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By Sara T. Fry & Robert M. Veatch 488 pp., Sudbury, MA: Jones & Bartlett, $58.95, 2006, paperback.


Review:If you're looking for help in understanding and making decisions about every day ethical dilemmas, this book is for you. Whether you have a background in ethics and understand the lingo or not, Fry and Veatch offer a user-friendly resource. They begin by differentiating nursing ethics from other kinds of ethics (biomedical, physician, etc.), explaining that nursing ethics deals with the unique moral problems nurses face in the care of clients. They explain the theory behind Western ethical thinking and fundamental questions to ask in order to make a complete and systematic ethical analysis. Although understanding "metaethics questions" ("What makes right acts right?"), normative ethics, and issues of beneficence, nonmaleficence, justice, autonomy, and so on is tough, the rest of the book is fairly easy to read. The reader learns to identify ethical conflicts, think through issues of moral authority, and examine how value judgments enter into every day decision making. The American Nurses Association Code of Ethics for Nurses, which provides moral authority for nurses as a profession, is incorporated into all aspects of the book.

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Common ethical issues as they apply to nursing are discussed in detail, such as the duty to produce good (beneficence) and avoid harm (nonmaleficence), the allocation of health resources (justice), constraints on autonomy (patients' and healthcare providers'), truth-telling (veracity), promise-keeping, confidentiality (fidelity), and the sanctity of human life. Specific problem areas are addressed such as abortion, genetics, death and dying, obtaining consent, and the patient's rights to refuse treatment.


The series of real life case studies presented in every chapter walk the reader through everyday ethical decision making. Over 150 actual case studies and conflicts are presented. The case studies are indexed so readers can search for a case similar to a situation they are experiencing in practice. Excellent "Critical Thinking Questions" are offered at key points and at the end of each chapter. A glossary allows readers to quickly look up and review ethical terms.


The greatest value of this book is its hands on application to real world nursing practice. When considering ethical dilemmas we most often think of Do Not Resuscitate orders, bioethics, or euthanasia. This book opens up and discusses ethical conflicts that arise every day like dealing with confused or non-compliant patients, cost containment, how to allocate our time in care giving, whistle-blowing, or when we're asked to withhold information from a patient. Conflicts for supervisors and bedside nurses alike are discussed. Any nurse will find this book a tremendous resource to their practice.




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