Nursing Values and Ethics Flashcards
Define ethics
the study of the philosophical ideals of right and wrong behaviour based on what you think you ought (or ought not) to do
Define values
a strong personal belief and an ideal that a person or group (such as nurses) believe to have merit
- influences behaviour
- reflects cultural and social influences, relationships, and personal needs
- varies among people, develops and changes over time
Define nursing ethics
focuses on the moral questions within the sphere of nursing practice, the nurse-patient relationship, the moral character of nurses and the nurse as a moral agent
- we direct our actions that lead to good and positive outcomes
According to CNA Code of Ethics, what are the two keys of ethics?
Self-reflection and dialogue
“Nurses need to recognize that they are moral agents in providing care..they have a responsibility to conduct themselves ethically in what they do..this includes self-reflection and dialogue”
What is the purpose of CNA Code of Ethics?
To serve as a foundation for nurses’ ethical practice
Provide guidelines to follow and help us work through ethical challenges
What are the two parts of CNA Code of Ethics?
Part I: Values and Ethical Responsibilities
Part II: Ethical Endeavours related to broad societal issues
Define: Ethical Problem
Conflicts between one or more values and uncertainty about the correct course of action
Define: Ethical Dilemma
When there are equally compelling reasons for and against one or more possible courses of action (a type of ethical problem)
- once you choose one, you dismiss the other
Define: Ethical (moral) distress
Nurses know or believe they know the right thing to do, but do not or cannot take the right action
- could be structural or system issues, personal limitations (not strong enough weigh or voice)
Define: Ethical Residue
What nurses experience when they seriously compromise themselves or allow themselves to be compromised
- i.e. you didn’t say something and you allowed compromise
Define: Ethical Disengagement
Can occur if nurses begin to see the disregard of their ethical commitment as normal
Define: Ethical Courage
Is exercised when nurses stand firm on a point of moral principle or a particular decision about something in the face of overwhelming fear or threat to themselves
- i.e. say what they want to say and is consistent
A nurse demonstrates the standard of “ethics” by
- Identifying ethical issues and communicating them to the health care team
- Identifying options to resolve ethical issues
- Evaluating the effectiveness of the actions taken to resolve ethical issues
- Identifying personal values and ensuring they do not conflict with professional practice (are you arguing on behalf of client to advocate or is it personal?)
CNO ETP Competencies on ethical practice
80 Demonstrate knowledge of the difference between ethical and legal considerations and their relevance when providing nursing care
Ethical Considerations in Relationships
Nurses: power differentials, treat one another in a respectful manner, share knowledge, provide feedback and guidance for professional development
Students: informs and requests permission from client
Nurses and Nursing students: place the safety and well-being of the person in care above all other objectives, including fulfilling educational obligations
What are the role of values?
Inner standard that motivates us to do what we do
Influences our judging of good and bad
Influence how we interpret dilemmas and take next steps
How are values formed?
a. Family experience
b. Moral development
c. Cultural, ethnic, and religious communities
d. Individual experience
Professional nursing values
- provide safe, compassionate, competent and ethical care
- promote health and client well-being
- promoting respect and informed decision making (choice)
- honouring dignity
- maintaining privacy and confidentiality
- promoting justice (fairness)
- being accountable
- respect for life
- maintaining commitment
- truthfulness
Values Clarification
The process of appraising one’s values helps a person decide priorities and make decisions
- identify one’s own values and beliefs (self check, not about you)
- leads to better understanding of others
- plays a key role in communication
- be aware of values of employers, patients, physicians and others
Personal and professional values
- values are culturally formulated
- we know what we know as a result of our knowledge in our role
How do ethical theories help decisions making?
Six theories
- introduces clarity
- helps to identify, articulate and analyze ethical concerns/dilemmas
- facilitates the development of justifiable action
Deontology
Defines actions as right or wrong
- based on fidelity to promises, truthfulness and justice
Utilitarianism (consequentialism)
Proposes that the value of something is determined by its usefulness
- the greatest good for the greatest number of people
Bioethics
Obligation-based, outcome-oriented, based on reason
- four guiding principles: autonomy, beneficence, non-maleficence and justice
- examine each situation and decide which principle has priority
Feminist ethics
Focuses on inequalities between people
- being attentive to issues of difference: power dynamic or structure within a system
Relational ethics
Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives
Virtue ethics
Focuses on question of character rather than action
- how we ought to be vs how we actually act
Explain Beneficence
guiding principle of bioethics
- to protect the patient from harm
- to promote the patient’s welfare
- rooted in utilitarianism
Explain Autonomy
guiding principle of bioethics
- person self-governance, patient choice
- free from controlling interferences
- choice, privacy, self-mastery, freedom, self-determination
Explain Non-maleficence
guiding principle of bioethics
- obligation to do no harm
- one ought not to inflict evil or harm
- one ought to prevent evil or harm
- one ought to remove evil or harm
Explain Justice
guiding principle of bioethics
- fair, equitable and appropriate distribution of societal goods, including health care services
- unbiased allocation of resources
Process of working through ethical conflict
a. assessment/description of situation
- examine beliefs, values, knowledge of self and others
- consider policies and guidelines
b. plan/approach
- take into account factors from assessment, options, and consequences
- decide best course of action
c. implementation/action
- good communication and interpersonal skills are key
d. evaluation/outcome
- determine if the result is satisfactory
- reassess and re-plan if needed
7 steps to analyze an ethical dilemma
- determine whether the issue is an ethical dilemma
- gather all relevant information
- examine and determine your own values
- verbalize the problem
- consider possible course of action
- reflect on the outcome
- evaluate the action and the outcome
What are some ethical issues surrounding patient care?
- futile care (quality of life)
- advanced care planning
- medical assistance in dying
- allocation of (scarce) resources/access to care
Issues of Safety in the Work Environment
Moral distress: know or believe they know the right thing to do but for various reasons (some beyond one’s own control), do not or cannot take the right action to prevent a particular harm
Moral integrity: ethical sensitivity to be aware of harm that is being caused
Moral residue: compromise themselves or allow themselves to be compromised because of situational constraints
