MIDTERM EXAM Flashcards
What is ETHICAL/MORAL PRINCIPLES
-Statements about broad general, philosophical
concepts
* Provide the foundation for moral rules which
are specific prescriptions for action
* Useful for ethical decisions
What are the examples ETHICAL/MORAL PRINCIPLES
- AUTONOMY
- NONMALEFICENCE
- BENEFICENCE
- FIDELITY
4.5. Justice - VERACITY
- ACCOUNTABILITY
- RESPONSIBILITY
➢ Right to make one’s own decisions
➢ Each client is unique
○ Has the right to be who that
individual is & right to choose
personal goals
➢ Nurses must treat clients with
consideration
Autonomy
RESTRICTIONS/LIMITATION
➢ If there is potential harm to self or others
➢ communicable diseases or acts of
violence
ELEMENTS or Parts of Autonomy
A. PATIENT’S RIGHTS
B. PATIENT’S BILL OF RIGHTS
C. INFORMED CONSENT
CONFIDENTIALITY
PRIVACY
Proxy Consent
A. PATIENT’S RIGHTS
○ Right to Appropriate Medical
Care and Humane Treatment.
○ Right to Informed Consent.
○ Right to Privacy and
Confidentiality.
○ Right to Information.
○ The Right to Choose Health Care
Provider and Facility.
○ Right to Self-Determination.
○ Right to Religious Belief.
○ Right to Medical Records.
○ Right to Leave.
○ Right to Refuse Participation In
Medical Research.
○ Right to Correspondence and to
Receive Visitors.
○ Right to Express Grievances.
○ Right to be Informed of His
Rights and Obligations as a
Patient.
a document that provides patients with
information on how they can reasonably
expect to be treated during the course of
their hospital stay.
PATIENT’S BILL OF RIGHTS
➢ specific wording varies from hospital to
hospital, most bills of rights include the
following focus areas:
○ High-quality hospital care
○ A clean and safe treatment
environment
○ Involvement in care o Protection
of patients’ privacy
○ Help with patients’ billing and
insurance claims
○ Preparing for the end of patients’
hospital visits
- Agreement by
a client to accept a course of treatment
or a procedure after being provided
complete information, including the
benefits and risks of treatment,
alternatives to treatment option that the
patient wishes to receive or not to
receive
INFORMED CONSENT
Two types of Consent:
Express
Implied
What is usually naa sa INFORMED CONSENT?
complete information, including the
benefits and risks of treatment,
alternatives to treatment
3 major elements of informed consent:
- Consent must be given voluntarily.
- Consent must be given by a client or
individual with the capacity &
competence to understand. - Client or individual must be given
enough information to be the ultimate
decision maker
Parts of Informed Consent
● The diagnosis or condition that requires
treatment
● The purposes of the treatment
● What the client can expect to feel or
experience
● The intended benefits of the treatment
● Possible risks or negative outcomes of
the treatment
● Advantages and disadvantages of
possible alternatives to the treatment
(including no treatment)
➢ The process by which people with the
legal right to consent to medical
treatment for themselves or for a minor or a ward, delegate that right to another
person.
D. PROXY CONSENT
3 fundamental constraints:
- The person making the delegation must
have the right to consent - The person must be legally & medically
competent to delegate the right to
consent - The right to consent must be delegated
to a legally & medically competent adult
- keeping of another person or entity’s information private
CONFIDENTIALITY
➢ refers to the right of an individual to
keep his or her health information
private
➢ the right of individuals to withhold
themselves and their lives from public
scrutiny
○ right to be left alone
PRIVACY
What law protects confidentiality of the patient?
Data Privacy Act - RA 10173, 2012
➢ “do no harm”
➢ Not placing someone at risk of harm &
unintentionally causing harm
Nonmaleficence
➢ “doing good”
➢ Implement actions that benefit clients
Beneficence
➢ Fairness
➢ Weigh the facts carefully in order to
divide time or services justly
Justice
➢ loyalty
➢ Faithful to agreements and promises
➢ involves loyalty, truthfulness, promise
keeping, advocacy and respect
➢ Nurses have responsibility to clients,
employers, government, profession,
society and to themselves
Fidelity
➢ Truth telling
➢ Having Integrity
➢ Professional accountability &
responsibility
Veracity
➢ answerable to oneself and others for
one’s own actions.
