Week 4: Professional, ethical and legal obligations in nursing: a critical appraisal Flashcards
Philosophical study of morality
ethics
Standards or beliefs that a person holds concerning what is right and wrong
morals
An ideal that has significant meaning or importance to an individual, group or society
values
What are the three types of values we learned about?
Personal values
Professional nursing values
Organizational values
name the value based on the description:
A - ideals upheld by the nursing profession
B - Ideals you hold near and dear to yourself
C - Ideals from your organization
A - Professional nursing values
B - personal values
C - organizational values
Arise in situations in which our actions or those others are at odds with our beliefs
values conflict
The process of becoming more conscious of and naming what one values or considers worthy
values clarification
What is the purpose of value clarification?
increases our awareness of ourselves and assists us in making choices (especially good when faced with ethical dilemmas)
Name the ethics type (normative vs. non-normative) based on the description
A - value-based judgements
B - value-neutral
C - Focuses on what is right and wrong and what should we do in different situations
D - Doesn’t take a position
E - Description and fact-based
A - normative B - non-normative C - normative D - non-normative E - non-normative
Different naming conventions for normative ethics
guiding ethics
prescriptive
Situations in which there are conflicts between one or more values and uncertainty about the correct course of action
ethical problems
Arise when there are equally compelling reasons for and against two or more possible courses of action
Ethical dilemma
Occurs when a nurse feels a lack of clarity or indecision, or is even unable to know what the moral problem is, while at the same time feeling uneasy or uncomfortable
ethical and moral uncertainty
Cases where even if you had all the empirical evidence, you would still not know what to do
ethical/moral uncertainty
the emotional and psychological pain that occurs when ‘one knows the right thing to do but institutional constraints make it nearly impossible to pursue the right course of action
moral distress
Occurs in situations when you feel that you cannot fulfill your ethical obligations and commitments
moral distress
Belief that there are no universal standards or right and wrong; something considered right in one society could be considered wrong in another
ethical relativism
Belief that human beings share fundamental principles of right and wrong but that there is much diversity in how they are applied
ethical universalism
Values as a means to an end
instrumental value
Things that are not merely instrumental but have value in and of themselves
intrinsic value
In instrumental value, the emphasis is on the _______; in intrinsic value, the emphasis is on the ______.
outcome
process
Morality is about producing good consequences, outcomes or results, not having good intentions.
utilitarianism
Utilitarianism:
- we should do whatever will bring the most _____ to the ______ people
benefit, most
Utilitarianism is morally demanding for two reasons, what are they?
1 - asks us to do the most, to maximize utility, not the minimum
2 - asks us to set aside personal interests
Looks at the good and bad consequences of each individual act and calculates utility each time the act is performed
Act utilitarianism
Looks at the consequences of having everyone follow a particular rule and calculates the overall utility of accepting or rejecting the rule
rule utiliarianism
What are the arguments against act utilitarians (by rule utilitarians)?
Takes too long
not consistent or fair - can justify disobeying important moral rules/violating individual rights
what are the arguments against rule utilitarians (by act utilitarians)?
Rule worship - basically goes against maximizing utility
Act utilitarians can still use rules of thumb for pressing situations
What are the criticisms of utilitarianism?
1 - Impractical - too many opinions
2 - How to measure utility - no consensus
3 - Justice - not just - what happens to the rest of the world
Duty based ethics; What matters is the kind of action it is according to moral rules or principles, rather than the action’s consequences
Deontological theory
Most influential deontologist
Immanuel Kant
Unconditional obligation that is binding in all circumstances and is not dependent on a person’s inclination or purpose
categorical imperative
A central idea in many deontological theories is the idea of ______.
autonomy
Anyone who acts to give voice to different female perspectives, attempts to balance or integrate male and female thinking, or who promotes feminine over masculine views.
Feminist
Common thread of feminism?
Changing the distribution and use of power
Stopping the oppression of women
Feminist ethics:
- centers around the fact that scientific thinking and philosophy have been largely ____-dominant
- historically rare for women to be ______ or influence _____ and ______ thought
- reject _______ assumptions about autonomy (i.e. women have limited autonomy)
- argue that humans are fundamentally ________ (rather than rational)
- concerned with women’s issues (e.g. abortion, surrogacy, etc.)
male
educated, social, political
liberal
relational
Suggests that women and men make ethical choices based on a different set of values, perceptions and concerns
feminine ethics
Feminine ethics:
- greater interest in ______, ______ and desires
- _____ and ______ are seen as key indicators of right action
- when faced with a moral issue, women tend to use _______ form of reasoning and tend to seek out solutions where the needs of ____ parties are met
values, feelings
emotion, intuition
empathetic, all
Asserts that men and women make ethical decisions differently
justice vs care
Concerns for fairness, rights and rules
ethics of justice
focus is on understanding responsibilities and relationships, empathy and caring
ethics of care
CNA code of ethics:
- outlines _ core nursing values
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CNA code of ethics
- Providing ____, compassionate, competent and ______ care
- Promoting ____ and ____-_____
- Promoting and respecting _______ _______ _______
- Honouring ______ (includes boundaries)
- Maintaining ______ and _________
- Promoting _____
- Being __________
safe, ethical health, well-being informed decision making dignity privacy and confidentiality justice accountable
When providing care, nurses do not discriminate on the basis of race, ethinicty, culture, political and spirituals beliefs, social or marital status, etc.
Promoting justice
Includes the right to the information necessary to make choices and to consent to or refuse care
client choice/self-determination
What are some limits to choice?
Incompetence/incapacity
endangering self or others
laws
policies
human life is precious and needs to be respected, protected and treated with consideration
respect for life
limited access to a person, the person’s body, conversations, bodily functions or objects immediately associated with the person
privacy
involves keeping personal information private
confidentiality
Refers to allocating limited health care resources on the basis of objective health factors
fairness
How does one work through ethical situations?
Assess
plan
implement
Evaluate
Name the step based on the description:
o Take stock of all aspects; knowledge of family, values of patient, HCPS, etc.
o Consider all codes of ethics
o Discuss with everyone involved
plan
Name the step based on the description:
provide support and information as needed to all involved in the situation
implement
Name the step based on the description:
consequences, outcomes
evaluate
