Introduction
Throughout history, people have been using their reasoning to determine what is right or wrong in different circumstances and in justifying why it is so. This criterion is the basic foundation of normative ethics. In most cases, health care professionals encounter highly complex issues while dealing with their patients or the health care system at large. Handling such issues requires a strong foundation based on knowledge and skills that can be applied so as to generate solutions that benefit both the patient (in terms of quality treatment) and the organization as regarding to the management of risks and preservation of life (Ashcroft, Dawson & Draper, 2007). Arguably, for one to be recognized as a professional, he/she must understand the foundation of the field of practice. In other words, a health care professional is expected to fully understand the nuts and bolts that hold the health care system together. The same case applies in ethical studies.
Ethics in the healthcare business is not simply doing what we consider to be right. As mentioned earlier, issues encountered in this sector are often exceedingly complex and assuming that there is a one-shoe-fits-all approach to dealing with these issues is an outrageous fallacy. To make matters worse, the society and other health care professions also have their inflexible ethical expectations. To this end, it is not only logical, but also wise for a healthcare practitioner to have a strong foundation and a deeper insight in the theories and principles of ethics if they are to act professionally in regard to decision-making processes (Ashcroft, Dawson & Draper, 2007). This paper shall set out highlight various ethical theories and principles that are used in the health care sector. This shall aim at elaborating how these theories and principles can be applied to solve issues in this sector.
Ethics and Health Care: A Brief Overview
There are various documented theories that can be applied in solving ethical issues in the health care sector. You may be questioning the importance of knowing such theories and principles. Well, the answer is that a lack of a solid ethical foundation leaves an individual with no other choice but to make decisions that lack a solid structure to support those decisions (Morrison & Monagle, 2009). A practitioner would therefore lack the ability to defend his/her actions whenever the need arises. In addition, you would not be adequately equipped to deal with the issues that are inherent in today’s health care sector. As such, understanding the ethical theories that apply in health care delivery is not only pivotal, but also a necessity in today’s dynamic, and aggressive working environment.
Important of Ethical Theories in Health Care
Morrison and Monagle (2009) contend that we live in an era whereby technological advancements in the medical and scientific arenas are constantly presenting people with challenges that demand similar thought processes. Resource allocation is slowly becoming global, new diseases are cropping up globally, nature is taking its toll on our lives and people all over the world are finding it more difficult to cope as poverty and diseases become a common place to the global population. Understanding ethics presents people with an avenue through which solutions for these vexing situations can be found.
In addition, equipping ourselves with adequate ethical knowledge enables us to work with others (colleagues, patients, policy-makers and stakeholders). This means that ethical understanding enables practitioners to understand alternative views thereby fostering cultural competence on a global scale (Brannigan & Boss, 2000). Ashcroft, Dawson and Draper (2007) define normative ethics as the study of what is considered as right or wrong. As such, normative ethics sets out to examine the formulated theories of ethics and how they apply in various fields such as health care. With this in mind, you may be tempted to think that normative ethics offer conclusive outcomes since they set out to determine the right course of action that can be taken to solve a particular issue, and explain why it is the right move. However, there are many disagreements in various fields such as health care, engineering and even business on how the results are interpreted.
There are various types of ethical theories that are often used in healthcare situations. Some of these theories shall be defined, elaborated and applied in health care.
Authority-Based Theories
In this category, the theories are often based on religious faith such as Christianity, Buddhist or Muslim ethics. Marlin (2002) asserts that in some cases, theories in this category are based on ideologies. For example, Karl Marx writings, and theories that try to explain capitalism. These theories are based on what an authority considers to be right. As such, the ethicist in this case tries to determine the ruling that the authority would pass in regard to the given problem. Marlin (2002) states that in most cases, ethical teachings often avoid religion-based ethical theories despite the constant protest from those who hold deep religious beliefs. In health care, religious-based theories should never be used to solve issues or make decisions. Geirson and Holmgren (2010) attribute this to the fact that there is a worldwide disagreement on which authority reigns over the rest. This is tricky since there is no prescribed way of knowing which authority or ideology is correct. Most of the theories in this category are normative relative to whoever uses them. As such, they often lead to conflicts and there is no method to sort them out that is agreed upon.
Despite these limitations, there are some benefits that can be accrued from understanding this category of theories. For example, all religions have their own beliefs regarding the source and solutions for ailments and suffering. In most cases, patients often have their religious beliefs and attitudes that help them make sense and find comfort in their circumstances. On the plus side, understanding authority-based theories enable practitioners to deliver a more patient-focused treatment or solution. However, an ethical dilemma may arise whenever a patient feels as though his/her religious beliefs have been violated or disrespected by the practitioner.
In regard to the influence of authority-based theories in the formulation of health care policies, Hester (2001) argues that acknowledging and understanding the religious philosophies behind these theories may enable a practitioner to steer away from contentious issues (such as abortion, euthanasia and resource allocation among others) that may offend or undermine the religious beliefs held by the people responsible for making the policies. For example, when dealing on an international perspective, a healthcare practitioner who understands the alternative views held by different parties can find a common morality that is readily acceptable by all members, thereby ensuring that the policies made are readily acceptable to all.
Similarly, it should be noted that religion plays a pivotal role in helping people determine what is right or wrong. This can be attributed to the fact that all religion provides answers regarding the nature of the world and how we should exist in it. In addition, religions help people understand themselves, their purpose and how they should co-exist with each other in this earthly realm. In short, religion explains the world and how each individual fits in it. Conclusively, it is not advisable for a health care practitioner to apply this category of theories in the field. However, they can be used as a tool to provide quality treatment to patients, or to negotiate agreeable terms where health care policies are concerned. On a personal note, having an understanding of authority-based theories enable an individual to better understand his/her religious stand thereby acting as a guideline that prevents the practitioner from imposing his/her religious views on the patient and vise versa.
Virtue Ethics Theory
This theory as defined by Melia (2004) argues that we should find a solution for humanity and then work towards achieving that solution. It focuses on finding perfection and excellence in all we do. It therefore proposes that as human beings, we should work towards developing ourselves to excellence by using the best of our ability. The questions in this theory include: What kind of an individual should I become? Or how can we live together in harmony? Devettere (2009) contends that this theory is very influential in formulating professional code of ethics in the health care sector. Virtues are described as desirable moral qualities. According to Melia (2004), this theory was founded on the tenets that everyone is innately virtuous but there is need for development and nurturing before a person can exhibit a virtuous character. This sentiment is further supported by Loewy and Springer (2004), who defines elitism as a state in which a person who has been nurturing virtues becomes virtuous after long practice.
As mentioned earlier, the virtue ethics is all about exhibiting the highest good we possibly can. This theory is very important since it helps practitioners maintain professional conduct. Understanding this theory enables practitioners to better their character and that of their patients. In addition, Greenhalgh (2007), states that virtue ethics enable practitioners to balance their obligations more efficiently. For example, there are some treatments such as chemotherapy, which are harmful to the patients but beneficial in the long-run. A professional practitioner equipped with the knowledge of virtue ethics can effectively communicate the harms as well as the benefits of such treatments to the patient and get consent to administer the treatment.