➢ means you are liable or answerable for
one’s actions. In order to be responsible,
you must be accountable and vice versa
Accountability
➢ the specific accountability or liability
associated with the performance of
duties of a particular role
➢ involves having authority over one’s
actions.
Responsibility
➢ provides specific guidelines for
determining when it is morally
permissible to perform an action in
pursuit of a good end in the full
knowledge that the action will also bring
about bad results (David Solomon, The Encyclopedia of Ethics)
➢ An action that is good in itself has two
effects
➢ guidelines for determining when it is
ethically permissible for a human being
to engage in conduct in pursuit of a
good end with full knowledge that the
conduct will also bring about bad
results.
Principle of double effect
4 BASIC MORAL CRITERIA:
- The intervention or act itself must be
good or at the very least, indifferent - The intent of the intervention must be
good - The good must be the result of the act
and not the result of the bad effect. - There must be a compelling necessity
for the act- the benefits must outweigh
the costs
➢ This principle is aimed in helping
individuals discern how to properly
avoid, limit, or distance themselves from
evil in order to avoid a worse evil or to
achieve an important good.
Principle of legitimate cooperation
criteria to judge how legitimate your
cooperation with the evil is
➢ The moral object of your action is good,
and you are operating out of good
intentions.
➢ Your cooperation is only material
cooperation, not formal
➢ Your cooperation is remote rather than
proximate, so it causes minimal evil
effects
➢ Your action does not cause scandal
➢ certain general conditions that
are…equally to everyone’s advantage
➢ the sum total of social conditions which
allow people, either as groups or as
individuals, to reach their fulfillment
more full and more easilv.
➢ used in various contexts to identify
actions or outcomes that have some
definable benefit that extends beyond
individual gain.
Common good
➢ the doctrine holds that nothing should
be done by a larger and more complex
organization which can be done as well
by a smaller and simpler organization.
○ activity which can be performed
by a more decentralized entity
➢ The principle states that only those
decisions and tasks that cannot be
effectively decided upon or performed
by a supported or subsidized lower level
authority ought to be relegated to a
more central or higher authority.
Subsidiarity
- Grounded in the presupposition that God
has absolute Dominion over creation, and
that, insofar as human beings are made in
God’s image and likeness, we have been
given a limited dominion over creation and
are responsible for its care
PRINCIPLE OF STEWARDSHIP
- is caring for the gifts God has given us,
including the environment, our own personal
talents and other resources
*being responsible guardians - humans are merely stewards with a
responsibility to protect and cultivate
spiritual and bodily functions.
STEWARDSHIP
- Nurse leaders
- directly centered on working with nurse
practitioners and nurse educators to
transform the practice environments in
which they work - to make practice environments
more positive, healthy and engaging
NURSE’S ROLE:
What is the nurse’s role?
- to make practice environments
more positive, healthy and engaging
- refers to the execution of responsibility of
the health care practitioners to look after,
provide necessary health care services, and
promote the health and life of those
entrusted to their care.
