ETHICO-MORAL ASPECTS OF NURSING Flashcards
refers to a standard to examine and understand moral life
Ethics
systematic study of what a person’s conduct and actions should be with regard to self, other humans, and the environment
Ethics
justification of what is right or good
Ethics
studies how people make judgment in regard to right or wrong
Ethics
branch of moral science concerned with the obligations that a member of the profession owes to the public
Professional Ethics
division of ethics that relates to human health
Health care ethics
related to all the principles of right conduct as they apply to the profession
reinforces the nurses’ ideals and motives in order to maximize the effectivity of their service
NURSING ETHICS
Greek word autos (self) & nomos (governance)
AUTONOMY
involves self determination & freedom to choose & implement one’s decision, free from deceit, duress, constraint or coercion
AUTONOMY
allowing patient to refuse treatment
AUTONOMY
disclosure of his ailment, prognosis, mode of treatment
AUTONOMY
maintaining mode of confidentiality
AUTONOMY
may occur when there is potential harm to others such as communicable diseases or acts of violence
Restriction
The person making the decision?
a. must be deemed competent
b. have the individual capacity to make a rational decision
c. must be of legal age
d. the decision should be of his own free will
e. should not be coerced or put under duress
legal exception of the rule of informed consent which allows the caregiver to proceed with the care (emergency, incompetence, waiver or implied consent)
Therapeutic privilege
to maximize efficiency of health care, the patient & health care providers are bound to tell the TRUTH
Veracity
Patient has the responsibility to provide accurate and complete information about his
a. complaints
b. past illness
c. previous hospitalizations
d. Medications being taken
e. Allergies
f. Religious restrictions
Physician should tell the patient & his family his
a. diagnosis
b. plan of care
c. treatment
d. possible risks involved
e. length of treatment
f. Possible expenses
g. Other options they may take if there be any
physicians/health practitioners are requested not to tell the relative the exact nature of the patient’s illness
BENEVOLENT DECEPTION
the relative requests the physician not to tell the patient his true diagnosis
BENEVOLENT DECEPTION
practitioner himself intentionally
BENEVOLENT DECEPTION
Withhold information according to his sound judgment (revelation would do more harm to an emotionally unstable or depressed person)
BENEVOLENT DECEPTION
a young married male who was diagnosed to have AIDS, requested the doctor no to tell his diagnosis to his wife
BENEVOLENT DECEPTION
the children of an aged grandmother suffering from metastatic cancer request the doctor not to tell their mother her diagnosis and instead to proceed with the chemotherapy
BENEVOLENT DECEPTION
acts of kindness and mercy that directly benefit the patient
Beneficence
acts promote the health of the patient, prevent illness or complications, alleviate suffering, and assist towards peaceful death
Beneficence
PATIENT’S BILL OR RIGHTS
- considerate and respectful care
- relevant, current and understandable information concerning diagnosis, treatment,
risks involved, medically reasonable alternative benefits needed to make informed consent - make decisions regarding his plan of care; in case of refusal, he is entitled to other appropriate care and service or be transferred to another hospital
- have advance directive (living will) concerning treatment or designating a surrogate decision maker
- every consideration of his privacy such as in case discussion, consultation & treatment
- Confidentiality of communications and records
- Review his records concerning his medical care and have these explained to him except when restricted by law
- be informed of business relationship among the hospital, educational institution, health care providers that may influence the patient’s treatment and care
- consent or decline to participate in experimental research affecting his care
- Reasonable continuity of care when appropriate and be informed of other care options when hospital care is no longer appropriate
- be informed of hospital policies and practices that relate to patient care
*ALL activities provided to patients must be conducted with deep considerations of their values and dignity.
in some way similar to the principle of beneficence, stated as an admonition in the negative form to remind practitioners to do no harm
Nonmaleficence
not assisting in or performing abortion
Nonmaleficence
not assisting persons to commit suicide
Nonmaleficence
not performing euthanasia
Nonmaleficence
not willfully subjecting patients to experimental drugs whose potential harm may be greater than the expected benefit
Nonmaleficence
Not harming a person’s reputation by revealing confidential information
Nonmaleficence
refers to the right
to demand to be treated justly, fairly and equally
Justice
guarantees that the state shall adopt an integrated and comprehensive approach to health development and shall endeavor to make essential goods, health & social services available to all people at affordable cost. There shall be priority for the needs of the underprivileged, the sick, the elderly and the disabled, the women and children. The state shall endeavor to provide free medical care to paupers, establish and maintain an effective food and drug regulatory system, and undertake appropriate health manpower development & research responsive to the country’s health needs & problems. It shall establish a special agency for disabled persons for their rehabilitation.
ARTICLE XIII of the Phil. Constitution
affirms that health is a basic human right.
DOH
provides for a universal compulsory health insurance program in the country. Employees from public & private sectors are covered with medicare privileges.