In addition, if the patient views the practitioner as a virtuous person, their confidence in the services provided increases. Also, caregivers who have practical wisdom (a virtue) are able to find viable solutions and work towards attaining them. As such, people who have practical wisdom can consult each other and come up with appropriate remedies to different issues. Over the years, healthcare organizations have used such people to form ethics committees which help in determining ethical courses of actions and resolving conflicts. Such progress has been made possible through the understanding of what the virtue ethics theory entails.
On the same note, Loewy and Springer (2004) contend that a virtuous person (one having practical wisdom) can effectively decide on which theory to apply so as to solve an issue. Take a physician for example; their primary duty is to cater for the needs of their patients. However, this is not their only obligation they have other duties such as recruiting, training and firing employees, as well as conducting scientific studies and managerial duties. All these roles are handled differently and different theories can be used to diffuse them. In such cases, an individual who has undergone the professional socialization process recommended in this theory is more likely to select and apply the theories that ethically examines and solves the problem.
Biomedical Principles Emanating From Virtue Ethics Theory
The four core ethical principles used in healthcare delivery have their roots in the virtue ethics theory (Greenhalgh, 2007). They include beneficence, non maleficence, justice and autonomy. Beneficence refers to the caregiver’s responsibility to extend kindness/goodness to their patients. This principle dictates that healthcare practitioners have the responsibility to keep the patient’s interest before their own by ensuring that they get the most benefit from all health care related practices (Greenhalgh, 2007). The second principle of non maleficence states that health care practitioners should avoid doing harm to others. This principle sets out to protect patients from practices that may put them at risk or at harms ways in a health care setting (Devettere, 2009).
The third principle of justice suggests that health care practitioners should treat their patients fairly, equitably and lawfully without malice or discrimination. The final principle is that of autonomy, which refers to the ability to make decisions for oneself without external or emotional influences. This principle holds that people should always respect the decisions made by others and that making decisions for other people without their permission is wrong or in ethical terms; paternalism. These four principles show virtuous characteristics that should be inherent in all health care practitioners. Not only do they protect the patients from harm and unfair health care practices, but they help the practitioners act in an ethically and legally acceptable manner (Loewy & Springer, 2004).
Natural Law Ethics
In this research, the theory of natural law is interpreted using the foundation laid by St. Thomas Aquinas (Engelhardt, 2006). The key idea behind this theory is that nature has a rational and providential order of occurrences (Engelhardt, 2006). As such, no human being should interfere with this order. This theory is very important in health care and it is mostly applied in debates regarding abortion, euthanasia, social justice and birth control (Cherry, 2004). As a health care practitioner, it is important to understand this theory because it helps us understand the difference between good and evil practices in accordance to the natural order of life.
This theory therefore proposes that under no circumstance should the life of an individual be cut short by another person because this would disrupt the rational and providential purpose of life. However, there are various issues that have been forwarded by critics of this theory. Opponents of this theory argue that in as much as the decisions formed through this theory are specific; the details surrounding the issue may change (Gensler, 2011). So the question is: how does a practitioner know that his/her decision is right under this theory? The principle of double effect was therefore developed to act as a guide to ethical decision making under this theory.
This theory is founded under four basic assumptions. The first assumption is that we try our best to avoid evil effects because we do not desire for them to happen. Secondly, the immediate effect of any decision made should be good. Thirdly, the good effect should not be as a result of an evil act. This assumption suggests that the end should not justify the means. Finally, the principle assumes that the good effect should always outweigh or at least be greater than the evil effect. These assumptions can therefore help a practitioner make ethical decisions in situations where there is a conflict between what is good or evil (Gensler, 2011).
For example, abortion is considered as an evil by most people, however, saving the life of a pregnant woman is considered as a good deed. Similarly, euthanasia is in some areas considered as an evil, but using morphine to alleviate pain is good. As such, by applying the principle of double effect, a practitioner is better placed to make ethical decisions because the assumptions behind this principle act as guidelines to effective and ethical decision-making.
Discussion: Value of Ethical Theories in Health Care
No matter the circumstances, decisions have to be made and accounted for. As such, understanding the aforementioned theories (among others) is pivotal to health care professionals since it helps them choose the appropriate theory t apply in different situations. Arguably, without these theories, decisions made regarding treatment, prescriptions, patient care and health care policies would be left at the mercies of personal feelings, rational and perspectives of the parties involved. As a result, patients would suffer since there would be no mechanism to determine or justify the decisions made by practitioners.
For health care managers and practitioners, these theories help them act in the best interest of the patients by applying the practical wisdom discussed in the virtue ethics theory. For clinicians, they can apply the deontological approach and perform their duties as subscribed. Managers are also better placed to decide on the best course of action, all the while adhering to the policy and rules that are set in place to govern the activities of their staff.
In regard to policy making, these theories can come in handy when a particular policy maker wishes to understand, evaluate and determine the most probable attitude held by various stake holders. Knowledge of these theories in such cases help policy makers decide on policies that are most likely going to be approved by stakeholders because they appeal to their sense of justice and ethical conduct.
Conclusion
Evidently, the twenty-first century comes with various health care ethical challenges to individuals, society and organizations that participate in this sector. As such, a deeper understanding of the ethical theories that govern this sector is not only logical, but also necessary if ethical conduct is to prevail. From this research, it is clear that individual ethical theories cannot suffice in creating appropriate responses for the challenges that are inherent of this sector. As a result, a detailed review of different theories has been provided and scenarios in which each theory can be applied provided.
While not all theories have been discussed, it is clear that having a foundation of ethical theory is critical in ensuring that quality services are offered to various stakeholders. In addition, knowledge of these theories helps health care practitioners make correct decisions, and provide adequate support for their decisions. By applying these theories and their principles, professionals in the health care sector will be able to do their work more efficiently, all the while minimizing the chances of gross misconduct and harmful practices that may eventually cost them their careers.
Cultural and Ethical Implications of DNA testing: Application of Theory
Introduction
The past few decades have witnessed great scientific breakthroughs, inventions and discoveries due to technological and intellectual advancements. The biological field of studies has as a result improved in terms of sophisticated equipment as well as advanced procedures used in diagnostic processes that were once considered as theories and reserved only for the well-to-do specialized hospitals. One of the most notable technological advances in this field is arguably the development and implementation of genetic testing. Jonsen, Veatch and Leroy (1998) define genetic testing as the process through which the presence of genetic markers within the patient’s body of specific ailments can be determined or detected. The importance of this testing cannot be elaborated fully considering that over 3% of all children in the united states are born with severe genetic disorders (Jonsen, Veatch & Leroy, 1998).
