Chapter 2 Flashcards
Exam 1
How was bioethics brought on?
Brought on by:
medical advances and
discovery of human rights violations in the name of medical science
Examples of human rights violations in the name of medical science?
- WWII and Nazi experimentation
- Tuskegee research
What does bioethics focus on?
Focused on decisions about resource allocation and the ethical treatment of research subjects
The Belmont Report
Respect for persons
Beneficence
Justice
Beauchamp & Childress (1979)- What did they do?
Principles of biomedical ethics. Outlined the 4 Main Principles of Bioethics
4 Main Principles of Biomedical ethics
- Autonomy
- Beneficence
- Nonmaleficence
- Justice
Ethical Principlism:
Guidelines for moral decisions & morality of actions
What do ethical principles do?
Provide framework for analyzing, resolving bioethical problems
In Professional–Patient Relationships:
What occurs?
Unavoidable Trust
Human Dignity
Patient Advocacy
Unavoidable trust- what does it create and what does it require professionals to do?
Creates asymmetrical power structure
Requires professionals to act ethically
Human Dignity
Must be protected in all nursing care
Enhanced by assessing patients’ priorities and abilities
Patient advocacy- what must occur?
Identify unmet patient needs
Provide patients with necessary information
Increase the availability of health care
Autonomy
Freedom and ability to act in a self-directed manner
Example of autonomy
INFORMED CONSENT
Informed consent includes: list four things
- Person agreeing must be competent
- Must be made voluntarily
- Discloses all material information
- Recommendations of a plan
Persons must receive information
Consent for treatment must be voluntary*
Persons must be competent.*
Informed consent includes: list three things
- Statement of understanding risks/benefits
- Decision in favor of plan
- Authorization- verbal or written
What does the Self-Determination Act of 1990 focus on?
Focused on advance directives
HIPAA Privacy and Security Rules
Gives patients’ privacy
What is the nurse’s role in informed consent?
Witness voluntary consent from patient or legal guardian or surrogate
What is the provider’s role in informed consent?
Obtain consent, disclose risks/benefits, declare competence & understanding, and answer questions
Intentional Nondisclosure
Near misses, Emergency situations, Therapeutic privilege, Placebos
Nonmaleficence
Intentional avoidance of harm
Intentional avoidance of harm is done how?
Oversight by regulatory agencies
Best practices & EBP to minimize harm
RUle of double effect
Intended effect VS “Besides the intention” effect
Benefit vs Risk
Futile Treatment are treatments believed to:
- offer no benefit to the patient
- Potentially harm patient
-There is no ethical requirement to provide such a treatment
What is an example of futile treatment?
Antibiotics for a virus
Negligence
Failure to render reasonable care, which results in damages or injury
Malpractice
Malpractice: A negligent act by a professional, usually someone licensed
Alleviating human suffering is a keystone of what?
Buddhist beliefs
Beneficence is considered what?
A legal responsibility of nurses
What are three rules of beneficence?
Protect and defend the rights of others.
Prevent harm from occurring to others.
Remove conditions that will cause harm.
What are two rules of beneficence?
Help persons with disabilities.
Rescue persons in danger.
Paternalism
Acting beneficently without respecting autonomy
Two types of paternalism
- Soft paternalism
- Hard Paternalism`
Soft Paternalism
to protect persons from their own nonvoluntary conduct
Example of soft paternalism
Depression, addiction
Hard Paternalism
Interventions intended to be beneficent, even though the person’s actions are informed, voluntary, and autonomous
Examples of hard paternalism
Example- prescription drug laws and providers
Intentional nondisclosure in therapeutic privilege
Justice
Refers to fairness/equity
What is fairness/equity?
Equal treatment without prejudice
Social justice
equitable distribution of benefits/burdens
Distributive justice: re:
Distributive justice: re: allocation of resources
Goal of Patient Protection and Affordable Care Act
Goal of increasing healthcare equity
Common causes of moral suffering
Being in morally unsatisfactory situations
Taking action that is not morally commendable
Second-Victim Phenomenon
Healthcare errors affect patients and their caregivers
Stress, grief
Ethical dilemma
“Right versus right”
Judged by Law
How common are ethical dilemmas
Extremely uncommon in day-to-day life
Approaches to Ethical Decision Making
- Have Moral Imagination
- Reflective Practice
What does it mean to have a moral imagination?
Respond to patients’ values
Avoid becoming stuck in routine/protocol
Consider “what if?” questions
What is included in reflective practice?
Reflection-on-action
Reflection-in-action
What does ‘reflection on action’ mean?
Looking back on actions
What does ‘reflection in action’ mean?
Stopping to think before and during actions
Four Topics Approach
Medical indications
Patient preferences
Quality of life
Contextual features
What is included in critical thinking? (six things)
- Ask clear, pertinent questions.
- Identify key problems.
- Analyze relevant information.
- Generate reasonable conclusions.
- Remain open-minded.
- Beware the Slippery Slope Argument
Why should you beware of the slippery slope argument?
May move toward illogical extremes
Can become alarmist
Ignore people’s ability to make distinctions
RaDonda Vaught case
Think about it
