Midterm Flashcards
The Middle Ages (5th-15th Centuries)
- A period of significant scientific change
- Famine, plague, and war made populations vulnerable to the onslaught of epidemic disease.
- Healing was often sought through religious interventions such as by religious relics and by visiting sacred places.
- Nurses believed their duty was to God and to the spiritual rather than the need of the patient.
- Physical, emotional and comfort needs were set aside.
- Mental illness was viewed as possession by the devil or punishment for sins.
- Patients were chained, starved, kept under filthy conditions, and at times tortured.
Renaissance (15th-17th centuries)
- Birth of scientific revolution and a new era in the healing arts.
- Cartesian philosophy resulted in a separation between the acts of caring and curing.
- Nurse’s role restricted to the caring realm of the healing arts.
- Caring was given lower priority than healing. Medicine overshadowed nursing++
- Nursing care provided by nuns
reformation
- “Dark period of nursing” in Britain
- Nursing care removed from the nuns.
- Hospital care provided by convalescent patients, prostitutes, prisoners, and drunkards.
- Conditions in hospitals became deplorable.
- Much of Canada’s hospital care originated from France, not Britain
- Lay women such as Marie Hebert (arrived in Quebec in 1617) came from France to open hospitals and care for the Aboriginal populations
The Modern Era
- Nursing as we know it today began to emerge in the modern era (18th-19th centuries).
- Nursing training schools emerged, social justice was fought for.
- Florence Nightingale (born in 1820, died in 1910) worked to free nursing from the bonds of the church; became a model for all nurses; described nursing as ‘caring for the mind and body’ (first reference to holistic nursing); and addressed moral and social issues.
ethical philosophy
- The intense and critical examination of beliefs and assumptions
- offers principles for deciding what actions and qualities are most worthwhile
philosophy of practice
-Includes assumption about norms and values
- Includes ethics, social and political philosophy, and philosophy of law.
- It is philosophy of practice, specifically moral philosophy, that provides the groundwork for discussion of many of the ethical dilemmas nurses must face
moral philosophy
the philosophical discussion of what is considered good or bad, right or wrong, in terms of moral issues
ethics
a formal process for making logical and consistent decisions, based upon moral philosophy
morality
traditions or beliefs about right and wrong
naturalism
- matter of feeling
- Ethics is dependent on human nature and psychology
- Differences in moral codes are a result of social conditions
- All people have similar underlying psychological tendencies, suggesting universality in moral judgment
- All people have tendency to make similar ethical decisions
- Sympathy/empathy is a motivating factor in moral decision making
- What is best in this case?
- Utilitarianism
rationalism
- matter of reason
- All people have unique feelings and perceptions
- Ethical values have an independent origin in the nature of the universe and can become known to humans through the process of reasoning
- Truths about the world are universal and superior to what we receive from our senses and experiences
- Moral/ ethical rules originate from a higher source and are always true
- What is right always?
- deontology
utilitarianism
- consequentialism
- based in naturalism
- Action is judged as good or bad in relation to the consequence, outcome, or end
- Right action is that which has the greatest utility or usefulness (no action is in itself good or bad, always depends on the end derived from them)
Forward looking
deontology
- Kantianism
- based in rationalism
- Rightness or wrongness of an act depends upon the nature of the act, rather than its consequences.
- We must fulfill certain duties owed to others
- We must all act as members of a community of equal and autonomous individuals, and each member must treat all others as moral beings. Each person should have regard for the desires of others and allow for freedom of decision.
- backward looking- what is driving us? Motivating us?
- Most professional codes of ethics are based upon Kantian principles
virtue ethics (character ethics)
- Actions of individuals are based on a certain degree of innate moral virtues
- Shifts our focus from the action (what we ought to do) to the actor (who we are, and what moral virtues we value)
- A person with moral virtue has consistently moral action and a morally appropriate desire
5 focal virtues
compassion
discernment
trustworthiness
integrity
conscientiousness
fundamental virtue
caring
relational ethics
- Requires that we focus on the relationship as a significant and central aspect of health care ethics
1) Mutual respect (respect for an attention to difference)
2) Engagement (aim to strive for authenticity and connection)
3) Embodiment (holistic care, consideration of emotion and subjective experience alongside empirical knowledge)
4) Environment (how relationships connect us to larger social groups, systems, and communities)
bioethics
- Support the improvement of client care by assisting clients, families, staff, physicians & volunteers resolve ethical issues.
- Case consultation
- Ethics education
- Policy development
- Research on ethical issues
Jurisprudence exam
tests:
- Nursing regulation
- Scope of practice
- Professional responsibility and accountability
- Ethical practice
- The nurse-client relationship
150 multiple choice, 3 hours and 15 minutes
$40 fee
unlimited attempts, ($40 each time)
knowledge and comprehension
application
critical thinking
ethical principles
basic and obvious moral truths that guide deliberation and action
Respect for autonomy
Beneficence
Non-maleficence
Veracity
Confidentiality
Justice
Fidelity
paternalism
acting in a dominant manner, possibly on behalf of the patient.
veracity
truth telling
justice
fair, equitable, and appropriate treatment
fidelity
- promise keeping
nurses have 4 fundamental responsibilities
to promote health,
to prevent illness,
to restore health
to alleviate suffering.
values
- Values are ideals, beliefs, customs, modes of conduct, qualities, goals preferred by people, groups and society
- Learned in conscious and unconscious ways, become ingrained and guide us in making decisions/choices
axiology
- Branch of philosophy that studies values
- Includes the study of aesthetics, or what is “right” or “wrong” in human relations and conduct
moral thought
individual cognitive evaluations of right and wrong, good and bad (what you think)
moral values
preferences or dispositions that reflect right or wrong in human behaviour (what you ought to do)
how are values acquired
- Developed over time, may stay with us or change in response to our development, experiences, education, and exposure to other perspectives
- What are the influences that help to shape our values?
- Conscious acquisition (instruction by parents, teachers, mentors, religious leaders, etc.)
- Unconscious acquisition (socialization and role-models)
moral autonomy
- The most important step in values formation is one’s freedom to choose those values most cherished and to relinquish those that have little meaning
- taking responsibility for our own values and beliefs
- stop embracing values of other and embrace our own values instead
self awareness
- Ethical relationships begin with self-knowledge and our willingness to express that awareness to others honestly and appropriately
- What we believe to be the truth is always coloured by our perceptions and surrounding contextual forces, and can change over time
- We must remain open to other perspectives, and attempt to understand the reasons others have for the decisions they make
- Self-knowledge is an ongoing, evolving process that requires us to make a commitment to know the truth about ourselves
values clarification
- process of becoming more conscious of and articulating what we value or consider worthy
- Reflection sheds light on our personal perspective and develops insight into our values which in turn improves our ability to make decisions
values conflict
When personal values are in conflict or at odds with a patient’s, colleague’s, or institution’s values interpersonal conflict may result.
moral integrity
authenticity: maintaining and articulating consistent fundamental values and beliefs over time
overt values (explicit values)
- explicitly communicated through documents or mission/vision/value statements
covert values (implicit values)
-implicit expectations not in writing, often only identified through the process of working through a challenging or centious situation, which highlights unspoken expectations or norms that are apart of the value system of that organization
moral distress
- Reaction to a situation in which there are moral problems that seem to have clear solutions, yet we are unable to follow our moral beliefs because of external restraints.
- Knowing the morally right action to take but being prevented from doing so by institutional constraints
- Evidenced by anger, dissatisfaction, frustration and poor performance in the work setting.