Abstract

Fidelity is a concept that has been used in the contemporary ethics literature of nursing and medicine. Commonly fidelity has been used to define in part desirable ethical practice in both disciplines. However a problem existed in relation to its use, the concept lacked clarity of definition. Some authors believed that fidelity should be considered a key concept for practice in the health care context. Because it was not clearly defined it was difficult to know how to practice fidelity effectively. This problem of definition prompted the present research. The study addresses the question; what is the definition of fidelity in the contemporary health care context of nursing and medicine? ;A pragmatic-contextual approach was used to determine a working definition of fidelity as found in the nursing and medicine literature. This approach was used in order to consider the influence of context on concept definition. Based on this approach concepts are viewed as tools of a community of concept users. The purpose of concepts in this context is to accomplish common goals and to solve problems. ;The analysis of fidelity yielded five attributes: object/recipient, commitment, expectation, action, and outcome. A model case was identified as were antecedents, surrogate terms, related terms, and consequences. The context of use of nursing, the focal discipline, was described. The significance of the use of the concept in contemporary nursing was also examined. It was concluded that fidelity is a bridge concept used to accomplish a transition in professional values. Fidelity as defined assists in promoting the professional nursing goal of moral autonomy and the values of patient advocacy, caring, and accountability to the patient, not to the physician, hospital, or the nursing profession. Fidelity is a promising new ethical value/principle for contemporary nursing. However it is currently not clear what its role is to be in health care in the future.