Deck 0 Chapter 22: Ethics and Values

Question 1

Ethical dilemmas are common occurrences when caring for patients. The nurse understands that dilemmas are a result of

1. Presence of conflicting values.
2. Hierarchical systems.
3. Judgmental perceptions of patients.
4. Poor communication with the patient.

Answer 1

1. Presence of conflicting values.

Rationale:

Poor communication and the hierarchical systems that exist in health care, such as reporting structures within the hospital or the historically unequal relationship between physicians and nurses, may complicate dilemmas. The primary, underlying reason that ethical dilemmas occur is that there are no clear cut, universally accepted solutions to a problem when participating individuals do not share the same values. Without clarification of values, the nurse may not be able to distinguish fact from opinion or value, and this can lead to judgmental attitudes.

Question 2

A nurse argues that we need to reform our health care system because we have a large number of people who are uninsured and end up needing expensive emergent care when low-cost measures could have prevented their illnesses. What ethical framework is she using to make this case?

1. Deontology
2. Ethics of care
3. Feminist ethics
4. Utilitarianism

Answer 2

4. Utilitarianism

Rationale:

Utilitarianism is a system of ethics that believes that value is determined by usefulness. This system of ethics focuses on the outcome of the greatest good for the greatest number of people. Deontology would not look to consequences of actions. The ethics of care would not be helpful because consensus on this issue is not achievable. Relationships, which are an important component of feminist ethics, are not addressed in this case.

Question 3

Which issue has increased the attention paid to quality of life concerns in recent history?

1. Health care disparities
2. National movement regarding disabled persons
3. Aging of the population
4. Health care financial reform

Answer 3

2. National movement regarding disabled persons

Rationale:

Quality of life (QOL) is often at the center of ethical dilemmas, including futile care and DNR discussions, and has been reshaped in the United States. The national effort to better respect the abilities of the disabled has forced Americans to reconsider the definition of QOL. Health care disparities, an aging population, and health care reform are components impacted by personal definitions of quality but are not the underlying reason why QOL discussions have arisen in the United States.

Question 4

Which patient is most likely to have difficulty with the ethical concept of autonomy?

1. 18-year-old patient in labor
2. 35-year-old patient with appendicitis
3. 53-year-old patient with pancreatitis
4. 78-year-old patient with rheumatoid arthritis

Answer 4

4. 78-year-old patient with rheumatoid arthritis

Rationale:

The principle of autonomy refers to freedom from external control and includes commitment to include patients in decisions about their care. People from different generations have differing expectations regarding inclusion in their care. Often, patients who are part of the Silent Generation (born 1925-1945) value formality and authority, which may make them less comfortable with making their own health care decisions

Question 5

During a severe respiratory epidemic, the local health care organizations decide to give health care providers priority access to ventilators over other members of the community who also need that resource. Which philosophy would give the strongest support for this decision?

1. Feminist ethics
2. Utilitarianism
3. Deontology
4. Ethics of care

Answer 5

2. Utilitarianism

Rationale:

Focusing on the greatest good for the most people, the organizations decide to ensure that as many health care workers as possible will survive to care for other members of the community.

Question 6

Determinations regarding quality of life are

1. Based on a person’s ability to act according to ethical principles.
2. Based on a patient’s self-determination.
3. Value judgments that can vary from person to person.
4. Consistent and stable over the course of one’s lifetime.

Answer 6

3. Value judgments that can vary from person to person.

Rationale:

Determinations regarding quality of life are value judgments. This means that they are judgments based on what individuals believe is desirable. Beliefs about what people find desirable vary from person to person.