Ethical Issues in Nursing

Question 1

What are ethics?

Answer 1

• Ethics address beliefs about appropriate behaviors within a social context
• Laws are a minimal level of conduct that is enforced via the threat of penalties and/or punishments

Question 2

Ethics in nursing

Answer 2

• Principles we utilize when interacting with patients, family members, other healthcare professionals, society as a whole
• The general public consistently ranks nursing as the most ethical profession in Gallup polls
• Bioethics is a newer idea which deals with ethical issues within healthcare

Question 3

Values, behaviors, and attitudes associated with nursing

Answer 3

• Altruism
• Preservation of Autonomy
• Preservation of patient Dignity
• Integrity
• Social Justice

Question 4

Examples of bioethical issues

Answer 4

• Use of stem cells
• Organ transplants
• Sexual reassignment surgery
• End of life/assisted suicide
• Abortion
• New means of reproduction

Question 5

Ethical decision making

Answer 5

• The answer to an ethical dilemma or question is not always readily apparent
• Two people both attempting to act ethically in their decision making may even arrive at opposite conclusions
• How do we decide what is ethical or not ethical?

Question 6

Ethical decision making

Answer 6

• Ethical Theories – establish a framework from which ethical decision making can be made
• Deontology – act out of a sense of obligation, duty, follow the law, etc.
• Utilitarianism – seeks an outcome with the best possible consequence. What’s the best or least bad option?
• Others – Egoism, Kantianism, Confucian theory, Dialectical Materialism

Question 7

Ethical Principles

Autonomy

Answer 7

respect for an individuals choices and actions

Question 8

Ethical Principles

Accountability

Answer 8

answerability, blameworthiness, having the expectation of giving an account

Question 9

Ethical Principles

Beneficence

Answer 9

to help someone

Question 10

Ethical Principles

Non-maleficence

Answer 10

to not inflict harm on someone

Question 11

Ethical Principles

Veracity

Answer 11

being truthful, being honest, having/establishing trust in others

Question 12

Challenges to these principles

Answer 12

• How do we ensure patient autonomy when patients potentially desire treatment that is harmful or suboptimal?
• How do we establish and build trust in our patients?
• How accountable are we for our patient’s care?
• How do we balance our desire for beneficence against the potential to become paternalistic?

Question 13

The role of the nurse

Answer 13

• Ethical dilemmas do present themselves to nurses, even in seemingly mundane circumstances.
• We must act as a patient advocate, regardless of our personal feelings or thoughts about a situation or dilemma.
• But, how do we do that?

Question 14

Ethical decision making process

Answer 14

• Identify the ethical dilemma
• Analyze available alternatives
• Select one alternative or action
• Justify this selection

Question 15

Resources

Answer 15

• Ethics committees – made up of hospital staff from all levels, consultants, lawyers, religious leaders, ethics experts
• Education/training
• ANA code of ethics: http://www.nursingworld.org/DocumentVault/Ethics_1/Code-of-Ethics-for-Nurses.html