Week 5 Flashcards
what are the CNAs ethical endeavours (3)
- ethical nursing practice addresses broad aspects of social justice that are associated with health and wellbeing
- greater equity
- advocacy
define: ethics
- the study or examination of morality thru a variety of different approaches
how you respond to an ethical situation is a reflection of…
- the core values, beliefs, and character that make you the person who are you and ultimately, the professional you want to become
describe the complexity of ethics
- ethics encompasses many different dimensions of a person’s life
describe the scope of ethics
what are the 5 ethical principles
- respect for persons
- nonmaleficence (do no harm)
- beneficence (do good)
- justice (treat people equitably, fairly, appropriately)
- fidelity (act loyal)
what are the CNA’s nursing values and ethical responsibilities (7)
- providing safe, compassionate, competent, and ethical care
- promoting health & wellbeing
- promoting & respecting informed decision making
- honouring dignity
- maintaining privacy and confidentiality
- promoting justice
- being accountable
what is included in the CNA’s nursing value and ethical responsibility “promoting health and wellbeing”
- nurses work with persons who have healthcare needs or are receiving care to enable them to attain their highest possible lvl of health and wellbeing
what is included in the CNA’s nursing value and ethical responsibility “promoting and respecting informed decision making”
- nurses recognize, respect, and promote a person’s right to be informed and make decisions
what is included in the CNA’s nursing value and ethical responsibility “honoring dignity”
- nurses recognize and respect the intrinsic worth of each person
what is included in the CNA’s nursing value and ethical responsibility “ maintaining privacy and confidentiality”
- nurses recognize the importance of privacy and confidentiality and safeguard personal, family, and community info obtained in the context of professional relationship
what is included in the CNA’s nursing value and ethical responsibility “promoting justice”
- nurses uphold principles of justice by safeguarding human rights, equity, and fairness and by promoting public good
what is included in the CNA’s nursing value and ethical responsibility “being accountable”
- nurses are accountable for their actions and answerable for their practice
what is societal ethics
- society provides a normative basis for ethical behavior with laws and regulations
with societal ethics, law is the..
- minimum standard of behavior to which all members of society are held
in nursing, legal standards of care are: (4)
- clinical standards of care
- liability
- negligence
- malpractice
what are professional ethics
- ethical standards and expectations of a particular professional
- code of conduct
- held to a higher standard bc of privileged role in society
- aimed at the highest ideals of practice
ex. CNA code of ethics
describe personal ethics
- continuously intersects with other categories of ethics
- sources of ethics are not static and change over time
with personal ethics, a potential for… exists
- conflict –> due to overlap not occurring perfectly
taking appropriate actions in response to ethically challenging situations requires 3 virtues of health professionals. what are they?
- courage
- compassion
- commitment
failure to act or respond in an ethically appropriate way is linked to… (3)
- serious and potentially dangerous errors
- personal stress
- professional burnout
healthcare decisions that present an ethical dilemma are made by…
- not individuals alone
- healthcare organization’s compliance officer and compliance committee are charged with the responsibility of ensuring that ethical standards are met
- institutes have reporting mechanisms for unethical behaviors
what are some ethical issues in nursing (8)
- protecting pt’s rights and human dignity
- not respecting informed consent treatment
- providing care with risk to the health of the nurse
- using or not using chemical or physical restraints
- understaffing
- prolonging the living and dying process w inappropriate measures
- policies that could threaten the quality of care
- working w unethical or impaire colleagues
interrelated concepts w ethics
what are implications for community in relation to ethics?
