Introduction to Nursing Law and Ethics (using the pandemic as a case)

Question 1

Why is nursing ethics important?

Answer 1

Historically, nurses were concerned with loyalty to physicians, punctuality and obedience

Question 2

Ethical Decision Making Framework Approach to Case-based Learning

Answer 2

1. Describing and defining the issue
2. Examining the values and principles in the situation
3. Defining the legal, organizational, regulatory rules and guidelines
4. Exploring similar cases and situations
   Outlining the course of action
   Evaluation the course of action and decision making

Question 3

Why is nursing ethics important?

Answer 3

historically nurses were concerned with loyalty to physicians, functionality, and obedience

Question 4

why is nursing ethics important? (today’s nursing practice)

Answer 4

Is autonomous and distinct from medicine, with unique ethical challenges

Possesses a set of professional standards and a framework of legal and ethical guidelines

Has its own ontology (relationship with reality) and epistemology (theory of knowledge)

Question 5

Nurses are able/expected to…

Answer 5

Nurses are expected to think critically, to offer evidence-informed solutions, to respectfully challenge other healthcare professional when they have concerns

Question 6

What position are nurses in?

Answer 6

Nurses are in the position of respect and power

Question 7

What are professions becoming?

Answer 7

professions are becoming more specialized, new professions are emerging. This often results in an expanded scope of practice.

Question 8

Why are ethics needed?

Answer 8

ethics are needed because of the technological advances, increasing complexity of healthcare and growing sophistication of science and technology (i.e., genetics)

Question 9

What do Canadians celebrate?

Answer 9

Canadians celebrate differences in values and beliefs

Question 10

Nursing Professional responsibilities (4)

Answer 10

Have an obligation to serve public interest and the common good

Possess a unique body of knowledge

Have multiple accountabilities

Are trusted to engage in decisions that influence and shape public policy, law, and societal norms

(CNO entry-to-practice competencies)

Question 11

Healthcare professionals need to know the law because

Answer 11

Failure to understand professional responsibilities and standards put the nurse at risk of disciplinary or legal action

Complex situations can arise before laws can be made to deal with them

Nurses have legal obligations to their patients

Nurses have corresponding rights

Question 12

Why the need for nurses to study ethics?

Answer 12

Nurses should study ethics because morality and care is at the heart of nursing practice, nursing practice as part of a team, but with different perspectives

Question 13

Ethics play a role in context of: (nurses need to study ethics)

Answer 13

Nurse client relationships, healthcare policy, healthcare organizations, healthcare system as a whole

Question 14

What is deontology

Answer 14

also known as the code of ethics

Question 15

a code of ethics represents

Answer 15

a key characteristic of professional body, a public declaration of a profession’s societal mission, a formal expression of a profession’s values and responsibilities

Question 16

CODE OF ETHICS for REGISTERED NURSES

Answer 16

1 - providing safe, compassionate, competent and ethical care

2 - promoting health and well-being

3 - Promoting and respecting informed decision making

4 - Perserving dignity

5 - Maintaining privacy and confidentiality

6 - Promoting justice

7 - Being accountable

Question 17

The CNA code of ethics for registered nurses…

Answer 17

was first published in 1980, has been periodically revised (most recently in 2018)

it offered nurses a framework for ethical practice

Question 18

The two parts of CNA code of ethics for registered nurses

Answer 18

1 - nursing values and ethical responsibilities

2 - ethical endeavours

Question 19

The code of Hammurabi

Answer 19

(1790 BC) is the first recorded collection of laws and ethical codes, in which: Justice was strict (an eye for an eye), the behaviour of women was regulated and class distinctions occurred.

Question 20

The Hippocratic Oath

Answer 20

(400 BC) contains principles found in modern day codes like beneficence and nonmaleficence, sanctity of life, competence, professional integrity, privacy and confidentiality

Question 21

The Nuremberg Code

Answer 21

(1947) was established after the trials of nazis accused of human experimentation

Question 22

What does the Nuremberg code (1947) reaffirm?