According to the Uhlmann, Schuette and Yashar (2010), the main purpose of genetic testing is to treat, cure or prevent disorders that are genetic in nature. One of the main benefits of this procedure is that it enables patients to know whether or not they have any genetic disorder. As such, this information can be used to formulate preventive measures or start treatment before the disorder takes its toll on the person. This paper shall set out to evaluate the cultural, social and ethical issues that surround genetic testing. This shall be done by employing various theories and analyzing the impact genetic testing has on people in regard to decision making.
Importance of genetic testing
According to the principles of biomedicine, the principle responsibilities of health care practitioners are to preserve life, alleviate pain and restore health of their patients using the available resources. Genetic testing presents practitioners with an avenue through which these responsibilities can be fulfilled. New technologies and research advancements have enabled practitioners to identify various genetic disorders and risk factors that affect mankind. Genetic testing falls under this category and it has played a pivotal role in identifying such disorders rapidly and efficiently than other methods. Lerman, Croyle and Tercyak (2002) contend that genetic testing may in the future become a common practice in medical routines.
Another advantage that can be accrued from genetic testing is that medical practitioners are able to detect dormant mutated genes that may be present in patients who physically seem healthy. This is important because people with such a condition may continue living normally oblivious of the health dangers that lurk within their bodies. The implication of such a test in this case is that once the carrier has been notified of his/her condition, viable preventive or curative measures can be recommended so that the patient is enlightened on the available choices.
This gives the patients an opportunity to make informed decision on the best course of action that should be taken to counter their condition. This advantage coincides with the virtue ethics theory which states that practitioners should always set out to do good to their patients. As such, informing the patient of the underlying condition and laying out the choices of treatment is in line with this theory and ensures that genetic testing are used for good (to better the patient’s well being).
Evidently, the health care systems adopted by most nations are shifting from the traditional curative approaches to preventive approaches of health care delivery. This move is supported by the deontological theory which places more emphasis on duty. The core duty of health care professionals is to improve the physical and mental well being of their patients. Genetic testing gives practitioners a chance to carryout this duty in the sense that the tests are preventive in nature. For example, if a patient tests positive for a disease such as cancer or diabetes, the results can be used to devise means of mitigating the disease from ever developing. For example, Bettina and Dunn (2001) assert that through genetic testing, genetic markers for Huntington’s disease were used to come up with the linkage analysis, which is effective in identifying unaffected carriers. This discovery has in the past decade proven to be effective when it comes to helping carriers cope with the disease.
Genetic testing has also gained popularity due to the fact that most employers today request all their employees to take the tests as part of the company policy. This move previously met a lot or criticism as people feared that it was a strategy of screening employees for genetic disorders that affected their ability to perform efficiently. However for DNA profiling to be used successfully, there has to be a DNA database where tissue samples, genetic information and personal data is stored indefinitely. This brings about the real fear that this information may be misused therefore leading to an infringement on the rights afforded to the individual. Brent (2000), states that this discriminatory tendency was forbidden by law. The author further contends that while it is legalized in some states, employers are legally advised not to make any employment decision based on the results of these tests (Brent, 2000). This is in line with the principle of justice which dictates that people should be treated equitably and fairly regardless of their differences.
The benefit of these tests to employers is that they are better placed to make informed decisions on the insurance policy to take for an employee as well as other medical allowances. In addition, these tests enable employers to identify an employee’s susceptibility to various working conditions thereby enabling the employer to properly assign tasks to the employee. In addition, the test results are of great importance to employers since insurance firms always require the medical history of a client so that they can effectively assess the risks and other factors. Such information help insurance companies decide on which cover an employee should be placed.
Each individual has some level of doubt regarding his/her health at some point in time. As such, it may be argued that there are many factors that may influence an individual’s decision to get a genetic test. For example, most people always dream of having a family in future. Despite this parental desire, there are always some doubts on whether the child will have any complication or disability. To this end, genetic testing (prenatal testing) provides such potential parents with an ease of mind in the sense that they can be tested for genetic markers that are inheritable (Boskey, 2007). While the emotional impact of such results may affect people differently, the virtue ethics theory recommends that counseling should be offered to test subjects before and after the test to help them cope with the results.
Impact of genetic testing on decision making
Arguably, genetic testing has gained prominence in the medical arena mainly due to the fact that it is among the latest procedures in medical advancement. As a result, companies have emerged that offer these tests at a fee. While these companies propose that their aim is to provide easy access to such services to clients, some states have been forced to shut down some of these companies and in some instances discourage people from soliciting genetic testing services from the same. These moves have been necessitated by the fact that the results of these tests have varied effects on how people make life decisions (Euan, 2009).
Jonse, Veatch and Leroy (1998) indicate that in most genetic testing procedures, the decisions made by the individuals are to a large extent influenced by cultural and emotional factors as opposed to the perceived risks that the results indicate. As such, a pregnant mother may be culturally inclined to terminate a pregnancy because the results of a genetic test indicate that the unborn child may have a genetic disorder. Such a decision is not based on the risks of having the baby, but on the mothers or societal view on having a disabled child. Such a decision has no relation to the facts presented by the results.
In such a case, it may be argued that genetic testing goes against the theory of natural law, which states that, there is a rational and providential order of things in nature. This means that man should not interfere with nature since everything has a purpose and it should exist until nature decides otherwise. As such, the decision to terminate a pregnancy simply because it proves to be challenging is unethical. This point disregards genetic testing in relation to its influence in decision making.
Similarly, the choices that are made through genetic testing include but are not limited to decisions to have a child, to abort and to pursue preventive care among others. Lerman, Croyle and Tercyak (2002), state that other factors that should be considered when making decisions include the severity of the disease, available treatments and the disease in question. Hartley et al (1997) state that results from studies conducted on couples who stood the risk of getting Tay-Sachs disease indicated that 85% of the women test subjects agreed to get tested. The authors further state that out of the 85%, 81% of the women agreed to take the test because they feared that their children would contract the disease. The decisions made after the test were mostly determined by the subject’s emotions rather than the findings.
In addition to this, statistics indicate that results from genetic testing carried out during prenatal care increases the chances of abortion. This is attributed to the fact that more knowledge regarding the risks that a particular disease poses to the mother and the child makes abortion an easy choice as compared to when the information is limited. As such, when a pregnant woman discovers that her unborn child is likely to be deformed or disabled in some way, she decides to terminate the pregnancy rather than risking bringing a child that will be socially unaccepted by family members and society. However, it should be noted that such choices are not made under duress and much deliberations and counseling should be done before making the final decision.
Cultural and Ethical Impacts of Genetic testing
Ethically genetic testing should be carried out in a manner that is acceptable to society and individuals. This means that the information gathered during such tests should not be used to discriminate people who are culturally different. This applies mainly to employers and insurance companies, who may be tempted to use such information for screening clients or employees.