National Health Insurance Act of 1995
gives honor & justice to the elderly by giving 20% discount in public establishments such as restaurants, & pharmacies; public utility vehicles; & hospitals including free medical & dental check up & free hospitalization in all government hospitals.
RA 7432 (Senior Citizens Act)
between one child with congenital defect over the need to protect the lives of thousands of children who would benefit from mass immunization against CD’s
The greatest good for the greatest number
nurses should commit themselves to the welfare of those entrusted to their care
ROLE FIDELITY
should be loyal to their sworn duty
ROLE FIDELITY
aka privileged communication because it is given based on trust
Confidential Information
if the patient insists on knowing their diagnosis, nurses may only repeat what doctors wish to disclose
Confidential Information
ALL information gathered by nurses should always be treated confidential even after the patient’s death; BUT may be revealed only when:
a. patients themselves permit such revelation as in the case of claim for hospitalization, insurance benefits, among others
b. The case is medico-legal such as attempted suicide, gunshot wounds which have to be reported to the local police or NBI or constabulary
c. the patients are ill of communicable disease and public safety may be jeopardized
d. given to members of the health team if information is relevant to his care
The privacy of communication and correspondence shall be inviolable except upon lawful order of the court or when public safety and order require otherwise.
ARTICLE IV Sec. 4 (1) of the New Constitution
PATIENTS’ RESPONSIBILITIES
- Providing information
- Complying with instructions
- Informing the physician of refusal to treatment
- paying hospital charges
- Following hospital rules and regulations
- Showing respect and consideration
Bill of Rights of Registered Nurses
RN
a. promote & restore health
b. prevent illness
c. protect the people entrusted to their care
d. work to alleviate the suffering
experienced by IFGC
e. provide services that maintain respect for human dignity & embrace the uniqueness of each patient
NURSES HAVE THE RIGHT TO
- practice in a manner that fulfills their obligations to society & to those who receive nursing care
- practice in environments that allow them to act in accordance with professional standards & legally authorized scopes of practice
- a work environment that supports & facilitates ethical practice, in accordance with the code of ethics for nurses and its interpretive statements
not yet widely used in the Philippines, it is used extensively in the US
Living wills or Advance Directives
the patient designates a health care representative, usually a member of the family, a friend or a family physician to make decisions for him/her own health care decision
Living wills or Advance Directives
this includes decisions to accept or refuse any treatment, service or procedure used to diagnose or to treat his/her physical/mental condition to provide, withhold or withdraw life-sustaining measures
Living wills or Advance Directives
desire to make anatomical gifts after death are also indicated in the will, if the patient desires to do so
Living wills or Advance Directives
signed by the patient
attached to the patient’s chart
has a force of law
Living wills or Advance Directives
witnessed by 2 other persons who declare that the patient signed the will, that the latter appears to be of sound mind, free of duress or undue influence
Living wills or Advance Directives
witnesses must be 18 years of age or older & are designated as the person’s health care representative or alternate as such
Living wills or Advance Directives
The whole is greater than its parts
The principle of Totality
There is always an exemption to the rule
Epikia
Instrument to the crime
One who acts through as agent is herself responsible
You cannot betray yourself
No one is obliged to betray herself
systematic guides for developing ethical behavior
Code of Ethics
answer normative questions of what beliefs & values should be morally accepted
Code of Ethics
states that the hallmark of all professionals is their willingness to accept a set of professional & ethical principles which they will follow in the conduct of their daily lives
Code of Good Governance promulgated by the PRC on July 23, 2003
adopted by the PRC & the 42 Professional Regulatory Boards to cover an environment of good governance in which all Filipino professionals shall perform their duties
Code of Good Governance promulgated by the PRC on July 23, 2003
implies a commitment to a life of sacrifice and genuine selflessness in carrying out their professional duties even at the expense of personal gain
Service to Others
should perform their responsibilities with the highest sense of integrity& imbued with nationalism & spiritual values
Integrity & Objectivity
should maintain objectivity, be free from conflicts of interest, refrain from engaging in any activity that would prejudice their abilities to ethically carry out their duties nor make any representations that would likely cause a reasonable person to misunderstand & be deceived
Integrity & Objectivity
level of competence is necessary (knowledge, technical skills, attitudes & experience, in undertaking only those professional services they can reasonably deliver
Professional Competence
shall maintain & support one professional organization that promotes a deep spirit of solidarity & teamwork
Solidarity & Teamwork
shall always carry out their professional duties with due consideration of the broader interest of the public, serve them with professional concern consistent with their responsibilities
Social & Civic Responsibility
shall remain open to challenges of a more dynamic & interconnected world, rise up to global standards & maintain levels of professional practices fully aligned with global best practices
Global Competitiveness
In the eyes of the PRC, all professions are equal and therefore, every one shall treat other professionals with respect and fairness
Equality of all Professions
