Per Nortvedt

• Hjulstad, Kristine; Bondevik, Hilde; Hem, Marit Helene & Nortvedt, Per (2022). “Struck down by cancer with no old life to fall back on” a clinical study of illness experiences among Norwegian adolescent and young adult cancer survivors investigating the ethical implications of their illness narratives. Cancer Reports. ISSN 2573-8348. doi: 10.1002/cnr2.1765. Fulltekst i vitenarkiv
• Heggestad, Anne Kari Tolo; Konow-Lund, Anne-Sophie; Christiansen, Bjørg & Nortvedt, Per (2022). A vulnerable journey towards professional empathy and moral courage. Nursing Ethics. ISSN 0969-7330. doi: 10.1177/09697330221074013. Fulltekst i vitenarkiv
• Heimark, Sondre; Mariampillai, Julian Eek; Larstorp, Anne Cecilie Kjeldsen; Fadl Elmula, Fadl Elmula M.; Nortvedt, Per & Høieggen, Aud (2021). Hvordan tilnærme seg pasienter med antatt terapiresistent hypertensjon og nedsatt medikamentetterlevelse? Indremedisineren. ISSN 1891-1617. 1, s. 34–37. doi: 10.4045/tidsskr.15.0978.
• Konow-Lund, Anne-Sophie; Christiansen, Bjørg; Heggestad, Anne Kari Tolo & Nortvedt, Per (2021). Sykepleierstudentens empati i møte med sårbare pasienter. Klinisk Sygepleje. ISSN 0902-2767. 35(3), s. 181–193. doi: 10.18261/ISSN.1903-2285-2021-03-02.
• Gustad, Kristine Espengren; Askjer, Åsta; Nortvedt, Per; Fredheim, Olav Magnus & Magelssen, Morten (2020). Refractory suffering at the end of life and the assisted dying debate: An interview study with palliative care nurses and doctors. Clinical Ethics. ISSN 1477-7509. doi: 10.1177/1477750920946613. Fulltekst i vitenarkiv
• Risberg, Eirik Julius & Nortvedt, Per (2020). Professional Moral Reasoning and (lack of) Empathy. Tidsskrift for professionsstudier. ISSN 2446-0273. 16(31), s. 74–83. Fulltekst i vitenarkiv
• Nortvedt, Per (2020). Refleksjon over klinisk-etiske dilemma. I Magelssen, Morten; Førde, Reidun; Lillemoen, Lillian & Pedersen, Reidar (Red.), Etikk i helsetjenesten. Gyldendal Akademisk. ISSN 9788205534605. s. 221–233.
• Nortvedt, Per (2020). Introduction to Care Ethics and Phenomenology, Care Ethics and Phenomenology: a Contested Kinship. Peeters Publishers. ISSN 978-90-429-4079-6. s. 133–13.
• Nortvedt, Per (2020). Phenomenology and Care: Reflections on the Foundation of Morality, Care Ethics and Phenomenology: a Contested Kinship. Peeters Publishers. ISSN 978-90-429-4079-6. s. 133–161.
• Tønnessen, Siri; Scott, Anne & Nortvedt, Per (2020). Safe and competent nursing care: An argument for a minimum standard? Nursing Ethics. ISSN 0969-7330. 27(6), s. 1396–1407. doi: 10.1177/0969733020919137. Fulltekst i vitenarkiv Vis sammendrag

  There is no agreed minimum standard with regard to what is considered safe, competent nursing care.Limited resources and organizational constraints make it challenging to develop a minimum standard. A spart of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone,leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. Thus,both patients and nurses would benefit from the development of a minimum standard of nursing care.Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs indifferent settings and may thus be different in different contexts and countries

