ch 21 ethical and legal issues in nursing Flashcards
what is morality
is the beliefs abt what we think to be right or wrong in our actions and behaviours toward those around us and is in essence v similar to ethics
what is ethics
• Ethics is the process of carefully thinking thru whats right or wrong in behave, decision aking and values.
isnt just ab thinking/reflecting on whats good but examining the norms, issues, foundations of our societies
is morality or ethics more assoc with academic and philosophical study of right and wrong
ethics
is ethics or morality more of an individual thing that reflects social norms
while morality is assoc more w indiv and more general social normas values and beliefs
what is bioethics
and how does it differ from medical ethics
• Bioethics examines ethical issues about human lives, ehaltha nd illness eg euthania, stem cell research, mat-fetal conflict, MAID.
meanwhile medical ethics is concerned with the ethical dimensions of medical care
what is applied ethics
where theories, principles and value judgements used to work thru ethical dilemmas in specific contexts
do the general tragic situations of bioethics apply to realities of nursing ethical challenges
no. nurses epeirence everyday ethical challenges which are smaller than the typical tragic cases in bioethics but nonetheless challenging. They often aren’t genuine dilemmas
t or f each act while nursing is a moral statement
true…
what are these ethical concerns that nurses encounter referred to as
practice issues
practical problems
what does nursing ethics see as central
relationships (bet nurse-pt, nurse-nurse etc etc)
what are the 3 levels of moral response to ethical problems
- Expressive level-mgiht just state how we feel without rationale for those beliefs eg “Im against euthanasia bcuz killing is worng”
- Prereflective level –justify response w legal religious or professional norms without critically reflecting on those norms eg I oppose euthanasia cuz of professional duty to do no harm
- reflective level-justification for our position is based on principles or values weve reflected on and make decision to use s basis for our stance eg i oppose euthanasia as the sactit of life and do no harm taes precedence over autonomy. Reasoning at this level doesn’t guarantee easier resolution o agreement but it does provide more opportunity for discussion
what are the two theories discussed in applied ethics
deontology and conseuentialism
what is deontological ethic
• Deontological ethics-mostly involves duties to others.
o Consistency and following thru on duties to others makes actions morally right eg truth telling is absolute duty from respect of persons
what are 3 challenges to deontology
Often hard to see what duties are
Oftenf ace multiple competeing duties w no advice on how to balance them
To just pay attention to duties nd not consider the outcomes or consequences is in real life irresponsible and difficult
what is consequentialism
• Consequentialist theories-rightness or wrongness of action is determined by outcomes of the action
what is the most common theory under consequentialism
utilitarianism
what is utilitarianism
what is the most common theory under consequentialism
3 challenges to utilitrianism
We cant predict outcomes well
Meas abstract ideas like happiness is hard
Matter of perspective whats good or bad
as a response to the criticisms of these ethical theories ( therye hard to apply in reality, lack guidance of what principles to use for decisions)
what was devised and what is included in this
principlism
4 principles to guide healthcare as response to criticism: autonomy, beneficence, nonmaleficence and justice
what errors do new earners often make with principlism
• Its easy to use but new learners often apply it pragmatically and inflexibly
what is the criticism of principlism
limiting to think of ethical probs just w 4 principles. It also less applicable in other contexts (non-western)
what outlines expectations of ethical practice
code of ethics
who enforces a code of ethics
• Code cant be enforced by courts but profesion has legal right to sanction those who dont adhere to ethical duties
who would sit on a provincial regulatory body committee
lay people and nurses
what are the 3 legal obligations of nurses
o To have knowledge of legal boundaries of their jobs
o To protect pt rights
o Protect themselves from liability
what is a fiduciary duty
-a trust based duty. Nurse must give reasonable/competent std of care.
if in a fiduciary role are you allowed to place your own needs first
no
in relation to professional competence when violating the following: professional misconduct, negligence, duty of care what is it called
unintentional torts
what is a tort
o A tort is an act of wrongdoing that leads to harm or injury. After, the injured party makes claim for damages to deter future similar wrongs
what are examples of intentional torts
battery, invasion of privacy, assault
what are the 2 kind of unintentional torts
negligence-when any Tx or care is obviously below acceptable level and results in injury to pt
liability (dictionary defn, being responsible for sometihng)
what is a duty of care and what happens when this isnt met
obligation not to harm un or intentionally. If don’t meet this and injury results this is negligence and professional misconduct
what 4 things are required for case of negligence
- Duty of care must exist
- Duty of are must be breached thru actions/conduct
- Must be resultant injury/harm
- Must be evident that harm/injury resulted directly from person w duty to care
with unintentional negligence is the focus on punishment of the perp or on compensation
fous on compensation for injury
what is moral distress and is it only caused by institutional constraints
• Moral distress-knowing right thing to do but unable to do it. If unaddressed can lead to moral residue the remains of unhealed moral wounds which build over time
-can also be caused by issues n the moral agent (lac of knowledge etc)
what is moral integrity
• Integrity often describe a person of good moral standing but can also mean wholeness completeness and being morally intact
4 necessary elements of moral integrity
moral autonomy
-fidelity to promise
-steadfastness
wholeness
moral autonomy
- . Moral autonomy
Our developing sense of who we are in r/t the values we hold. When young our parents have moral authority over us and our values are det by surroundings eg socioecon, culture, friends. With age we find our own ideas and take responsibility for them. W inc moral autonomy is inc integrity
fidelity to promise
- Fidelity to promise
2 aspect: making a promise and keeping it
Keeping a promise shows we abide by social norms, are trustworthy, reliable
steadfastness
- Steadfastness
Like sticking to moral guns
Often ongoing development of this as we lern to stand up for what we think is right
Eg of this: questioning order of futile Tx, student nurse telling nurses not to talk of pts in public, advocating for marginalized pt and fighting the system
wholeness
- Wholeness
All nurses have multiple roles in lives and it can be hard to be morally consistent eg friendly w pt but rude w parents
Integrity requires that we try to incorporate our values and beliefs across the many roles in our lives
having a poor ethical climate at work is linked to what for nurses
• Having a poor ethical climate
how can moral leadership be demonstrated
with commitment and moral courage (in practice this means advocating for others despite pressures to act differently)
can moral courage be taught
yes since its a virtue it can
