Nursing Ethics

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Leyla Dinç (LD): I graduated in 1986, and began to work as a nurse in the ... Master's degree in nursing in 1993, and worked on a thesis about ethical problems ...

Nursing Ethics http://nej.sagepub.com/

Leyla Dinç interviewed by Elizabeth Niven Nurs Ethics 2010 17: 404 DOI: 10.1177/0969733010363782 The online version of this article can be found at: http://nej.sagepub.com/content/17/3/404.citation

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Interview Nursing Ethics 17(3) 404–406 ª The Author(s) 2010 Reprints and permission: sagepub.co.uk/journalsPermissions.nav 10.1177/0969733010363782 nej.sagepub.com

Interview

The intention behind this series of interviews with members of the Nursing Ethics Editorial Board by other Board members is to introduce members of the Board to readers. Here, Elizabeth Niven from New Zealand interviews Leyla Dinc¸ from Turkey. Elizabeth and Leyla have known each other for over five years. The interview was conducted by email.

Leyla Dinc¸ interviewed by Elizabeth Niven Elizabeth Niven (EN): I would like to introduce you to Leyla Dinc¸, from Turkey, who has served on the Nursing Ethics Board for five years. First tell us a little about yourself as a person and how your involvement with nursing ethics developed. Leyla Dinc¸ (LD): I graduated in 1986, and began to work as a nurse in the cardiovascular intensive care unit (ICU) of the university hospital. For a nurse, the various monitors, chest tubes, intravenous lines, urinary catheters, endotracheal tubes and ventilators in ICUs are seen only as mechanical devices that are used for constant monitoring of patients’ health condition and part of treatment procedures. However, for a patient with a life-threatening condition, this apparatus signifies the inability to breathe unaided, to eat, to speak, to move independently. Sometimes, for patients, the expression in their eyes, the fear in their face, is the only connection with health care professionals. Usually, it is the nurse they see for the first time when they become aware of who and where they are, and what is happening to them. Therefore, it is the nurse who must first understand the feelings of panic, anxiety, suffering, being in need and vulnerability. The relationship between a nurse and a patient is special; it requires sensitivity and a deep understanding. The nurse–patient relationship is the starting point for ethics in nursing. During my five-year experience as a nurse I realized the importance of the nurse–patient relationship even though I did not know the meaning of ethics. I received my Master’s degree in nursing in 1993, and worked on a thesis about ethical problems in nursing. This was my first academic work, which motivated my interest in ethical issues in nursing. I completed my PhD in nursing in 1998 and began to work as a nurse educator. I have been working as a faculty member at Hacettepe University Faculty of Health Sciences Nursing Department for more than 10 years. EN: How did you come to work in nursing ethics? LD: Nurses deal with people’s health and increasingly they face ethical problems in practice that require ethical decision making and responsibility. Ethics education alone cannot make nurses good nurses, but it can influence their insights, ethical choices and actions by increasing their knowledge and decision-making skills. I believe that nursing ethics is an important part of nursing education and students should be prepared as responsible professionals. In this respect, I have committed my personal efforts to integrate the necessary content for ethics education for nurses. However, I have to admit that, being acquainted with Verena Tschudin, the founding editor of Nursing Ethics, increased my interest and reflection on nursing ethics. With her encouragement I started to work on Nursing Ethics as a consultant editor. Her support paved the way for improving my formal background in ethics. I am a student of Erasmus Mundus Master of Bioethics now. The Master’s programme has been designed to offer an advanced education in health care ethics, specifically paying attention to international bioethics with special attention to European philosophical as well as theological traditions in this area. The courses are offered for one year in three universities: the Catholic University in Leuven, Radboud University in Nijmegen and University of Padova. Although I had always tried to improve my background in nursing ethics through personal effort, I was aware that, without any

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Interview

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formal education in ethics, as a nurse educator my contribution to our students would be limited. Therefore my intention is to acquire more theoretical knowledge and practical skills in bioethics, as well as health care ethics, in order to contribute more to nursing ethics. It is my hope to offer a separate course on nursing ethics in my institution after I qualify as an MD in bioethics. EN: Now to move to your national setting. I’m interested in your work in an environment where there are strong religious and secular influences. Can you tell me some practical challenges that nurses in Turkey might face as they seek to work with these sometimes apparently opposing views of what is good and right? LD: Although the predominant population of Turkey is Muslim, it is a secular democratic country. Secularism does not refer to exclusion of religion from the public sphere, but to state neutrality toward religions and to the separateness of state constitutions and religious affairs. However, despite the secular tradition in Turkey, the influence of religion in political and social life has increased over the last decade and raised some internal conflicts. It is interesting that women especially are on the forefront of these conflicts. For instance, the headscarf has become like a symbol of identification for women to show whether they are religiously orientated or secular. Paradoxically, women’s rights were obtained during the modernization reforms of Atatu¨rk, the founder of modern Turkey. Before 1926, women had no right to divorce or to child custody, or property rights in marriage. The first nursing school in Turkey was established in 1925 after the establishment of the Turkish Republic. In this sense, for me, secularism is the cornerstone of women’s rights in Turkey and as members of a nursing profession we cannot tolerate discrimination on the basis of religion or gender in practice. It is really a challenge to find the right middle ground, but this is our reality, and we have to respect both religious and secular worldviews and choices. Both religion and secularism have common aims towards good and refraining from wrong. We have to consider the common goods and reconcile with each other. EN: What different challenges arise in rural as opposed to urban settings for health care practitioners? LD: There are inequalities in health and in the quality of health services among regions and between rural and urban areas. The geographical distribution of health personnel is also very unequal, with fewer staff per population in less developed regions. Geographical conditions, free market orientated politics and socioeconomic factors contribute to health disparities. Consequently, health care practitioners usually prefer to work in urban settings because life in rural regions is difficult. We are traditionally a collective society, in which solidarity and national interests precede individual choices. Probably, the trends towards more individualistic ways of life due to lowered economic conditions have also influenced the choices of health practitioners. We have to care first and foremost for ourselves in order to care about others. EN: We are aware that western ethics may not align comfortably with other cultures, whether religious or traditional or secular, yet the influence of western ethics can be pervasive. How useful are the articles published in Nursing Ethics for your students? What developments would you like to see in articles? LD: Unfortunately, despite the quality and worldwide credibility of Nursing Ethics, most of our students are not able to read its content because of the English language. Although English is the main foreign language at our universities, and some courses are offered in English, there is no nursing school in Turkey that offers education solely in English. It would be wonderful if Nursing Ethics could be published in Turkish too, so that not only nurse academics but also our students could benefit from its content. Regarding the influence of western ethics, I think, as an international journal, Nursing Ethics provides enough space for different cultural approaches. However, I would be pleased to read more articles from other parts of the world, including Asia, the Middle East and Latin America.

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Nursing Ethics 17(3)

EN: And now to the future: How do you see nursing ethics developing over the next decade, specifically in Turkey, but also internationally? LD: I do not know if it is appropriate and technically possible to translate Nursing Ethics into different languages, including Turkish, but this would be a great contribution to nurses’ perspectives, because this journal is a leading scientific resource in nursing ethics. EN: Thank you, Leyla, for this insight into your practice world. Your comments about nurses seeking common understandings as they work in different communities show the relational ethic that nurses worldwide exemplify. You remind us again that, although each of us work in different environments, we have the common bond of being nurses.

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