Ch 22 potter Ethics and values Flashcards
issues are resolved by reference to laws that are usually concrete and publicly determined.
Legal
issues of behavior and character
-values play important role
ethics
usually refer to judgment about behavior, based on specific beliefs
Morals
refers to the study of the ideals of right and wrong behavior.
ethics
is a deeply held personal belief about the worth a person holds for an idea, a custom, or an object. The values that a person holds reflect cultural and social influences
value
represents a branch of ethics within the field of health care.
- agreement building
- ex: not enough kidney transplant vs ppl In need
bioethics
refers to freedom from external control.
-commitment to include patients in decisions about all aspects of care as a way of acknowledging and protecting a patient’s independence
Autonomy
retaliation (revenge after mistake done by nurse) against an employee who makes a legitimate report about clinical safety issues.
Institutional whistle blower protections prohibit
refers to taking positive actions to help others
Beneficence
refers to harm or hurt
Maleficence
refers to the avoidance of harm or hurt.
Nonmaleficence
refers to fairness and the distribution of resources (used frequently in discussion regarding access to health care resources)
Justice
refers to the promotion of open discussion without fear of recrimination whenever mistakes, especially those involving adverse events, occur or nearly occur
just culture
refers to faithfulness or the agreement to keep promises
-follow the policies and procedures set forth
Fidelity
is a set of guiding principles that all members of a profession accept
- nurse’s obligation to the patient, the role of the nurse as a member of the health care team, and the duties of the nurse to the profession and to society
- key principles: advocacy, responsibility, accountability, and confidentiality.
code of ethics
refers to the application of one’s skills and knowledge for the benefit of another person
Advocacy (key principle to code of ethics)
refers to a willingness to respect one’s professional obligations and to follow through.
responsibility
refers to answering for your own actions.
Accountability
establishes national patient safety guidelines to ensure patient and workplace safety through consistent, effective nursing practices
TJC (the joint commission)//part accountability
promotes ethical decision making by setting standards for collaborative interprofessional communication
ANA Code of Ethics// part accountability
refers to the health care team’s obligation to respect patient privacy.
Confidentiality
is a deeply held belief about the worth of an idea, attitude, custom, or object that affects choices and behaviors.
value
defines actions as right or wrong based on their adherence to rules and principles such as fidelity to promises, truthfulness, and justice
- making decisions or “right-making characteristics”
Deontology
proposes that the value of something is determined by its usefulness.
- outcome speak to the greatest good for the greatest number.
- value is determined by usefulness
utilitarian system of ethics & teleology
main emphasis is on the outcome or consequence of action
- Between 2 actions, perform that one that has better consequences
- one determines whether an act is right or wrong by looking solely at its consequences
philosophy is sometimes called consequentialism ( utilitarian system of ethics)
Utilitarianism measures the effect that an act will have; deontology looks at the act itself and judges its “rightness” by the rules or principles it upholds.
difference of utilitarian & Deontology
, turns away from conventional principles of ethics as a way to determine best actions and focuses instead on the details of a situation
Casuistry, or case-based reasoning
, it looks to the nature of relationships to guide participants in making difficult decisions, especially relationships in which power is unequal or in which a point of view has become ignored or invisible
feminist ethics
philosophy often resonates with nurses who, in their intimate experiences with patients, are often making ethical decisions while engaged in caring relationships.
Ethics of Care
are ethical dilemmas and moral distress
Two common ethical problems that nurses encounter
when two opposing courses of action can both be justified by ethical principles
-ex: lying to benefit pt (like taking meds) or be truthful but refuse to take meds
ethical problem is called a dilemma
instead of competing options for action, the nurse feels the need to take a specific action while believing that action to be wrong
- often manifests as anger or frustration
moral distress
described a Moral Distress Consult Service that is accessible to all units in the hospital and helps address pervasive or persistent issues that are causing moral distress.
Hamric and Epstein (2017) (moral distress)
created the Standards for Establishing and Sustaining Healthy Work Environments and an Assessment Tool that health care teams can use to identify and address gaps
American Association of Critical-Care Nurses (AACN)
is the ability to grow and even gain confidence from adverse and complex ethical problems
Moral resilience
involves individuals from different disciplines and backgrounds who support health care institutions with three major functions: providing clinical ethics consultation, developing and/or revising policies pertaining to clinical ethics and hospital policy (e.g., advance directives, withholding and withdrawing life-sustaining treatments, informed consent, organ procurement), and facilitating education about topical issues in clinical ethics
ethics committee
involve asking patients to identify their priorities, what they enjoy, and what matters most to them
Subjective measures (about quality of life)
can include the: age of a patient, the patient’s ability to live independently, or the ability to contribute to society in a gainful way
Objective measures of quality of life
refers to interventions unlikely to produce benefit for a patient
futile
on the basis of need
Medicaid programs (if don’t have employer insurance then u may qualify)
a federal insurance program available to all individuals over the age of 65.
Medicare(if don’t have employer insurance then available over age 65 yrs)
was passed to create regulations that control costs and improve the availability of insurance
Affordable Care Act (ACA)
education, policy developer/reviewer/ recommender, and case consultation
-devoted teaching and processing of ethical issues and dilemmas exists in most health care facilities
ethics committee (multidisciplinary)
