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The United States’ population is rapidly aging. As older people require more expensive medical and nursing attention, health-care/nursing costs keep rising, to the extent that they are not sustainable. As a result, the USA is faced with an ethical dilemma. While egalitarian ethical principles and the provisions of the American Nurses Association (ANA) code of ethics require the provision of medical/nursing care to everyone regardless of age, severity of disease and productivity, utilitarians view that as impossible. Assuming that provisions ANA’s codes of ethics are the same as ethical principles, this paper aims to discuss the debate between those two sides in detail.

The paper, viewing the rise of health-care/nursing costs as the cause of the above ethical dilemma, discusses Daniel Callahan’s utilitarian argument that, given the ever-rising health/nursing costs as a percentage of GDP, the USA will be forced to ration health care/nursing on the basis of age. The ethical arguments opposing Callahan’s arguments will also be presented.

While the debate between those two viewpoints is bond to continue, some writers have tried to find a compromise, a solution by assuming that, through efficiency, health/nursing costs can be lowered, making Callahan’s age-based rationing unnecessary.

This paper is original as it, by including nursing costs as an inseparable component of health-care costs, makes the aforementioned debate applicable to nursing care.

Nurses and other professional caregivers are increasingly recognising the issue of moral distress and the deleterious effect it may have on professional work life, staff recruitment and staff retention. Although the nursing literature has begun to address the issue of moral distress and how to respond to it, much of this literature has typically focused on high acuity areas, such as intensive care nursing. However, with an ageing population and increasing demand for resources and services to meet the needs of older people, it is likely that nurses in long‐term care are going to be increasingly affected by moral distress in their work. This paper briefly reviews the literature pertaining to the concept of moral distress, explores the causes and effects of moral distress within the nursing profession and argues that many nurses and other healthcare professionals working with older persons may need to become increasingly proactive to safeguard against the possibility of moral distress.

Purpose: As specific emotional arenas, hospitals are characterized by the interweaving of various emotional requirements, arising from different sources of norms, rules, or guidelines. This study aims to highlight an often-overlooked dimension of emotional labor in healthcare by describing the coexistence of emotional rules (i.e. feeling and/or display rules) through a multilevel perspective (institutional level, cluster/department level, service level, ward level, professional level). Study Design/Methodology/Approach: These emotional requirements for nurses and nursing assistants are investigated through three sets of data (observation, interviews, and internal documents) in a French public hospital, focusing on two hospital services: three long-term care units (primary field of investigation), and five adult medical emergency wards (secondary field of investigation). Findings: The results of the analysis show the pervasive nature of emotional requirements which are intertwined and more or less implicit/explicit according to the level analyzed. In addition to organizational rules, professional and social emotional rules contribute to shaping emotional requirements, particularly through rules of “empathetic expression” and those of retenue bienveillante. Research Limitations/Implications: This research has contributed to showing the dynamic nature of emotional requirements and their appropriation and modulation by healthcare professionals. The qualitative methodology used allows for unique insights but limits the generalization of results. Originality/Value: This research has addressed various gaps in the existing literature by describing emotional requirements through a multilevel analysis, by outlining a set of rules that had not been previously described (retenue bienveillante) and by including the population of nursing assistants as well as nurses in a study on hospital emotional labor. Future research could envisage spatial analysis of emotional labor to help better understand emotional requirements' variability according to emotionalized zones.

The purpose of this paper is to characterize issues related to head nurses’ decision making when managing ethical dilemmas.

The study is qualitative descriptive, in which researchers stay close to the data. The data were collected in the format of unstructured written reflections. Inductive conventional latent qualitative content analysis was applied to the data.

The issues of head nurses’ management of decision making in ethical dilemmas relate to the following aspects: taking risks in deviating from the formalities, balancing power and humaneness, maintaining the professional hierarchy, managing resistance to change, managing with limited options, and experiencing the decline of nurse’s professional and/or human dignity.

Reflections in written form were preferred to semi-structured interviews and the researchers were unable to contact the participants directly and to ask additional questions. All the reflections were produced in a language other than English.

The issues of head nurses’ management of decision making in ethical dilemmas reveal the gap between societal expectations and the opportunities to improve nursing leadership in health care organizations.

The issues of head nurses’ decision making when managing ethical dilemmas are related to contexts that reflect the attitudes of society and health care system toward nursing management.

The study adds to the understanding of issues of the management of decision making in ethical dilemmas. It is an ongoing systematic process that encourages head nurses to learn from practice and manage the quality of care by empowering themselves and nurses to take responsibility for leadership.

Equality is a basic human right. However, LGBTQ individuals often have their human rights violated because of their gender identity or sexual orientation. They also experience discrimination because of homophobic and transphobic attitudes. They frequently deal with derisive attitudes at school, are discriminated against in the workplace and struggle to access health services. This paper aims to determine the discriminatory attitudes of nurses in their social and professional lives toward LGBTQ individuals.

This study involved 503 nurses and used a questionnaire to examine their views regarding members of the LGBTQ community. The questionnaire consisted of 24 questions. Ten experts from the fields of social psychology, sociology, and nursing provided the necessary inputs, which were subsequently incorporated into the questionnaire.

The nurses were found to have a negative attitude toward LGBTQ individuals; they felt that they should not be allowed to live in comfort in Turkey and that they disrupted the social order and compromised public morality. It was observed that married (in general), male (in particular), and have fewer nursing education nurses are much more likely to have a discriminatory attitude toward LGBTQ people, and they were more discriminatory in their society rather than in their professional lives.