• Nortvedt, Per (2019). Needs and closeness?Defending a reasonable partiality in nursing care. Nursing Philosophy. ISSN 1466-7681. 20(3). doi: 10.1111/nup.12256.
• Kjelsvik, Marianne; Sekse, Ragnhild Johanne Tveit; Moi, Asgjerd Litleré; Aasen, Elin Margrethe; Nortvedt, Per & Gjengedal, Eva (2019). Beyond autonomy and care: Experiences of ambivalent abortion seekers. Nursing Ethics. ISSN 0969-7330. 26(7-8), s. 2135–2146. doi: 10.1177/0969733018819128. Fulltekst i vitenarkiv Vis sammendrag

  Background While being prepared for abortions, some women experience decisional ambivalence during their encounters with health personnel at the hospital. Women’s experiences with these encounters have rarely been examined. Objective The objective of this study was to explore ambivalent abortion-seeking women’s experiences of their encounters with health personnel. Research design The data were collected in individual interviews and analysed with dialogical narrative analyses. Participants and research context Thirteen women (aged 18-36 years), who were uncertain of whether to terminate their pregnancies during the first trimester, were interviewed before and after they made their decisions. The participants were recruited at six Norwegian outpatient clinics. Ethical considerations Approval was granted by the Regional Committee for Medical and Health Research Ethics. Findings The ambivalent pregnant women sought to make autonomous decisions while simultaneously involving their closest confidants and health personnel in the process. The following three types of narratives of women’s experiences with encounters with health personnel were identified: the respected women, the identified women and the abandoned women. Discussion The findings are discussed in terms of the ambivalent pregnant woman’s autonomous responsibility in considering an abortion and how her autonomy can be enabled or impaired during encounters with health personnel. Conclusion and implication Although the women considered themselves autonomous and responsible for their final decisions, they wished health personnel were involved in their situations. The health personnel contributed by enabling or disabling the possibility of decision-making in accordance with the women’s values. The findings indicate that health personnel who care for women considering abortions must be trained in dialogical competence.

• Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per & Halvorsen, Kristin (2018). Older patients with late-stage COPD: their illness experiences and involvement in decision-making regarding mechanical ventilation and noninvasive ventilation. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 27(3-4), s. 582–592. doi: 10.1111/jocn.13925.
• Skirbekk, Helge; Hem, Marit Helene & Nortvedt, Per (2018). Prioritising patient care. The different views of clinicians and managers. Nursing Ethics. ISSN 0969-7330. 25(6), s. 746–759. doi: 10.1177/0969733016664977. Vis sammendrag

  Background: There is little research comparing clinicians’ and managers’ views on priority settings in the healthcare services. During research on two diffe rent qualitative research projects on healthcare prioritisations, we found a striking difference on how hospital executive managers and clinical healthcare professionals talked about and understood prioritisations. Aim: The purpose of this study is to explore how healthcare professionals in mental healthcare and somatic medicine prioritise their care, to compare different ways of setting priorities among managers and clinicians and to explore how moral dilemmas are balanced and reconciled. Research design and participants: We conducted qualitative observations, interviews and focus groups with medical doctors, nurses and other clinical members of the interdisciplinary team in both somatic medical and mental health wards in hospitals in Norway. The interviews were recorded and transcribed verbatim. Ethical considerations: Basic ethical principles for research ethics were followed. The respondents signed an informed consent for participation. They were assured anonymity and confidentiality. The studies were approved by relevant ethics committees in line with the Helsinki Convention. Findings: Our findings showed a widening gap between the views of clinicians on one hand and managers on the other. Clinicians experienced a threat to their autonomy, to their professional ideals and to their desire to perform their job in a professional way. Prioritisations were a cause of constant concern and problematic decisions. Even though several managers understood and empathised with the clinicians, the ideals of patient flow and keeping budgets balanced were perceived as more important. Discussion: We discuss our findings in light of the moral challenges of patient-centred individual healthcare versus demands of distributive justice from healthcare management. Conclusion: The clinicians’ ideals of autonomy and good medical and nursing care for the individual patients were perceived as endangered. Keywords Areas of practice, clinical ethics, empirical approaches, ethics and leadership/management, ethics of care/ care ethics, intensive care, mental health/psychiatry, moral/ethical climate of organisations, professional ethics, qualitative research, theory/philosophical perspectives, topic areas

