Introduction to Nursing Law and Ethics (using the pandemic as a case) Flashcards
Why is nursing ethics important?
Historically, nurses were concerned with loyalty to physicians, punctuality and obedience
Ethical Decision Making Framework Approach to Case-based Learning
- Describing and defining the issue
- Examining the values and principles in the situation
- Defining the legal, organizational, regulatory rules and guidelines
- Exploring similar cases and situations
Outlining the course of action
Evaluation the course of action and decision making
Why is nursing ethics important?
historically nurses were concerned with loyalty to physicians, functionality, and obedience
why is nursing ethics important? (today’s nursing practice)
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)
Nurses are able/expected to…
Nurses are expected to think critically, to offer evidence-informed solutions, to respectfully challenge other healthcare professional when they have concerns
What position are nurses in?
Nurses are in the position of respect and power
What are professions becoming?
professions are becoming more specialized, new professions are emerging. This often results in an expanded scope of practice.
Why are ethics needed?
ethics are needed because of the technological advances, increasing complexity of healthcare and growing sophistication of science and technology (i.e., genetics)
What do Canadians celebrate?
Canadians celebrate differences in values and beliefs
Nursing Professional responsibilities (4)
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)
Healthcare professionals need to know the law because
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
Why the need for nurses to study ethics?
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
Ethics play a role in context of: (nurses need to study ethics)
Nurse client relationships, healthcare policy, healthcare organizations, healthcare system as a whole
What is deontology
also known as the code of ethics
a code of ethics represents
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
CODE OF ETHICS for REGISTERED NURSES
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
The CNA code of ethics for registered nurses…
was first published in 1980, has been periodically revised (most recently in 2018)
it offered nurses a framework for ethical practice
The two parts of CNA code of ethics for registered nurses
1 - nursing values and ethical responsibilities
2 - ethical endeavours
The code of Hammurabi
(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.
The Hippocratic Oath
(400 BC) contains principles found in modern day codes like beneficence and nonmaleficence, sanctity of life, competence, professional integrity, privacy and confidentiality
The Nuremberg Code
(1947) was established after the trials of nazis accused of human experimentation
What does the Nuremberg code (1947) reaffirm?
This code reaffirms that research must be conducted with adherence to the ethical principles of informed consent (autonomy), beneficence, and nonmaleficence
Early nursing ethical codes (history of nursing codes of ethics)
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)
Nursing values and ethical responsibilities: Part I of the code is organized around seven values. Those seven values are…
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
1 - (providing safe, compassionate, competent and ethical care) - ethical responsibilities in this section include…
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
2 - (promoting health and well-being) ethical responsibilities in this section include…
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
3 - (promoting and respecting informed decision making) when caring for a capable person, ethical responsibilities include…
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
4 - (preserving dignity) ethical responsibilities include…
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
5 - (maintaining privacy & confidentiality) ethical responsibilities that relate to the collection, use, access to, and disclosure of personal and health information include
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
6 - (promoting justice) ethical responsibilities include…
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
7 - (being accountable) ethical responsibilities include …
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
Nursing values and ethical responsibilities: Part II of the code is ethical endeavours which is divided into….
what roles the nurse has and how the code challenges the profession of nursing
nurses have a role in the provision of social justice, including advocating for….
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
this section of the code challenges the profession of nursing to work collectively with others to:
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.
in the end, the code draws attention to those who are vulnerable in our society, including…
children, the elderly, visible minorities, and the homelessness
the Canadian healthcare act
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
Ethical committees: may provide one or more of the following functions…
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
summary - a better understanding of ethics with assist nurses in making and defending ethical choices. Nurses have the opportunity to…
defend and protect patient’s rights, promote compassionate care, enhance the dignity of their patients understanding
