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NURS 3560 - Ethics > Week 3 > Flashcards

Week 3 Flashcards

1
Q

what are the 5 main ethical theories in healthcare

A
  • goal or consequenced based
  • duty-based
  • character based (virtue)
  • relationships based (ethics of care, feminist)
  • principles
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2
Q

what is the most prominent ethical theory? what is another name for this?

A
  • goal or consequence based

- utilitarian

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3
Q

what is another name for duty based ethical theory

A
  • deontological
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4
Q

describe consequence based theories (3)

A
  • rightness or wrongness of actions depends on the goodness or badness of the consequences of actions
  • considers the ripple effect –> what could happen as a result of this decision
  • goal is to maximize utility –> greatest good for the greatest number
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5
Q

by the consequence based theory, what makes a choice good/ethical? (3)

A
  • good outcome = ethical choice
  • choice is good/ethical if it results in more good/happiness than harm/unhappiness
  • even if some unhappiness results, it is still ethical if good > harm
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6
Q

what are concerns with consequence-based ethics (2)

A
  • majority can overrule individual rules

- may create injustice

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7
Q

what is considered w consequenced-based ethics (5)

A
  • what could happen if we do this action?
  • what could happen if we dont?
  • what is the worst case scenario?
  • best case scenario?
  • what choice would produce the greatest benefit and minimize possible harms?
  • consider the ripple effect
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8
Q

describe duty-based ethics (3)

A
  • involves adherence to duties/rules
  • about the duty of obligation “to act according to particular rules or principles”
  • little consideration of the consequences of an action –> consequences may be considered but right or wrong is not exclusively related to consequences
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9
Q

based on duty-based ethics, what is considered a good/ethical choice

A
  • an action is ethical if it is based on ethical rules, regardless of the consequences
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10
Q

duties considered w duty-based ethics includes (5)

A
  • confidentiality
  • veracity (truthfulness)
  • preventing harm
  • fairness
  • duty to care

these are often written down as laws or policies or Codes of Ethics

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11
Q

what are concerns w duty-based ethics

A
  • duties can & do conflict, some are even mutually exclusive
  • may ignore consequences
    ex. what if telling the truth would cause harm to someone?
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12
Q

what may be considered with duty-based reasoning (5)

A
  • what standard laws do we need to follow?
  • does the Code of Ethics say anything about the topic?
  • is there a facility policy to consider?
  • do we have consent?
  • right to refuse
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13
Q

describe character-based theories

A
  • involves thinking about a person you admire, or an exemplary nurse and what they would do
  • aka virtue theory
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14
Q

what are virtues

A
  • character traits that predispose a person w good intentions to act w practical wisdom
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15
Q

what virtues may be considered w character-based theories (6)

A
  • honesty
  • kindness
  • loyalty
  • fairness (moral virtues)
  • intelligence
  • prudence (practical virtues)
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16
Q

what is considered w character-based ethics (3)

A
  • what would a good nurse do?
  • is the action consistent w values like honesty and kindness?
  • what would someone you consider a moral exemplar choose?
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17
Q

describe relationship-based theories (3)

A
  • focuses on preserving relationships, improving communication, enhancing cooperation, and minimizing harm to everyone involved while promoting an ideal of caring
  • recognizes the web of relationship that health and health care exist within
  • ethics of care
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18
Q

what does relationship-based ethics acknowledge (4)

A
  • power dynamics
  • social context
  • inequities
  • trauma
19
Q

relationship-based reasoning considers.. (4)

A
  • is it appropriate to use our power for the action?
  • would it cause mistrust?
  • how might the action affect the pt’s relationship with other residents? the staff? their family?
  • how would the action impact our relationship w the pt
20
Q

what are 6 principles of biomedical ethics?

A
  • autonomy
  • beneficence
  • non-maleficence
  • justice
  • fidelity
  • veracity
21
Q

describe the principle of respect for persons/autonomy

A
  • involves the concept of self-determinantion or being in charge of one’s self
  • linked to CNA professional values of promoting and respecting informed decision-making & preserving dignity
22
Q

autonomy is a pt’s right of…

A
  • they have the ability to make their own decisions on whats best for them AND it will not impede someone else’s rights
23
Q

autonomy requires?

