<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_fon-2019-0005_s_006_w2aab3b7b5b1b6b1aab1c17b1Aa"><h3>Objective</h3><p>This study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses’ paternalistic decision-making for patients. Meanwhile, critical awareness will be developed and the underlying issues of paternalism in nursing decision-making will be analyzed. Then, by applying the procedure, improvement in nursing decision-making practice will be expected.</p></sec><sec id="j_fon-2019-0005_s_007_w2aab3b7b5b1b6b1aab1c17b2Aa"><h3>Methods</h3><p>Taylor’s model of emancipatory reflection with four steps, including construction, deconstruction, confrontation, and reconstruction, is utilized to guide the author’s reflection.</p></sec><sec id="j_fon-2019-0005_s_008_w2aab3b7b5b1b6b1aab1c17b3Aa"><h3>Results</h3><p>Guided by the socialization theory, the author’s personal and professional socialization is seen to be associated with the formation of the value of paternalism. The theory of reflexivity is applied to unearth the related issues, including deeper personal value, work environment, as well as historical and cultural contexts. Moreover, the power derived from policy, work relationship, and nursing administration, which could induce paternalism in the author’s nursing decision-making practice, was critically debated using the hegemony theory. Finally, new insights into paternalism will be achieved, which enable change in terms of how to facilitate patients’ autonomous decision-making.</p></sec><sec id="j_fon-2019-0005_s_009_w2aab3b7b5b1b6b1aab1c17b4Aa"><h3>Conclusions</h3><p>The process of refection makes it clear that respecting patients’ right and performing patient-centered caring are the bases to change the paternalism existing in the nursing decision-making practice currently. The reconstruction step assists the author in terms of how to value the patients’ autonomy and balance patients’ safety and choice, rather than being overprotective; carry out risk assessment, and search for strong evidence to counterbalance the positive and negative aspects of risk-taking; communicate with patients appropriately in a manner that they can comprehend; spend more time to explore patients’ preference and choice; make every effort to elevate the patients’ decision-making capacity; implement patient-centered care and shared decision-making in nursing practice; consult with other colleagues and obtain the required support when limitations or challenges exist; try to justify and avoid hidden paternalism behind policy or guidelines; deal with the power in hand well and fairly; and also positively face the powers that constrain the author.</p></sec></abstract>

ObjectiveThis study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses’ paternalistic decision-making for patients. Meanwhile, critical awareness will be developed and the underlying issues of paternalism in nursing decision-making will be analyzed. Then, by applying the procedure, improvement in nursing decision-making practice will be expected.MethodsTaylor’s model of emancipatory reflection with four steps, including construction, deconstruction, confrontation, and reconstruction, is utilized to guide the author’s reflection.ResultsGuided by the socialization theory, the author’s personal and professional socialization is seen to be associated with the formation of the value of paternalism. The theory of reflexivity is applied to unearth the related issues, including deeper personal value, work environment, as well as historical and cultural contexts. Moreover, the power derived from policy, work relationship, and nursing administration, which could induce paternalism in the author’s nursing decision-making practice, was critically debated using the hegemony theory. Finally, new insights into paternalism will be achieved, which enable change in terms of how to facilitate patients’ autonomous decision-making.ConclusionsThe process of refection makes it clear that respecting patients’ right and performing patient-centered caring are the bases to change the paternalism existing in the nursing decision-making practice currently. The reconstruction step assists the author in terms of how to value the patients’ autonomy and balance patients’ safety and choice, rather than being overprotective; carry out risk assessment, and search for strong evidence to counterbalance the positive and negative aspects of risk-taking; communicate with patients appropriately in a manner that they can comprehend; spend more time to explore patients’ preference and choice; make every effort to elevate the patients’ decision-making capacity; implement patient-centered care and shared decision-making in nursing practice; consult with other colleagues and obtain the required support when limitations or challenges exist; try to justify and avoid hidden paternalism behind policy or guidelines; deal with the power in hand well and fairly; and also positively face the powers that constrain the author.

Emancipatory reflection on a nursing practice-based ethical issue about nurses’ paternalistic decision-making for patients

Frontiers of Nursing

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

ObjectiveThis study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue...

Emancipatory reflection on a nursing practice-based ethical issue about nurses’ paternalistic decision-making for patients

Article Category: Discussion

Published Online: May 20, 2019

Page range: 19 - 26

Received: Oct 21, 2018

Accepted: Dec 22, 2018

DOI: https://doi.org/10.2478/fon-2019-0005

Keywords
reflection, paternalism, critical emancipatory reflection, Taylor’s model, decision-making, nursing ethical issue

© 2019 Tang, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Emancipatory reflection on a nursing practice-based ethical issue about nurses’ paternalistic decision-making for patients

Article Category: Discussion

Published Online: May 20, 2019

Page range: 19 - 26

Received: Oct 21, 2018

Accepted: Dec 22, 2018

DOI: https://doi.org/10.2478/fon-2019-0005

Keywordsreflection, paternalism, critical emancipatory reflection, Taylor’s model, decision-making, nursing ethical issue

© 2019 Tang, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
reflection, paternalism, critical emancipatory reflection, Taylor’s model, decision-making, nursing ethical issue