• Nortvedt, Per (2017). Empathy and medical therapy. I Maibom, Heidi (Red.), The Routledge Handbook of Philosophy of Empathy. Routledge. ISSN 978-1-138-85544-1. doi: 10.4324/9781315282015-25.
• Førde, Reidun; Hem, Marit Helene & Nortvedt, Per (2017). Etikk og prioritering i psykiske helsetjenester. I Pedersen, Reidar & Nortvedt, Per (Red.), Etikk i psykiske helsetjenester. Gyldendal Akademisk. ISSN 978-82-05-48163-3. s. 271–290.
• Førde, Reidun; Nortvedt, Per; Pedersen, Reidar & Hem, Marit Helene (2017). Skjønn, usikkerhet og ydmykhet i psykiske helsetjenester. I Pedersen, Reidar & Nortvedt, Per (Red.), Etikk i psykiske helsetjenester. Gyldendal Akademisk. ISSN 978-82-05-48163-3. s. 41–53.
• Hem, Marit Helene; Husum, Tonje Lossius & Nortvedt, Per (2017). Krenkelser i møte med de psykiske helsetjenestene. I Pedersen, Reidar & Nortvedt, Per (Red.), Etikk i psykiske helsetjenester. Gyldendal Akademisk. ISSN 978-82-05-48163-3. s. 210–228.
• Konow-Lund, Anne-Sophie; Heggestad, Anne Kari Tolo; Nortvedt, Per & Christiansen, Bjørg (2017). Developing mature empathy among first-year students: The learning potential of emotional experiences. Nordic journal of nursing research. ISSN 2057-1585. 38(3), s. 128–134. doi: 10.1177/2057158517722057.
• Mariampillai, Julian Eek; Eskås, Per Anders; Heimark, Sondre; Larstorp, Anne Cecilie Kjeldsen; Fadl Elmula, Fadl Elmula M. & Høieggen, Aud [Vis alle 7 forfattere av denne artikkelen] (2017). Apparent treatment-resistant hypertension?patient?physician relationship and ethical issues. Blood Pressure. ISSN 0803-7051. 26(3), s. 133–138. doi: 10.1080/08037051.2016.1277129.
• Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per & Halvorsen, Kristin (2017). Nurses' role and care practices in decision-making regarding artificial ventilation in late stage pulmonary disease. Nursing Ethics. ISSN 0969-7330. 24(7), s. 821–832. doi: 10.1177/0969733015626600.
• Heggestad, Anne Kari Tolo; Nortvedt, Per; Christiansen, Bjørg & Konow-Lund, Anne-Sophie (2016). Undergraduate nursing students`ability to empathize : A qualitative study. Nursing Ethics. ISSN 0969-7330. 25(6), s. 786–795. doi: 10.1177/0969733016664982.
• Magelssen, Morten; Nortvedt, Per & Solbakk, Jan Helge (2016). Rationing at the bedside: Immoral or unavoidable? Clinical Ethics. ISSN 1477-7509. 11(4), s. 112–121. doi: 10.1177/1477750916657664.
• Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per & Halvorsen, Kristin (2016). Considerations and values in decision making regarding mechanical ventilation for older patients with severe to very severe COPD. Clinical Ethics. ISSN 1477-7509. 11(4), s. 140–148. doi: 10.1177/1477750916657657.
• Magelssen, Morten; Supphellen, Magne; Nortvedt, Per & Materstvedt, Lars Johan (2016). Attitudes towards assisted dying are influenced by question wording and order: A survey experiment. BMC Medical Ethics. ISSN 1472-6939. 17(1). doi: 10.1186/s12910-016-0107-3. Fulltekst i vitenarkiv
• Heggestad, Anne Kari Tolo; Nortvedt, Per & Slettebø, Åshild (2015). Dignity and care for people with dementia living in nursing homes. Dementia. ISSN 1471-3012. 14(6), s. 825–841. doi: 10.1177/1471301213512840. Fulltekst i vitenarkiv Vis sammendrag