Similarly, there are individuals with strong cultural affiliations that should be considered before subjecting them to such tests. Genetic testing in some instances result in the alteration of genetic markers. Some cultures believe that alteration of one’s body is a sin. As such, practitioners are ethically bound to present all participants with an informed consent agreement which highlights the nature of the experiment, the risks and the physiological effects that the tests may have on them (European Commission, 2000).
In some cases, people have suffered greatly under the hands of unethical practitioners who put their interests and greed for knowledge before those of the patients. This is unethical and punishable by law. Patients on the other hand should be careful when providing personal information or volunteering for such tests. They should ensure that the people conducting the tests are certified and have only good intentions.
While genetic testing presents humankind with an avenue through which serious diseases can be prevented or cured, people should exercise caution when dealing with such practices. In as much as there are benefits, they should not be realized through harming others or deception (Betta, 2006).
Conclusion
This paper set out to explore an issue in healthcare that has serious implications on ethical and cultural conduct. To this end, this paper has reviewed various concepts and views of genetic testing. To this end, the description of genetic testing has been offered and the issues and concerns surrounding this procedure underscored. As a result, it has been deliberated that genetic testing is highly valued as being an important step in health care delivery, in that its application will become a fundamental component in medicine. In addition, the discussion presented herein has shown that the decisions made in regard to genetic testing results are not as simple as they seem. As such recommendations such as counseling and consultation have been offered so as to ensure that the decisions made are rational as opposed to them being emotional.
Considering that there is no standardized method that can be applied to determine how a person is going to react to the results, these recommendations may help individuals cope and deal with the results more effectively without causing harm to themselves or to others. Counselors should ensure that patients are mentally fit before recommending that they take such tests. In addition, practitioners using this method of testing should ensure that they do them in an ethical manner. This means that they should ensure that the patients understand the parameters of the tests, the benefits, weaknesses and potential impacts.
It has been observed that genetic testing comes with an array of advantages and disadvantages. However, it is evident that the advantages are greater than the disadvantages. As such, genetic testing should be promoted but policies should be put in place to ensure that the tests are conducted in an ethical and legal manner.
Research Methods and Critique
Introduction
Health care is a term that is mostly used to refer to the prevention, cure and treatment of various diseases and injuries that affect the physiological and psychological wellbeing of humans. As such, health care is among the most important aspect to human survival. Due to this importance, nations across the world have in the past up to date invested heavily in their health sectors in a bid to ensure that their citizenry have access to quality health care. Key among these investment is research on how best various ailments and treatments can be prevented, treated and cured. Research has therefore been a pivotal tool in the promotion of healthy living. Regardless of the field, there are various methods, techniques and instruments that are used to conduct research. These factors act as guidelines and ensure that researches deliver the best results with little to no complications or risks to the participants. This paper shall set out to explore the qualitative research methodology and how it applies in health care research.
Research Method in psychology: A Brief Overview
According to Haslam and McGarty (2003), psychology mainly involves the study of human behavior. To a large extent, this branch of science seeks to find out what the situation is and why it happens as it does in regard to human behavior. The author further asserts that there exists various research methods used in psychology. These methods differ in regard to the source of information, information sampling methodology and the instruments used to collect the data. In addition, the methods vary on the type of data they aim at collecting (qualitative or quantitative). Sugarman and Sulmasy (2010) state that quantitative research methods use mathematical models and statistical procedures to arrive at conclusions. On the other hand, qualitative research methods arrive at findings by employing methods that are neither mathematical nor statistical in nature (Sugarman & Sulmasy, 2010).
Quantitative research methods in psychology
Three main methods are used in psychological research. They are the descriptive method, the correlative method and the experimental research method. The research designs and methods of data collection used in these research methods include: interviews, questionnaires, case studies, observation, content analysis and correlations.
Descriptive research method
According to Hoskins and Mariano (2004), descriptive research seeks to observe and describe the phenomenon that is being studied. This research method does not test the relationship between variables and it simply depicts what is already evident within the targeted population or test area. For example, if a researcher intends to study the quality of health care institutions within a given area, he/she would observe them or measure the various criteria used instead of analyzing the relationships between various variables. Alternatively, this study (under the descriptive method of research) can be carried out without having a specific criterion in place.
Method critique
Like many other research methodologies, the descriptive research method has its strengths and weaknesses. In regard to strengths, Denzin and Lincoln (2011) argue that the descriptive research method gives researchers an opportunity to effectively use both the qualitative and quantitative data in order to analyze the population or the phenomenon that is being studied. In addition, descriptive research is advantageous since it offers the researcher a multifaceted approach. This means that the researcher can use case studies, observations, interviews and questionnaires as tools for data collection. In addition, this research method allows the researcher to offer several approaches (angles) on the information gathered.
For example, by using surveys, researchers are able to get statistical information on a phenomenon, how people view the event or even experience it. In addition, data collected from case studies enable researchers to provide details on how people experience events in a manner that other research methods cannot. Similarly, the descriptive research method eliminates the barriers that govern educational approaches thereby enabling the researcher to witness how the targeted population views the phenomenon or event being studied. Also, Weinberg (2002) argues that this method of research enables researchers to come up with other areas that can be researched upon. The author attributes this to the fact that the methods used to gather data are not specific and can generate different results other than those that were previously expected. As per the shortcomings, Denzin and Lincoln (2011) argue that confidentiality, validity and subjectivity are among the core disadvantages of this research method. In regard to confidentiality, the author contends that the methods used in descriptive research at times lack a standardized mechanism to guarantee privacy. Observation for example can be viewed as spying which is illegal since there is no consent from the participants. In addition, subjects may refuse to answer questions that seem to intrude their personal lives. Similarly, the chances that the subject responds in a manner that pleases the researcher are always high in this method of this research. This means that there is no way of telling whether the results or responses are true or false. In relations to subjectivity, the researcher decides on the data to include in his/her research. As such, if the researcher is biased, the results may not be as accurate as they ought to be.
Correlative research
Speziale and Carpenter (2010) define this method as a statistical research methodology that seeks to show the relationship between two variables. According to the authors, the relationship is studied under natural environment and the researcher cannot control the variables. This is unlike in the experimental research where the experimenter has the capacity to control the variables in order to get the desired result. An example of a correlative research is the study of the relationship between drug abuse and depression. Past studies indicate that the more an individual abuses drugs, the more depressed they become. On the other hand, the more depressed an individual gets, the more he/she abuses drugs. As such, relationships in correlative research are based on the extent the variables influence each other.
There are various types of correlative research methods. They include but are not limited to natural observation, surveys and archival research among others. Natural observation is advantageous in the sense that it allows the researcher to observe the variables at their natural setting. In addition, it can offer new ideas that can be pursued to further research and finally, it is the most efficient research technique when laboratory experiments are unavailable. However, there are some disadvantage sogf using this method. For starters, this research method is quite expensive and consumes a lot of time. As such, it cannot be used in studies that are time sensitive. Secondly, variables cannot be scientifically controlled. Thirdly, the researcher has no control over extraneous variables. Finally, if the participants are aware of the research, they may act differently thereby affecting the credibility and validity of the data collected.
