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Nurs Ethics. 2018 Mar;25(2):264-272. doi: 10.1177/0969733017714303. Epub 2017 Jun 20.

Sustainability in care through an ethical practice model.

Nursing ethics

Linda Nyholm, Susanne Salmela, Lisbet Nyström, Camilla Koskinen


  1. Åbo Akademi University, Finland; Vaasa Central Hospital, Finland.

PMID: 28631537 DOI: 10.1177/0969733017714303


BACKGROUND: While sustainability is a key concept in many different domains today, it has not yet been sufficiently emphasized in the healthcare sector. Earlier research shows that ethical values and evidence-based care models create sustainability in care practice.

OBJECTIVE: The aim of this study was to gain further understanding of the ethical values central to the realization of sustainability in care and to create an ethical practice model whereby these basic values can be made perceptible and active in care practice.

RESEARCH DESIGN: Part of the ongoing "Ethical Sustainable Caring Cultures" research project, a hermeneutical application research design was employed in this study.

PARTICIPANTS: Dialogues were used, where scientific researchers and co-researchers were given the opportunity to reflect on ethical values in relation to sustainability in care.

FINDINGS: An ethical practice model with ethos as its core was created from the results of the dialogues. In the model, ethos is encircled by the ethical values central to sustainability: dignity, responsibility, respect, invitation, and vows.

DISCUSSION: The model can be used as a starting point for ethical conversations that support carers' reflections on the ethical issues seen in day-to-day care work and the work community, allowing ethical values to become visible throughout the entire care culture.

CONCLUSION: It is intended as a tool whereby carers can more deeply understand an organization's common basic values and what they entail in regard to sustainability in care.

Keywords: Care; ethics; hermeneutic application research; model; sustainability

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