20.500.12556/DKUM-90139 Konflikt etično strokovnih normativov: Ugovor vesti medicinskih sester pri evtanaziji Conflict of ethical-professional norms: Nurses' conscientious objection in euthanasia V Sloveniji poteka razprava o evtanaziji, ki je osredotočena predvsem na etično in pravno odgovornost zdravnikov. Poznavanje etično pravno-formalnih stališč medicinskih sester do evtanazije na bolnišnični ravni je lahko pokazatelj pristojnim odločevalcem, katere zakonske predpise je treba sprejeti, da ohranijo stabilen in učinkovit javno zdravstveni sistem, katerega najštevilčnejši deležnik je zdravstveno-negovalni kader. Namen magistrskega dela je raziskati stališča medicinskih sester v povezavi z evtanazijo in ugotoviti, ali bi medicinske sestre uveljavljale ugovor vesti. Na osnovi izmerjenih stališč zaposlenih anestezijskih medicinskih sester bi predlagali ukrepe, ki bi lahko vplivali na organizacijo ali udejanjanje evtanazije. Na osnovi teoretičnih izhodišč in predhodnih tujih raziskav je bil izdelan anketni vprašalnik, v katerega je bila vključena celotna populacija anestezijskih medicinskih sester iz Univerzitetnega kliničnega centra Ljubljana. Pridobljene odgovore smo prenesli v programsko orodje za zahtevnejše analize SPSS® Statistics, kjer smo podatke statistično analizirali z ustreznimi statističnimi testi z izbrano stopnjo značilnosti pri 0,05 in jih s teoretičnimi spoznanji z našimi ugotovitvami povezali v celoto. Najvišja raven strinjanja je bila zabeležena pri trditvi, da ima človek pravico odločati o svoji smrti in da je evtanazija humana metoda pomoči bolni osebi. Anestezijske medicinske sestre so sicer v povprečju bližje verjetnosti, da bi sodelovanje pri evtanaziji izzvalo moralno sporen odnos, ki lahko vodi v konflikt interesov, vendar bi se v povprečju manj verjetno odločile za uveljavitev ukrepa ugovora vesti. A v primeru odločanja ali delovanja v javni matični bolnišnici ali v organizaciji za evtanazijo, bi sodelovanje odklonilo več kot polovica medicinskih sester oziroma skoraj vse, če izvajanje evtanazije ne bi bilo v interesu javnega zavoda. Mnenje medicinskih sester o uveljavitvi ugovora vesti v primeru uzakonitve evtanazije glede na starost in religijo v povprečju ni značilno odstopalo, medtem ko je bila glede na spol prepoznana statistično značilna razlika. Pri preverjanju obstoja povezanosti med izraženimi stališči smo s Pearsonovim koeficientom korelacije pri dveh raziskovalnih vprašanjih zaznali zmerno linearno povezanost. Povezava med izvajanjem dela v organizaciji za evtanazijo in stopnjo religije medicinskih sester pa ni bila statistično dokazana. Raziskava je pokazala, da so medicinske sestre pri anesteziji na splošno prepričane, da bi jih sodelovanje pri evtanaziji vodilo v moralno sporen odnos in v konflikt interesov, vendar v času javne razprave v Sloveniji na splošno odobravajo evtanazijo in pravico odločanja posameznika o svoji smrti, kar kažejo tudi druge primerljive raziskave. Zavedajo se, da bi sodelovanje pri evtanaziji lahko povzročilo moralne dileme ali občutke krivde. Poleg tega se medicinske sestre sprašujejo, ali bi takšno dejanje povzročilo kršenje kodeksa etike v zdravstveni negi, ki je, kot kaže, predvsem pri zelo vernih medicinskih sestrah usmerjeno k ugovoru vesti. Anketirane medicinske sestre bi bile v majhnem deležu pripravljene sprejeti sodelovanje v slovenski organizaciji za evtanazijo, vendar le pod pogojem, da pridobijo ustrezno soglasje delodajalca. Raziskava kaže, da anketirane medicinske sestre dobro poznajo področje obvladovanja bolečine, toda primanjkuje jim znanja pri oskrbi bolnikov ob koncu življenja. Spoznanja na osnovi evtanazije kažejo, kako lahko na zdravstveno-negovalnem področju pride do navzkrižja vrednot, kjer se mora ravno ugovor vesti v zdravstvu obravnavati drugače, saj morajo medicinske sestre, ki se v kliničnem okolju srečujejo s potrebami celotne družbe, ohraniti to pravico. V nasprotnem primeru lahko sodelovanje pri evtanaziji medicinske sestre privede v obup in odločitve, da zapustijo svojo profesijo. In Slovenia there has been a discussion about euthanasia which is mainly focused on the ethical and legal responsibility of doctors. Comprehending the ethical and legal views of nurses in regard to euthanasia at a hospital