Week 8 - Ethics and Values

Question 1

What is a value?

Answer 1

• A value is a strong personal belief and an ideal that a person or group (such as nurses) believes to have merit.
• Values are at the heart of ethics. Values influence behaviour through one’s conviction that a certain action is correct in a certain situation. An individual’s values reflect cultural and social influences, relationships, and personal needs. Values vary among people and the change and develop over time
• Enduring beliefs or attuites” values are at the heart of our ethics. Ones values reflect culture, social influences, and relationships. Values develop and change over time.
• Lots of our values come from our upbringing and when we are children we learn right from wrong and to form values on which to base these actions, known as moral development. Sometimes values can be confusing and conflicting.
• When giving clarifying information it should be brief and do not introduce our values

Question 2

What are ethics?

Answer 2

• Ethics is the study of the philosophical ideals of right and wrong behaviour based on what one thinks one ought (or ought not) to do. The term also commonly refers to the values and standards that individuals and professions strive to uphold. It is that values that matter most to people.
• Ethics is the study of good conduct, character, and motives. It is concerned with determining what is good or valuable for all people.

Question 3

What is the CNA Code of Ethics?

Answer 3

• Outlines nurses’ professional values and ethical commitments to their patients and the communities they serve Revision are usually made every 5 to 7 years
• It is intended to guide nurses in all contexts and domains of nursing practice (clinical practice, education, administration, research, and policy.
• As stated in the Code of Ethics, “the code provides guidance for ethical relationships, responsibilities, behaviours and decision-making and it is to be used in conjunction with professional standards, best practice, research, laws, and regulations that guide practice.
• statement of ethical values as nurses our commitments to persons with healthcare needs and people receiving care. Part of people self-regulatory is binding to the code of ethics.
• the code provides guidance for ethical relationships, responsibilities, behaviours and decision-making and it is to be used in conjunction with professional standards, best practice, research, laws, and regulations that guide practice.

Question 4

What are the 7 values of the CNA code of ethics?

Answer 4

• providing safe, compassionate, competent, and ethical care
• promoting health and well-being
• promoting and respecting informed decision making
• preserving dignity
• maintaining privacy and confidentiality
• promoting justice
• being accountable.

Question 5

What is values clarification?

Answer 5

• Values clarification is the process of appraising personal values. It is not a set of rules, nor does it suggest that certain values should be accepted by all people; rather, it is a process of personal reflection. When you clarify your values, you make conscious decisions about which values are most important in your practice, and this in turn shapes your professional identity in accordance with the related ethical values of the profession.

Question 6

What is morality and how is it different from ethics?

Answer 6

• Morality is concerned with norms, principles, or what “ought to be.”
• While ethics is focused on reflective analysis about those norms or principles and putting them into action.

Question 7

What is responsibility?

Answer 7

• Refers to the characteristics of reliability and dependability. It implies an ability to distinguish between right and wrong. In professional nursing, responsibility includes a duty to perform actions adequately and thoughtfully.

Question 8

what is accountability?

Answer 8

• It is grounded in the moral principles of fidelity (faithfulness) and respect for the dignity, worth, and self-determination of patients and others with whom nurses work.
• It means being able to accept responsibility or account for one’s actions—to be answerable to someone for something one has done.
  o Being ethically accountable does not mean that you will make the “right” decision based on what others believe; rather, it justifies whatever decision you do make
• (Fidelity and veracity)
• Accountability means being able to accept responsibility or account for one’s actions—to be answerable to someone for something one has done. Also keeping up with professional practice standards and fitness to practice to practice safety. Sharing knowledge.

Question 9

What is Fidelity?

Answer 9

• It is a guiding principle of relationships based on loyalty, promise-keeping, and truth-telling (veracity). As accountable professionals, “nurses are honest and practise with integrity in all of their professional interactions”

Question 10

What is answerability?

Answer 10

• It means being able to offer reasons and explanations to other people for aspects of nursing practice.

Question 11

What is informed consent?

Answer 11

• Informed consent means that nurses advocate on behalf of patients to make sure that the patient understands the treatment and has the capacity to give their consent for the treatment.

Question 12

What is the ethical responsibility of advocacy?

Answer 12

• The ethical responsibility of advocacy means acting on behalf of another person, speaking for persons who cannot speak for themselves, or intervening to ensure that views are heard. Advocacy recognizes the need for improvement of systems and societal structures to create equity and better health for all. Individually and collectively, nurses advocate for eliminating social inequities.

Question 13

What is constrained moral agency?

Answer 13

• It is if you feel powerless to act for what you think is right, or if you believe your actions will not effect change, then you will have difficulty being an effective advocate

Question 14

What is descriptive moral theory?

Answer 14

• It explains what people do or think about moral issues

Question 15

What is metaethics?

Answer 15

• It is the field of ethics that analyzes the meanings of key terms such as right, obligation, good, and virtue, attempting to distinguish what is moral and what is not.

Question 16

What is normative ethical theory?

Answer 16

• It is prescriptive in that it tells us how we ought to think about moral questions.

Question 17

What is applied ethics (or practical ethics?

Answer 17

• We look at how decisions should be made in particular situations and ask questions about what moral beliefs and values should apply in specific contexts. Theories that address issues of “right” or “ought” in applied ethics transcend disciplines.

Question 18

What is deontology?

Answer 18

• In deontology, actions are defined as right or wrong according to moral duties, principles, rules, or imperatives. The role of the moral agent (nurse) is to discern what their duties are and to act consistently with, and in the spirit of, those duties. They do not look at the consequences of the actions and concerns the presence of principle, regardless of outcome
• Commonly known to healthcare providers
• If the act is just and respects autonomy and provides good it is ethical
• Making sure the patient has autonomy, when they are part of their own care there is more chance for success.

