倫理的護理觀點：貼近身側的照護

Nursing Perspectives on Ethics: Caring within Arm's Length

本文倡議護理倫理的形成，是衍生自護理人員對於個別病患的道德義務的理解，以及護理人員在繁複的社會與組織架構下如何實踐這些義務。護理倫理的實現，聚焦於與特定人、社區、情境的好的連結。最重要的，護理倫理是一種實際的倫理觀，透過生活的每一天理解對於病人而言，生病、復原、或是走向死亡的意義，如此，抽象的倫理原則才得以豐富。因此，護士的經驗與尋求照護者的經驗，兩方的互動，建起了護理倫理的本質基礎。在探討國際間護理倫理的共通性與差異性之際，作者認為，各國醫療技術的先進程度是一種社會動態，顯著地改變了護理運作實務，並考驗護理能力，該如何去達成護理倫理的義務，在一隻手臂的距離內，貼近身側的照護病患。

This paper proposes that nursing ethics are derived from nurses’ ways of understanding their ethical obligations to individual patients, and nurses’ ways of fulfilling these obligations within complex social and institutional structures. Nursing’s view of ethical practice focuses on the good in relation to particular persons, communities and situations. Nursing ethics is first a practical ethics, in which abstract principles must be filled out through lived everyday understandings of what it means to the patient to be ill, to recover, or to move toward death. Thus, the experiences of nurses and those who seek nursing care, in interaction with each other, provide an essential grounding for nursing ethics. In exploring commonalities and differences in international nursing ethics, I propose that the advance of medical technology within countries is a societal dynamic that significantly alters nursing practice and challenges nursing’s ability to meet the obligations of an ethic of caring within arm’s length.