As the evidence related to ethical issues in maternal/child nursing continues to change and grow, this In Focus series provides valuable information for nurses who encounter ethical issues during the delivery of care. Three common ethical concerns are explored herein to provide the nurse with the most recent evidence to support practice: ethics consultation, handling of HIV screening, and parents’ decision making in the neonatal intensive care unit (NICU).
Catlin introduces an evidence-based practice approach compared to a traditional problem solving approach for use in ethical decision making. She provides examples from the World Health Organization, the International Council of Nursing, the American Nurses Association, and many other sources to illustrate a world–view of the ethical decision-making process. She highlights the importance of including groups with differing philosophical goals during ethics consultation demonstrating that nurses, physicians, families, institutions, and nations may have different views about the same issue.
Wocial and Cox describe ethical screening for human immuno virus (HIV) in the pregnant woman.
They compare the concepts of opt in testing (consenting to be screened) versus opt-out testing (everyone is screened unless an individual objects to be screened). Using case examples, the authors provide a compelling rationale for why routine HIV screening in pregnant women should be included in the standard prenatal testing package. They explain how opt-out testing will benefit women, who then obtain earlier diagnosis and treatment, and fetuses, who are then treated before birth to halt maternal infant transmission.
Using a systematic review process, Rosenthal and Nolan analyzed 10 qualitative studies on parental decision making in the NICU. Based on common themes identified in these studies, they created a theoretical model on the type of communication parents need from the health care team. The authors concluded that parents need to trust providers and feel compassion from them to be able to make the best decisions for their children.
The authors of these three articles write with respect for perinatal nurses who may experience ethical dilemmas in their daily work and offer them information on ethical deliberation, resources, and communication.