Date of Defense
7-30-1997
Department
Nursing
First Advisor
Dr. Shirley Bach
Second Advisor
Dr. Diane Hamilton
Third Advisor
Dr. John Martell
Abstract
In the British National Health Service (NHS), the general practice physician (GP) serves as gatekeeper to resources.1 In the United States, managed care physicians, who attempt to contain health care expenditures by establishing priorities and strictly regulating treatment accessibility, necessarily employ gatekeeping responsibilities in practice.2 However, both systems of health care generally overlook the potential contribution of nurses in identifying and implementing effective methods of resource allocation. The central focus of this thesis includes two primary assertions. First, I will argue that nurses currently function as gatekeepers both in England and the United States, and that the traditional nursing paradigm includes skills which naturally facilitate the gatekeeping role. For clarification, my argument is not that nurses should replace physicians as gatekeepers, but rather, that the nurse-gatekeeping model offers a viable alternative with merit significant enough to justify further investigation and potential incorporation into health policy. My second argument is one of philosophy and applied ethics. I will argue that the traditional ethical constraints of nursing do not necessarily preclude nurses from the practice of gatekeeping.
Recommended Citation
Grandy, David C., "Rethinking the Nursing Paradigm: The Ethics of Gatekeeping in American and British Nursing" (1997). Honors Theses. 1104.
https://scholarworks.wmich.edu/honors_theses/1104
Access Setting
Honors Thesis-Open Access