Sherpath Ch 7: Ethics and Morals Reasoning Exam 3

Question 1

three types of ethics

Answer 1

Metaethics: Universal truths, Where and how ethical principles are developed

Normative ethics: Moral standards that regulate behaviors

Applied ethics: Specific issues such as:
Allowing a natural death
Capital punishment
Abortion
Health disparities

Question 2

values

Answer 2

These are attitudes, ideals, or beliefs that an individual or a group holds and uses to guide behavior

Question 3

morals

Answer 3

Provide standards of behavior that guide the actions of an individual or social group

Focus on the behaviors and actions of what to do (good) and what to avoid (harm)

Question 4

ethics

Answer 4

Reflect on the actions an individual should take and maybe “codified,” as in the ethical code of a profession.

Derived from the Greek word “ethos,” which means habits or customs

Question 5

bioethics

Answer 5

Application of ethical theories and principles to moral issues or problems in health care

Referred to as biomedical ethics

Concerned with determining what should be done in a specific situation by applying ethical principles

For example: Discussions about genetic testing have a strong bioethical component surrounding the use of knowledge.

Question 6

What is the ANA’s position regarding personal moral values in the professional setting?

Answer 6

The American Nurses Association (ANA) states “the Code [of Ethics] for Nurses is nonnegotiable and that each nurse has an obligation to uphold and adhere to the code of ethics”

Question 7

How is moral integrity differentiated from moral distress?

Answer 7

-moral integrity: Developed and maintained by the process of moral reflection, which entails a critical examination of one’s morals, beliefs, and conduct
-In a professional setting, moral integrity is attained when one’s beliefs and actions are clearly identified so that professional ethics continue to mature and respond to changes in clinical practice.

-moral distress: A phenomenon of spiritual, emotional, and behavioral anguish
-Occurs when a nurse knows the correct action to take but cannot due to either internal (lack of moral courage) or external (administrative conflict) restraints
Moral distress can affect:
-Healthcare quality and patient outcomes
-Job satisfaction and retention
-Nurse’s physical, spiritual, and emotional well-being

Question 8

What are Kohlberg’s levels of moral reasoning?

Answer 8

pre-conventional, conventional, post conventional

Stages are progressed through over time.

Progression through the stages occurs at varying lengths of time and is dependent on the individual.

Stages are sequential, build on one another, and characterized by a higher capacity for moral reasoning than the preceding stage.

Question 8

pre-conventional stage

Answer 8

preconventional: The individual is inattentive to societal norms when responding to moral problems. Their perspective is self-centered.
What the individual wants or needs takes precedence over right or wrong. For example, toddler repeatedly reaching for a breakable object
-most observed in children under 9

Question 9

conventional stage

Answer 9

-Characterized by moral decisions that adhere to the expectations of one’s family, group, or society

A person in:
-Stage 3 makes moral choices based on what is pleasing to others
-Stage 4 makes moral choices based on a larger notion of what is desired by society

“Because it is the law” or “Following known rules”

-Observed in most adolescents and adults

Question 10

post-conventional

Answer 10

Consists of stages 5 and 6:
-Involves more independent modes of thinking than previous stages
-Individuals who apply moral reasoning at the postconventional level may ignore both self-interest and group norms in making moral choices.
-Part of their moral reasoning and behavior is based on a socially agreed-on standard of human rights (Haynes et al., 2004).

In this highest level of moral development, people create their own morality, which may differ from society’s norms. Kohlberg believed that only a minority of adults achieve this level.

Question 11

Three normative ethical theories

Answer 11

virtue (best character), consequentialist (best outcome), and duty (right action)

Question 12

Deontology

Answer 12

derived from the Greek word deon, which means “obligation” or “duty”.

Question 13

What are the beliefs and limitations of the utilitarianism and virtue ethics theories?

Answer 13

utilitarianism: Based on a fundamental belief that the moral rightness of an action is determined solely by the outcome.
-Medical triage (where sick or injured persons are classified by the severity of their condition to determine the priority of treatment) is an example of utilitarianism and is accepted worldwide as an ethical basis for determining healthcare treatment.

virtue ethics: natural tendencies to act, feel, and judge that develop through appropriate training but come from natural tendencies (Aristotle)

Question 14

key ethical principles used are

Answer 14

Beneficence (do good)

Nonmaleficence (do no harm)

Autonomy (respect for the person’s ability to act based on their own best interests)

Question 15

Human dignity and respect for persons are the foundation of the six ethical principles:

Answer 15

autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity.

Question 16

What is the principle of autonomy?

Answer 16

The principle of autonomy asserts that individuals have the right to determine their own actions and the freedom to make their own decisions.

Question 17

What is the principle of beneficence?

Answer 17

It is “the doing of good” and one of the critical ethical principles in health care. Providers are challenged daily when what constitutes “good” for a patient may also cause them harm or conflict with what the patient wants.

Question 18

What is the principle of nonmaleficence?

Answer 18

Nonmaleficence is the duty to do no harm.

It is the basis of medicine’s Hippocratic oath.

Inherent in the Code of Ethics for Nurses (ANA, 2015), the nurse must not act in a manner that would intentionally harm the patient.

Therapeutic interventions can carry risks of harm for the patient, but the treatment will eventually be good for the patient.

