, Linus & Gastmans, Chris. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p161-173
Notwithstanding the fact that care ethics has received increased attention, it has also faced much criticism. One of the focal points of critics is the normativity of care. Only when the objective normative basis of care is sufficiently clarified can care practices be evaluated and optimized from an ethical point of view. We emphasize that two levels of normativity can be identified: the context level and the foundational anthropology level. The personalist approach to care ethics is normatively stronger, at least on one level, namely the foundational anthropology level. This personalist approach to care ethics indicates in which direction action must be taken so that human action may be considered ethically sound. [ABSTRACT FROM PUBLISHER].

4. Harm in the absence of care: Towards a medical ethics that cares
By Martinsen, Elin. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p174-183
The aim of this article is to investigate the concept of care in contemporary medical practice and medical ethics. Although care has been hailed throughout the centuries as a crucial ideal in medical practice and as an honourable virtue to be observed in codes of medical ethics, I argue that contemporary medicine and medical ethics suffer from the lack of a theoretically sustainable concept of care and then discuss possible reasons that may help to explain this absence. I draw on the empirical studies of Carol Gilligan on care and connectedness as ontologically situated realities in human life. Based on a philosophical elaboration of her findings on the ethics of care emphasizing relationality, I try to show how the notion of ‘relational ontology’ originating from this stream of thought may be of help in developing a medical ethics that acknowledges care as a perspective to be observed in all interactions between physicians and patients. [ABSTRACT FROM PUBLISHER].

5. Is there a distinctive care ethics?
By Edwards, Steven D. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p184-191
Is it true that an ethics of care offers something distinct from other approaches to ethical problems in nursing, especially principlism? In this article an attempt is made to clarify an ethics of care and then to argue that there need be no substantial difference between principlism and an ethics of care when the latter is considered in the context of nursing. The article begins by considering the question of how one could in fact differentiate moral theories. As is explained, this cannot be done merely in light of the moral judgements they defend, nor their ontological commitments (e.g. their view of the nature of persons). Following these methodological beginnings, care-based ethics is described and critically discussed. It is shown that ontological commitments embraced within care ethics do not themselves show that care ethics is distinct from other approaches. The idea of ‘psychological care’ is also discussed, which stems from the work of Margaret Little. Her claim that the ‘gestalts’ of justice and care cannot be combined is rejected in favour of an approach that does just that and which has been developed by Joan Tronto. It is then claimed that the moral commitments of principlism are certainly not incompatible with those of an ethics of care in the nursing context. A challenge to the idea that principlism and ethics of care might be compatible is anticipated in the work of Eva Feder Kittay. This challenge is responded to and it is concluded that care considered as a moral orientation and the moral values embedded in principlism are best combined in the nursing context. Care provides a moral orientation over which the obligations referred to in principlism can be laid. [ABSTRACT FROM PUBLISHER].

6. The ethics of care: Role obligations and moderate partiality in health care
By Nortvedt, Per & Hem, Marit Helene &  Skirbekk, Helge. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p192-200
This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care. [ABSTRACT FROM PUBLISHER].

7. Ethics of caring and professional roles
By Paulsen, Jens Erik. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2, p201-208
Normative discussions about modern health care often revolve around principles stating what must not be done or how to ration scarce resources in the name of justice. These are important discussions. However, in order to have an impact on clinical roles, ethical reflection must be able to describe and address the complexities and challenges of modern nursing and doctoring, and maybe even the patient role. A multi-principled approach, such as the one suggested by Beauchamp and Childress, can obviously address almost any such issue, but a great deal of translation is often required in order to address role-related issues. I shall here argue that an ethics of caring is better suited to grasping the big picture when the question is how to create value-informed clinical roles in an era of rapid development. [ABSTRACT FROM PUBLISHER].

8. Mature care in professional relationships and health care prioritizations
By Nordhaug, Marita; Nortvedt, Per. Nursing Ethics, 03/01/2011, Vol. 18 Issue 2: p209-216
This article addresses some ambiguities and normative problems with the concept of mature care in professional relationships and in health care priorities. Mature care has recently been introduced in the literature on care ethics as an alternative to prevailing altruistic conceptions of care. The essence of mature care is an emphasis on reciprocity, where the mature agent has the ability to balance the concerns of self with those of others and act from a principle of not causing harm. Our basic claim is that the prevailing concept of mature care does not capture the real nature of professional relationships and role obligations in health care. As the focus of attention in professional care is and must be the patient’s particular medical and care needs, such care must principally be altruistic. Furthermore, we argue that mature care cannot adequately address moral conflict in health care without accepting some more principle-based approaches and a richer notion of partiality. [ABSTRACT FROM PUBLISHER].