According to the principles of justice and equality, which are a prominent part of the nursing code of ethics – “With the awareness that all people have equal rights, the nurse serves regardless of race, language, religion, age, gender, belief, social and economic status and political opinion” – nurses should not have a discriminatory attitude. This study reveals the inequality and the ethical problems that riddle Turkey’s health sector.

Health promotion programs in global health systems need to incorporate culturally competent care and provide linguistic access. This article describes the challenges in one country, the United States, and reports on research studies, which articulate the current gaps in meeting the above goals. Health care providers are bound by both legal and ethical standards to provide such care. Legal standards are cited. Regardless of legal standards, health care providers are also bound ethically to provide such care. An analysis of basic ethical concepts of principalism is described for the importance of these aspects of care.

The premise of this article is that one cannot have a successful health system without inclusion of culturally competent health promotion programs. And, one cannot have such health promotion programs without an understanding of the role that cultural and linguistic competence plays in the provision of clinically competent and cost-effective services. Not only is there a need for culturally competent care that is legally mandated in some countries, such care is ethically necessary. The first part of this paper will address the need for culturally and linguistically appropriate care and applicable laws and standards. The latter part of the paper will provide an ethical analysis. However, before doing that, one global perspective of health care concerns for underserved populations will be presented as well as a discussion of the importance of the use of ethical frameworks.

A need for increased attention to the ethical issues of organizational development has been voiced, and unless greater attention is given to ethical issues and problems, the continued potency of organizational development is in danger. While many disciplines train organizational development agents (e.g., psychology, sociology, communication, marketing, business, education), a need for an interdisciplinary code of ethics exists. In addition to proposing an interdisciplinary code of ethics for organizational development agents, the present paper discusses the ethical conduct of data collection, results publication, and change recommendations in the context of organizational development.

The purpose of this research is to examine the impact of Islamic value on ethical behavior including other factors identified in the literature. The focus of the paper is to investigate to what extent does Islamic value impact ethical behavior of United Arab Emirates (UAE) university students.

The research is based on a quantitative approach using a questionnaire survey from 500 anonymous respondents covering five major universities within the UAE region. The identified constructs have been utilized to test a theoretical model using the structural equation modeling (SEM) technique.

The results revealed that education and code of ethics and Islamic values are dominant predictors to elevate ethical behavior, as well as the role of religion has a positive impact on ethical behavior. The survey results revealed a reverse relationship between new technology and ethical behavior.

The measures of factors used to rate university students' perception of ethical behavior are a possible limitation of the research study.

No empirical study was found in the literature that specifically investigates the relationships between Islamic value and ethical behavior in the UAE region. The paper fills an important gap in the literature on ethics.

The purpose of this paper is to increase knowledge of the role organizational factors have in how health personnel make efficiency-thoroughness trade-offs, and how these trade-offs potentially affect clinical quality dimensions.

The paper is a thematic synthesis of the literature concerning health personnel working in clinical, somatic healthcare services, organizational factors and clinical quality.

Identified organizational factors imposing trade-offs were high workload, time limits, inappropriate staffing and limited resources. The trade-offs done by health personnel were often trade-offs weighing thoroughness (e.g. providing extra handovers or working additional hours) in an environment weighing efficiency (e.g. ward routines of having one single handover and work-hour regulations limiting physicians' work hours). In this context, the health personnel functioned as regulators, balancing efficiency and thoroughness and ensuring patient safety and patient centeredness. However, sometimes organizational factors limited health personnel's flexibility in weighing these aspects, leading to breached medication rules, skipped opportunities for safety debriefings and patients being excluded from medication reviews.

Balancing resources and healthcare demands while maintaining healthcare quality is a large part of health personnel's daily work, and organizational factors are suspected to affect this balancing act. Yet, there is limited research on this subject. With the expected aging of the population and the subsequent pressure on healthcare services' resources, the balancing between efficiency and thoroughness will become crucial in handling increased healthcare demands, while maintaining high-quality care.

This study aims to see the role of life satisfaction in the relationship between burnout and depression among nurses to highlight the human rights norms for institutions, as well as practitioners within the health sector to improve life satisfaction among nurses.

This was a survey-based study. Data was collected by using well-established questionnaires. The sample (N = 250) comprising nurses taken from different public and private hospitals of Islamabad. Participants were both male (n = 125) and female nurses (n = 125), with age range 20–51 (M = 29.95, SD = 4.95) years. The data was collected by using the convenient sampling technique from different government and private hospitals of Islamabad from September 2017 to December 2017.

Bivariate correlation analysis revealed that burnout was positively associated with depression and negatively associated with life satisfaction. Moreover, depression was negatively associated with life satisfaction. Moderation analysis demonstrated that life satisfaction moderated the relationship between burnout and depression. Female nurses scored high on burnout as compared to male nurses.

The use of self-report measures and the cross-sectional nature of the study design are the limitations of the study. The findings contribute by recognizing the various factors affecting the performance of nursing staff specifically in developing countries such as Pakistan.

This study demonstrated the vital implication of factors reducing depression among nursing staff through life satisfaction. Health care organizations should take measures to condense the level of burnout, make and boost a caring and fair working atmosphere to improve the level of life satisfaction, and therefore, reduce the negative emotions associated with burnout. It is concluded that life satisfaction may buffer the effect of burnout and subsequent depression.

This study has extended the prevailing literature by recognizing the moderating role of life satisfaction in the relationship between burnout and depression among nursing staff specifically highlighting their human rights in the Pakistani context.