title: Ethical conflict in long-term care: is legislation the answer?
abstract: The Omnibus Budget Reconciliation Act of 1987 radically redefined the relationship between nursing facilities and their residents. To explore the impact of this autonomy-enhancing but controversial legislation on nursing operations in skilled nursing facilities, two focus groups were convened. Nurse administrators identified ways in which the recently implemented legislation facilitates or inhibits resolution of the ethical conflicts they face. Participants concluded that legislation alone was insufficient to create needed reform in long-term care and recommended a multifaceted approach. A model is presented for creating a community of caring that identifies regulatory reform, professional empowerment, and organizational redesign as catalysts for a change.
authors.affiliation: Hahn School of Nursing, University of San Diego, CA 92110.
authors.forename: P A
authors.initials: PA
authors.lastname: Roth
authors.forename: J K
authors.initials: JK
authors.lastname: Harrison
mesh_terms: D000328:Adult; D002140:California; D003220:Conflict, Psychological; D004645:Empathy; D004993:Ethics, Nursing; D035082:Federal Government; D017144:Focus Groups; D033161:Government Regulation; D018166:Health Care Reform / Q000592:standards*; D006272:Health Facility Environment; D006801:Humans; D008134:Long-Term Care / Q000331:legislation & jurisprudence / Q000592:standards*; D008875:Middle Aged; D016294:Models, Nursing; D009718:Nurse Administrators; D028701:Patient Rights; D011209:Power, Psychological; D017009:Professional Autonomy; D012866:Skilled Nursing Facilities / Q000331:legislation & jurisprudence / Q000592:standards*