In regard to surveys, Ritchie and Lewis (2003) state that they are very effective in collecting large amounts of data over a short period of time. In addition, surveys are faster, flexible and cheaper than other research methods. On the other hand, results from surveys can be affected by the unrepresented sample or by questions that are poorly structured. On the same note, participants can affect the results of the survey. For example, some participants do not answer the questions as required, some may lie to save face or in some instances make errors due to mistaken memories.
As relating to archival research, Ritchie and Lewis (2003) define this research as a method that analyzes data presented in previous research or in historical records. For example, a researcher may use medical records of soldiers who have been deployed in Afghanistan so as to learn more about post traumatic stress disorder. The advantages of this research are that the researcher cannot introduce or change the variables that affect the event. In addition, Burns and Grove (2005) state that the large amount of information that is often available in previous research and historical records enable the researcher to identify trends, relationships and outcomes more efficiently as compared to other methods. Similarly, this research method is cheaper since the researcher can access relevant data from free archives and record databases.
Despite these benefits, Richardson (1996) states that archival research has no control over how the data was collected. As such, previous mistakes are not corrected but instead passed on without the knowledge of the current researcher. This means that the information presented in research using this method may be based on fallacies or biased ideologies. In addition, important pieces of information (such as dates) may not be available in the records or databases. Such factors make this type of research very unreliable.
Method critique
This method of research has been documented as being among the best in psychological studies. This has mainly been attributed to the fact that it allows the researcher to collect more data as compared to experimental research. In addition, since the researcher cannot control the variables, the results of such studies can easily be applied in real life situations. Similarly, this method opens up more areas of studies for other researchers since the methods used to collect data are not influenced by the researcher. In addition, it is a good starting point for new studies. As such, it allows the researcher to determine the strengths and weaknesses of the relationship being studied. At later dates, the parameters can easily be narrowed down to find specific variables and to some extent carry out causational experiments.
However, despite the fact that correlations can show the direction and the strength of a relationship, they do not indicate the cause of the relationship. In fact, Merriam (2009), states that only experimental research has the ability to test the cause of relationships. From the example used earlier, it was evident that there is a relationship between alcohol and drug abuse. However, the cause of the problem was not indicated. This brings in the concept of a third variable such as poverty, peer pressure or post traumatic stress disorder. For example, the death of a loved one may lead to depression and as a coping mechanism; an individual may start taking alcohol. Similarly, the same situation may result to alcohol abuse which increases depression.
Other than its inability to show cause, Silverman (2004), states that correlative research do not show which variable exerts more influence than the other. For example, establishing that drinking alcohol correlates to depression does not clearly explain whether drinking alcohol leads to more depression or being depressed leads to the consumption of alcohol. Without having a clear perspective of which variable has more influence than the other, it becomes difficult to come up with remedies that adequately address the issue. For example, in psychology, attending AA meetings may suffice in reducing or treating alcoholic urges but it does not necessarily mean that it takes care of the depression. Similarly, without knowing the cause of the phenomenon or event, it becomes difficult to devise solutions because at the end of it all, the researcher may be using the disease to figure out the symptoms instead of using the symptoms to cure the disease.
Experimental research
To a large extent, experimental research often refers to studies conducted within a controlled setting such as a laboratory, class of group. The main purpose of this type of research is to identify the cause of the phenomenon or event being studied. Silverman (2004), states that in experimental research, the researcher/experimenter has total control over the variables affecting the event being studied. As such, he/she can easily manipulate the variables and measure the resulting outcome appropriately.
The key purpose and advantage of experimental research is that it seeks to identify the cause and effect relationship that exist between two or more variables. Non-experimental research such as descriptive or correlation research are conducted in natural settings and are non-manipulative observational research. However, hjghghg states that an experimental research is usually carried out in laboratory controlled environment and the variables can be manipulated by the experimenter. As such, experimental researches boast of a higher internal validity than non-experimental research. However, non-experimental researches boast of a higher external validity as compared to experimental studies.
One of the greatest disadvantages of experimental studies is that they are conducted in controlled laboratory environments. As such, the results from such studies cannot be used to draw conclusions on events that affect the external settings. However, there are two exceptions that are allowed. The first one is in cases of natural experiments, which seeks to document and match the behavioral status of the subjects before and after a natural event (floods, hurricanes and so forth) has occurred. The second exception is in cases of field experiments that seek to manipulate natural conditions in order to examine how they influence the behaviors of the selected subjects. Field experiments are preferred in psychology since their results are internal and external valid (Haslam & McGarty, 2003).
Weinberg (2002), states that in experimental studies, the experimenter determines the behaviors of the subjects by manipulating the variables. In addition, the author states that the subjects should not know that they are participating in the experiment. This non-disclosure aims at ensuring that the subjects do not act differently during the experiment (Hawthorne effect). In regard to variables, the author contends that experimental studies are designed in relation to the independent, organism and dependent variables.
As such, the environmental stimulus that is manipulated represents the independent variable, while a specific dimension such as race or sex acts as the organism variable since they have a relatively stable characteristic. The dependent variable is represented by the behavioral dimension. The dependent variable is used to show the effects of the independent and organism variables.
Discussion
From the discussion presented here in, it is evident that the main advantage of qualitative research is that it seeks to observe events in their natural habitats as opposed to laboratory settings. This helps researchers in the psychological field get results that can easily be generalized and applied in real life situations. In addition, qualitative studies enable the researchers to capture holistic pictures of the subjects as opposed to quantitative researches which are characterized by isolation, reduction and manipulation of variables. This characteristic of qualitative research enables the researcher to provide a leeway through which individual differences can be considered. Finally, the non-intrusive nature of qualitative researches enables researchers to conduct their studies in an ethical manner especially in cases where the research is focused on a particular subject. This is not possible in quantitative researches whereby such cases are viewed as invasion of privacy.
Despite these benefits, qualitative research methods have greatly been criticized due to their subjectivity. The results of studies conducted through this method are often determined by the researcher. As such, the likelihood of biasness, falsified responses or human error is always very high. Also, unlike quantitative researches whereby the variables are controlled by the experimenter, researchers using the qualitative research method have little to no control over the variables. As such, confounded variables always cause problems in such studies. This means that the results found after the study could be as a result of other factors that the researcher was oblivious about. Finally, the results of qualitative researches are often difficult to replicate and in most cases impossible. This means that the results cannot be used to come up with a permanent solution since events and environments change.
Considering these challenges that are inherent of qualitative research, there are some factor that researchers should consider to ensure that their research practices are acceptable and deliver accurate and efficient results (Flick et al, 2007). Below are some of the recommendations on how this can be achieved. First of all, the researcher should have a clearly defined statement that documents the aims of the research being conducted. Secondly, the researcher should establish and determine whether a qualitative approach is the best for the study being conducted. Thirdly, the researcher should examine whether the research design used was appropriate in addressing the set aims of the research. Fourthly, the researcher should determine whether the recruitment strategy of researchers and subjects was the best towards addressing the aims of the research.