Question 19

What is the principle of justice?

Answer 19

According to the principle of justice, equals should be treated equally, and unequals should be treated differently.

Patients with the same diagnostic and healthcare needs should be treated the same and those with greater or lesser needs should be handled accordingly.

Questions about who obtains healthcare and whether health is a privilege, or a right are essential.

How much of the national resources should be appropriated to health care?

What healthcare problems should receive the most financial resources?

Who should be able to access healthcare services?

Question 20

What are the four fundamental responsibilities of nurses described in the preamble of the International Council of Nurses (ICN) Code of Ethics?

Answer 20

to promote health, to prevent illness, to restore health, and to alleviate suffering

Question 21

Which condition would stimulate higher levels of moral development? Select all that apply
Higher intellect

Independent participation

Creation of conflict in settings

Shared decision-making processes

Stages that are not sequential nor built on each other

Answer 21

Higher intellect
Correct answer: Higher intellectual functioning people use a higher level of moral reasoning than individuals with weaker intellectual capacities.

Independent participation
Wrong answer: An environment that offers group participation encourages better moral reasoning levels.

Creation of conflict in settings
Correct answer: Moral development is stimulated by the creation of conflict in settings in which the individual recognizes the limitations of present modes of thinking.

Shared decision-making processes
Correct answer: An environment that offers shared decision-making processes also encourages better moral reasoning levels.

Stages that are not sequential nor built on each other
incorrect: The stages of individual’s moral development are sequential, built on each other and characterized by a higher capacity for moral reasoning than the preceding stage.

Question 22

Which information describes the ethical principle of nonmaleficence? Select all that applies
Nonmaleficence is the basis of the Hippocratic Oath.

Therapeutic interventions may initially cause harm to the patient.

There is an unfavorable balance between the desirable and undesirable effects.

The rule of “double effect” is associated with maleficence.

It is the promoting of good and prevention of harm.

It is defined as the duty to do no harm.

Answer 22

Nonmaleficence is the basis of the Hippocratic Oath.
Correct answer: Nonmaleficence is defined as the duty to do no harm. This principle is the foundation of the medical profession’s Hippocratic Oath; it is likewise critical to the nursing profession.

Therapeutic interventions may initially cause harm to the patient.
Correct answer: With the ethical principle of nonmaleficence, therapeutic interventions can carry risks of harm for the patient, but the treatment will eventually be good for the patient.

There is an unfavorable balance between the desirable and undesirable effects.
Incorrect: There must be a favorable balance between the desirable and undesirable effects; the good outcome must outweigh the risks caused by the action.

The rule of “double effect” is associated with maleficence.
Correct answer: The concept that justifies risking harm is referred to as the rule of “double effect” and can be seen with the ethical principle of nonmaleficence. It is ethically permissible to do something that may produce a distressful or undesirable temporary situation if the intent is to produce an overall good effect.

It is the promoting of good and prevention of harm.
Incorrect: This is an example of beneficence. When determining what is “good,” nurses must assess their actions in the context of the patient’s life and situation.

It is defined as the duty to do no harm.
Correct answer: Nonmaleficence is the principle ethic defined as the duty to do no harm.

Question 23

Which condition would need to be met for a nurse to declare a conscientious objection to a patient care situation?

Answer 23

Another qualified nurse must assume care of the patient.

If a nurse objects to a certain situation or action for ethical reasons, most professional codes of ethics will allow for the nurse to remove themself if another competent professional can care for the patient.

Question 24

Which theorist believed that women’s relational orientation to the world would shape their moral reasoning differently from that of men?

Answer 24

Gilligan believed that women’s and girls’ relational orientation to the world shaped their moral reasoning different from men and boys, as women view moral dilemmas in terms of conflicting responsibilities.

Question 25

Which behavior would a nurse most likely display while facing moral distress?

Answer 25

Sense of powerlessness

Correct answer
Unaddressed moral distress can lead to nurse behaviors that exacerbate an integrity-compromising situation including feelings of powerlessness.

Question 26

Which information would describe the concept of veracity in nursing?

Answer 26

Veracity is fundamental to the development of trust.

Correct answer
Veracity is defined as telling the truth, or not lying. Nurses are regarded as honest and trust-worthy; therefore, veracity is an essential trait of a nurse.

Question 27

Which approach to ethical decision-making would increase the likelihood of finding an acceptable solution?

Answer 27

Gather more data after clarifying the problem.

Correct answer
Gathering more facts can help to clarify viewpoints and generate solutions, after the dilemma has been clarified. Besides gathering facts about the dilemma, it can also be helpful to learn about recent legal cases and precedents.

Question 28

In which document would a nurse find the most up to date information about professional values with considerations of contemporary social issues?

Answer 28

ANA Code of Ethics for Nursing with Interpretive Statements

Correct answer
The ANA’s Code of Ethics with Interpretive Statement strives to include information on contemporary issues that affect the nursing profession. It has been updated eight times and reflects social trends.

Question 29

Which description of the ethical principle of justice would be correct?

Answer 29

Patients with the same healthcare needs should be treated equally.

Correct answer
In an ideal world, all people would receive all available treatment and resources for their health needs, and those with greater or lesser needs would be handled accordingly.