Ethics Flashcards
Ethical vs Moral Reasoning
Ethical – collective determination of acceptable and unacceptable conduct in accordance with professional standards that reflect criteria for practice and community expectations – e.g. ‘RNs must act with…’
Moral – individual determination of ‘right’ and ‘wrong’ in accordance with personal standards, beliefs and values – e.g. ‘I believe it is wrong to…
8 Ethical Principles
- Autonomy
- Beneficence
- Non-Maleficence
- Accountability
- Veracity
- Fidelity
- Justice
- Confidentiality
Autonomy (define)
Respecting patients’ right to self-determination, including:
- Consent (or refusal) – voluntary, fully-informed and with capacity.
- Information – sufficient, timely and unbiased
- Communication
- Planning – e.g. EOL/ACP.
Veracity (define)
Providing complete, honest and unbiased information to patients, including:
- Diagnosis and prognosis
- Treatment – purpose, alternatives, side-effects.
- Rights – consent, refuse treatment, second opinions.
Fidelity (define)
Fulfilling obligations and not making promises that cannot be kept.
- Professional standards and codes
- Trusting relationships
Beneficence (define)
Acting in the patient’s best interests by:
- Adopting holistic view of person
- Providing person-centred care
- Balancing benefits against risks/harms
Non-Maleficence (define)
Avoiding causing un/intentional harm to patients by:
- Delivering evidence-based practice
- Implementing safety and quality measures
- Maintaining fitness and competence for practice
- Reporting notifiable conduct
Justice (define)
Fair and equitable distribution of care for patients, involving:
- Avoiding discrimination (bias/stereotyping)
- Protecting vulnerable patients
- Prioritising patients according to urgency
- Allocating resources appropriately
Accountability (define)
Accepting responsibility for actions and outcomes of nursing care, by:
- Reporting errors/incidents
- Promoting open disclosure
- Delegating and supervising care
- Maintaining accurate/timely documentation
Confidentiality (define)
Respecting privacy and protecting personal information
- Explaining req. for info and seeking informed consent to share
- Proper collection, access, use and disclosure of information
- Appropriate information protection measures
8 Steps for Ethical Reasoning
- Identify the ethical issues based on perspectives of main stakeholders (i.e. patient, families and caregivers)
- Clarify personal values and effect on ability to participate in decision-making.
- Allocate roles in decision-making process
- Determine possible courses of action and alternatives
- Rank each option according to which provides the greatest balance of benefits over possible harms.
- Develop a plan of action with stakeholders
- Implement plan, evaluate responses and modify as required.
4 Fundamental Responsibilities (ICN Code of Ethics)
- To promote health
- To prevent illness
- To restore health
- To alleviate suffering and promote a dignified death
Benefits of Ethical Frameworks
A. Diverse – accounts for predicaments outside our own experiences and complex issues.
B. Multi-faceted – promotes consideration of multiple perspectives in complex scenarios.
C. Structured – not susceptible to fracturing/paralysis during illness/trauma (cf. patient’s moral frameworks).
D. Objective – allows health professionals to support decision-making without pushing their own values/beliefs.
E. Directive – provides guidance for behaviour of patients, families and colleagues.
RN Standards for Practice
1.5 Uses ethical frameworks to make decisions.
2 – Engages in therapeutic and professional relationships
3 – Maintains capability for practice
6 – Provides safe, appropriate and responsive quality nursing
Medical Futility (define)
Medical futility refers to situations where the proposed therapy should not be performed because available data show that it will not improve the patient’s medical condition. Concept is used to justify decisions not to pursue treatment options requested by patients.
