Ethics 2 Flashcards
What is ethics
- systematic reflection on, and analysis of morality
- goal is to arrive at a caring response
- primary loyalty is to the pt
- A process that sees ‘what is’ and asks ‘what really ought to be?’
nursing code of ethics: provision #3
- Nurse promotes, advocates for and protects the rights, health, and safety of the pt
- HIPPA
autonomy
- pts right to make decisions about their own care
- pt agrees with their own care
- pt consents to treatment (if conscious)
- in an emergency situation, and the pt is unconscious, the health care team or family makes a decision in the best interest of the pt
- if there is a learning disability as long as the person can show signs of consent they can decide for themselves -> otherwise a guardian decides
paternalism
- taking care of a person instead of letting pt make decision for themselves
- limits pts. autonomy
- respecting autonomy is hard if health care doesnt agree with pt.
nonmaleficence
- do no harm
- somewhat passive
- refrain from abuse
- primary loyalty to the pt
- a person goes from a person to a pt when they enter the hospital
- they are feeling vulnerable, weak, lesser, passive
- avoid harm
- will my actions hurt the pt?
beneficence
- prevent harm
- remove harm when it is being afflicted
- bring about positive good
- active
- mindset that acknowledges “I am in a position to benefit someone”
in the esther korn case who was bound by the principle of fidelity
- the nurse
- a practitioners responsibility to be faithful to the pt, self, colleagues, institution, profession
fidelity
- a practitioners responsibility to be faithful to the pt, self, colleagues, institution, profession
- stay true to the pt and yourself
- caring response to the pt
veracity
- practitioner telling the pt the truth about diagnosis, prognosis, treatment options
- binds you to tell the truth
- 2nd level principle
- if the pt trust you, you can form a good relationship
- support the intent to be beneficent
- maintains fidelity (faithful to pt)
- EXCEPTION- therapeutic privilege -> details are too much for the pt to handle at one time -> they may cause harm to others or themselves
- withholding info for the best interest of the pt
- used as a last resort
justice
- what is right vs. what is good
- providers responsibility to treat pt. fair and equal
- pts have same level of care
- taking a child away from a drug addicted parent is RIGHT, it may not be GOOD
distributive justice
- using reasonable means to distribute justice
- demand is high and supply is low
- ex. ventilators, COVID vaccines, masks, mass tragedy
ethical problem prototypes
- moral distress
- locus of authority problem
- ethical dilemma
moral distress
- you face a challenge about how to maintain your integrity or the integrity of the profession
- can cause physical sickness
- physical response to distress/decisions
- something is blocking me from taking ethical action
- “this makes me uncomfortable, I dont know the whole story, someone is lying, funding deficit, short staff, policies, what dont I know”
locus of authority problem
- you face the challenge of deciding, from an ethical point of view, who should be the primary decision maker
- who has authority to make decision?
- is it the pt, doctor, nurse, family
- who has the power
ethical dilemma
- you face a challenge about the right thing to do
- there are 2 or more courses of action
- no one outcome feels completely “right”
- maybe both choices are wrong/right
- which is better?
- 2 choices where no one is happy in the end
deontology
- evaluating
- duty-driven
- means count
- if something is wrong but outcome is right -> still wrong
- process > outcome
- focuses on the process not the outcome
- medical team in the nancy cruzan case was prioritized -> driven by DUTY
teleology
- utilitarianism
- goal driven
- outcome > process
- least harm done
- process can be done out of order
- nancy cruzans family focused on teleology -> her dignity and outcome of life or not
deontology vs teleology
- 2 options are equally correct
- depends on the scenario
6 step process of ethical decision making
- formalized approach to reflection
- leads to a caring response
- gather as much relevant information as possible to get your facts straight -> research
- determine the precise nature of the ethical problem (if the data confirms that there is one) -> info on the problem -> is it moral distress? Etc.
- decide on the ethics approach that will best get to the heart of the problem -> deontology vs. teleology
- decide what should be done and how best it can be done (explore the widest range of options possible) -> explore all options, use pros and cons
- act
- reflect on and evaluate the action -> learn from experience
- steps 3-4 can be repeated several times
moral development
begins during childhood as a result of adult influences
morality
- values, duty, and character
- comes from relationships between people and how they can best live in peace and harmony
- establishes guidelines for language and behavior that are designed to preserve the fabric (structure/organization) of society
- guidelines (language behavior) determine what we should value
- individuals and groups act based on what they believe to be right or wrong and good or bad
- during childhood adults instill assumptions about right or wrong and good or bad, thus creating strong convictions
- these beliefs shape how we live and our reputation
morality is relational
- morality protects the quality of life for individuals, groups or the community
- ones language and behavior impact the interest of others
morality depends on context
-moral judgement is impacted by situations and circumstances
values
- the things we hold dear
- things that uphold our ideas of what is needed for morality to survive and thrive