  This article presents and discusses findings from a qualitative study on how the dignity of patients with dementia is preserved or harmed when they live in a nursing home. The results build on participant observation in two nursing home wards, combined with qualitative interviews with seven relatives of patients with dementia. The most important issue for relatives was that their family member with dementia was confirmed as a relational human being. However, relatives experienced lack of resources and task-centred care as threats to confirming, relational care and to patients’ dignity. Findings from participant observations confirmed this. In this article, we argue that care which focuses on the residents’ personhood, combined with a relational focus, is of great importance in maintaining the dignity of people with dementia living in nursing homes.

• Skirbekk, Helge & Nortvedt, Per (2014). Inadequate Treatment for Elderly Patients: Professional Norms and Tight Budgets Could Cause "Ageism" in Hospitals. Health Care Analysis. ISSN 1065-3058. 22(2), s. 192–201. doi: 10.1007/s10728-012-0207-2.
• Hem, Marit Helene; Halvorsen, Kristin & Nortvedt, Per (2014). Alturism and Mature Care: Some Rival moral consideration in care. Nursing Ethics. ISSN 0969-7330. 21, s. 794–802. doi: 10.1177/0969733014521094.
• Hem, Marit Helene; Halvorsen, Kristin & Nortvedt, Per (2014). Altruism and mature care: Some rival moral considerations in care ethics. Nursing Ethics. ISSN 0969-7330. 21(7), s. 794–802. doi: 10.1177/0969733014521094.
• Nortvedt, Per (2013). Hvis mellommenneskelige grunnvilkår er gode - hvorfor ser vi da så mye ondskap? I Alvsvåg, Herdis; Bergland, Ådel & Førland, Oddvar (Red.), Nødvendige omveier : en vitenskapelig antologi til Kari Martinsens 70-årsdag. Cappelen Damm Akademisk. ISSN 978-82-02-40744-5. s. 87–97.
• Heggestad, Anne Kari Tolo; Nortvedt, Per & Slettebø, Åshild (2013). 'Like a prison without bars': Dementia and experiences of dignity. Nursing Ethics. ISSN 0969-7330. 20(8), s. 881–892. doi: 10.1177/0969733013484484. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this article is to investigate how life in Norwegian nursing homes may affect experiences of dignity among persons with dementia. The study had a qualitative design and used a phenomenological and hermeneutic approach. Participant observation in two nursing homes units was combined with qualitative interviews with five residents living in these units. The study took place between March and December 2010. The residents feel that their freedom is restricted, and they describe feelings of homesickness. They also experience that they are not being seen and heard as individual autonomous persons. This lack of freedom, experiences of homesickness and feelings of not being confirmed and respected as individual autonomous persons, may be a threat to their personal dignity. In order to protect and enforce the dignity of persons with dementia living in nursing home, we should confirm them as whole and individual persons, and we should try to make the nursing homes less institutional and more home-like.

• Nordstrand, Magnus Andreas; Nordstrand, Sven Jakob; Materstvedt, Lars Johan; Nortvedt, Per & Magelssen, Morten (2013). Medisinstudenters holdinger til legalisering av eutanasi og legeassistert selvmord. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 133, s. 2259–2263. doi: 10.4045/tidsskr.13.0439.
• Nordstrand, Sven Jakob; Nordstrand, Magnus Andreas; Nortvedt, Per & Magelssen, Morten (2013). Medical students' attitudes towards conscientious objection: a survey. Journal of Medical Ethics. ISSN 0306-6800. 40, s. 609–612. doi: 10.1136/medethics-2013-101482.
• Heggestad, Anne Kari Tolo; Nortvedt, Per & Slettebø, Åshild (2013). The importance of moral sensitivity when including persons with dementia in qualitative research. Nursing Ethics. ISSN 0969-7330. 20(1), s. 30–40. doi: 10.1177/0969733012455564. Fulltekst i vitenarkiv Vis sammendrag

