Values and Ethical Issues Flashcards
Values
a belief about the worth of something such as a person, an idea, or an action
Values often guide ______
behavior
T/F: You are born with the set of values you have
False, you are not born with values, but acquire them.
How are values formed?
developed throughout a lifetime, through influence of environment, family, and culture.
Value System
organization of values into a personal or organizational code of conduct
Value Development
happens over a lifetime through value transmission
Value Clarification
discovery process of coming to understand our own values and value systems
Altruism
- concern for well-being of others
-> Advocates for patients
-> Wants the best outcome for all patients
-> Mentors other nurses
Autonomy
right to make own decisions
How do nurses work to provide autonmy for pts?
- Provide inormation about decision-making
- Works in partnership with patients and their families
- Respects the patient’s decisions when providing care
Human dignity
respect for the inherent worth of patients
- Take care of pt all the same
- Provides culturally competent and sensitive care
- Protects patient’s privacy and confidentiality
- Sensitive to patient’s needs when planning care
Integrity
acting honestly and ethically even when people are not watching
- Provide honest and accurate information
- Document honestly and accurately
- Is accountable for own practice.
Social Justice
ensure equal treatment
- Supports fairness
- Promotes universal access
- Gets involved in policy and legislation to help positively influence decisions regarding nursing, nursing education, and healthcare
Attitudes
feelings/positions taken regarding people, ideas (such as compassion), and objects
Values Clarification
- A process of coming to understand our own values and value systems
- Important to know and understand our own values in order to understand the values of those in our care
How do you get value clarification?
Clarification exercises
Which of the following are common source of conflicts? Select all that apply.
A. Disagreements between nurses adn patients
B. Effective teamowork among nurses
C. Conflicts with nurses and coworkers
D. Disputes between nurses and healthcare institutions
E. Following evidence-based practice guidelines
F. Tensions between nurses and physicians
A, C, D, F
When interacting with patients or other nurses, what are topics that can cause conflict? Select all that apply
A. Religion
B. Culture
C. Personal Values
D. Favorite foods
E. Moral Compass
F. Dream cars
A, B, C, E
Ethics
systematic inquiry into the principles of right and wrong conduct, of virtue and vice, and good and evil as they relate to conduct
(Thinking carefully about right and wrong actions, good and bad character, to help us live well and do the right thing.)
What is the difference between legal and ethics?
Legal: Defines what is required or prohibits by law
Ethics: Involves moral principles
Where are nursing ethic derived from?
- Professional Code of Ethics
- Ethics committees
Nursing ethics
- Formal study of ethical issues that arise within the practice of nursing
- Analysis used by nurses to make ethical judgments
Nurses often encounter ethical dilemmas in their practice. Which of the following are common ethical issues faced by nurses? Select all that apply.
A. Cost containment
B. Inaqequate staffing
C. End-of-life issues
D. Breaches of patient confidentiality
E. Excessive shifts and fatigue
F. Incompetent, unethical, or illegal colleagues
A, C, D, F
Code of ethics for nursing
do not need to memorize the 9 ethics, but be familiar
- Nine ethics statements defining ethical nursing practice in the United States
Compare utilitarian and deontologic theroies of ethics. Define them. Provide an example for each.
Utilitarian:
- The rightness or wrongness of an action depends on the consequence of the action
- Ex: people don’t like abortion but the consequences of the action can be positive
Deontologic:
- An action is right or wrong are based on a rule, independent of its consequences
- Ex: A nurse believes that abortion is wrong based on a rule that an innocent life should never be taken.
Define the following key ethical principle:
Autonomy
(Definition, How should nurses uphold it?)
Definition:
- Right to self-determination
- Respect of the right of the patient to make their own health decisions
How should nurses uphold it?
- Support patient with education
- Act as patient advocate
Define the following key ethical principle:
Nonmalefience
(Definition, How should nurses uphold it?)
Definition:
- Avoid causing harm
How should nurses uphold it?
- Seeks ways to prevent harm
Define the following key ethical principle:
Beneficience
(Definition, How should nurses uphold it?)
Definition:
- Benefit the patient and balance benefits against risks and harms
How should nurses uphold it?
- Actively promote patient’s well-being
- Be sensitive to patient’s views of what is a benefit or harm to them
Define the following key ethical principle:
Justice
(Definition, How should nurses uphold it?)
