Final Exam Flashcards
Ethics
a systemic approach to understanding, analyzing and distinguishing matter or right and wrong as they relate to human beings
Morals
specific beliefs, behaviours and ways of being derived from ethics
Value
something desirable, prized, held dear; to attach a degree of goodness to something which elevates it to a place of prominence in one’s thinking where it will influence one’s behaviour
Belief
confidence, faith, or trust in something; believe something to be the truth, an option
Bioethics
the study of ethical issues and decision making associated with the use of living organisms– many types, such as medical, clinical, ecological and environmental
Medical ethics
the greatest amount of work in bioethics has been in medical ethics– evaluates the marits, risks and social concerns of activities in the field of medicine
Relational ethics
focus on the relationship as a significant and central aspect of health care ethics– emphasizes four main themes: mutual respect, engagement, embodiment and environment
Virtue ethics
trait or character that is socially valuable and present in a person– truthfulness, kindness and honesty
What are the 5 focal virtues?
compassion
discernment
trustworthiness
integrity
conscientiousness
Discernment
a sensitive insight involving astute judgement and understanding to action– being mindful
Conscientiousness
acting with good intention, trying to do what is right, after determining what is the “right” choice of action– acting good even when it is difficult
Utilitarianism
focuses on the outcome to determine the correct choice– “the end justifies the means”
also called consequentialism
Deontology
focuses on the actions themselves– the moral choice is based on the path rather than the outcome so nobody is more important than anyone else
Sanctity of life
preserve life
Autonomy
promote freedom of choice
Non-maleficence
do no harm
Beneficence
do good
Veracity
be truthful
Fidelity
be faithful/loyal
Justice
treat all fairly
Egalitarian model
everyone receives and equal share of the available resources– Canada’s health care resources are allocates based on this model
Moral/ethical dilemma
-the best course of action is unclear
-strong moral reason to support each position
-have to choose what is the most right and least wrong
Moral uncertainty
-not sure of morally correct action to take
-not sure what moral value/principle to apply
-not able to define actual problem
-feeling of concern and “gut feeling”
Moral distress
-unable to act upon
-right action is clear
-nurses feel personally responsible
Public law
defines a person’s rights and obligations in relation to government, and describes the divisions of government and their powers
Private law
Also called civil law, determines a person’s legal rights and obligations in many activities that involve other people
branches include tort law and contract law
Contract law
deals with the rights and obligations or people who make contracts
-may be written or oral
-in health care contracts may be expressed or implied
-the nurse-client relationship is an implied contract
Tort law
a tort is a wrong or injury that a person suffers because of someone else’s action either intentional or unintentional
The Apology Act
an apology made by or on behalf or a person in connection with a matter– does not constitute an implication of fault or liability by the person in connection with the matter
Define assault
any action which places another person in apprehension of being touched without that person’s consent
Define battery
harmful or unwarranted contact with another person
Define false imprisonment
-confinement without cause and without authority of law
-unjustifiable detention
-threat of intent to confine
What are some examples of intentional torts?
-fraud
-assault
-battery
-false imprisonment
-defamation
-slander
-intentional infliction of emotional distress
What is the Regulated Health Professions Act?
an act that we are governed by that means each regulated health profession will be governed under common legislation but will also have its own profession-specific regulation
Define direct liability
legal responsibility for one’s own actions
Define vicarious liability
legal responsibility for the actions of another for whom one is responsible
-often hospitals are found vicariously liable for their employees
What is an inquiry?
-done by a provincial or federal appointed commissioner (Ex judge)
-establishes the facts caused from an event/issue and then make recommendations
-public
-only advisory– no legal power
-commonly done in tragic events, such as a plane crash or misconduct by a government official
What is an inquest?
-done by a
minister of justice or chief medical examiner
-purpose is to determine the identity, facts surrounding the death, how they died, and whether the death was preventable
-ex. pediatric cardiac surgery inquest
What is informed consent?
-an ethical imperative
-includes the right to refuse interventions and to choose from alternatives
-informed consent helps us to reduce paternalistic decision making by providers
-must be voluntary
Define capacity
-having the ability to understand what you are told
-requires a certain level of cognitive development or awareness
Define comprehension
-person’s actual understanding of what they are being told
-it is possible to have capacity to understand but not be able to understand because of some other factor, such as language or medical jargon
What is the difference between explicit consent and implied consent?
explicit– clear statement of consent from the pt (written for most procedures/treatment)
implied– inferred from a pt’s conduct (such as them giving you their arm when you ask if you can draw blood)
When are the exceptions to informed consent?
emergencies– no time
deemed not competent
waivers– do not want to know prognosis/risks
What are the nursing roles and responsibilities in regards to informed consent?
-verifying that the pt is aware of options and the implications of each
-advocating for the pt to ensure criteria for autonomous decision making is met
-explore pt and family understanding of information received
What is a healthcare directive?
Documents that outline treatment decisions that pts have asked to be followed if they become unable to communicate or make decisions for themselves
What was the result of the Health Care Directive Act of 1993?
health care professionals are now legally obligated to follow the identified written instructions of pts
Who should have access to the pt’s health care directive?
-family members
-healthcare team
-can be a copy in the person’s chart
What is in a health care directive?
-DNR
-end of life care
-considers current individual medical decisions
-proxy
What is a proxy?
a person who makes health care decisions on the person’s behalf when the person is unable to communicate
What are the 3 health care professional’s legal and ethical responsibilities?
-stay aware from care that is not medically possible
-be conscious of poor standards of health care and futile care
-involving family in decision making
What is moral integrity?
-good moral character
-sense of being whole or complete
What influences moral integrity?
-our values and beliefs
-enhances, challenged or supported through how we conduct ourselves in relationships
What are the steps of the conflict resolution framework?
1) remain attentive to personal values
2) clarify obligations
3) determine the nature of the problem
4) consider and weight alternatives
5) develop respectful solutions
Define a fiduciary relationship
ethical duty to act in the best interest of another
(part of the clarify obligations step of problem solving in situations of conflict)
Who does the nurse have an obligation?
-patient and families
-institution that they work for
-other nurses and health care team members
Define harrassment
any behaviour that demeans, humiliates, or embarrasses a person, and that a reasonable person should have known was unwelcome (touching, comments, jokes, name-calling, etc.)
What are tips and tricks for conflict resolution?
-active listening
-using I statements
-understanding others perspectives
-advocating for what you feel is right to maintain moral integrity
Define power
the authority to carry out an action/influence others
Define empower
to facilitate the ability of another person to do or to act
Define empowerment
process of personal growth and development– to empower
What are examples of personal empowerment
-self care
-self actualization
-awareness
What are examples of professional empowerment
-personal accountability and support of nursing colleagues
-collaboration
-decision making
-improving outcomes
-being involved
How do you facilitate empowerment?
-ethical principles
-communication
-autonomy
-access to resources
-collaboration
What are barriers to empowerment?
-taking risks
-anxiety and fear
-paternalistic attitudes in health care
-institutional norms
-social, cultural, political factors
-limited resources, stereotypes
Define whistle blowing
speaking out against unsafe or questionable practice
What are the three things that must be explored before deciding to whistle blow?
1) serious or potential harm to the public
2) reported problem appropriately through the proper systems or person
3) the whistle blower must be sure or have evidence that speaking out will result in positive change
Define epidemic
the occurrence in a community or a region of cases of an illness, specific health-related behaviour or other health-related events clearly in excess of normal expectancy
Define pandemic
an epidemic occurring worldwide or over a wide area crossing international boundaries, and affecting a large number of people