A
  • relevant info
  • ability to understand
  • freedom to act on that info
24
Q

what is done if the pt cannot express their wishes

A
  • we need someone who knows them to communicate on their behalf
    ex. a substitute decision maker
25
Q

describe the principle of beneficence (4)

A
  • focuses on doing or promoting good in others
  • protecting and defending the rights of others
  • providing a benefit
  • good intentions and good outcomes
26
Q

the principle of beneficence is linked to…

A
  • promoting health and wellbeing

- providing safe, competent, compassionate, and ethical care

27
Q

describe “the good”: what is good, who decides what is good

A
  • pellegrino and thomasma have argued that the biomedical good (what the team or physician recommends) is less important than the pt’s perspective on what is good
28
Q

describe the principle of paternalism

A
  • making decisions for pts in the pt’s best interests, but without their consent
  • making people do what is good for them
  • preventing people from doing what is bad for them
29
Q

describe the principle of non-maleficence

A
  • refers to the obligation to do no harm - avoid, prevent, and minimize
  • need to balance the risks and benefits of a plan of care
30
Q

harm or injury may refer to..

A
  • physical and emotional harm
31
Q

what is a con regarding the principle of non-maleficence

A
  • it can be impossible to do good without doing some amount of harm or risk
32
Q

describe the principle of justice (5)

A
  • refers to fairness in determining what someone or some group is owed, merits, deserves, or is entitled to
  • the basis of treating people equally/equitably
  • human rights & public good
  • nobody advantaged or disadvantaged
  • social justice, fairness, equity
33
Q

describe the principle of fidelity or integrity (4)

A
  • relates to trustworthiness & accountability
  • refers to the obligation we have to remain faithful to our commitments
  • connected to the concept of loyalty, keeping promises, and being faithful to those who have entrused themselves to us for care
  • having integrity, being decent, acting honorably, being true to one’s value
34
Q

describe how nursing entails a fiduciary relationship

A
  • the nurse provides services which by their nature cause the pt to trust in their specialized knowledge and integrity of the professional
  • nurses have a duty to provide knowledge, competent, and safe care and practice w integrity
  • connected to duty to care, non-abandonment, non-judgment, and accountability
35
Q

describe the principle of veracity or truthfulness (3)

A
  • refers to our obligation to tell the truth and not to lie or deceive others
  • veracity is central to informed consent
  • linked to values of being accountabile & promoting and respecting informed decision-making
36
Q

what do ethical principle ask us to consider (6)

A
  • what does the pt want (autonomy)
  • what will do most good? (beneficence)
  • what will prevent harm (non-maleficence)
  • what is fair to the pt & others (justice)
  • is it truthful?
  • would it help us to be faithful to our commitments to the pt & others?
37
Q

therapeutic relationships…. (5)

A
  • planned and goal directed towards the client’s needs
  • always in the best interests of the person
  • recognize a power imbalance
  • recognize vulnerability
  • remain within the Zone of Helpfulness
38
Q

describe the Zone of Helpfulness

A
  • want to avoid being underinvolved and overinvolved

- be somewhere in the middle

39
Q

non-therapeutic relationships… (3)

A
  • abuse of trust
  • exploits client for personal gain
  • nurse benefits more than the pt
40
Q

what is a boundary crossing (2)

A
  • brief, intentional, and intended to benefit the client

- personal disclosures to gain trust and develop therapeutic rapport

41
Q

what is a boundary violation

A
  • when the benefit to client is no longer the focus of the relationship
    ex. social or sexual relationships, accepting expensive gifts
42
Q

what are some warning signs of boundary crossings/violations (9)

A
  • giving person contact info
  • communicating electronically
  • giving gifts to a client
  • paying special attention to a current client (spending time w the client outside their shift, on a break)
  • discussing personal issues
  • changing assignments to care for a certain pt
  • dressing differently for a certain pt
  • frequently thinking about a pt
  • feeling other members of the team do not understand a client
  • keeping secrets w a pt
43
Q

what do nurses consider when making ethical decisions (5)

A
  • consequences & outcomes
  • duties and obligations
  • good character (virtues)
  • relationships (caring, power)
  • ethical principles
44
Q

the process for making difficult ethical decisions….. (3)

A
  • requires the systematic examination of a problem and its possible solutions
  • ensures no important considerations are missed
  • provides a way of justifying or explaining a decision

NURS 3560 - Ethics (7 decks)

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