Chapter 41 - Ethics and Values Flashcards
1
Q
Morals and Ethics
A
- Morals
- Private, personal, or group standards of right and wrong
- Moral behavior, in accordance with custom, reflects personal moral beliefs
- Morals consider in a broad, general manner what is good or bad, right or wrong (e.g., “In general, it is wrong to steal”).
- Ethics
- Systematic study of right and wrong conduct
- Formal process for making consistent moral decisions
- Ethics answers the question, “What should I do in a given situation?” (e.g., “Is it wrong to steal if you have to do it to feed your children?”).
- Ethics uses specific rules, theories, principles, and perspectives to inquire into the justification of an individual’s actions in a particular situation.
- It seeks to discover what we “ought” to do in certain circumstances.
2
Q
Nursing Ethics
A
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Bioethics
- Application of ethical principles to every aspect of healthcare.
- Nursing ethics is a subset of bioethics. It refers to ethical questions that arise out of nursing practice.
3
Q
Ethical Agency
A
Also called moral agency
- Ability to base practice on professional standards of ethical conduct and to participate in ethical decision-making.
- Nurses have choices and are responsible for their actions.
- An ethical agent must be able to:
- Perceive the difference between right and wrong
- Understand abstract ethical principles.
- Reason and apply ethical principles to make decisions, weigh alternatives, and plan sound ways to achieve goals.
- Decide and choose freely.
- Act according to choice (this assumes both the power and the capability to act).
4
Q
Compromised Ethical Agency
A
Moral distress
- Inability to carry out a moral decision
- Perceived constraints: Internal
- Not enough knowledge, socialization
- Perceived constraints: External
- Providers; nurse administrators; other nurses
- The law; threat of lawsuit
Moral outrage
- Belief that others are acting immorally
- Feel powerless
- Cannot prevent a “wrong”
- Respond with “whistleblowing”
5
Q
Whistleblowing
A
- Identification of an unethical or illegal situation
- Can involve one person or an entire organization
- Reporting such an action to someone in authority
- Need accurate information
- May have consequences; THINK before you act
- American Nurses Association (ANA) working to protect whistleblowers
THINK:
- Talk with an attorney or other legal representation.
- Have concrete and credible evidence of the violation or wrongdoing.
- Institute a survival plan, if your job is put in jeopardy or you are fired.
- Note the nature and consequences of the problem—its type, severity, and potential impact.
- Know your reporting options and support systems.
6
Q
Ethical Problems for Nurses: Sources
A
- Consumer awareness: As a result of increased consumer awareness and availability of information online, professionals now are expected to share knowledge with patients and to obtain truly informed consent for treatments.
- In some cases, consumers are demanding treatment that is not medically needed.
- Technological advances: With every new technology, new issues arise.
- Multicultural population: You will work with patients and colleagues from a variety of cultural backgrounds who probably hold very different sets of values.
- Cost containment: The emphasis on cutting healthcare costs creates many morally questionable situations.
7
Q
Ethical Problems: Sources
A
- Nature of the work
- Nurses’ ethical problems
- Nurses’ unique position in healthcare organizations
- Nature of the profession
- Caring vs. time spent with patients
- Autonomy vs. escaping hard choices
- Higher pay vs. cost effectiveness
- Professionalism vs. caring
8
Q
Factors in Ethical Decision Making
A
- Developmental stage: A person’s stage of moral development affects the way they reason about moral issues.
- We learn and internalize our morals throughout the life span, beginning in childhood.
- Kohlberg’s research found that children go through a sequence of moral reasoning ability, proceeding through several stages.
- Stage I: Moral reasoning is based on personal interest and avoiding punishment.
- Stage II: Principles focus on pleasing others and following rules.
- Stage III: Moral principles are based on universal and impartial principles of justice. This is the final level; it occurs in adulthood.
- Gilligan
- Challenged Kohlberg’s perspective of moral development, citing it as being male-biased.
- Girls develop morally by paying attention to community and to relationships
- Boys tend to process dilemmas through more abstract ideals or principles.
9
Q
Values
A
What do you value? Person to person
Ideals, beliefs, customs, modes of conduct, qualities, or goals that are highly prized or preferred by individuals, groups, or society.
- about the worth of something
- Highly prized ideals, customs, conduct, goals
- Freely chosen
- Learned through observation and experience
- Vary from person to person
- Can change
People express their values through behaviors, feelings, knowledge, and decisions
10
Q
Factors in Moral Decision Making
A
- Attitudes
- Feelings toward person, object, idea
- Includes thinking and feeling component
- Dispositions toward things affecting what a person thinks, feels and does
- Attitudes can be cognitive (thinking), affective (feeling), and behavioral (doing)
- Beliefs
- Something that one accepts as true
- Not always based on fact
11
Q
Nurses as Ethical Agents
A
- Moral/ethical agency means
- Know the difference between right and wrong.
- Understand abstract ethical principles.
- Apply ethical principles in decision making.
- Weigh alternatives; plan to achieve goals.
- Decide and choose freely.
- Act according to choice.
- Consider value neutrality
- means that we attempt to understand our own values regarding an issue and to know when to put them aside, if necessary, to become nonjudgmental when providing care to clients.
12
Q
Consequentialism
A
- The rightness or wrongness of an action depends on the consequences of the act rather than on the act itself.
- Teleology – study of final causes
- Utilitarianism- greatest good for greatest number
13
Q
Deontology
A
- Doing right or wrong regardless of consequences
- Formalism – based on unchanging rules/principles
- Categorical imperative – established by the philosopher Immanuel Kant (1724–1804),
- States that one should act only if the action is based on a principle that is universal—or in other words, if you believe that everyone should act in the same way in a similar situation.
14
Q
Feminist ethics
A
- Reasoning uses relationships and stories rather than universal principles.
- Feminists argue that it is impossible to avoid being influenced by one’s relationships.
- They see that influence as positive and believe it should not be lessened by an attempt to be objective—and in any case, that objectivity is impossible anyway.
- Addresses female perspective issues
15
Q
Ethics of Care
A
Nurses include a responsibility to care as a part of their professional behavior.
- Nursing’s responsibility to care in ethical situations
- Principles combined with feelings
- Caring central force in nursing
- Promote dignity and respect
- Person centered care for all
- Cultivating responsiveness to others
- Kindness, attentiveness, empathy, compassion, reliability are fundamental