  Abstract The aim of this article is to show the importance of moral sensitivity when including persons with dementia in research. The article presents and discusses ethical challenges encountered when a total of 15 persons with dementia from two nursing homes and seven proxies were included in a qualitative study. The examples show that the ethical challenges may be unpredictable. As researchers, you participate with the informants in their daily life and in the interviews, and it is not possible to plan all that may happen during the research. A procedural proposal to an ethical committee at the beginning of a research project based on traditional research ethical principles may serve as a guideline, but it cannot solve all the ethical problems one faces during the research process. Our main argument in this article is, therefore, that moral sensitivity is required in addition to the traditional research ethical principles throughout the whole process of observing and interviewing the respondents.

• Lind, Ranveig; Nortvedt, Per; Lorem, Geir F & Hevrøy, Olav (2013). Family involvement in the end-of-life decisions of competent intensive care patients. Nursing Ethics. ISSN 0969-7330. 20(1), s. 61–71. doi: 10.1177/0969733012448969.
• Tønnessen, Siri & Nortvedt, Per (2012). Hva er faglig forsvarlig hjemmesykepleie? Sykepleien Forskning. ISSN 1890-2936. 7(3), s. 280–285. doi: 10.4220/sykepleienf.2012.0134.
• Nortvedt, Per (2012). The Normativity of Clinical Health Care: Perspectives on Moral Realism. Journal of Medicine and Philosophy. ISSN 0360-5310. 37(3), s. 295–309. doi: 10.1093/jmp/jhs015.
• Lind, Ranveig; Lorem, Geir F; Nortvedt, Per & Hevrøy, Olav (2012). Intensive Care Nurses' Involvement in the End-of-Life Process - Perspectives of Relatives. Nursing Ethics. ISSN 0969-7330. 19(5), s. 666–676. doi: 10.1177/0969733011433925.
• Hagen, Gunn Helen; Hage, Christine Ødegaard; Magelssen, Morten & Nortvedt, Per (2011). Medisinstudenters holdninger til selvbestemt abort. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 131(18), s. 1768–1771. doi: 10.4045/tidsskr.10.1161.
• Skirbekk, Helge & Nortvedt, Per (2011). Making a Difference: A Qualitative Study on Care and Priority Setting in Health Care. Health Care Analysis. ISSN 1065-3058. 19(1), s. 77–88. doi: 10.1007/s10728-010-0160-x.
• Dreyer, Anne; Førde, Reidun & Nortvedt, Per (2011). Ethical decision-making in nursing homes: Influence of organizational factors. Nursing Ethics. ISSN 0969-7330. 18(4), s. 514–525. doi: 10.1177/0969733011403553.

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• Nortvedt, Per (2021). Omtanke. en innføring i sykepleieetikk. Gyldendal Akademisk. ISBN 9788205550827. 277 s.
• Vosman, Frans & Nortvedt, Per (2020). Care Ethics and Phenomenology: a Contested Kinship. Peeters Publishers. ISBN 978-90-429-4079-6. 227 s.
• Nortvedt, Per & Nortvedt, Finn (2018). Smerte- fenomen og etikk. Gyldendal Akademisk. ISBN 978-82-05-50124-9. 130 s.
• Pedersen, Reidar & Nortvedt, Per (2017). Etikk i psykiske helsetjenester. Gyldendal Akademisk. ISBN 978-82-05-48163-3. 362 s.
• Nortvedt, Per (2015). Empathy. Springer Science+Business Media B.V.. ISBN 978-3-319-05544-2. 7 s.
• Nortvedt, Per (2013). Nursing Philosophy 5 Questions. Automatic Press/VIP. ISBN 87-92130-49-6.
• Nortvedt, Per (2012). Omtanke- en innføring i sykepleiens etikk. Gyldendal Akademisk. ISBN 978-82-05-42333-6. 279 s.

