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Nursing Reports
Special Issues
Ethics in Nursing Practice: Dignity, Moral Agency and Contemporary Challenges
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Ethics in Nursing Practice: Dignity, Moral Agency and Contemporary Challenges

A Special Issue of Nursing Reports (ISSN 2039-4403).

Deadline for manuscript submissions: 31 December 2026 | Viewed by 1793

Editor

Dr. Younjae Oh

E-Mail Website
Guest Editor
College of Nursing, Hallym University, Chuncheon 24252, Gangwon-do, Republic of Korea
Interests: dignity; dignified care; ethical responsibility; moral or ethical competence; moral or ethical sensitivity; moral or ethical reasoning; moral or ethical motivation; moral or ethical behaviour; moral distress; moral residue; moral resilience; ethical leadership; ethical climate; ethical communication
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ethics is the cornerstone of nursing practice. Nurses bear a fundamental ethical responsibility to safeguard patient dignity while navigating the increasingly complex demands of clinical, organizational and societal landscapes. In contemporary healthcare, nurses are frequently confronted with intricate ethical dilemmas—ranging from end-of-life decision-making and mental health challenges to interprofessional conflicts and systemic resource limitations. Such environments require high levels of moral sensitivity, ethical reasoning and professional competence, supported by ethical communication within and across teams.

When organizational constraints and an unsupportive ethical climate impede the fulfillment of ethical duties, nurses may experience moral distress, which can lead to moral residue and compromise both professional integrity and the quality of patient care. Conversely, moral resilience and ethical leadership can strengthen nurses’ moral agency and support ethically sustainable practice even under adverse conditions.

This Special Issue, “Ethics in Nursing Practice: Dignity, Moral Agency and Contemporary Challenges”, aims to advance scholarly discourse on how ethical competence is developed, sustained and operationalized across diverse nursing contexts. We invite original research (qualitative, quantitative and mixed-methods), systematic reviews and theoretical analyses addressing dignity-affirming care, ethical responsibility, moral sensitivity and reasoning, moral distress and resilience, ethical leadership, ethical climate and ethical communication. Through this collection, we seek to provide actionable insights for nursing practice, education, leadership and policy.

Dr. Younjae Oh
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nursing Reports is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dignity
  • ethical responsibility
  • moral or ethical competence
  • moral or ethical sensitivity
  • moral or ethical reasoning
  • moral distress
  • moral resilience
  • ethical leadership
  • ethical climate
  • ethical communication

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Published Papers (2 papers)

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14 pages, 422 KB  
Article
Linking Work Environment to Turnover Intention: The Mediating Role of Moral Distress Among Emergency Nurses
by Habib Alrashedi, Omar Almaslamani, Nader Alnomasy, Khalil A. Saleh, Hamdi Lamine and Sameer A. Alkubati
Nurs. Rep. 2026, 16(6), 208; https://doi.org/10.3390/nursrep16060208 - 22 Jun 2026
Viewed by 702
Abstract
Background/Objectives: While previous research has explored the effects of moral distress and the work environment separately, there is limited evidence on how these two factors are associated with nurses’ turnover intention. Therefore, in this study, we assessed the mediating role of moral [...] Read more.
Background/Objectives: While previous research has explored the effects of moral distress and the work environment separately, there is limited evidence on how these two factors are associated with nurses’ turnover intention. Therefore, in this study, we assessed the mediating role of moral distress in the correlation between nurses’ work environments and turnover intention. Methods: This study employed a multicenter cross-sectional design of emergency nurses from April to June 2025. The Measure of Moral Distress—Healthcare Professionals, Practice Environment Scale of the Nursing Work Index (PES-NWI), and Turnover Intention Scale were used to collect data. The mediating effect was analyzed using Hayes’ PROCESS macro (Model 4, Version 4.2) software with the bootstrap technique (5000 repetitions, 95% bias-corrected confidence interval). Statistical significance was set at a threshold of p < 0.05. Results: Mediation analysis revealed that work environment had a significant negative effect on moral distress (β = −0.251, B = −45.293, 95% CI [−70.376, −20.210], p < 0.001). Moral distress significantly increased nurse turnover (β = 0.202, B = 0.008, 95% CI [0.003, 0.012], p = 0.003), while the work environment had a significant negative direct effect on turnover (β = −0.391, B = −2.629, 95% CI [−3.507, −1.751], p < 0.001). The total effect of work environment on nurse turnover was also significant (β = −0.442, B = −2.970, 95% CI [−3.837, −2.102], p < 0.001). Bootstrapping confirmed a significant indirect effect of moral distress (β = −0.051, 95% CI [−0.092, −0.016]), indicating partial mediation. Conclusions: This study revealed that nurses’ work environment was significantly associated with turnover intention, both directly and indirectly, through moral distress. Moral distress acted as a statistically significant but modest partial mediator of the association between the work environment and turnover intention, suggesting that it may partially explain this relationship. Strategies by healthcare organizations should be organized to optimize proactive work environments and mitigate moral distress among nurses. Full article
(This article belongs to the Special Issue Ethics in Nursing Practice: Dignity, Moral Agency and Contemporary Challenges)
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15 pages, 225 KB  
Perspective
Ending Abusive Patient- and Family-Initiated Relationships in Alberta Nursing Practice: The Case for a Nurse-Specific Regulatory Standard
by Dawid Karczewski, Tomasz Karczewski and Mihaela Olsen
Nurs. Rep. 2026, 16(7), 212; https://doi.org/10.3390/nursrep16070212 - 25 Jun 2026
Viewed by 527
Abstract
Background/Objectives: Patient- and family-initiated abuse of nurses is widely recognized as workplace violence, but it also raises a distinct professional-regulatory question: when may a nurse end or restrict an established therapeutic relationship without creating an allegation of abandonment or discriminatory denial of care? [...] Read more.
Background/Objectives: Patient- and family-initiated abuse of nurses is widely recognized as workplace violence, but it also raises a distinct professional-regulatory question: when may a nurse end or restrict an established therapeutic relationship without creating an allegation of abandonment or discriminatory denial of care? This perspective focuses on Alberta and examines whether the province’s nursing regulator provides a comprehensive, nurse-specific, all-registrant standard comparable in clarity to Alberta’s physician standard. The concern is not the absence of every form of protection but the absence of a clearly defined regulatory pathway for all Alberta RNs and NPs. Methods: Publicly available legal, occupational health and safety, regulatory, legal-risk and scholarly materials were purposively selected where they addressed relationship termination, discontinuing or declining care, workplace violence, immediate safety risk, abandonment, documentation, continuity of care or patient safeguards. Results: The College of Physicians and Surgeons of Alberta standard provides a clearly defined regulatory pathway, including immediate discharge where a patient poses a safety risk, is abusive or fails to respect professional boundaries. Alberta nursing materials contain important elements but do not yet constitute a dedicated Alberta RN/NP standard applicable across office-based, community, virtual, home care and independent nursing practice. Interprovincial nursing standards demonstrate feasibility, operational detail, emerging professional consensus and potential templates for policy transfer; however, they do not bind the CRNA or create an Alberta regulatory benchmark for complaint review. Conclusions: Alberta should adopt a nurse-specific standard for ending or restricting abusive patient- and family-initiated relationships. Such a standard should include ordinary and urgent safety pathways, prohibited grounds, documentation requirements, continuity safeguards, employer integration and practical templates. Nurse protection and patient protection are mutually reinforcing regulatory objectives. Full article
(This article belongs to the Special Issue Ethics in Nursing Practice: Dignity, Moral Agency and Contemporary Challenges)
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