Management of ethical situations by military nurses during wartime

Management of ethical situations by military nurses during wartime


Name: Janice Agazio


Presenter/Poster: Podium

Year: 2014


The purpose of this study was to explore how military nurses identify, assess, manage, and personally resolve ethical issues occurring in nursing practice during wartime deployments?

The specific research questions addressed included:  What were the ethical issues encountered by military nurses in nursing practice during deployment for OEF and OIF? How do nurses identify these situations as involving ethical issues? How do nurses appraise these situations in assessing and choosing a course of action? How were ethical situations managed? How were the ethical situations resolved? How do military nurses personally resolve the outcome of the ethical issues that they encountered during their deployments?

Using grounded theory, military nurses from all three services were interviewed to elicit their experiences with ethical issues while deployed in support of the recent wars. Using a focused interview guide, interviews were conducted until theoretical saturation was achieved. Data analysis was conducted using methods detailed by Strauss and Corbin (1998). Rigor was maintained in study methods and analysis using tenets from Lincoln and Guba (1985) and Morse et al's (2002) verification strategies.

Symbolic interactionism served as the conceptual framework underlying grounded theory as design and method. Identification of ethical concerns were guided by the ethical principles as defined in the Belmont Report.

Thirty-five Nurse Corps participants from the Air Force, Army, and Navy shared their deployment ethical experiences. Ethical issues occurred regarding respect for persons, justice, and beneficence. Many struggled to find internal peace regarding care of detainees, cultural differences, end of life decision making, pain management, and care of civilian casualties. A theory of managing ethical decision making during wartime emerged from the core construct, doing the right thing.

This study provided a description of the process military nurses use to resolve ethical issues during wartime and will contribute to an ethical issues toolkit” and development of a military ethical issues instrument. By better understanding how nurses defined, assessed, and managed the ethical situations they encountered, we can better prepare our deploying nurses for future conflicts.

This research was sponsored by the TriService Nursing Research Program, Uniformed Services University of the Health Sciences; however, the information or content and conclusions do not necessarily represent the official position or policy of, nor should any official endorsement be inferred by, the TriService Nursing Research Program, Uniformed Services University of the Health Sciences, the Department of Defense, or the U.S. Government.