Ch 22 Ethics And Values

Front 1

Ethics

Back 1

- Is the study of conduct and character

- Concerned with determining what is good or valuable for individuals

Front 2

Autonomy

Back 2

- Refers to the commitment to include clients in decisions about all aspects of care
- Signed consent
- Self-determination
- Patient’s right to choose for themselves whatever they want to choose

Front 3

Beneficence

Back 3

- Refers to taking positive actions to help others
- Encourages the urge to do good for others
- Best interests of the client remain more important than self-interest

Front 4

Nonmaleficence

Back 4

- Maleficence refers to harm or hurt

- Nonmaleficence is the avoidance of harm or hurt

- The will to do good and also equal commitment to do no harm

- The commitment to provide least harmful interventions illustrates nonmaleficence

Front 5

Justice

Back 5

- Refers to fairness

- Criteria set by a national multidisciplinary committee make every effort to ensure justice by ranking recipients according to need

Front 6

Fidelity

Back 6

- Refers to the agreement to keep promises
- Supports the reluctance to abandon clients
- Includes an obligation to follow through with care offered to clients
- Assess a client for pain, offer a plan to manage the pain
- Monitor the client’s response to the plan

Front 7

Code of Ethics

Back 7

- Is a set of guiding principles that all members of a profession accept
- Codes serve as guidelines to assist professional group when questions arise about correct practice or behavior
- ANA reviews and revises the code regularly, to reflect changes in practice

Front 8

Advocacy

Back 8

- Refers to the support of a cause
- You advocate for the health, safety, and rights of the client

- Follow institutional policies and procedures to report any occurrence of incompetent, unethical, illegal, or impaired practice by any health care member that has the potential to affect client health or safety

Front 9

Responsibility

Back 9

- Refers to willingness to respect obligations and to follow through on premises
- You are responsible for your actions

Front 10

Accountability

Back 10

- Refers to the ability to answer for one’s own actions
- Health care institutions also play a role in accountability by monitoring individual and institutional compliance with national standards established by The Joint Commission and the ANA
- National guidelines to ensure client safety and workplace safety through consistent, effective nursing practices
- Monitoring provision of client education about smoking cessation for all client populations
- Establishing national standards for continuing education and curriculum development for nursing schools
- Protection of ethical decision making, by requiring health care institutions to create and accessible multidisciplinary forum for discussion about ethical issues

Front 11

Compliance Officer

Back 11

Responsible for making sure that the institution remains in compliance with health care standards and regulations

Front 12

Confidentiality

Back 12

- In health care has widespread acceptance in US

- HIPAA mandates the confidential protection of clients’ personal health information

Front 13

Value

Back 13

Is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior


Front 14

Value Formation

Back 14

- Development of values begins in childhood, shaped by experiences within the family unit

- Schools, governments, religious traditions and other social institutions also play a role in the formation of values, reinforcing or sometimes challenging family values


Front 15

Values Clarification

Back 15

- You need to tolerate differences, which sometimes (although not always) become the key in the search for resolution of ethical dilemmas

- Ethical dilemmas almost always occur in the presence of conflicting values

- One needs to distinguish between
value, fact, and opinion

Front 16

Deontology

Back 16

- Proposes a system of ethics that is perhaps most familiar to health care practitioners
- Defines actions as right or wrong based on their “right-making characteristics such as fidelity to promises, truthfulness, and justice”
- Specifically does not look to consequences of actions to determine rightness or wrongness
- You try to decide about the ethics of controversial medical procedure, deontology guides you to focus on how the procedure ensures fidelity to the client, truthfulness, justice, and beneficence
- If an act is just, respects autonomy, and provides good, then the act will be right, and it will be ethical, according to this philosophy

Front 17

Utilitarianism

Back 17

- A utilitarian system of ethics proposes that the value of something is determined by its usefulness
- The greatest good for the greatest number of people is the guiding principle for determining right action in this system
- Reducing incidence of HIV is good for a great number of people

- This philosophy is also known as consequentialism, because its main emphasis is on the outcome or consequence of action

Front 18

Teleology

Back 18

The study of ends or final causes

Front 19

Feminist Ethics

Back 19

- Critiques conventional ethics such as deontology and utilitarianism
It focuses on inequalities between people

- Proposes that principles distract you from dealing with larger issues of community

- Propose that the natural human urge to be influenced by relationships is a positive value

Front 20

Ethic of Care

Back 20

- People who write about this are often nurses or physicians
- They promote a philosophy that focuses on understanding relationships, especially personal narratives
- “the one-caring” and “the cared for”
- Emphasize the role of feelings but not at the expense of principles such as autonomy and beneficence
- His definition of care includes the obligation to appreciate, understand, and even share the pain or condition of a client


Front 21

How to Process an Ethical Dilemma

Back 21

- Resolving an ethical dilemma
- It requires deliberate, systemic discourse
- Requires negotiation of differences of opinion
- Process begins with the gathering of all pertinent information and then the group proceeds through assessment, planning, implementation, and evaluation
- If the issue is an ethical one, it will entail at least one of the following:
- You are unable to resolve it solely through a review of scientific data
- It is perplexing. You cannot easily think logically or make a decision about the problem
- The answer to the problem will have a profound relevance for areas of human concern
- Everyone agrees on the statement of the dilemma
- Next discussion listing possible courses of action helps the group explore options
- When the process involves a family conference or changes in the management plan, you will document the process in the medical record

Front 22

Ethical Process

Back 22

- Is this an ethical dilemma?
- Gather as much information as possible that is relevant to the case
- Examine and determine your own values on the issues
- Verbalize the problem
- Consider possible courses of action
- Negotiate the outcome
- Evaluate the action

Front 23

Institutional Resources

Back 23

- Ethics committees are usually multidisciplinary
- They serve several purposes:
- Education, policy recommendation, and case consultation
- Any person involved in an ethical dilemma, including nurses, physicians, health care providers, clients and families of clients are able to request access to an ethics committee

Front 24

Futile Care

Back 24

Refers to something that is “useless, hopeless, serving no useful purpose” interventions unlikely to produce benefit for the client

Front 25

Allocating Scarce Resources

Back 25

- Key issue in discussions about access to care
- Organ transplants, vaccines, blood

Front 26

Quality of Life

Back 26

Central to discussions about futile care, cancer therapy, physician-assisted suicide, and DNR