Next, the researcher should consider the following factors: whether the data collection was conducted in a manner that addressed the issue being studied, whether the interaction between the researcher and the subjects was adequately deliberated upon, whether the ethical issues were well addressed, whether the data analysis was sufficient or thorough enough and finally, whether the research was valuable (Flick et al, 2007). By putting these factors in mind, the research conducted is bound to be efficient, conclusive and comprehensive, thereby mitigating all chances of falsification, subjectivity and human errors that are inherent in qualitative research.
Conclusion
This research outlined the qualitative research method and its application in psychological studies. To this end, a brief overview of qualitative research has been provided and methods used in this research discussed. The strengths and weaknesses of this research methodology have also been provided and recommendations on how the strengths can be improved and weaknesses eliminated have been offered. Considering that psychology focuses on the study of behavior, this method of research is the best since it allows researchers to study their subjects in their natural habitat. As such, they are able to have a holistic view of how various variables interact to influence certain behaviors. If the recommendations provided herein are applied, the shortcomings present in this research methodology can be mitigated thereby ensuring that the results from qual8tative researches are credible and valid.
Defending a Personal Philosophy of Ethical Practice Using Discipline-Specific Core Values and/or Essential Principles and Practices in Nursing
Introduction
In today’s business environment, rules, regulations and laws are put in place to ensure that businesses are conducted in an ethical and professional manner. They act as guidelines through which professional conduct can be upheld and maintained in all organizational processes and activities. In the healthcare sector, such guidelines are of great importance since they help establish how different practitioners should carryout their responsibilities in their working environment. Despite these safety measures, there comes a time when healthcare practitioners face ethical dilemmas as they work. While in some cases the set guidelines can be applied to find a solution for such issues, the solutions to other ethical issues depend primarily on the principles and values held by the practitioner.
As an aspiring healthcare provider, I hold it as my personal philosophy that I should handle all my patients professionally with the compassion, fairness, worth and respect that they deserve regardless of their ethnicity, nature of their illness, color social or financial status and character. This philosophy is based on my personal belief that we should treat others as we would like them to treat us if situations interchanged. As such, professional conduct is core to fulfilling this philosophy. This essay shall therefore set out to defend this personal philosophy by using relevant principles and values that are inherent in the healthcare profession. Considering that the healthcare field is wide, I shall place more emphasis on applying this philosophy in nursing. To this end, I shall elaborate what professionalism in nursing entails.
Arguably, the values and beliefs that we have are of significant importance since in most cases, they determine what we value most in our lives. Personal values are best defined as the core principles and attitudes that help us make key decisions in our lives (Pandey and Singh, 2008). The authors further state that, personal values make up the foundation on which an individual’s success and accomplishments are forged. As such, having a deeper understanding on one’s value and belief system plays a pivotal role in guaranteeing excellence in all that we set out to do (Clark, 2008). My career decision to work as a healthcare practitioner was mainly influenced by my personal philosophy. I focused my life and actions towards making a positive impact in the lives of as many people as I could, through my career.
Altruism is among the main values that influence my decision making process, attitudes and perspectives on different situations. Altruism can simply be described as the genuine concern an individual exhibits towards the well-being of others. The healthcare sector has different fields through which an individual can apply this principle. My decision to work in the healthcare sector is therefore a reflection of my altruistic nature since it affords me opportunities to benefit others through my services. This is evident in the way I interact with my patients and fellow employees. Clark (2008) asserts that showing genuine concern for one’s staff and clients is a core indicator of leadership skills in a work setting. To this end, the question that is left begging is: How should a healthcare practitioner act in order to show professionalism?
Zerwekh and Claborn (2009) describe nurses as healthcare professions who are motivated by science, have technical skills and are caring. Arguably, the nursing profession is among the most taxing in the healthcare industry. This can be attributed to the fact that nurses, more than other healthcare practitioners, are expected to show high levels of professional values and behaviors since they interact with patients more often than doctors. As such, having professional values is very important to nurses since it can help them better the health of their patients and to a large extent, help prolong the lives of those in medical need. Considering that nurses operate across healthcare boundaries and offer different services in different sectors, I believe that having professional values may go a long way in ensuring that they effectively deliver in all that they set out to do.
According to the Royal College of Nursing (2004), all professional healthcare practitioners should be able to make decisive and accurate judgments in regard to the assessment, diagnosis, evaluation and prescription processes involved in healthcare delivery. In addition, professionalism in nursing is all about having adequate knowledge on the techniques and criterions used to asses the needs of the patients, and determining the best course of action to be taken to come up with a viable solution that meet the immediate needs of the patients. Most important of all, a professional should take responsibility of the decisions and actions that they take regardless the outcome. Accountability helps avoid such situations, and helps others find quick solutions to correct the mistakes made.
There are some behaviors that should be exhibited by all professionals in the healthcare sector. With this in mind, I believe that all healthcare practitioners should be dependable. Dependability plays a pivotal role in forging professional relationships with patients. For example, a nurse should ensure that he/she reports to work on time and ensure that he/she carries out his/her duties and responsibilities effectively to completion. Ensuring that a professional clears his/her responsibility before the deadline, all the while following the set schedules is in my book, professional conduct. Another factor that should be considered by professional nurses is how one presents him/herself at work and in front of the patients. Professional presentation is all about presenting yourself in a manner that is acceptable and charismatic to your colleagues and patients at all times (Kasar & Clark, 2000). Considering that nurses interact with many patients having different needs, high levels of organization may help nurses perform their duties more effectively and efficiently. This in turn, guarantees that the services provided by such individuals meet the expected standards and are appreciated by both the patients and colleagues.
Similarly, cooperation and good inter-personal skills among workers is also good indicator of professionalism in nursing. In most cases, healthcare professionals are called upon to work together in interdisciplinary or collaborative environments. For example, diseases such as autism require psychiatric, psychological and medical interventions to help patients overcome or cope with the disease. As such, cooperation among the different professionals may help find conclusive solutions that may help the patient find comfort. However, a lack of cooperation among the professionals in this case may only lead to negative, if not life-threatening results.
Dumont et al (2010) supports this sentiment by stating that all healthcare practitioners should invest more in learning about different healthcare professions. The authors suggest that this can only be accomplished by attaining inter-professional education, which entails acquiring knowledge regarding the needs of different patients and their loved ones, as well as the proficiencies and approaches that nurture professional collaboration. The authors further assert that it is through inter-professional education that practitioners can serve optimally in the healthcare sector. Dumont et al (2010) attribute this statement to the fact that this education dictates the roles and responsibilities that should be carried out by different practitioners. This reduces the chances on inter-profession conflicts in the healthcare sector.
