Nursing Ethics 🧑⚕️🩺🏥 Flashcards
What are the Difficult ethical encounters experienced by nurses in the clinical setting?
Oncology nurses encounter ethical dilemma more frequently in terms of:
a. Resuscitation state of the patient
b. Futile treatment
c. Not telling the truth
d. Dying with dignity
e. Conflicting values in pain management
f. Use of resources
g. Decision-making at the end-of-life care
h. Giving bad news (Baysal et al., 2019) h
Emergency care providers are frequently with stressful situations where they have to make decisions quickly but face barriers to ethical decision-making
what are the face barriers to ethical decision-making ?
a. Perception of the situation
b. patient-related factors
c. input and output imbalance
d. uncoordinated health system (Storaker et al., 2019)
Unsupportive organizational environments
What are the Organizational environments at times fail to be supportive.
- Low staffing levels
- Overload of work
- Hierarchical interactions that do not promote the dignity of nurses
Unsupportive organizational environments
Specifically, nurses’ ethical conflicts were related to situations
- Violated the rights, safety or well-being of the patient or relatives
- Those that threatened nurses’ dignity and professionalism
- Inadequate attention to the moral conflict of nurses’ values
- The physician-nurse power hierarchy
- The influence of culture and insufficiency of patient care
- Professional collaboration (Usberg et al., 2021, Ko et al., 2019)
. Moral Distress / Ethical Dilemma by professional nurses, newly-graduates and nursing students
Oftentimes, all of these challenges bring moral or ethical distress to nurses that can profoundly affect their nursing behavior and nursing practice to the detriment of patient health outcomes
Specifically, feelings of moral distress were associated with the following:
Professional anguish over patient care decisions, e.g. concerns of continuing life support measures perceived not in the patient’s best interest or futile care
2. Team and unit level concerns e.g. poor communications, bullying, working with incompetent colleagues, witnessing practice errors and lack of collegial collaboration;
3. System-level factors e.g. feeling unsupported by senior administration and institutional culpability as a result of health care processes and system constraints impeding reliable patient care delivery. (Prompahakul & Epstein, 2020, Vincent et al., 2020, Deschenes et al., 2020)
Such moral distress experienced in an ethical climate has been shown to affect nurses’ behaviors
Unaddressed moral distress may lead to:
1.Withdrawal from the moral dimensions of patient care (Prompahakul et al., 2021)
2. Moral disengagement leading to ethical insensitivity (Haahr et al., 2020),
3. Burn-out (Prompahakul et al., 2021, 40 Haahr et al., 2020)
4. Ultimately causing nurses to leave the profession. (Prompahakul et al., 2021)
Their vulnerability to negative workplace culture because of distress is from the following:
- Bullying
2.Exclusion - Being a scapegoat
- Collegial incivility can cause ethical tensions making them doubt their capabilities due to lack of experience
- At worst, new graduates experience disillusionment from lost ideals about ethical practice. (Hazelwood et al., 201
Central to the study of ethics is the concept of human acts.
BASIC ETHICAL CONCEPTS
the object of study of ethics, are voluntary acts which proceeds from the free will. Human acts depend on human’s judgment and choice hence entail a moral responsibility. Human acts form the human personality and structure. Human acts that humans perform, build up their lives. The doing or the absence of doing builds the kind of life the person lives. (Ocampo, 2018) The kind of life that is good, well and happy. For patients, the kind of life that is healthy
Human acts
asserted that, in the study of moral philosophy or ethics, human acts are said to be proceeding from man’s will according to the dictates of reason. Acts performed by the individual which are not subject to his will and reason are not called strictly human acts but rather are natural acts. (Ortigas, 2006, p. 66) Human acts are proper to man since it is performed by a human being. However, not every act that a human being does is distinct to man. There are acts that human beings do which are also performed by animals
Thomas Aquinas
Actions done Consciously and freely by the agent/or by man
Human Acts
What are the 3 ESSENTIAL QUALITIES/ Constituent Elements of Human Acts
- Knowledge of the act
- Freedom 3. Voluntariness
Actions beyond one’s consciousness; not dependent on the intellect & the will.
