Chapter 22 Ethics and Values

Question 1

Autonomy

Answer 1

refers to freedom from external control
Ex. a patient faces surgery, the surgeon has an obligation to review the surgical procedure, including risks and benefits, out of respect for the patient’s autonomy

Question 2

Beneficence

Answer 2

refers to taking positive actions to help others, the best interests of the patient remain more important than self-interest - service to others

Question 3

Non maleficence

Answer 3

avoidance of harm or hurt - balance between risks and benefits

Question 4

Justice

Answer 4

fairness and equal access to health care resources, including distribution of resources
Ex. health insurance, organ transplants

Question 5

Fidelity

Answer 5

the agreement to keep promises

Ex. unwillingness to abandon patients even when care becomes controversial or complex –> abortions

Question 6

Code of ethics

Answer 6

set of guiding principles that all members of a profession accept

Question 7

ANA

Answer 7

American Nurses Association

First set of codes of ethics

Question 8

Advocacy

Answer 8

the support of a particular cause

Ex. health, safety, rights of patients, rights to privacy

Question 9

Responsibility

Answer 9

willingness to respect one’s professional obligations and follow through on promises

Question 10

Accountability

Answer 10

the ability to answer for one’s action

-ANA: national standards

Question 11

Accountability : TJC

Answer 11

The Joint Commission: applies Accreditation

Question 12

Confidentiality

Answer 12

widely respected

If violations occur: US Department of Health and Human Services take charge

Question 13

HIPAA

Answer 13

Health Insurance Portability and Accountability Act of 1996

Question 14

Value

Answer 14

personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior -reflect culture and social influences

Question 15

Value formation

Answer 15

begins in childhood, shaped by experience within the family unit
Ex. schools, government, religion, friends
Ex. individual experiences: loss in early life values things different to those free of suffering

Question 16

Values Clarification

Answer 16

Ethical dilemmas –> conflict: to resolve think VALUE, FACT, OPINION

Question 17

Ethics are more

Answer 17

flexible than fixed

Question 18

Deontology

Answer 18

actions as right or wrong based on their “right-making characteristics” – does not look at consequences
Ex. fidelity to promises, truthfulness, justice, and beneficence

Question 19

Utilitarianism

Answer 19

relies on the application of a certain principle

-the value of something is based on its usefulness

Question 20

Utilitarianism: Consequential-ism

Answer 20

main emphasis is on the outcome or consequence of action

Question 21

Utilitarianism: Teleology

Answer 21

Greek meaning “end” - study of ends or final causes

Question 22

Utilitarianism measures:

Answer 22

the effect that an act will have; deontology looks to the presence of principle regardless of outcome
-does not guarantee agreement

Question 23

Feminist Ethics

Answer 23

critiques conventional ethics

practices solutions of the nature of relationships and positive values (power is unequal, point of view)

Question 24

Ethics of Care

Answer 24

Like feminists, both promote philosophy that focus on understanding relationships with a personal narrative

Question 25

Nel Nodding

Answer 25

one-caring = provides care
cared-for = patient
-code of ethics

Question 26

Consensus of Bioethics

Answer 26

respect and agreement, skill and practice

-Act of discovery: “collective wisdom” - consensus building

Question 27

Processing an Ethical Dilemma: Elements

Answer 27

the presumption of good will, strict confidentiality, patient-centered decision making, welcome participation of family

Question 28

Curtin says it’s an ethical issue if 1 one of the following:

Answer 28

1. unable to resolve through scientific data
2. perplexing –> cannot logically make decision
3. answer = relevance for human concern

Question 29

Resolution of ethical issues:

Answer 29

1. Ask ?
2. Gather info
3. Clarify values–> fact, opinion, values
4. Verbalize problem
5. Identify possible courses of action
6. Negotiate a plan
7. Evaluate the plan over time

Question 30

Ethics committees:

Answer 30

1.education, 2.policy recommendation, 3.case consultation

goals= promote rights, decisions, patient-centered outcomes

Question 31

Issues: Quality of Life

Answer 31

take account- age, ability to live independently, contribute to society, other measures
-centered= DNRs. end of life care, cancer therapy, disabled access

Question 32

Issues: Genetic Screening

Answer 32

alert a patient to a condition that may not yet be evident but is certain to develop in future Ex. women over 35 and pregnant

Question 33

Issues: Care at End of Life

Answer 33

predictions are not always accurate (dementia)

Question 34

Futile

Answer 34

hopeless, serves no purpose

-no recovery, dying

Question 35

Issues: Access to Care

Answer 35

46. 3 mill uninsured 15% of pop
    - mostly women and children, 19-29
    - most homeless but 80% working families