According to McVicar (2003), stress and fatigue are among the main issues suffered by nurses in their workplaces. The author states that nurses are often required to work harder and long hours to cater for the needs of the ever increasing patient list. As a result, nursing requires high levels of skill, teamwork and emotional input. This emotional labor emanates from the fact that nurses are taught and expected to develop relationships and they are not supposed to distance themselves from their patients. Considering the different diseases and injuries that they come across, they are bound to suffer immensely psychologically.
Professionalism, which in this case refers to cooperation and good inter-professional as well as extraprofessional interactions, may help such practitioners reduce workplace conflicts, which are highlighted by Zerwekh and Claborn (2009) as being among the major stressors in the nursing field. Professionalism in my point of view means going out of one’s way or comfort zone and learning cooperative skills for the good of the patients as well as the organization that one represents. Professionalism is about compromising, nurturing and developing good communication and interactive skills through the application and employment of conscious efforts.
Nursing Professional Ethics
In regard to professional ethics, I believe that practitioner owe it to themselves and the people around them to act ethically. Mathieson (2006) defines professional ethics in nursing as the principles and standards that guide how a nurse should conduct his/her work-related activities. These ethical standards are drafted and specified by renowned professional nursing associations such as the International Council of Nurses, which is responsible for designing the international codes of ethics for all nurses. These codes decisively specify the behaviors that nurses should exhibit in their practice. For example, the internationally accepted ethical codes for nurses states that the core responsibilities of nurses are health restoration and promotion, prevention of illness and the alleviation of all manners of suffering.
Furthermore, these responsibilities are sealed by the code of respecting everyone and upholding the right that each individual has to live. This means that regardless of the circumstances or the severity of ailment, professional nurses should at all times remember that the patient has a sacred right to life. As such, everything possible should be done to ensure that the patient lives. Johnstone (2008) supports this sentiment by stating that nurses are ethically bound to cater for the interests and wellbeing of their patients by promoting and protecting them in the best way possible. This is further stipulated in the nursing code of ethics, which dictate that all nurses should focus their efforts towards the provision of quality services as opposed to the provision of nursing services that are below the set standards.
In some cases, nurses are forced to make decisions that may be viewed from an ethical or legal perspective. Zerwekh and Claborn (2006), state that in such situations, professional nurses should base their decisions on the set guidelines rather than relying on their personal beliefs. Ethical codes are designed to help practitioners make decisions that are in the best interest of both the organization and the patient. As such, professionalism in such cases is about making decisions that are devoid of personal feelings and attitudes. Johnstone (2008) recommends that when a nurse is forced to handle a situation that is not properly described in the set codes of ethics, he/she may follow a legally prescribed course of action. Nemie (2009) provides a good example by stating that euthanasia may be an acceptable practice in Holland, but is not permitted in Malaysia. In such a case, I believe that professional conduct would be to follow the laws that govern the country in which the practitioner is working.
With these undertones, I can argue that personal ethics should only play a secondary role in determining and deciding the right course of action to be followed by a practitioner. This is mainly because personal beliefs are in most cases not supported by scientific proof, which is integral in the nursing field. However, it should be noted that going against one’s beliefs may have serious health (psychological and physical) implications. This sentiment is elaborately supported by (Nemie, 2009) who states that neglecting one’s personal principles may have adverse mental and physical effects on the individual.
Principles of healthcare delivery
There are four principles that act as the framework for dealing with ethical issues in the healthcare sector. The first one is the respect for autonomy. This principle suggests that the decisions made by a practitioner should be devoid of any outside or personal influences and should be respected by others. This is inline with my philosophy in the sense that it supports the notion of treating others with respect regardless of their differences. Nemie (2009) observes that this principle is highly valued in the western countries (developed countries) as compared to developing countries. For example, a HIV/AIDS patient in most African countries is viewed as a risk and is mostly stared down upon. Stigmatization and stereotyping affect the quality of treatment such individuals receive in society as well as in hospitals. This is not fair and it goes against my philosophy on professional conduct. On the other hand, terminally ill patients in most developed countries are treated with the same level of respect and attention as other patients who come in with moderate illnesses.
The second principle promotes beneficence. The principle of beneficence advocates for the balance between risks and costs when it comes to giving treatments. Professionalism in this case requires the practitioner to act in a manner that benefits the patient and considers the patient’s ability to get the quality of service that is required to restore him/her to full health. According to this principle, a practitioner who gives preferential treatment to some patients should be legally persecuted because the interests of all patients should be the driving factor when it comes to giving treatments. From my point of view, a professional nurse should always ensure that his/her actions benefit the patients regardless of what the situations dictate.
Arguably, majority of the population is greatly dissatisfied with the current health care system provided and the insurance schemes in particular. Arguably, an effective healthcare system should reflect high degrees of efficiency, acceptability and equitability. This is not the case with the current healthcare system, which is lacking these qualities. For example, over the years, cases have been reported whereby patients fail to get medical attention because they do not have the financial backing required to give them access to quality healthcare. This is a classical case of unprofessional conduct and it contradicts my philosophy and the principle of beneficence.
According to Blackmer (2007), the principle of non maleficence protects patients from harm that may be caused to them by healthcare practitioner. It is a known fact that some treatments may cause the patient some level of harm. However, such treatments should not unnecessarily risk the life of the patient. All healthcare practitioners should know that their primary responsibility is to restore the health of the patient in a professional manner. For example, accepting to do a heart surgery to an elderly, while knowing that his status cannot handle such an operation, is unprofessional and goes against the principle of non maleficence. Upholding justice is the last principle that governs healthcare practices.
The Annals of Internal Medicine (2002) elaborates this principle by stating that healthcare practitioners should actively work towards eradicating any form of discrimination in the healthcare sector and following the laws and regulations that govern the land. For example, results from a current study showed that close to 20,000 adults die each year in America as a result of lack of comprehensive insurance covers (California Nurses Association, 2009). This is mainly due to the fact that most hospitals do not cater for people without comprehensive insurance until it is too late. As such, such people do not get quality care because they cannot afford it. Other than being unprofessional, such actions contradict with the principle of justice, which proposes that all patients should be treated equally regardless of their differences.
Monitoring professionalism in healthcare delivery
In most cases, healthcare providers design measures and guidelines in a bid to ensure that operations are conducted in an ethical and professional manner. I believe that such initiatives go a long way in facilitating quality and efficient execution of duties and responsibilities held by practitioners. For example, a patient chart is very effective in monitoring how nurses and doctors are performing their duties. A patient’s chart can be used to evaluate the quality of care a patient is receiving and at the same time, to assess the quality of care the nurse is administering to a specific patient. As such, this tool, among others, can be used to foster professionalism and improve the nurse’s performance wherever he/she is lacking. In addition, professional codes of conduct also promote professionalism in the sense that they dictate what is professionally acceptable, and what not (Mathieson, 2006).
