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NUR351 > Week 8 - Nursing Ethics: Principles, Values, and Contexts > Flashcards

Week 8 - Nursing Ethics: Principles, Values, and Contexts Flashcards

1
Q

What is ethics?

A

The study of the philosophical ideals of right and wrong behaviour based on what you think you ought (or ought not) to do

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2
Q

Characteristics of ethical thinking (3)

A
  • Critically reflective
  • Systematic examination of moral life
  • Compells us to consider and reconsider our ordinary actions, judgments and justification
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3
Q

Critical reflection of ethical dillemas (DeVries & Timmins)

A

Critical reflection focuses on “consistency and inconsistency of actual care delivery with values, standards, and regulations

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4
Q

Characteristics of NURSING ethics (2)

A
  1. Relational. Focuses on everyday relationships and processes of care
  2. “Boundary work”: moral ‘in-between’ position; values of patient, family, other health providers, institutions, and self
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5
Q

Ethical uncertainty

A

Occurs when a nurse feels indecision or lack of clarity, or is unable to even know what the moral problem is

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6
Q

Ethical problems

A

Conflicts between one or more values and uncertainty about the correct course of action

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7
Q

Ethical dilemmas

A

When there are equally compelling reasons for and against one or more possible courses of action

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8
Q

Ethical (moral) distress

A

Nurses know or believe they know the right thing to do, but do not or cannot take the right action (Can vs Ought)

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9
Q

Ethical residue

A

What nurses carry from morally distressing times in our lives when, in ethically distressing situations, we feel as though our values were compromised;

“Right” decisions might still feel bad going forward

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10
Q

Ethical disengagement

A

Can occur if nurses begin to see the disregard of their ethical commitment as normal

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11
Q

Ethical courage

A

When a nurse stands firm on a point of moral principle or a particular decision about something in the face of overwhelming fear or threat to himself or herself

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12
Q

Three overarching principles of nursing ethics

A

Advocacy
Responsibility
Accountability

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13
Q

Advocacy (4)

A
  • Acting on behalf of another person
  • Speaking for persons who cannot speak for themselves
  • Includes protecting patient’s right to choice
  • Requires attention to power dynamics
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14
Q

Responsibility

A

Reliability, dependability

Responsible actions lead to trust (patients, colleagues, society)

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15
Q

Accountability (3)

A
  • Accepting responsibility, accounting for your actions (and inactions)
  • Offering reasons, explanations for aspects of nursing practice
  • Awareness of professional standards, laws, regulations; ensuring competence and fitness to practice safely
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16
Q

“Allyship”

A

Using position to workwiththose from an oppressed group to remedy the systemic denial of privilege and power

Creating opportunities for others to be heard

17
Q

What are “ethical values” ?(3)

A
  • Strong personal belief and an ideal that a person or group believes to have merit
  • Inner standards which motivate you to act as you do and by which you judge behavior
  • Influence how you interpret confusing/conflicting information
18
Q

Values formation

A

Influenced by social, relational, cultural, contextual/environmental factors

Chosen/discarded/transformed based on reflection, experience, dialogue

19
Q

Values clarification (3)

A
  • process of appraising personal values
  • helps to articulate the priorities that guide decision making
  • leads to greater self-awareness
20
Q

Values conflict

A

Occurs when personal values may be at odds with those of patients/families, colleagues, institutions

21
Q

CNA (2017) Values (7)

A
  1. Promoting Health & Well-being
  2. Promoting and Respecting Informed Decision Making
  3. Maintaining Privacy and Confidentiality
  4. Providing Safe, Compassionate, Competent and Ethical Care
  5. Promoting Justice
  6. Being Accountable
22
Q

CNO (2009) Values (7)

A
  1. Client Well-being
  2. Client Choice
  3. Privacy & Confidentiality
  4. Respect for Life
  5. Maintaining Commitments:
    - To clients
    - self
    - colleagues
    - profession
    - team members
    - quality practice settings
  6. Truthfulness
  7. Fairness
23
Q

Concept of “Moral Environments in Nursing Practice”

A
  • Healthcare environments have “ethical lives”
  • Moral agency is dialogical, relational, and influenced by context
  • Social positioning and proximity can leave nurses feeling overburdened by, and uncertain of, their responsibilities.
  • Work environments can become morally uninhabitable

I.e.,: Care erosion, cognitive dissonance, dialogue, and critical reflection

24
Q

Deontology

A

Kant

  • Right action based on duty and reason
  • Based on rationality and obligation to “good”

Critiques:

  • abstract, irrelational
  • conflict of “obligations”

Contribution:
- moral rules applied to all

25
Q

Utilitarianism

A

Betham and Mill

  • Concept of utility; greatest good for greatest number of people
  • Calculated

Critiques:
- who decides what’s “good”?

Contribution:

  • used often in public policy (e.g., COVID)
  • beneficence based
26
Q

Virtue Ethics

A

Aristotle

  • How we ought to be (versus what we should do or how we should act)
  • Reason, virtuous character and proper motivation leads to moral choices
  • ‘Golden mean’ – be brave but not reckless (there is a limit)

Critique:
- What is a ‘good’ person?

Contribution:
- Emphasizes the development of good moral character

27
Q

Feminist Ethics

A
  • Makes visible the moral significance of values/virtues associated with women and other people historically discounted from ethical reasoning
  • Integrates moral emotion, subjective knowledge
  • Relational. Attends to power dynamics in everyday life

Critique
- Relativistic and not generalizable

Contribution:

  • Captures the ethical complexity in the ‘everyday’
  • Addresses vulnerable populations
  • Sensitive to socio-political context
28
Q

Relational Ethics

A

Bergum

Environment – influence of context on N-P relationship

Embodiment – mind/body connection

Mutual respect – attention to both pt and caregiver needs

Engagement – open, trusting, responsive

Critique:
- Doesn’t address power dynamics within relationships

Contribution
- Focus on ethics enacted through relationships

29
Q

Moral Principles (4)

A

Respect for Autonomy
Beneficence
Non-Maleficence
Justice

30
Q

Process of ethical decision making

A

Follows the nursing process:

  • Assessment
  • Plan
  • Implement/act
  • Evaluate
  • Reassess and re-plan
31
Q

Special considerations for ethical decision making (3)

A
  • Both action and inaction have moral consequences.
  • You remain accountable
  • Would the decision be the same if something about the person or the context was different?

NUR351 (6 decks)

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