Answer 22

This code reaffirms that research must be conducted with adherence to the ethical principles of informed consent (autonomy), beneficence, and nonmaleficence

Question 23

Early nursing ethical codes (history of nursing codes of ethics)

Answer 23

had a strong foundation in christian mortality, focused on obedience, compliance, etiquette, and loyalty to the physician, and were less focused on judgement, reflection, or critical thinking

EX: the Nightingale Pledge (pg 62)

Question 24

Nursing values and ethical responsibilities: Part I of the code is organized around seven values. Those seven values are…

Answer 24

1 - providing safe, compassionate, competent and ethical care

2 - promoting health and well-being

3 - Promoting and respecting informed decision making

4 - Perserving dignity

5 - Maintaining privacy and confidentiality

6 - Promoting justice

7 - Being accountable

Question 25

1 - (providing safe, compassionate, competent and ethical care) - ethical responsibilities in this section include...

Answer 25

using speech and body language to demonstrate compassion, questioning unsafe care, collaborating with others to provide safe care, providing care during a natural or human-made disaster, preventing and minimizing all forms of violence

Question 26

2 - (promoting health and well-being) ethical responsibilities in this section include...

Answer 26

providing care directed first and foremost to the person, family, or community in their care, advocating for the least restrictive measures possible measures possible for those in their care, and collaborating with others to maximize health benefits

Question 27

3 - (promoting and respecting informed decision making) when caring for a capable person, ethical responsibilities include...

Answer 27

providing information needed for informed decisions, recognizing that individuals may chose to defer to family or community values in decision making, supporting the right to refuse or withdraw consent for treatment, and respecting the choice to engage in unhealthy lifestyles or treatments

Question 28

4 - (preserving dignity) ethical responsibilities include...

Answer 28

relating to all persons with respect, intervening when others fail to do so, taking into account a person's unique values, customs, and beliefs as well as their social circumstances, providing care in a discreet manner, maintaining professional boundaries, advocating for a dignified and peaceful death

Question 29

5 - (maintaining privacy & confidentiality) ethical responsibilities that relate to the collection, use, access to, and disclosure of personal and health information include

Answer 29

respecting information and adhering to privacy laws, taking reasonable measures to avoid being overhears when conversing with patients, taking care not to access information inappropriately, intervening if others inappropriately access or disclose information

Question 30

6 - (promoting justice) ethical responsibilities include...

Answer 30

avoiding discrimination (on any grounds) when providing care, refraining from judging, stigmatizing, or demeaning behaviours, refusing to engage in any inhumane or degrading action, and intervening with other do so, and making fair decisions and advocating for fair allocation of resources

Question 31

7 - (being accountable) ethical responsibilities include ...

Answer 31

practising with honesty and integrity, in accordance with the code, practising within the limits of competence, protecting the safety of others when a colleague is unable to perform his or her duties, clearly and accurately representing themselves by name, title, and role, and identifying and addressing conflicts of interest

Question 32

Nursing values and ethical responsibilities: Part II of the code is ethical endeavours which is divided into....

Answer 32

what roles the nurse has and how the code challenges the profession of nursing

Question 33

nurses have a role in the provision of social justice, including advocating for....

Answer 33

policies to address the social determinants of health, accessible, universal, comprehensive health care services, environmental preservation, positive, healthy work environments, and the resolution of global health issues

Question 34

this section of the code challenges the profession of nursing to work collectively with others to:

Answer 34

recognize the diversity of the Canadian population, consider the challenges that influence the health and well-being of the world population, strive to reduce the disparities due to: poverty, homelessness, vulnerability.

Question 35

in the end, the code draws attention to those who are vulnerable in our society, including...

Answer 35

children, the elderly, visible minorities, and the homelessness

Question 36

the Canadian healthcare act

Answer 36

1 - public administration (all administration of provincial health insurance must be carried out by a public authority in a non-profit basis) 2 - Comprehensiveness (all necessary health services, include hospitals, physician and surgical dentists, must be insured) 3 - Universality (all insured residents are entitled to the same level of health care) 4 - Portability (a resident that moves to a different province or territory is still entitled to coverage from their home province) 5 - Accessibility (all insured persons have reasonable access to health care facilities

Question 37

Ethical committees: may provide one or more of the following functions...

Answer 37

consultation - advice/support in ethical decision making Education - through in-services, workshops, case presentations, and internal publications Policy making - by establishing policies or guidelines to assist staff in dealing with complex issues

Question 38

summary - a better understanding of ethics with assist nurses in making and defending ethical choices. Nurses have the opportunity to...

Answer 38

defend and protect patient's rights, promote compassionate care, enhance the dignity of their patients understanding