Conclusion
The main purpose of this paper was to relate my personal philosophy on professionalism to the nursing field of practice. To this end, a comprehensive discussion detailing the meaning of professionalism in nursing has been provided. In addition, the legal and ethical aspects that facilitate professionalism in nursing have been highlighted. Similarly, attributes that constitute to a professional nurse have been discussed herein. The ethical theories and principles that are used to foster professionalism have been evaluated. It is evident that professionalism comes in different shades depending on the practitioner. While some of the qualities mentioned in this paper are inborn, others are acquired through experience and education. By following the ideas and recommendations made within this paper, nurses can be better placed to provide the quality of service that they are expected to without malice or doubt.
Arguably, professionalism is guaranteed by following set guidelines, rules and regulations. However, having personal philosophies play a pivotal role in ensuring that a professional stays in line. While there may be situations that cannot be solved by ethical codes or laws, personal philosophies and belief systems may prove to be helpful since they are often founded on moral grounds. It therefore goes without saying that all professional healthcare practitioners should have as their primary guide personal philosophies, which are backed by ethical and legal rules and regulations. This will ensure that professionalism prevail even in the toughest of times.
References
Annals of Internal Medicine. (2002). Medical Professionalism in the New Millennium: A Physician Charter. Medical Journal of Australia, (177): 263-265.
Blackmer, J. (2007). Professionalism and the Medical Association. USA: World Medical Association.
California Nurses Association. (2009). The Cost of Healthcare – More Americans priced out of Care. Web.
Clark, L. (2008). Clinical leadership: Values, beliefs and vision. Nursing Management, 15(7): 30 – 35.
Dumont, S et al. (2010). Implementing an Interfaculty Series of Courses on Interprofessional Collaboration in Prelicensure Health Science Curriculums. Education for Health, 23(1): 2 – 14.
Johnstone, M. (2008). Questioning Nursing Ethics (Ethics & Legal). Australian Nursing Journal, (15): p. 19.
Kasar, J., & Clark, N. (2000). Developing Professional Behaviors. Boston, MA: Slack Incorporated.
Mathieson, F. (2006). Examining the Law and Ethics Surrounding Palliative Care. Primary Health Care, (16)4: 36 – 40.
McVicar, A. (2003). Workplace Stress in Nursing: a Literature Review. Washington, DC: Blackwell Publishing Ltd.
Nemie, J. (2009). Challenges for the Nursing Profession in Malaysia: Evolving Legal and Ethical Standards. Journal of Nursing Law, (13)2: 54 – 63.
Pandey, S., & Singh, M. (2008). Women Empowerment and Personal Values as Predictors of Reproductive Health. Journal of the Indian Academy of Applied Psychology, (34)2: 309 – 316.
Royal College of Nursing. (2004). Defining Nursing. Web.
Zerwekh, G. J., & Claborn, C. (2009). Nursing Today: Transition and Trends. London: Elsevier Health Sciences.
Ashcroft, R., Dawson, A., & Draper, H. (2007). Principles of health care ethics. New York: John Wiley and Sons.
Brannigan, M., & Boss, J. (2000). Healthcare ethics in a diverse society. USA: Mayfield Pub. Co.
Cherry, M. (2004). Natural law and the possibility of a global ethics. New York: Springer.
Devettere, R. (2009). Practical decision making in health care ethics: cases and concepts. USA: Georgetown University Press.
Engelhardt, H. (2006). Global bioethics: the collapse of consensus. USA: M & M Scrivener Press.
Geirsson, H., & Holmgren, M. (2010). Ethical Theory: A Concise Anthology. New Jersey: Broadview Press.
Gensler, H. (2011). Ethics: A Contemporary Introduction. Boston: Taylor & Francis.
Greenhalgh, T. (2007). Primary health care: theory and practice. Boston: John Wiley and Sons.
Hester, D. (2001). Community as healing: pragmatist ethics in medical encounters. USA: Rowman & Littlefield.
Loewy, E., & Springer, R. (2004). Textbook of health care ethics. New York: Springer.
Marlin, R. (2002). Propaganda and the ethics of persuasion. New Jersey: Broadview Press.
Melia, K. (2004). Health care ethics: lessons from intensive care. New York: SAGE.
Morrison, E., & Monagle, J. (2009). Health care ethics: critical issues for the 21st century. California: Jones & Bartlett Learning.
Burns, N., & Grove, S. (2005). The practice of nursing research: conduct, critique, and utilization. Boston: Elsevier/Saunders.
Denzin, N., & Lincoln, Y. (2011). The SAGE Handbook of Qualitative Research. New York: SAGE.
Flick et al. (2007). Designing Qualitative Research. New York: SAGE.
Haslam, S., & McGarty, C. (2003). Research methods and statistics in psychology. Washington, DC: SAGE.
Hoskins, C., & Mariano, C. (2004). Research in nursing and health: understanding and using quantitative and qualitative methods. New York: Springer.
Merriam, S. (2009). Qualitative research: a guide to design and implementation. Boston: John Wiley and Sons.
Richardson, T. (1996). Handbook of qualitative research methods for psychology and the social sciences. New York: Wiley-Blackwell.
Ritchie, J., & Lewis, J. (2003). Qualitative research practice: a guide for social science students and researchers. New York: SAGE.
Silverman, D. (2004). Qualitative research: theory, method and practice. New York: SAGE.
Speziale, H., & Carpenter, D. (2010). Qualitative Research in Nursing: Advancing the Humanistic Imperative. Boston: Lippincott Williams & Wilkins.
Sugarman, J., & Sulmasy, D. (2010). Methods in Medical Ethics. USA: Georgetown University Press.
Weinberg, D. (2002). Qualitative research methods. New York: Wiley-Blackwell.
Betta, M. (2006). The moral, social, and commercial imperatives of genetic testing and screening: the Australian case. New York: Springer.
Bettina, M., & Dunn, S. (2001). Psychological effect of genetic testing for Huntington’s disease. American Journal of Medical Genetics, (48): 137–144.
Boskey, E. (2007). America Debates Genetic DNA Testing. USA: The Rosen Publishing Group.
Brent, N. (2000). Nurses and the law: a guide to principles and applications. Boston: Elsevier Health Sciences.
Euan, A. (2009). Genetic testing – should you need a doctor’s permission? 2008. Web.
European Commission. (2000). Genetic testing: policy issues for the new millennium. New York: OECD Publishing.
Hartley, N et al. (1997). The uptake and acceptability to patients of cystic fibrosis carrier testing offered in pregnancy by the GP. Journal of Medical Genetics, (34): 459–464.
Jonse, A., Veatch R., & LeRoy, W. (1998). Sourcebook in Bioethics. USA: Georgetown University Press.
Lerman, C. et al. (2002). Genetic Testing: Psychological Aspects and Implications. Journal of Consulting and Clinical Psychology, (70)3: 784–797.
Uhlmann, W., Schuette, J., & Yashar, B. (2010). A Guide to Genetic Counseling. New Jersey: John Wiley and Sons.