HEALTHCARE:
- development of self
- refining skills and improving competencies
- Become visible and sound role models
within their institutions to maintain the
balance between self and professional
PERSONAL:
- actions taken by individuals, groups or
networks, with various motivations and
levels of capacity, to protect, care for or
responsibly use the environment in pursuit
of environmental and/or social outcomes in diverse social- ecological contexts
ENVIRONMENTAL/ECOLOGICAL:
- refers to each individual’s duty to
“preserve a view of the whole human
person in which the values of the intellect,
will, conscience and fraternity are utmost
importance”
INTEGRITY
- Refers to the duty to preserve intact the
physical component of the integrated bodily
and spiritual nature of human life, whereby
every part of the human body “exists for the
sake of the whole as the imperfect for the
sake of the perfect”. - The whole is greater than any of
its parts
TOTALITY:
- every measure should be taken to
preserve the totality of the human body and
mind - jeopardizing the human body and
mind for other purposes is wrong
PRINCIPLE OF TOTALITY
- the process of having a medical operation
to make it impossible to have children
Sterilization
Types of Sterilization
- Direct / Surgical/ voluntary sterilization
o Tubal ligation & vasectomy - Involuntary Sterilization (with mental
illness, mentally challenged/incompetent - Forced and Coerced Sterilization
*Eugenic Sterilization
° To prevent them from having
offspring that would have the same
“abnormality” - Indirect sterilization
。 a side effect of a medical treatment
directly aimed at specific pathology
- the act of damaging something severely,
especially by violently removing a part
Mutilation
Types of Mutilation
- Female Circumcision / FGM (female
genital mutilation) - Reconstructive surgeries
o transsexual surgery
o Castration and construction of a
pseudovagina for a male
o construction of a nonfunctional
pseudo-penis and testes for the female
。 mastectomy and hysterectomy - Amputations
Who said the phrase “no one can be forced to bear the tremendous pain in the amputation of a member or in an incision into the body: because no one is held to preserve his life with such torture”
Domingo Soto (1494-1560)
- All persons have the right & duty to protect
& preserve their bodily and functional
integrity.
Preservation of Bodily Functional
Integrity
- recognized both the sanctity of life (life is
indeed sacred), and some degree of quality
of life
° a lack of quality means that life
can be let go. - humane application of the theology of
human life to health care ethics is clearly
PRINCIPLE OF ORDINARY AND
EXTRAORDINARY MEANS
measures are those that are
based on medication or treatment or other
which is directly available and can be
applied without incurring severe pain, costs
or inconveniences, but which give the
patient in question justified hope for a
commensurate improvement in his health
ORDINARY
measures are those
that are based on medication or treatment
which cannot be applied without incurring
severe pain, costs or other inconveniences.
* Their application, however, would not give
the patient any justified hope for a
commensurate improvement in his health
* it is never obligatory to make use of
medical measures that are morally
“extraordinary” in order to preserve life
EXTRAORDINARY
A means is ORDINARY which is:
- scientifically established,
- statistically successful, and
- reasonably available.
- The gift of human sexuality must be used
in marriage in keeping with its intrinsic,
indivisible, specifically human teleology. - It should be a loving, bodily, pleasurable
expression of the complimentary,permanent self- giving of a man and a
woman to each other, which is open to
fruition in the perpetuation and expansion of
this personal communion through the family
they beget and educate. - Is based on the understanding of sexuality
as one of the basic traits of the human
person and must be developed in ways
consistent with enhancing human dignity
Principle of Personalized Sexuality
Human sexuality is a complex of
VALUES:
a. physical pleasure;
b. the expression of intimate love;
C. the transmission of life to a new
generation;
d. a paradigm and symbol of more universal
forms of love.
。 Sex with prostitutes
Extramarital sex
A branch of philosophy that seeks to determine how
human actions may be judged right or wrong.
Ethics
A branch of philosophy that seeks to determine how
human actions may be judged right or wrong.
Ethics
Who said “character is of central importance to ethics, and
one cannot have a good character without having formed good
ethoi or habits.”
Aristotle
ETHICS is Greek for _____, and MORALITY comes from ______,
which is Latin for customs.
customs;mores
Refers to human conduct and values. Also may be perceived as prescriptions or rules
to guide our actions and behavior
Morality
Refers to the study of those. Also may be perceived as a set of analytical tools
or a process that helps to identify right conduct and
determine appropriate behavior
Ethics
A branch of knowledge that deals with living
organisms and vital processes.
Biology
The field of applied ethics that is concerned with the vast array of moral decision-making situations that arise in the practice of medicine in addition to the procedures and the policies that are designed to guide
such practice.
Healthcare Ethics
Healthcare Ethics AKA.
Medical Ethics
A multidisciplinary lens through which to view
complex issues and make recommendations
regarding a course of action.
Healthcare Ethics
Application of the core principles of bioethics
Autonomy
Nonmaleficence
Beneficence
Justice
Are viewed as
synonymous, health ethics is more limited as it
confines itself to the moral behavior in relation
to health.