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• Nortvedt, Per & Solberg, Carl Tollef (2023). Prioritering på klinisk nivå og under pandemien.
• Nortvedt, Per; Røise, Olav; Rostoft, Siri & Pedersen, Reidar (2022). Man bryr seg mindre jo mer man gjør det. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 142(18), s. 1538–1538. doi: 10.4045/tidsskr.22.0667.
• Hofmann, Bjørn Morten & Nortvedt, Per (2021). Etikk i den kliniske hverdag-refleksjon og praktisk problemløsning.
• Pedersen, Reidar & Nortvedt, Per (2020). Fag, etikk og juss. I Magelssen, Morten; Førde, Reidun; Lillemoen, Lillian & Pedersen, Reidar (Red.), Etikk i helsetjenesten. Gyldendal Akademisk. ISSN 9788205534605. s. 37–49.
• Nortvedt, Per (2020). Fag, etikk og juss. I Magelssen, Morten; Førde, Reidun; Lillemoen, Lillian & Pedersen, Reidar (Red.), Etikk i helsetjenesten. Gyldendal Akademisk. ISSN 9788205534605. s. 37–50.
• Pedersen, Reidar & Nortvedt, Per (2018). Etikk i psykiske helsetjenester. Vit. s. 20–21.
• Pedersen, Reidar & Nortvedt, Per (2018). Empati i utdanning og praksis. Hva styrer de profesjonelles oppmerksomhet og fortolkning?
• Pedersen, Reidar & Nortvedt, Per (2018). Empati, moralsk persepsjon og fortolkning i helsetjenesten. Hva ser vi og hva overseer vi?
• Pedersen, Reidar & Nortvedt, Per (2017). Introduksjon. I Pedersen, Reidar & Nortvedt, Per (Red.), Etikk i psykiske helsetjenester. Gyldendal Akademisk. ISSN 978-82-05-48163-3. s. 15–18.
• Pedersen, Reidar & Nortvedt, Per (2017). Forord. I Pedersen, Reidar & Nortvedt, Per (Red.), Etikk i psykiske helsetjenester. Gyldendal Akademisk. ISSN 978-82-05-48163-3.
• Lillemoen, Lillian & Nortvedt, Per (2017). Å skynde seg langsomt, en konsekvens av plikt? Tidsskriftet sykepleien. ISSN 0806-7511.
• Kristoffersen, Nina M. J. & Nortvedt, Per (2016). Pasient og sykepleie - verdier og samhandling. I Kristoffersen, Nina M. J.; Nortvedt, Finn; Skaug, Eli-Anne & Grimsbø, Gro H. (Red.), Grunnleggende Sykepleie 1 - fag og funksjon. Gyldendal Akademisk. ISSN 978-82-05-47769-8. s. 89–138.
• Sævareid, Trygve Johannes Lereim; Lillemoen, Lillian & Nortvedt, Per (2016). Å skynde seg langsomt, en konsekvens av plikt? Dagens medisin. ISSN 1501-4290.
• Aasen, Henriette Sinding; Eick, Frode; Kvalbein, Tone; Nortvedt, Per & Harlem, Mads (2015). Strides om helsehjelp til papirløse. Tidsskriftet sykepleien. ISSN 0806-7511. 5, s. 38–40.
• Eick, Frode; Karlsen, Marry-Anne & Nortvedt, Per (2015). Sykepleiere må tenke selv. Tidsskriftet sykepleien. ISSN 0806-7511.
• Hem, Marit Helene; Halvorsen, Kristin & Nortvedt, Per (2015). Altruism and mature care: some rival moral considerations in care ethics.
• Nortvedt, Per (2014). Makt kan føre til ondskap. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2014). Sykepleie og ondskap. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2014). Ondskap i sykepleien. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2014). Kjølig distanse kan gi dårligere behandling. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2014). Er omsorg realistisk? Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2014). Livssynsnøytralt testamente. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per & Vosman, Frans (2014). An ethics of care: New perspectives, both theoretically and empirically? Nursing Ethics. ISSN 0969-7330. 21(7), s. 753–754. doi: 10.1177/0969733014546961.
• Lind, Ranveig & Nortvedt, Per (2013). When end-of-life decisions are made, what then? Vis sammendrag

