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.