Articles on Bowel Cancer Screening

9. Bowel cancer screening could save hundreds of lives
AM (ABC), 22/03/2011
Database: Australia/New Zealand Reference Centre
TONY EASTELY: New data shows that the incidence of bowel cancer in Australia is predicted to rise by 50 per cent in the next 10 years. Cancer Council Australia figures also show that one fifth of Australians who are diagnosed with bowel cancer are having the disease picked up too late. It says reinstating a national screening program and making it available to all Australians over 50 every two years would save hundreds of lives

10. Biennial bowel cancer screen could save 500 lives a year
By Wallace, Louise. Australian Doctor, 25/02/2011: p6
The article reports on the findings showing that a fully implemented biennial bowel cancer screening program would prevent up to 500 death annually..

11. Cancer kit axing 'to cost lives'
By DAN HARRISON CANBERRA. Age, The (Melbourne), 11/01/2011
Database: Australia/New Zealand Reference Centre
Abstract: THE lapse of a bowel cancer screening program will cost lives, Cancer Council Australia chief executive Ian Olver has warned..

12. In your best interests
By Handley, Alison. Nursing Standard, 4/21/2010, Vol. 24 Issue 33: p18-19
Database: Nursing & Allied Health Collection: Comprehensive
Abstract: Nurses in Birmingham are raising awareness of the national bowel cancer screening programme throughout their diverse community.

13. Exploratory study examining barriers to participation in colorectal cancer screening
By Paddison, Johanna S.& Yip, Marcus J. Australian Journal of Rural Health, Feb 2010, Vol. 18 Issue 1: p11-15
To examine the Stage of Change distribution for bowel cancer screening in a regional Australian community and the factors associated with varying positions on the continuum of change.
 Design: Survey of a convenience sample.
Setting: Community sample. Participants: A total of 59 (31 male, mean age = 59) service club members from a South Australian regional community. Main outcome measure: Self-reported Stage of Change for bowel cancer screening behaviour.
Results: Attributing greater embarrassment and discomfort to bowel cancer screening was associated with earlier positions on the Stages of Change. Perceiving that bowel cancer screening might have positive value for personal health was associated with more advanced positions on the continuum of change. Those who perceived breast and prostate screening procedures to be embarrassing or to cause discomfort were significantly less likely to be participating in bowel cancer screening. No significant relationships were found between bowel cancer screening Stage of Change and worry about vulnerability; personal, family or wider social network case reports of bowel cancer; and the population-level value attributed to the cancer screening procedures.
Conclusion: Bowel cancer screening participation rates are currently lower than those associated with breast and prostate screening. Reducing perceptions of embarrassment and discomfort, increasing awareness of potential health benefits and maximising participation in other screening procedures might increase participation in bowel cancer screening. [ABSTRACT FROM AUTHOR].
Database: Nursing & Allied Health Collection: Comprehensive

14. Screening participation in individuals with a family history of colorectal cancer: a review
By Rees, al. European Journal of Cancer Care, May 2008, Vol. 17 Issue 3: p221-232
Database: Nursing & Allied Health Collection: Comprehensive
Abstract: Literature regarding screening behaviour in individuals with a family history of colorectal cancer was reviewed, in order to determine the prevalence of screening in this population and identify factors associated with screening participation. Four electronic databases were searched from 1994. Thirty papers met the inclusion criteria, including 3 community surveys, 13 studies on first-degree relatives of colorectal cancer patients, and 14 studies on genetic services for colorectal cancer risk assessment. Individuals with a family history of colorectal cancer, who have not received risk assessment, frequently have never had any form of screening for colorectal cancer. Uptake of endoscopic screening when offered to individuals identified as being at increased risk was generally high (often >60% participation). Having a medical recommendation to screen, a stronger family history and perceiving fewer barriers to screening were identified as predictors of screening behaviour. Existing data suggest that use of screening tests in individuals with a family history of colorectal cancer is variable, and our understanding of factors associated with screening behaviour is limited. A number of methodological problems in research to date were identified, and further research is needed in order to inform interventions to support sustained screening participation in this population. [ABSTRACT FROM AUTHOR].