- CHNs are required to uphold the values identified in the CNA code of ethics & following the canadian community health nursing standards of practice in ethical, legal, and professional nursing practice standards
what are two important ethical obligations CHNs face
- confidentiality
- accountability
describe advocacy in health ethics r/t CHN
- advocacy is the application of info and resources to effect systemic changes that shape the way people in a community live
describe advocacy in health ethics for PHN
- advocacy is intended to benefit aggregates
ex. to reduce death or disability in groups of people, and uses info and resources to reduce the occurrence or severity of public health programs
what are required ethical principles for effective advocacy (6)
- act in the client’s best interests
- act in accordance w the client’s wishes and instructions
- keep the client properly informed
- carry out instructions w diligence and competence
- act impartially and offer frank, independent advice
- maintain client confidentiality
what are bioethics
- systematic duty of moral dimmensions of the life sciences and healthcare and involves the use of ethical methodologies in an interdisciplinary setting, arose over concerns about new technologies and procedures, and how they should be applied in society to humans in medicine and research
- ethical issues that arise in the virtue of our biological nature –> we get sick and need others expertise
- ethical issues arising in the virtue of our bodies
with bioethics, medical decisions should belong to…
- the person in that body
surgery without informed consent is..
- battery
ethical issues in public health often involve: (4)
- what should be done or what course of action should be taken
- which values or ethical principles should guide the decision to be made
- how a conflict or tension between different values or principles might be resolved
- once a decision has been made, how it should be implemented
what makes ethical issues in public health unique
- applies to the entire population
what are examples of ethical issues in public health (5)
- protecting pts rights and dignity
- not respecting informed consent
- risk to nurses health
- restraints
- policies threatening quality of care
etc.
what are Upshur’s 4 ethical principles for public health
- the harm principle
- principle of least restrictive or coercive means
- reciprocity principle
- transparency principle
describe the harm principle
- a foundational principle of ethics
- sets out the justification to take action to restrict the liberty of an individual or a group in order to prevent harm to others
describe the principle of least restrictive or coercive means
-recognizes that a variety of means exist to achieve public health needs, but the full authority and power should be used for exceptional circumstances
according to the principle of least restrictive or coercive means, what should precede any restriction or coercive measures (3)
- education
- facilitation
- discussion
describe the reciprocity principle
- society must be prepared to facilitate individuals and communities in their efforts to discharge their duties
describe the transparency principle
- refers to the manner and context in which decisions are made
all stakeholders are involved in developing policy on how to manage a particular infectious disease –> which Upshur principle is this
- transparency
the public health department is providing financial compensation to a person who is quarantined –> which Upshur principle is this
reciprocity principle
an individual is committed under the Mental Health Act to protect and prevent harm to others –> which Upshur principle is this
- harm reduction
A person exposed to a communicable disease is provided instructions on how to quarantine at home –> which Upshur principle is this
- no answer (least restrictive ???)
A person exposed to a communicable disease is provided instructions on how to quarantine at home –> which Upshur principle is this
- no answer (least restrictive ???)
describe the political nature of ethics
- ethical problems in the community can also take on a political nature
- power, in itself, is ethically neutral
- the use of power is of ethical significance
- efforts to prevent disease and injury restrict the liberty of individuals, thereby limiting their choice and autonomy (ie. seat belt laws)
see the CNA code of ethics Part II for the 16 ethical endeavours
…
define: social justice
- the fair distribution of resources & responsibilities among the members of a population, with a focus on the relative position of one social group in relationship to others in society, as well as on the root causes of disparities and what can be done to eliminate
what are the 10 attributes of social justice
- equity
- human rights
- democracy and civil rights
- capacity building
- just institutions
- enabling enviro
- poverty reduction
- ethical practice
- advocacy
- partnership
social justice approaches tend to be concerned with…
- the ethical use of power in healthcare
- can also be social justice between nurses and physicians, staff and students, pt and staff
social justice assumes that all societies experience…
- systematic oppression and inequities (ex. racism, sexism, heterosexism, classism) which affect some people more than others
with social justice, every individual contributes to…
- oppression and equity, even if unintentionally, and are responsible for contributing to the achievement of social, political, and economic parity
social justice is important when…
- situating the ethical dimensions of healthcare policy within a broad political understanding of the role of healthcare services in society