Definition:
- Fair and equal action
How should nurses uphold it?
- Distribute care justly
- Recognize instances of bias or discrimination
Define the following key ethical principle:
Fidelity
(Definition, How should nurses uphold it?)
Definition:
- Keep your promises (being faithful)
How should nurses uphold it?
- Remain faithful
-> Follow up and follow through with patient - Never abandon a patient
- Keep confidentiality
Define the following key ethical principle:
Veracity
(Definition, How should nurses uphold it?)
Definition:
- Be truthful
How should nurses uphold it?
- Do not deceive
- Do not mislead
- Veracity v beneficence
-> To tell or not to tell?
Define the following key ethical principle:
Advocacy
(Definition, How should nurses uphold it?)
Definition:
- The protection and support of another’s rights
How should nurses uphold it?
- Primary commitment is to the patient
- Priority is the good of the individual patient
- Carefully evaluate the competing claims of the patient’s autonomy (self determination) and patient well-being
What nursing process do nurses use when making an ethical decision?
A.D.P.I.E
What is the ethical problem?
Doing something to limit patient while keeping their health in mind
Paternalism
What is the ethical problem?
a situation where a nurse might consider being dishonest to ease a patient’s anxiety
Deception
What is the ethical problem?
patient’s right to have their personal information protected
Privacy
What is the ethical problem?
Keeping patient information secret
Confidentiality
What is the ethical problem?
difficulty distributing care evenly to patients in need when understaffed
Alocation of scarce nursing resources
What is the ethical problem?
Patients have to right to consent and refuse treatment at any time for any reason
Valid consent or refusal
What is the ethical problem?
New technology clashes with an patients ethical or moral beliefs
Conflicts concerning new technologies
What is the ethical problem?
physician’s behavior or practice is substandard, potentially endangering patients
Unprofessional, incompetent, unethical, or illegal physician practice
What is the ethical problem?
nurse’s action deviates from accepted standards, potentially harming patients
Unprofessional, incompetent, unethical, or illegal nurse practice
What is the ethical problem?
Occurs when there are not enough nurses to provide quality care, potentially putting patients at risk
Short staffing
What is the ethical problem?
Disclosing information about potentially dangerous, unethical or illegal practices
Whistle-Blowing
What is the ethical problem?
ethical dilemmas related to reproductive decisions and the initiation of life
Beginning-of-life-practices
What is the ethical problem?
ethical challenges surrounding death and dying
End-of-life-issues
A high fall risk alert patient has a tendency to get out of bed without asking the nurse for assistance. The nurse wants to place the patient on restraints in order to prevent a potential fall from happening.
What is the ethical problem stated above?
Paternalism
A postoperative patient asks a student nurse if it is their first time administering an IM injection. Although it would be the student nurses’ first time administering IM injection, they reply that they’ve done it multiple times.
What is the ethical problem stated above?
Deception
A student nurse takes a picture of a patient’s sacral wound and sends it to her clinical group.
What is the ethical problem stated above?
Privacy
A hospital has a limited number of ventilators, and a nurse must help decide which critically ill patients receive one, knowing that not all can be saved.
What is the ethical problem stated above?
Allocation of scarce resources
A nurse is asked by a patient, who is in the country illegally and cannot afford to pay for the visit, not to tell anyone about their situation.
What is the ethical problem stated above?
Confidentiality
A patient is in dire need of a life-saving blood transfusion. However the patient refuses the blood because they are a Jehovah’s witness. The nurse feels conflicted about honoring the patient’s decision.
What is the ethical problem stated above?
Valid consent or refusal
A patient expresses her desperation to have a child, but also shares concerns about the ethical implications of the IVF process, such as the disposal of the unused frozen embryos
What is the ethical problem stated above?
Conflicts concerning new technologies
A nurse observes a surgeon showing up to work intoxicated and operating on patients. The nurse is unsure if they should report them, since the surgeon is well-respected in the hospital.
What is the ethical problem being stated?
Unprofessional, incompetent, unethical, or illegal physician practice
A nurse notices another nurse pocketing several opioids for personal use but is unsure whether to report them.
What is the ethical problem stated above?