  Abstract ESICM Paris 2013. Ethics and end of life care When EOL decisions in ICU are made, what then? Family members’ experiences of the withdrawal of treatment Introduction End-of-life decisions for terminally ill ICU patients are common in ICUs (1). These processes are thoroughly described in research from the perspectives of both ICU staff and the patients’ family (2, 3). However, little is known about how families experience treatment withdrawal in the final hours after the end-of-life decision-making process. Objectives In this study the objective was to analyse the families’ experiences of the process of treatment withdrawal after the end-of-life decision. Methods A constructivist interpretive approach to the grounded theory method of qualitative research was employed with interviews of 27 bereaved family members of former ICU patients 3-12 months after the patient’s death. Results The core finding is that facing the final hours of the patient’s life is a process in several stages where the family needs support and guidance, and appreciate being cared for by nurses and doctors they have met before. The first experiential stage is about temporal dimensions, either experienced as rushing into death as if to ”get it over” or as using more time in the process. The next stage involves understanding how the ”turning off moment” will take place and how it was actually carried out. This was done in three ways: This was done in three ways: extubation; decreased oxygen and increased morphine; turning off equipment. Despite advance information, several participants were anxious about the patient’s reaction, such as signs of struggling from suffocating. This stage was followed by strong sense impressions of facing the death of a loved one. Spirituality and being able to bid farewell was the last official ICU stage for the families. However, this was followed by emptiness when leaving the dead body in the ICU, feeling unable to go on with life. In this phase several participants longed for more support, care and follow up from the ICU staff. Conclusions Families need to be guided through all the stages they experience in the withdrawal situation. More attention should be paid to communication of how health care personnel assume that the process will progress and thereby try to prepare the families for the many strong impressions which follow treatment termination. We also suggest that clinicians should be more sensitive of the moment when families leave the ICU, and perhaps offer a follow-up talk some weeks later. References: 1. Cohen S, Sprung C, Sjøkvist P et al (2005) Communication of end-of-life decisions in European intensive care units. Int Care Med 31:1215-1221 2. Halvorsen K, Førde R, Nortvedt P (2009) Value choices and considerations when limiting intensive care treatment: a qualitative study. Acta Anaesthesiol Scand 53:10-17 3. Lind R, Lorem GF, Nortvedt P, Hevrøy O (2011) Family members’ experiences of ”wait and see” as a communication strategy in end-of-life decisions. Int Care Med 37:1143-1150 Grant acknowledgement Funded by the University Hospital of North Norway

