Background: Ethics, being a fundamental component of nursing practice, must be integrated in the nursing education curriculum. Even though different bodies are promoting ethics and nursing researchers have already carried out work as regards this concept, it still remains difficult to clearly identify the components of this competence. Objective: This integrative review intends to clarify this point in addition to better defining ethical competence in the context of nursing practice. Method: An integrative review was carried out, for the 2009–2014 period, (...) in the CINAHL, MEDLINE, and EMBASE databases and in the journal Nursing Ethics. The keywords nursing ethics or ethical competence were used in order to make sure to widely encompass the concept of “ethical competence” in the case of a university curriculum in nursing. In the end, 89 articles were selected. Ethical consideration: We have respected the ethical requirements required regarding the sources and authorship. There is no conflict of interest in this literature review. Results: Ethical sensitivity, Ethical knowledge, Ethical reflection, Ethical decision-making, Ethical action, and Ethical behavior are the most frequently used terms with regard to ethical competence in nursing. They were then defined so as to better ascertain the possible components of ethical competence in nursing. Conclusion: Even though ethical competence represents a sine qua non competence in nursing practice, no consensus can be found in literature with respect to its definition. The identification of its components and their relationships resulting from this integrative review adds to the clarification of its definition. It paves the way for other studies that will contribute to a better understanding of its development, especially among nursing students and practicing nurses, as well as the factors that may exert an influence. More adapted education strategies can thus be put forward to support its development. (shrink)

The entry into force in Quebec of the law regulating medical assistance in dying seems to have revived discussions on the concept of conscientious objection (CO) among health professionals. In order to better understand this concept, an integrative review of 39 articles, both national and international, was carried out. To be considered for this review, the articles had to include a definition of CO and at least one criterion justifying its acceptability, or not, in the Western context of care. A (...) theoretical representation of the data extracted from the articles was developed by an inductive thematic process. This representation, which illustrates CO and its criteria of acceptability in the health field, is articulated in relation to four interconnected poles. Two of these poles, care and professional competence, underlie the very definition of CO since without one or the other, the latter cannot exist. The other two poles, collective and individual, convey the values and powers involved when it comes to CO in a healthcare context. The interaction between these four poles illustrates the criteria of acceptability or non-acceptability of CO. This representation of CO thus makes possible a dynamic view of CO and has the advantage of being adaptable to various types and contexts of care, beyond medical assistance in dying. It also offers a theoretical basis for further exploration of this concept. (shrink)

The introduction of medical assistance in dying (MAID) in Quebec and Canada raises the question of extending this service to minors. The constant presence of nurses at the patient’s bedside leads them to receive requests related to MAID. The aim of this study is to explore the perceptions of nurses working in paediatric oncology services concerning the possibility for adolescents over 14 years of age requesting MAID. Six nurses working in paediatric oncology or palliative care or in direct contact with (...) adolescents at the end of their lives as part of their nursing work took part in an individual semi-directed interview. The results of this research highlight that: 1) nurses recognise their supportive role in the care of patients at the end of life; 2) most have a professional opinion in favour of the MAID for adults and distinguish this from their personal opinion; 3) they value the discussions around the MAID and are concerned about the establishment of criteria for it; and 4) long experience as a nurse leads to more concerns about the expansion of the MAID, but at the same time makes nurses more comfortable providing information about this subject. In light of these findings, academic and paediatric health care institutions need to recognise and evaluate the need for training nurses on MAID to better equip them to deal with such situations and thus better meet the needs of their patients. (shrink)