Penn professor calls for more focus on ethics in nursing

Nursing students at Penn learn valuable skills in biology and physiology, but they also study a more unusual subject: ethics.

While there isn’t a significant amount of research on ethics in nursing, bioethics as a whole enjoys a greater presence at Penn than it does at many other universities.

“One of the unique aspects of Penn Nursing is that we do have a bioethics course,” School of Nursing professor Connie Ulrich said. Ulrich is the only nurse bioethicist at the University, but the Department of Medical Ethics and Health Policy itself has over 40 primary and affiliated faculty. “I think we recognize that nurses have to think about the ethical decisions that are made on a daily basis related to their patients.”

Ulrich recently wrote an editorial titled “Nurses and Industry: Conflict or Collaboration?” for the journal Annals of Internal Medicine, about the need for greater research into ethical problems nurses may face. The editorial was spurred by a recent study by Grundy et al. that found that nurses were having increasing contact with pharmaceutical and biotech companies, which could lead to potential conflicts of interest.

“Much of the [bioethics] research has focused on physicians and physician conflict of interest in working with industry; the focus has not been on nursing,” Ulrich said. “But in this study we saw that nurses were interacting on a daily basis with industry and helping to make decisions related to patient care.”

All nursing students at Penn are required to take either a class on health care ethics or public health policy, a requirement that reflects the relatively strong presence of bioethics at the University in general.

“I think a lot of it does stem from this really strong bioethics department that we have,” College junior Darby Marx said. Marx is editor-in-chief of the Penn Bioethics Journal, a peer-reviewed undergraduate publication.

“Recently the bioethics minor was developed,” Darby said, “And I think that was ... a bunch of different departments getting together and saying, ‘Hey, this is a growing field and it’s becoming increasingly important in the realm of health care.’”

Managing Editor and College junior Jamie Atienza said she thought that the relative awareness of bioethics at Penn might be due to the school’s pre-professional atmosphere.

“I think at some point everybody who is pre-med, or pre-health in general, gets at least some exposure to the issues that come up in bioethics, whether it be in health policy or a global health class,” she said.

Atienza and Marx said that despite the wide range of subjects covered in the Penn Bioethics Journal, ethics in nursing had not been explored in the publication.

“We actually don’t talk about nursing ethics at all, which is interesting because we have such a big nursing community,” Atienza said. “When we consider the hospital setting, it’s very much patient-provider, patient-physician relationships.”

The lack of submissions on ethics in nursing to the Penn Bioethics Journal may be due to the relative lack of research focus on ethics in nursing in general. Ulrich hopes that the recent study by Grundy et al. will draw attention to the issue.

“Because the study was small, we really couldn’t generalize the information,” Ulrich said. “We need more research to better understand the role[s] of nursing and industry, [and] we need larger studies to look at those specific interactions and whether or not those interactions influence the ethical conduct of nurses in that clinical setting.”

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