Question 19

What is utilitarianism?

Answer 19

• According to a utilitarian system of ethics, the value of something is determined by its usefulness. This philosophy, utilitarianism, may also be known as consequentialism because its main emphasis is on the outcome or consequences of an action.
• A third term associated with this philosophy is teleology (from the Greek word telos, meaning “end”), which is the study of ends or final causes.

Question 20

What is bioethics?

Answer 20

• Biomedical ethics came to denote ethical reasoning for physicians, whereas bioethics became the general term for principled reasoning across health care professions. Bioethical theory is based on obligation, outcome, and reason.
• The central idea of bioethics—also known as health care ethics—is that moral decision making in health care should be guided by four principles: autonomy, beneficence, nonmaleficence, and justice
• Bioethical theory is based on obligation, outcome, and reason.

Question 21

What is autonomy?

Answer 21

• Autonomy refers to one’s freedom or self-determination.
• Asking the patients how they would like something like a bed bath done, the goals that they can create

Question 22

What is beneficence?

Answer 22

• Beneficence means promoting someone else’s good or well-being.
• Long term benefit of vaccine outweighs short term pain of injection.

Question 23

What is nonmaleficence?

Answer 23

• Maleficence refers to harm or hurt; thus, nonmaleficence is the avoidance of harm or hurt.
• Looks at what the treatment will do and cause

Question 24

What is justice?

Answer 24

• Justice refers to fairness and equity.
• Who got the covid vaccine first? (elderly and healthcare workers)

Question 25

What is relational ethics?

Answer 25

• Relationships are the basis of ethics in nursing. According to relational ethics theory, ethical understandings are formed in, and emerge from, a person’s relationships with others, including patients, families, communities, and colleagues.
• Ethical understanding is formed in and comes from a person’s relationship (patient/ family/ community/ colleagues)
• Most helpful in decision-making at the individual level
• It shows out respect when doing back tasks like giving an IV
• Recognizing that all healthcare interactions are human-centered.
• How does the relationship shape choices (good or bad)
• “People are contextual beings who exist in relation with others and with social, cultural, political, and historical processes.”

Question 26

What is an ethical dilemma?

Answer 26

• A conflict between two sets of human values, both of which are judged to be “good,” but neither of which can be fully served. Ethical dilemmas can cause distress and confusion for patients and caregivers.
• Resolving ethical dilemma requires the deliberate, critical and systemic, and might require the negotiation of differences.

Question 27

What are the steps to analyze an ethical dilemma?

Answer 27

 Step 1: Determine whether the issue is an ethical dilemma.
 Step 2: Gather all the information relevant to the case.
 Step 3: Examine and determine your own values on the issues.
 Step 4: Verbalize the problem.
 Step 5: Consider possible courses of action.
 Step 6: Reflect on the outcome.
 Step 7: Evaluate the action and the outcome.

Question 28

Attitudes

Answer 28

• Mental position/feeling
• good verses bad

Question 29

What are beliefs?

Answer 29

• A conclusion about what we see to be true.
• ‘true’/’false’
• Ex. Might be based on feelings not facts like religion

Question 30

What is advocacy?

Answer 30

• Acting on a person’s behalf
• Speaking up for our patients
• Recognizes the need for improvement of systems and practice standards/qualities and equity for all.
• Also advocate for health polices and issues that affect patients and family members

Question 31

Can something be a belief but not a value?

Answer 31

(beliefs= ideas you have about the world which influences values= principles that you live by)

Question 32

Are values static?

Answer 32

• No, they are always changing based on experiences)

Question 33

Can your personal values conflict with your professional values? What might be an implication of conflicting values?

Answer 33

• We must always understand that everyone has different personal values and make sure your own personal values do not impact someone’s care.

Question 34

What is a value system?

Answer 34

A value system is how we organize our values based on priorities.

Question 35

What are morals?

Answer 35

• The principles of right and wrong, behavior, and good vs bad.
• Governs private and personal interactions

Question 36

What are the ethical theories?

Answer 36

• Philosophical theories
• Also referred to as moral philosophy
• Several ethical theories and principles:
   Descriptive theories (it explains what people do or think about moral issues, such theories explain the rules, morals, and principles people use when making moral decisions)
   Metaethics (analyzes the meaning of key terms such are right, obligation, good, and virtue)
   Normative ethics (prescriptive, tells how we ought to think about moral question)
   Applied ethics (aka practical ethics asks questions the rules, morals, and principles people use when making decisions)

Question 37

What is law?

Answer 37

• The system of rules that a particular state, province, etc. recognizes as regulating the actions of its members and can enforce penalties
• Governs relationships with others and society

Question 38

What is ethics (in relation to law)

Answer 38

• Ethics is the moral principle that governs our personal behaviors or actions
• Governs professional interactions

Question 39

Why are ethics and ethical theory important for nursing?

Answer 39

• Ethics is central to nursing and the delivery of safe and competent nursing care
• Ethical decision-making should include gathering all of the important information and working collaboratively with the client and all members of the HC team
• When making an ethical decision apply a framework/principles/theory

Question 40

Nurses and ethics

Answer 40

• As nurses we are bound to professional standards (BCCNM) and the CNA code of ethics, but we are also relational beings and decisions are often complex and impacted by many contextual factors outside of just personal/professional values (e.g., resources, staffing)
• As nurses our values will not always align with other healthcare providers