Natural Acts of Man
What are the 3 ESSENTIAL QUALITIES of Acts of Man
• Done without knowledge
• Without consent
• Involuntary
What are the 3 ACTS not morally accountable
• Acts of persons asleep or under hypnosis.
• Reflex actions where the will has no time to intervene
• Acts of performed under serious physical violencee.g. a hostage obliged to do an evil action.
is central to the study of ethics because of the responsibility and/or accountability that comes with it.
Human Act
is that field of philosophy that specifically studies human acts in the light of morality. The issue of man’s action in every stage of life will always be a source of enduring philosophical wonder.
Ethics
Who quote this “the unexamined life is not worth living”
Socrates
nursing philosopher first introduced moral distress, known as moral dilemma in his book in 1984, which means ethical distress.
Jameton
he believed that a person will encounter such a negative experience when that person knows the right way for performing something but organizational limits would make the execution impossible for him. 4-9
Jameton
presented the first model of moral distress which he defined as the experienced mental imbalance and negative emotion when the individual makes an ethical decision but is not able to act in line with their decision.
Wilkinson
Specific example of Ethical Dilemma nurses encounter
A young woman asking for abortion because she is not ready for a baby and has no job. You as a nurse believe in the inviolability of life yet you also understand the young woman’s predicament on raising the child and respect her autonomy.
2. A woman with congestive heart disease is pregnant, being asked to terminate pregnancy but wants to deliver the baby to full term despite the risk on her part. - you respect the patient’s autonomy and also believes in the inviolability of life yet you also recognize the risk and harm the patient is facing due to her pregnancy,
3. A cancer patient in pain asking for more morphine despite being given already the prescribed dosage. you understand the suffering of the patient but you also recognize the harm that morphine can do and can’t do on terminal pain.
the author of Ethics Primer, wrote an exhaustive chapter on the She Liza Ocampo, the antiqued Plato’s form of Good According to her of Plato believeral good. She wrote that Aristotle critiqued Ple, Aristotle argued that there exists multiple virtues that there is a single form of good and virtuaired through the Practice of habit. (Ocampo, 2018, varying degrees. These virtues can be in his Nicomachan This after the name of his 301.056) Furthermore, Aristotle as serred world for him, allows for degrees, levels and difference
Dr. Ma. Liza Ocampo,
give Key Points on Moral Good
• The sense of good or the good of man can be understood not only on how the said good affects himself but also with those around him since man is a political animal
• Aside from existing degrees, levels and differences, the senses of good can be understood in an empirical manner. The good (of human experience) has to be seen, heard, touched, tasted and felt.
• All forms of good actions seek happiness.
is a good which is desired in itself because of its intrinsic goodness, which means that man naturally tends towards these goods. Example: any virtue, health, science and wellness
Honorable good
is the same honorable good in as much as its possession silences desire and produces joy. Examples are any sense-perceptible good in so far as it produces pleasure or delight and the satisfaction produced by a virtue of scientific knowledge.
Pleasurable good
is a good which is not desired for its own goodness but for the sake of attaining some other good. It is a good which is desired as a means. It is not desired for its own sake but for the sake of honorable or pleasurable good. Any useful good is directed towards an ultimate good. Example: bitter medicine to obtain health or a painful surgery to help a person recover from a diseased organ and be healthy
Useful good
analogous and relate to each other in varying situations. The character of being good primarily befits the honorable good, secondarily the pleasurable good and remotely, the useful good.
• The honorable, pleasurable and useful goods
are linked together since the source of joy is the good and the root of pain is evil. The good is delightful and causes greater satisfaction while privation of good/evil or bad results to sadness and pain.
• The honorable and the pleasurable good
• Sometimes the _____________ is dissociated from the pleasurable good. Badness or evil can be pleasing because of some good that accompanies it but not necessarily honorable. The delight produced by this is transitory and deceptive and oftentimes in the end is transformed into pain
honorable good