• Lind, Ranveig; Nortvedt, Per; Lorem, Geir F & Hevrøy, Olav (2013). Avslutning av livsforlengende intensivbehandling - etterlatte familiers erfaringer.
• Nortvedt, Per (2013). Få helsearbeidere har nok tid. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2013). Hva er "det moralske" ved moralsk sensitivitet? Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2013). Betydningen av følelser i klinisk arbeid. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2013). Ubehag er ikke nok. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2013). Et helsevesen for pasienter og pårørende eller helsepersonell? Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2012). Idealisering eller varselskudd? betydningen av grunnleggende sykepleie. Tidsskriftet sykepleien. ISSN 0806-7511.
• Fonn, Marit & Nortvedt, Per (2012). Etikk er mer enn synsing. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2012). Fremtidens sykepleieetikk og NSFs ansvar. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2012). Fremtidens sykepleieetikk må bli kunnskapsbasert. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per (2012). Sykepleien er "limet" i den sykes hverdag. Tidsskriftet sykepleien. ISSN 0806-7511.
• Nortvedt, Per; Pedersen, Reidar & Solbakk, Jan Helge (2012). Lege, student og medmenneske. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 132(10).
• Nortvedt, Per (2012). Skal nåværende kone ha beskjed? Sykepleien. ISSN 0039-7628.
• Hem, Marit Helene & Nortvedt, Per (2012). Kliniske prioriteringer i psykisk helsevern.
• Heggestad, Anne Kari Tolo; Nortvedt, Per & Slettebø, Åshild (2012). Verdighet og rasjonalitet hos personer med demens.
• Heggestad, Anne Kari Tolo; Nortvedt, Per & Slettebø, Åshild (2012). Pasienter med demens og pårørendes opplevelse av betydningen av autonomi i sykehjem.
• Heggestad, Anne Kari Tolo; Nortvedt, Per & Slettebø, Åshild (2012). Opplevelse av verdighet i demensomsorgen.
• Lind, Ranveig; Lorem, Geir F; Nortvedt, Per & Hevrøy, Olav (2012). “Intensive care nurses’ involvement in the end-of-life process,- perspectives of families”.
• Hem, Marit Helene; Skirbekk, Helge & Nortvedt, Per (2011). Different views on priority settings among clinicians and executive officers in Norwegian hospitals. Empirical findings from the study”Mapping a normative terrain of an ethics of care”.
• Kristoffersen, Nina M.J. & Nortvedt, Per (2011). Relasjonen mellom sykepleier og pasient. I Kristoffersen, Nina M.J.; Nortvedt, Finn & Skaug, Eli-Anne (Red.), Sykepleiens grunnlag, rolle og ansvar. Gyldendal Akademisk. ISSN 978-82-05-40006-1.
• Nortvedt, Per; Skirbekk, Helge & Hem, Marit Helene (2011). Care transformations: attentiveness, professional ethics and thoughts towards differentiation response. Nursing Ethics. ISSN 0969-7330. 18(2), s. 266–267. doi: 10.1177/0969733010395669.
• Nortvedt, Per (2011). An ethics of care: normative challenges. Nursing Ethics. ISSN 0969-7330. 18(2), s. 147–148. doi: 10.1177/0969733010393072.
• Solbakk, Jan Helge; Hofmann, Bjørn M. & Nortvedt, Per (2011). Overfladisk synsing. Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116.
• Hem, Marit Helene; Skirbekk, Helge & Nortvedt, Per (2011). Ulike syn på prioriteringer blant klinikere og ledere i psykiatrisk og somatisk avdeling.
• Hem, Marit Helene; Skirbekk, Helge & Nortvedt, Per (2011). Different views on priority settings among clinicians and executive officers in Norwegian hospitals. Empirical findings from the study ”Mapping a normative terrain of an ethics of care”.
• Hem, Marit Helene & Nortvedt, Per (2011). Kliniske prioriteringer i psykisk helsevern. En foreløpig presentasjon av data.
• Magelssen, Morten; Nortvedt, Per & Syse, Henrik (2014). Life, medicine and human fulfilment. End-of-life decisions in light of a revised natural law theory. Akademika Publishing. ISSN 978-82-8264-884-4. Fulltekst i vitenarkiv
• Lind, Ranveig; Lorem, Geir F; Nortvedt, Per & Hevrøy, Olav (2013). Family members' experiences of decision-making processes in the context of withholding or withdrawing treatment in the ICU. UiT Norges arktiske universitet. ISSN 978-82-7589-383-1.

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