level can help policymakers understand which legal regulations should be passed in order to maintain a stable and effective public health care system, considering health nursing staff to be the largest part of it. The objective of my master’s thesis is to explore the views of nurses in regard to euthanasia and find out whether nurses would be conscientious objectors. Based on the results, measures could be suggested in order to potentially affect the organisation or realisation of euthanasia. In reference to theoretical bases and prior foreign surveys, a survey questionnaire was made. Every single nurse anaesthetist at University Medical Centre Ljubljana was included in the survey. The obtained data was then analysed by SPSS® Statistics using significance level of 0,05 and later the theoretical framework and our findings were combined. The highest level of agreement was noticed with the statement saying that every man has the right to decide on his/her death and that euthanasia is a humane method that helps an ill person. However, nurse anaesthetists are on average closer to the probability that participation in performing euthanasia would provoke a morally disputable relationship which could lead to a conflict of interests. But still, on average, they would less probably decide for conscientious objection. Whereas more than half, if not almost all nurse anaesthetists, would refuse to participate in the performance of euthanasia if it wasn’t performed in the interest of a public institution. As far as the views of the nurses relating to enforcing conscientious objection in the case of legalisation of euthanasia is concerned, there wasn’t a significant difference in regard to age and religion. However, a statistically distinctive difference regarding gender was noticed. By using the Pearson correlation coefficient in order to check the correlation between two research questions, we were able to note proportional linear correlation. Nevertheless, we could not statistically prove the correlation between work performance in the organisation for euthanasia and the religious level of nurses. The survey has shown that, in general, nurses see participation in the euthanasia process as a morally dubious relationship leading to a conflict of interests, but considering current public discussion about euthanasia in Slovenia and other comparable surveys, they generally approve euthanasia and the right of an individual to decide on his/her death. Nurses are aware of the fact that participating in the euthanasia process could lead to moral dilemmas or remorse. Moreover, nurses are in doubt whether such an act could cause the violation of the ethical code in the health care system. Consequently, extremely religious nurses would consider conscientious objection. Only a small percentage of nurse respondents would be willing to participate in a Slovenian organisation for euthanasia on condition they received appropriate consensus from their employer. According to the results of the survey, it is obvious that nurses are well familiar with the controlling of the pain, but they lack knowledge in the field of palliative care. Findings as regards euthanasia show us how quickly we can deal with conflicts of interests in the field of health care. Therefore, it is crucial that conscientious objection in medical service is considered differently in order to enable nurses in the clinical environment, faced with the needs of the entire society, to preserve this right. Otherwise, participation of nurses in the euthanasia process can lead to despair and a decision to leave their profession. anestezijska medicinska sestra evtanazija ugovor vesti konflikt interesov etika Nurse anaesthetist euthanasia conscientious objection conflict of interests ethics true true false Slovenski jezik Angleški jezik Magistrsko delo/naloga 2024-08-23 08:44:53 2024-11-15 09:29:19 2024-11-20 09:58:22 0000-00-00 00:00:00 2024 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 215071747 MAG_Bucic_Pajo_2024.pdf MAG_Bucic_Pajo_2024.pdf 1 2F40288B97DF00F2D32BC002AE6D77FE ed6ca7fc757162e821d592c190201b165b099bf4c005abc6c142c2edc1ce8ff8 61a8805a-64ad-11ef-af0b-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=183534 Fakulteta za organizacijske vede 0 0 0