Ethical Response Eassy

PN1001 – Session 4

Values  A strong personal belief  An ideal or standard that a person or group believes

has merit, which individuals and professions strive to uphold

 Reflect cultural and social influences, relationships, and personal needs

 Varies among people; develops and changes over time

Value Formation  Family experience  Moral development  Cultural, ethnic, and religious communities (cultural

values)  Individual experiences

Ethics  Study of good conduct, character, and motives  Philosophical ideals of right and wrong  A reflection of what matters most to people or

professions  Nurses in Canada guided by the Canadian Nurses

Association’s Code of Ethics (2008)

Code of Ethics  Is a set of guiding principles accepted by all

members of a profession  Helps professional groups settle questions about

practice or behaviour  Includes responsibility, accountability, and advocacy

CNA Code of Ethics  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

Ethical Theory  Deontology

 Defines actions as right or wrong  Utilitarianism (consequentialism)

 Proposes that the value of something is determined by its usefulness

 Bioethics  Obligation(-) and reason-based, outcome-oriented

 Feminist ethics  Focuses on inequalities between people

 Relational ethics  Emphasizes the importance of understanding relationships,

especially as they are revealed in personal narratives

Relational Ethics  “What should I do?” and “What should I do for

others?”  Core elements:

 Engaged interactions  Mutual respect  Embodied knowledge  Uncertainty  Vulnerability  Interdependent environment

Bioethics  Autonomy  Justice  Beneficence  Nonmaleficence

Autonomy  Freedom and the right to choose what will happen to

one’s own person  Informed consent  Criticism: that autonomy can lead to a focus on the

rights of one at the expense of others; mitigated by enactment of relational ethics

 Best promoted through social change rather than through protecting individual freedom of choice

Justice  The concept that everyone should be treated equally

and fairly  Moral justice  Distributive justice  Social justice

Beneficence  The concept that actions should do good  Reflected in provision of quality of care based on

competent, compassionate practice

Nonmaleficence  The concept that actions should do no harm  Reflected in practice, administration, education, and

research  Competent practitioners  Safe work environment

Ethical Dilemma Step 1: Determine whether the issue is an ethical dilemma. Step 2: Gather all relevant information. 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.

Ethical Committee  Present in most health care organizations  Provides structure and guidance for clinical ethical

decisions and fulfill a patient advocacy role  Involved in conflict resolution  Provides ethical review of research proposals

Ethical Issues  Patient care issues

 Informed consent  Futile care  Advance directives  Withdrawal of food and hydration

 Issues of safety in the work environment

Review Question #1 The patient states that she needs to exercise regularly, watch her weight, and reduce her fat intake. What does this demonstrate about the patient? 1. She believes she will have a heart attack. 2. She values health promotion activities. 3. She believes she will not become sick. 4. She has unrealistic expectations for herself.

Review Question #2 Which one of the following is an example of ethical responsibility? 1. Delivery of competent care 2. Formation of interpersonal relationships 3. Application of the nursing process 4. Evaluation of new computerized technologies

Review Question #3 The nurse stops at an accident scene to provide emergency care to the victims. Ethically, how would these actions best be labelled? 1. Respect for persons 2. Beneficence 3. Maleficence 4. Triage

Review Question #4 As the nurse prepares to take Mrs. Jones to the operating room for surgery, Mrs. Jones states, "I wish I knew what was going to happen to me when I am put to sleep." Which initial action by the nurse is most appropriate? 1. Notify the physician. 2. Explain the procedure to the patient. 3. Ask the patient if she would like to postpone

surgery. 4. Document the comment on the patient's chart.

Any Questions?