著者

宮脇 美保子 宮林 郁子 谷垣 静子 酒見 隆信

出版者

慶應義塾大学

雑誌

基盤研究(C)

巻号頁・発行日

2010-04-01

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看護師がとるべき倫理的行動について判断できているにもかかわらず、その判断に従って行動できないことにより生じる「倫理的悩み」についてのインビューを中堅看護師を対象に行った。データをM-GTAを用いて分析した結果、【患者の尊厳を傷つけること】【看護師の都合を優先すること】【必要なケアを省略すること】【ケアの公平さを欠くこと】【患者に対して誠実さを欠くこと】【組織から行動を制約されること】の6つがカテゴリー化された。「倫理的悩み」は看護師に〈後ろめたさ〉〈あきらめ〉〈無力感〉〈感情の平坦化〉といった心理的ダメージを与え、看護の質に影響を及ぼしており、倫理的支援システム構築の重要性が明らかとなった。

著者

古田 真弥子 宮脇 美保子

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.38, pp.31-40, 2020 (Released:2022-07-20)

著者

宮脇 美保子

出版者

日本生命倫理学会

雑誌

生命倫理 (ISSN:13434063)

巻号頁・発行日

vol.15, no.1, pp.41-45, 2005-09-19 (Released:2017-04-27)

参考文献数

13

被引用文献数

1

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ケアリングとしての看護は古いが、専門職としての看護は他の職業と比較して歴史が浅い。では、看護が主張する専門性とは何であろうか。看護の本質は人をケアすることである。このケアは、看護手順以上のことを意味している。看護師は、常に個人の尊厳や価値、権利を大切にしながら患者をケアしているのである。しかしながら、医療技術が発達するにつれて、看護師も、周囲の人も機器を扱う技術で看護師の価値を測るようになってきた。その結果、看護師自身が行うことにあった看護独自の貢献は、あまり重視されなくなった。このような認識は、社会の人々がもつ看護師は医師の助手であるというイメージと関係があると思われる。しかし、一方で専門職としての発展に伴い、患者に対する自らの臨床判断と看護行為について直接責任を負う看護師も増えてきている。看護の責務とは、ある看護場面において自分が選択した行動の結果に責任を負うとともに、行動をおこさなかったことに対する結果を受け入れることであり、患者が反倫理的や違法行為によって脅かされているときは患者を擁護する行動をとることである。

著者

宮脇 美保子

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.21, pp.140-152, 2003-10-05 (Released:2018-02-01)

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Nursing is an emerging profession trying to fulfill the criteria that define a true profession. The professional work of nursing is approached in a scientific manner. The nursing process is defined as an intellectual activity meant to be approached regularly and systematically now that the nursing process is the accepted method of professional practice. However, the nursing process is not the only capability required of nurses. The nursing process is nothing more than a problem-solving process by which nurses meet patients' needs. The patient's set of problems, referred to as the "nursing diagnosis," is undergoing international standardization. To standardize is to risk overshadowing the care that originally motivated the more scientific approach to solving patients' problem. Still more, with the increased complexity of medical care, nurses have taken over more and more of the activities associated with medical practice. Consequently, in the actual reality of practice, nurses sometimes lose sight of caring. What is the primary expertise to which nursing lays claim? So far, nurses have always valued the idea of caring for persons. Has nursing abandoned its caring role? Caring means that persons, the subjects of nursing care, are treated not as objects or impersonally but always in a way that considers the essence of the person, i. e., the opposite of mechanization and depersonalization. Also, what patients want and need most from nurses has been and still remains quality, humanized care. Therefore, nurses are challenged to enhance and develop the caring tradition of nursing as expressed through the nursing process.

著者

宮脇 美保子

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.19, pp.72-82, 2001-10-20 (Released:2018-02-01)

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Until recently, the western scientific methods have been viewed as the major and only valid and reliable ways to approach knowledge and understand people. Western science has developed a worldview which is in sharp contrast to that of the Far East. From the second half of the 17th to the end of the 19th century, the mechanistic Newtonian model of the universe dominated all scientific thought. Nature was viewed as not a mere machine, but in fact a very large machine. Such mechanistic philosophy was embodied in industrial society. However, the first three decades of the 20th century radically changed the whole situation in physics. At that time, Western science finally started to look to the eastern philosophies. In contrast to the mechanistic Western view, the eastern view of the world is organic. Incidentally, nursing science is a new intellectual activity. Established as recently as 50 years ago, it has occupied only a short span of time in the history of science. In the mid-1800s, Florence Nightingale called for nurses to develop an in-depth understanding of man and nature as interacting wholes. After one hundred years, Martha Rogers emerged as one of the most original thinkers in nursing. According to her "human beings are not disembodied entities, nor are they mechanical aggregates... human being is a unified whole possessing his/her own integrity and manifesting characteristics more than and different from the sum of its parts". Her model has had a significant influence on current scientific inquiry and professional nursing practice, including serving as a basis for the explication of other nursing theorists, including those of Newman, Parse, and Watson. Thus in the last part of the 20th century, the new world view has become more evident in nursing science.

著者

宮脇 美保子

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.17, pp.77-84, 1999-10-01 (Released:2018-02-01)

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The purpose of this study is to describe health professionals' involvement in patient-centered medical practice and to suggest solutions to various problems. In today's advanced medical society, the health profession is facing issues in patient-centered medical practice. However, in cases of the progressive cancer, the physician usually tells the patients' family first about the patients' diagnosis and prognosis prior to informing the patient. This is a problem because in these cases it is truly an infringement on the rights of the patient to know his or her condition. All of the patients have to be respected as individuals. The problem is often assumed that the idea of informed consent came from America and therefore there is a cultural difference between Japan and the West. In Japan, fundamental human rights are guaranteed under the Constitution. In reality, there has traditionally been a lack of individualism and a deficiency in concern about human right among the health profession. In recent years, as things are changing so rapidly, patients are growing in recognition of their rights and the general public has a fairly wide knowledge of medicine. There is increasing dissatisfaction within medical care that ignores informed consent. Who does the patient's life belong to? The patient needs to know about his or her health information first and then to decide if whom how to inform family members of his or her medical condition. I believe that we must respect the autonomy of every individual. That respect includes health professionals protecting the patient's right of self-determination.

著者

宮脇 美保子

出版者

日本医学哲学・倫理学会

雑誌

医学哲学医学倫理 (ISSN:02896427)

巻号頁・発行日

no.21, pp.140-152, 2003-10-05

被引用文献数

1

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Nursing is an emerging profession trying to fulfill the criteria that define a true profession. The professional work of nursing is approached in a scientific manner. The nursing process is defined as an intellectual activity meant to be approached regularly and systematically now that the nursing process is the accepted method of professional practice. However, the nursing process is not the only capability required of nurses. The nursing process is nothing more than a problem-solving process by which nurses meet patients' needs. The patient's set of problems, referred to as the "nursing diagnosis," is undergoing international standardization. To standardize is to risk overshadowing the care that originally motivated the more scientific approach to solving patients' problem. Still more, with the increased complexity of medical care, nurses have taken over more and more of the activities associated with medical practice. Consequently, in the actual reality of practice, nurses sometimes lose sight of caring. What is the primary expertise to which nursing lays claim? So far, nurses have always valued the idea of caring for persons. Has nursing abandoned its caring role? Caring means that persons, the subjects of nursing care, are treated not as objects or impersonally but always in a way that considers the essence of the person, i. e., the opposite of mechanization and depersonalization. Also, what patients want and need most from nurses has been and still remains quality, humanized care. Therefore, nurses are challenged to enhance and develop the caring tradition of nursing as expressed through the nursing process.