Chapter 6- Ethics In Nursing Flashcards
Values
Defined as attitudes, ideals, or beliefs that guide behavior
Morals
Established rules of conduct to be used to distinguish right from wrong
Ethics
Codified actions that specify what actions an individual should take
Bioethics
Application of ethical principles to moral issues in health care
Laws
Man-made rules of conduct that protect society
The purpose of laws
To protect the rights of one individual from infringement by another
As a group becomes larger and more complicated, laws tend to…
Increase
Ethical accountability
Each person is responsible for his or her own actions
One of the key elements of being a professional
Ethical accountability
Nurses are accountable to…
Clients Public Profession of nursing Facility administration Physicians Other nurses (peer review)
Accountability is…
Answerability
What is Kolberg’s Stages of Moral Reasoning?
An approach to moral reasoning. It has three levels of moral reasoning
Kolberg’s stages of moral reasoning, the levels specifically
Preconventional
Conventional
Postconventional
Utilitarianism
The end justifies the means.
No set rules or principles to govern day to day decisions.
All decisions depend on situation.
Group happiness.
Moral decisions in utilitarianism
The greatest good for the greatest number of people
Deontology
The most basic principle is “survival of the species”
Principles of right and wrong
Principles echo those in the bill of rights
In reality, most people use a ________ of ultilitarianism and deontology.
Combination
Principalism
Uses key ethical principles of beneficence, nonmaleficencr, autonomy, and justice to resolve ethical dilemmas
The primary ethical responsibility of nurses in practice
Respect for others
Six ethical principles
Autonomy Beneficence Nonmaleficence Justice Fidelity Veracity
Autonomy
Individuals have the right to determine their own actions and freedom to make their own decisions.
Respect is cornerstone
Autonomic deductions are based on:
Individual values
Adequate information
Freedom from coercion
Reason and deliberation
Beneficence
Based on promoting good for others… this is the primary goal of nursing and health care
One of the oldest of the ethical requirements in health care
Nonmaleficence
Duty to do no harm
Foundation of Hippocratic oath
Principle of double effect
One may produce a distressful or undesireable effect if intent is to produce overall good result
Justice
Equals should be treated the same and unequals should be treated differently.
How is justice used in reference to health care?
It relates to allocation of resources.
Fidelity
Faithfulness or honoring one’s commitments or promises
Fidelity is the key foundation for:
Nurse-patient relationship
Code of ethics for nurses
Maintaining competence
Veracity
Telling the truth, not lying
Exceptions to veracity in nursing
If a patient asks not to be told the truth
If a patient is mentally incompetent
If harm will come to the patient from telling the truth
Advance directive
Decisions made by competent individuals about their future health care
Living will
A written advance directive that identifies treatments, procedures, tests and so on, that a person wants or does not want should he or she become unable to make such decisions.
Abandonment
Unilateral severance of the professional relationship with the client without adequate notice and while the need for care still exists
Key phrase in relation to abandonment
Without adequate notice
Nursinf code of ethics
Defines as a social contract through which the profession informs society of principles and rules guiding its function
Code of ethics for nurses with interpretive statements
Nursing profession’s expression of its ethical values and duties to the public
Scopes and standards of practice
Defines standards of practice and standards of professional performance
International Council of nurses code of ethics for nurses
Rights and responsibilities of nurses related to people, practice, society, co-workers, and the profession
Ethical decision making
Requires that the nurse make judgements or decisions when two or more values in a situation are incongruent.
Model for ethical decision making
Clarify the ethical dilemma Gather additional information Identify options Make a decision Act Evaluate
Common ethical dilemmas in nursing include conflicts between
Patients, their families, health care professionals, and institutions
Some major issues involved in ethical dilemmas in nursing with relationships
Personal value systems Peers' and other professionals' behaviors Patients' rights Institutional and societal issues Patient data access issues Global dilemmas
Ethical dilemma: when personal values are in conflict with professional values
Professional ethics outweigh personal ethics in professional setting
Nurses should find work in which personal ethics are not routinely challenged
Ethical dilemma: when nurses or other health care providers routinely fail to meet standards of care
Through incompetence or impairment resulting from drug or alcohol addictions or by other breaches
Ethical dilemma: when patients demand to have a voice in a health care decision that is controversial
Advance directives
Rights for patients with physical or mental disabilities
Ethical dilemma: when cultural differences pose communication problems between patients and health care providers
Medical interpretation requires knowledge of medical terminology, cultural wisdom and sensitivity to patient’s needs
Ethical dilemma: when nursing shortages promote proposals for changes in immigration laws
Removing immigration cap would exacerbate shortages in other countries
It challenges ability to ensure competency to provide safe nursing care, which occurs now through NCLEX from approved U.S. schools
Ethical dilemma: when nurses disagree with policies of their institutions
Institutional ethics committees have been created to assist with ethical dilemmas in institutional settings through consultation and emotional support for nurses
Ethical dilemma: when technology creates electronic portals into patients’ confidential medical info
Places great responsibility and power in the hands of health care workers and exacerbates basic ethical problems that exist