Unprofessional, incompetent, unethical, or illegal nurse practice
A nurse is assigned too many patients and knows that it is impossible to provide adequate care to all of her patients..
What is the ethical problem stated above
Short Staffing
A nurse working in a long-term care facility is unsure about exposing unsafe patient conditions as it can lead to an investigation and the nurse would face severe retaliation.
What is the ethical problem stated above
Whistle-blowing
A nurse working in labor and delivery struggles with personal beliefs about abortion when assisting with a procedure.
What is the ethical problem stated above?
Beginning-of-life practices
A terminally ill patient requests medical assistance in dying (MAiD), but a nurse is unsure whether her personal beliefs should influence her role in the process
What ethical problem is stated above?
End-of-life issues
What are the 3 activities in value processing? Provide an example
Choosing: chooses freely from alternatives after carefully considering the consequences of each alternative
- Ex:Deciding to live a healthy lifestyle after researching the benefits of diet and exercise
Prizing (Treasuring): something that is valued (inv pride, happiness, public affirmation)
- Ex: Display trophy for completing a marathon
Acting: acts on the value by combining choice and behavior with consistency and regularity
- Ex: Joining a gym and scheduling classes throughout the year
What are the four common mods of value transmission?
- Modeling: learn what is high/low value through observations
- Moralizing: learn value system
- Laissez-faire: explore values on their own with little/no guidance, leading to confusion/conflict
- Rewarding/punishment: rewards for demonstrating values; punished for unacceptable values
In what ways do values influence beliefs, ethical conduct, and professional nursing?
- Beliefs – Shape views on health, illness, and human needs.
- Ethical conduct – Guide decision-making and advocacy.
- Professional nursing – Influence nurse-patient interactions.
What is moral distress?
occurs when you know the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action
Moral distress occurs when an individuals ____ integrity is ________.
moral; compromised
Moral resilience
developed capacity to respond well to morally distressing experiences and to emerge strong.
What are the 4 A’s to rise above moral distress? Describe each one.
- Ask - recognize/become aware of your distress
- Affirm - validate your feelings and commit to addressing the issue
- Assess - identify the sources and severity of emotional distress
- Act - take steps to address your moral distress
In order to destigmatize moral distress, we need to reduce the ____ and ____ associated with discussing moral distress
fear; shame
T/F: To destigmatize moral distress, you should not discuss it with your peers.
False: moral distress should be discussed through open communication and with support systems.
Be familiar with the moral distress scale
When a nurse is educating a paitent on what options they have available to them in regards to treatment, the nurse is practicing which key ethical principle?
A. Beneficience
B. Autonomy
C. Fidelity
D. Veracity
B. Autonomy
When a nursing as actively seeking ways to prevent patient harm, what key ethical principle are they practicing?
A. Justice
B. Fidelity
C. Nonmaleficence
D. Advocacy
C. Nonmaleficence
When a nurse is actively promoting the well being of the patient while being sensitive to the patient’s view of what can benefit or harm them, the nurse is practicing which key ethical principle?
A. Justice
B. Veracity
C. Autonomy
D. Beneficience
D. Beneficience
When a nurse is able to recgonize instances of bias and provide fair and equal care, they are practicing which key ethical principle?
A. Justice
B. Beneficience
C. Advocacy
D. Autonomy
A. Justice
When a nurse follows up and through with their promisis when providing patient care, they are practicing which key ethical principle?
A. Fidelity
B. Veracity
C. Beneficience
D. Autonomy
A. Fidelity
When a nurse maintains patient confidentiality and never abandons their patient, they are practicing which key ethical principle?
A. Beneficience
B. Fidelity
C. Veracity
D. Advocacy
B. Fidelity
A patient is nervous about their condition. The nurse decides that it is important to not decieve or mislead the patient but rather be truthful with them. Whick key ehtical principle are they practicing?
A. Fidelity.
B. Veracity.
C. Autonomy
D. Nonmaleficince
B. Veracity.
A doctor is actively undermining a patients pain level. The nurse witnessed this interaction and uses a professional and asssertive tone to convey that their patient is not lying about their pain and that it should be taken serious. Which key ethical principle is the nurse practicing?
A. Veracity.
B. Autonomy
C. Advocacy
D. Beneficience
C. Advocacy
