Week 9 - Ethical Decision Making Flashcards
Review ethical principles and theories. Explore ethical theories and principles used in healthcare. Apply ethical principles and theories to practice ethical decision-making
1
Q
What is a nurse and the four pillars?
A
- The use of the title “nurse” is reserved for those who have met all requirements. The practice of nursing is varied, with employment opportunities being open only to members of the profession.
- Taken together, the four pillars of regulator, union, professional association, and education provide oversight, governance, and advancement for the profession and contribute to the high level of public trust that nurses and nursing enjoy.
o Regulator: serve and protect the public
o Professional: advance the profession and improve health
o Educational: advance education and represent nursing programs
o Union: support the nurse and strengthen working conditions
2
Q
What kind of relationship do nurses have with their patients?
A
- Nurses have a fiduciary relationship with their patients meaning they are a professional (the nurses) who provides services that by their nature cause the recipient (the patient) to trust in the specialized knowledge and integrity of the professional.
- In a fiduciary relationship nurses are obligated to provide knowledge, competent, and safe care and to act in the best interest of their patients, as well as nursing students.
3
Q
Federal Law
A
The federal law applies across the country. The Constitution of Canada is the primary source of Canadian law and gives the provinces authority over matters such as the management of hospitals, the solemnization of marriage, and civil rights. In the constitutional context, civil rights have a broad meaning and refer to private relationships between people, including contract rights, ownership of property, and negligence disputes.
4
Q
Canada’s two systems of Law
A
- In Canada, there are two systems that deal with private law issues: civil law (based on Roman law) in Quebec and common law (based on British common law) in the rest of the country.
5
Q
Statute law
A
- When either a civil or a criminal case goes to court, rulings are made based on statute law and previous case rulings. How courts rule on the circumstances and facts surrounding the case is called a precedent.
- If legal rulings are made in a case, the court is bound to follow that decision in subsequent similar cases. Not every jurisdiction has case law on a given issue.
- Statute law is created by elected legislative bodies such as the Parliament of Canada and provincial or territorial legislatures. Federal statutes apply throughout the country, and provincial and territorial statutes apply only in the province or territory in which they were created.
6
Q
Professional regulation
A
- Nursing is regulated at the provincial or territorial level and they each have legislation that grants authority to a nursing regulatory body to operationalize and enforce the laws and regulation that define the profession and practice of nursing.
7
Q
The regulatory bodies
A
- are accountable to the public for ensuring safe, competent, and ethical nursing care
- are responsible for granting certificates of registration, offering practice support, ensuring continuing competence of their members, investigating complaints against members’ conduct, and disciplining members when necessary.
- are responsible for developing codes of ethics, setting standards of practice, and approving nursing education programs that meet the expectations of the Canadian Association of Schools of Nursing (CASN) framework for nursing education
8
Q
Nurses and regulation
A
- Nurses must be registered with the nursing regulator of the province or territory in which they practise. The requirements for registration (or licensure, as applicable) vary across the country, but most provinces and territories require that nurses meet minimum education requirements and pass an examination. Registration (or licensure) enables nurses to practise nursing and use the applicable protected nursing title and initials.
- Registration can be suspended or revoked by the regulatory body if a nurse’s conduct violates provisions in the registration statute.
- Due process must be followed before resignation can be suspended or revoked. Due process means that nurses must be notified of the charges brought against them and have an opportunity to defend themselves against the charges in a hearing.
9
Q
Standards of Care
A
- Standards of care are legal guidelines for nursing practice. Standards establish the expectation that nurses will provide safe and appropriate patient care. If nurses do not meet them, they may face legal action
- All provincial and territorial legislatures have passed health professions acts or nursing practice acts that define the scope of nursing practice. These acts set educational requirements for nurses, distinguish between nursing and medical practice, and generally define nursing practice.
- Accreditation Canada requires that accredited health care institutions have nursing policies and procedures in writing that detail how nurses are to perform their duties.
- In a negligence lawsuit, these standards of care are used to determine whether the nurse has acted as any reasonably prudent nurse in a similar setting with the same credentials would act.
10
Q
Building Blocks of Scope of Practice
A
- From biggest to smallest:
- population’s health care needs
- community/service area’s health care needs
- client’s total health car needs
- legislated scope of RN(NP) practice;
- employer policy on RN(NP) practice
- individual RN scope of practice
11
Q
What is a tort?
A
- A tort is a civil wrong committed against a person or property. Torts may be classified as intentional or unintentional. Intentional torts are willful acts that violate another person’s rights
o Examples are assault, battery, invasion of privacy, and false imprisonment. Negligence is an example of an unintentional tort.
12
Q
Assault
A
- Assault is conduct (such as a physical or verbal threat) that creates in another person apprehension or fear of imminent harmful or offensive contact. No actual contact is necessary for damages for assault to be awarded
13
Q
Battery
A
- Battery is any intentional physical contact with a person without that person’s consent. The contact can be harmful to the patient and cause an injury, or it can be merely offensive to the patient’s personal dignity. Can even by a life saving measure. A patient has the right to revoke or withdraw consent at any time.
14
Q
Invasion of Privacy
A
- The tort of invasion of privacy protects the patient’s right to be free from unwanted intrusion into their private affairs. Patients are entitled to confidential health care.
- The nurse’s fiduciary duty requires that confidential information not be shared with anyone else except on a need-to-know basis.
- A nurse should not assume that a patient’s spouse or family members know the patient’s entire medical history, especially potentially sensitive issues such as mental illness, pregnancy, medical assistance in dying, or sexually transmitted infections.
- Sometimes nurses must breach privacy. For example, if the patient has a gunshot wound, testing in court, or in cases of suspected child abuse.
- Nurses are under no legal obligation to release confidential information to the police except in rare cases in which the life, safety, or health of the patient or an innocent third party is in jeopardy. Such a statement should first be reported to the employer’s administration or legal counsel before being released to the police.
- Make sure to not share any passwords to the electrical systems that healthcare institutions use to keep patient records.
- Nurses must also be extremely cautious about what information or images they post online, as any information can be easily distributed and make its way into the public domain.
15
Q
False Imprisonment
A
- The tort of false imprisonment serves to protect a person’s individual liberty and basic rights. Preventing a patient from leaving a health care facility voluntarily may constitute the tort of false imprisonment. The inappropriate or unjustified use of restraints (e.g., by confining a person to an area, or by using physical or chemical restraints) may also be viewed as false imprisonment
- Nurses must be aware of the facility’s policies and the legislation in their jurisdiction to know when and how restraints can be used.
