Analysis of Decision-Making in Ethical Dilemma Cases among Clinical Nurses

윤리적 딜레마 사례에 대한 간호사의 의사결정 분석

Purpose: This study was done to analyze the contents of nurses' ethical decision-making in four of hypothetical dilemma cases using the Cameron's Ethical Decision-Making Model of 'Value, Be, Do'. Method: Sixteen nurses who work at ICU at present or worked before, participated from April 10 to May 10 in 2002. The participants were interviewed three times each and for 40 minutes at once, with a structured questionnaire at their working places and locker rooms. The data was analyzed by a procedure of qualitative content analysis into three categories; what should I value, who should I be, what should I do. Result: 1) In consistency, most of subjects showed a unified voice in 'Value, Be, Do'. Exceptionally 8 subjects showed inconsistency such as 3 in active treatment to the incurable patients(case 1), 1 in treatment truth-telling to the terminally ill patients(case 2), 3 in conflict with uncooperative doctors(case 3), 3 in dying patients and euthanasia(case 4). Only one subject showed inconsistency in 3 dilemma cases. 2) Closing the interview procedure, the subjects evaluated Cameron's Model as it would help them build consistent value, carry right action, and cope to conflicts. Conclusion: On the basis of the results, it is recommended that nursing ethics should adopt the ethical decision-making model, and be applied to the curriculum of nursing colleges and continuing education program for clinical nurses.