there are 3 important features of social justice approaches that are useful to consider when using social justice as a framework for community nursing practice:
- social justice approaches tend to be concerned with the ethical use of power in healthcare
- social justice approach tends to view persons relationally as unique, connected to others, and interdependent, that is, vulnerable and unequal to power
- social justice tends to elicit concern for issues of everyday life and not primarily crisis issues
what are the 7 ethical foundations of public health and community practice
- inclusion
- diversity
- participation
- empowerment
- social justice
- advocacy
- interdependence
describe the ethical foundation of public health “inclusion”
- the act of being included
- means being accepted and able to participate fully within the family, community, and the society within which one lives
describe the ethical foundation of public health “diversity”
- the condition of being diverse, differing from one another, and composed or distinct or unlike elements or qualities
describe the ethical foundation of public health “participation”
- the desired outcome of participation in decision maker is greater social cohesion, evidenced by the creation of shared values, the reduction of health & wealth disparities, and the building of community spirit and capacity for action
describe the ethical foundation of public health “empowerment”
- both a process and outcome
describe empowerment as a process
- empowerment is the development of knowledge & skills that increase one’s mastery over decisions that affect one’s life
describe empowerment as an outcome
- empowerment is the achievement of mastery
describe the ethical foundation of public health “social justice”
- the just distribution of resources and opportunity within a society
describe the ethical foundation of public health “advocacy”
- the act of disseminating info to influence opinion, conduct, public policy, or legislation
- the pursuit of influencing outcomes, including public policy & resource allocation decisions within political, economic, and social systems and institutions that directly affect people’s lives
describe the ethical foundation of public health “interdependence”
- public health strives for the health of entire communities and recognizes that the health of individuals is tired to the life of community
see CNA code of ethics Part 1
….
describe steps in the framework for decision making (6)
- preliminary step = determine how they will structure the decision-making process
1. identify the issue and context (facts and interests at play)
2. identify ethical considerations (values and principles)
3. identify and assess options
4. select best course of action and implement
5. evaluate
with the framework for decision making, what should be considered in step 2 “identify ethical considerations”
- values
- procedural
what are the ethical values (5)
- respect for persons
- non-maleficence
- beneficence
- trust
- justice
what are the procedural considerations for the framework for decision making (5)
- accountability
- inclusiveness
- responsibility
- responsiveness
- transparency
what are similarities between bioethics and public health ethics
- public health ethics = emphasizes communitarian values and social justice, balancing individual autonomy and the common good remains central, but doesn’t begin with an emphasis on individual interests
what is harm reduction
- public health approach aimed at reducing the adverse health, social, and economic consequences of at-risk activities such as the use of illicit substances
- combo of policies, programs, and practices
- how do we reduce the risks? (not eliminate the behavior)
what are the cornerstones of harm reduction (3)
- human rights
- social justice
- treating all people w respect, dignity, and compassion
what type of approach should be used with harm reduction
- non-judgemental approach accepting of people who use drugs, families, and communities
what are the principles of harm reduction (5)
- pragmatism
- humanism
- focus on harms
- balancing costs and benefits
- hierarchy of goals
define: pragmatism
- acceptance that risky behaviors are unlikely to disappear entirely
define: humanism
- no moral judgements
describe: focus on harms
- risk behavior is secondary to the harms that it might produce
describe balancing costs and benefits
- in the long run, what costs more and who benefits?
describe the hierarchy of goals
- focus on the most pressing needs first
harm reduction does not require…
- abstinence or discontinuation of use
harm reduction empowers…
- people who use substances to make informed decisions
harm reduction emphasizes… (4)
- humanistic values
- dignity
- compassion
- nonjudgmental acceptance
towards people who use substances
harm reduction is complementary to…
- prevention and treatment approaches
describe the cost of harm reduction
- is cost-effective
describe evidence r/t harm reduction
- is evidence-based
describe participation r/t harm reduction
- includes participation by people who use substances in policy-making and program development
harm reduction challenges…
- policies and programs that maximize harm
what are RN competencies for PHAC
- a public health practitioner is able to utilize public health ethics to manage self, others, info, and resources
what are RN competencies for CHNC
- standard 8 professional responsibility and accountability
- the CHN recognizes ethical dilemmas and applies ethical principles & CNA code of ethics
- the CHN works collaboratively in determining the best course of action when responding to ethical dilemmas
