Nurses' ethical conflicts: What is really known about them?

The purpose of this article is to report what can be learned about nurses' ethical conflicts by the systematic analysis of methodologically similar st udies. Five studies were identified and analysed for: (1) the character of ethical conflicts experienced; (2) similarities and differences in how the conflicts were experienced and how they were resolved; and (3) ethical conf lict themes underlying four specialty areas of nursing practice (diabetes e ducation, paediatric nurse practitioner, rehabilitation and nephrology). Th e predominant character of the ethical conflicts was disagreement with the quality of medical care given to patients. A significant number of ethical conflicts were experienced as 'moral distress', the resolution of which was variable, depending on the specialty area of practice. Ethical conflict th emes underlying the specialty areas included: differences in the definition of adequacy of care among professionals, the institution and society; diff erences in the philosophical orientations of nurses, physicians and other h ealth professionals involved in patient care; a lack of respect for the kno wledge and expertise of nurses in specialty practice; and difficulty in car rying out the nurse's advocacy role for patients.