15. Bowel cancer screening: the story so far
By Mowat, Emma & Jupp, Miriam. Primary Health Care, Apr 2008, Vol. 18 Issue 3: p25-29
: The article discusses the Bowel Cancer Screening Programme of the national charity Bowel Cancer UK in Great Britain. It outlines the symptoms of the disease which includes blood in stools, a persistent change in bowel habit and weight loss. It highlights the prevalence, as well as the impact of detecting the disease in an early stage. It examines the significance of the faecal occult blood test (FOBt) for the medical screening ..
Database: Nursing & Allied Health Collection: Comprehensive

Courses, Conferences

16. Short Courses Our ‘Managing to Make a Difference’ series will dramatically improve your skills in leading, managing or relating to organisations in the not-for-profit sector.
- Supervision Skills for Health & Service Professionals
- Train the Trainers
- Governance
- Community Funding
- Understanding your Organisation’s finances
- Developing and Managing Staff Performance
- Conflict Management
- Legal Issues
- Working for Effective Employment Relations – Workplace  Wellbeing
- Understanding the Media

17. Progressing Social Enterprise in NZ seminar
: 28 April 2011,
Venue: 9.30AM-12 noon, St John's Conference Centre (Corner Willis & Dixon Streets)
This joint seminar from NZ Federation of Voluntary Welfare Organisations, OCVS and ANGOA will feature Hugh Rolo - Head of Assets and Investment, Development Trusts Association in UK. Hugh is being brought to Wellington by the Community Economic Development Trust, following the Waitakere conference.
Cost: $20 (plus GST). An invoice will be sent upon registration.
RSVP: Space is limited, so reserve a place by 26 April 2011 by email to

18. SAFEGUARD National Health & Safety Conference 2011
1-2 June 2011
Venue: SKYCITY Convention Centre, Auckland
More information:

19. Reviewing NZ's Accident Compensation System
Examining and understanding the current ACC. The future reforms, proposals and governance that will shape our system
: 17 & 18 May 2011
Venue: Amora Hotel, Wellington
More information:


20. Download journal articles from scientific and scholarly journals, free of charge
Directory of Open Access Journals
Aim and Scope:
The aim of the Directory of Open Access Journals is to increase the visibility and ease of use of open access scientific and scholarly journals thereby promoting their increased usage and impact. The Directory aims to be comprehensive and cover all open access scientific and scholarly journals that use a quality control system to guarantee the content. In short a one stop shop for users to Open Access Journals.

Includes journals such as:
Australasian Medical Journal 
ISSN: 18361935
Subject: Medicine (General)
Publisher: The Australasian Medical Journal pty ltd.
Country: Australia
Language: English
Keywords: internal medicine, pharmacy, mental health, medical education
Start year: 2008

Adolescent Health, Medicine and Therapeutics 
ISSN: 1179318X
Subject: Pediatrics
Publisher: Dove Medical Press
Country: United Kingdom
Language: English
Keywords: adolescents, adolescent medicine, pathology, disease treatment
Start year: 2010

Aporia : The Nursing Journal 
ISSN: 19181345
Subject: Nursing
Publisher: University of Ottawa
Country: Canada
Language: English, French
Keywords: health care, nursing critique, health and social sciences, nursing and social sciences
Start year: 2009

PLoS Medicine is the leading open-access medical journal, providing an innovative and influential venue for research and comment on the major challenges to human health worldwide. We specifically seek to publish papers which have relevance across a range of settings and that address the major environmental, social, and political determinants of health, as well as the biological.

News - National

21. ED staff express concerns for safety
ODT 11 April, 2011
Senior and junior Dunedin Hospital emergency department doctors are worried that staffing levels are unsafe. Clinical leader Dr Tim Kerruish said senior staff shared the concerns raised by their junior counterparts about the levels and proposed roster changes. Chief operating officer Vivian Blake said she expected to meet staff representatives soon to better understand their concerns and "get to the bottom of it".

22. Concerns raised over cancer test kits
ODT - 8 April 2011 

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