Bioethics and Health Ethics
Moral science that deals with the
obligation of a professional
towards his profession, the
public, and to his client.
Professional Ethics
Refers to the moral, social & political problems that
arise from biology & the life sciences generally that
involve, directly or indirectly, human wellbeing.
Bioethics
“Bioethics” emerged between _____ to ____
1960s;1970
Who is the oncologist that conceptualized bioethics as a comprehensive field of thought
and action
Van Potter
Enduring beliefs or attitudes about the worth of a person,
object, idea or action.
Values
It influence decision and actions
Values
Values are learned through observation &
experience
Value Transmission
Influenced by sociocultural environment:
Societal traditions
Culture
Ethnic & religious groups
Family and peers
Internalization of
accumulative values derived
from society and environment
Personal Value
A process by which people identify, examine, and develop
their own individual values
Values Clarification
Fundamental professional nursing values
of human dignity, equality, and prevention
of suffering have not varied over time or
across groups
Clarifying Nurse’s Value
Nurses need to identify clients’
values as they influence and
relate to a particular health
problem
Clarifying Client Value
What are the process to help clarify their values.
List alternatives
Examine possible consequences of choices
Choose freely
Feeling about the choice
Affirm the choice.
Act with a pattern
The expected standards of moral
behavior of a particular group as
described in the group’s formal code of professional ethics
Ethics
The expected standards of moral
behavior of a particular group as
described in the group’s formal code of professional ethics
Ethics
Refers to private, personal standards of what is right and
wrong conduct, character and attitude.
Morality
Law reflects moral values of society
Distinguish Morality and Law
Some religions have differences in moral perspective in
relation to health
Distinguish Morality and Religion
Some religions have differences in moral perspective in
relation to health
Moral Development
Nurses can use moral theories in explaining ethical decisions and discussions of problematic situations
Ethical Theories/Moral Frameworks
Three Types of Moral Theories
Consequences
Principles & Duties
Relationships
Hold only the consequences of actions matter
morally
Teleological Theories
Actions are morally right if and only they maximize the good (or, alternatively
minimizes the bad).
Utilitarianism
Logical and formal process & emphasize individual rights, duties & obligations
Deontological Theories
Requires people to follow rules & do their duty
Kant’s Theory
Q
It stresses courage, generosity,
commitment & the need to nurture and
maintain relationships
Relationship-Based Theories
Moral norms derive their normative force from the idea of contract or mutual agreement
Contractarian Ethics
Moral judgments must be made
within the context of the entirety of a situation and that all normative features of a situation must be viewed as a whole.
Situation Ethics
An action is morally right if the
consequences of that action are
more favorable than unfavorable
only to the agent performing the
action.
Ethical Egoism
Acceptance of a conduct code based on absolute, indisputable rights and duties
Ethical Absolutism
Views moral values as entirely relative to
different societies and contexts
Ethical Relativism
Do not consider consequences
Deontological
May consider the consequences of moral actions when deciding if they are right or wrong.
Teleological
An approach that
focuses on character
with the assumption
that a person of good
character will tend to
behave in ways that
are consistent with
their character.
Virtue Ethics
Concerned with the
character of individual
nurses and seeks ways to
enable nurses to develop
character traits
appropriate for actions
that enhance wellbeing.
Virtue Ethics in Nursing
5 Essential Nursing Values
Altruism
Autonomy
Human Dignity
Integrity
Social Justice
Concern for the welfare and well being of others.
Altruism
Right to self-determination. Respect patient’s right
Autonomy
Respect for inherent worth and uniqueness of others
Human Dignity
Honesty as reflected in the code of ethics and accepted standards
Integrity
Acting in accordance with fair treatment regardless of status, socio-cultural, gender differences
Social Justice
Client is aware of alternative actions.
List alternatives
Making sure the client understands the results of each action
Examine possible consequences of choices
Ensure wise decision without any external influence
Choose freely
Verify effects of decision on client’s feelings
Feeling about the choice
Verify how clients discuss decision to others
Affirm the choice
Determine client’s consistency of behaviour
Act with pattern
