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73 Cards in this Set
- Front
- Back
What is ethics?
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1. The study of conduct and character
2. Reasons and rationale to explain right and wrong |
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What is ethics concerned with?
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1. Determining what is good or valuable for individuals, for groups of individuals, and for society at large
2. Concerned with questions of good or bad, right and wrong conduct, character or motives |
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What does respect for autonomy refer to?
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The commitment to include clients in decisions about all aspects of care. For example, the consent that clients read and sign before surgery illustrates this respect for autonomy.
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What does the signed consent ensure?
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That the health care team obtained permission from the client before proceeding with the surgery
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What is beneficence?
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Taking positive actions to help others, that requires that the best interests of the client remain more important than self-interest.
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What is an example of beneficence?
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A child may ask for a pill to be crushed and mixed with a favorite food, even though you know the child is able to swallow pills whole. Your commitment to do good for others guides you to comply with the child's wishes, even if you are having a busy day.
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What is nonmaleficence?
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1. The avoidance of harm or hurt
2. The commitment to provide least harmful interventions |
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What is justice?
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Fairness
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What is fidelity?
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1. The agreement to keep promises
2. The reluctance to abandon clients, even when disagreement occurs about decisions that a client makes 3. This also includes an obligation to follow through with care offered to clients. |
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What is a code of ethics?
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1. A set of guiding principles that all members of a profession accept
2. It is a collective statement about the group's expectations and standards of behavior |
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What is patient advocacy?
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1. Refers to the support of a cause
2. As a nurse, you advocate for the health, safety, and rights of the client 3. You safeguard the client's right to physical and auditory privacy |
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What is an example of patient advocacy?
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You find a private place for discussion with the client's physician or health care provider about the results of the client's diagnostic testing. As a client advocate, 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.
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What is responsibility?
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A willingness to respect obligations and to follow through on promises
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What is the American Nurse Association Code of Ethics?
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1. The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
2. The nurse's primary commitment is to the client, whether an individual, family, group, or community. 3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the client. 4. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum client care. 5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. 6. The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action. 7. The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development. 8. The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs. 9. The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. |
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What is accountability?
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The ability to answer for one's own actions
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What is a compliance officer?
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The person responsible for making sure that the institution remains in compliance with health care standards and regulations
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What is confidentiality?
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The rights and privileges of clients for protection of privacy without diminishing access to quality care
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What federal legislation mandates confidentiality protection of patient's personal health information?
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Health Insurance Portability and Accountability Act of 1996 (HIPAA)
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What are some protections of HIPAA?
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1. You cannot copy or forward medical records without a client's consent
2. You cannot share health care information, including laboratory results, diagnosis, and prognosis, with others without specific client consent, unless the information is necessary in the course of providing care 3. When medical records are computerized, computer security measures such as special access codes for all authorized users and computer “firewalls” protect systems from unauthorized access |
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What is a value?
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A personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior
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Are values static?
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No, they develop and change over time
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What are ethical dilemmas?
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Almost always a result of conflicting values
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What is deontology?
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1. A traditional ethical theory that proposes a system of ethics that is perhaps most familiar to health care practitioners
2. Actions are defined as right or wrong based on their “right-making characteristics such as fidelity to promises, truthfulness, and justice” 3. Deontology specifically does not look to consequences of actions to determine rightness or wrongness. Instead, it examines a situation for the existence of essential rightness or wrongness |
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What is consequentialism?
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A utilitarian system of ethics that proposes that the value of something is determined by its usefulness and emphasizes the outcome or consequence of action.
(also referred to as TEOLOGY) |
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What is the similarity between deontology and consequentialism?
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As with deontology, utilitarianism provides guidance, but it does not guarantee agreement
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What is the focus of feminist ethics?
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Inequalities between people. It looks to the nature of relationships for guidance in the processing of ethical dilemmas.
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What are the ethical issues among the aging population?
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1. Older people are usually not as familiar with the concept of autonomy as people from younger generations. As a result, older adults are sometimes uncomfortable disagreeing with physicians, health care providers, or nurses. They view assertiveness as a violation of trust.
2. As people age, they develop clinical conditions that affect the communication process: hearing deficits, memory impairments, chronic illness, isolation. Some clients become incapacitated by stroke or disease. Most older adults take multiple medications, some of which affect cognitive skills in subtle ways. It is important to evaluate the competence of a client to make decisions and to provide assistance where necessary, especially when treatment choices, consent, or ethical issues arise. 3. Consensus about medical goals for the older adult is hard to achieve. When is a person so diminished by old age that a treatment plan not only prolongs life, it also prolongs suffering? Working to ensure dignity and comfort is as important as achieving medical success. |
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What are the characteristics of an ethical dilemma?
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1. You are unable to resolve it solely through a review of scientific data. To decide if it is an ethical issue, you need to gather detailed information about the situation. This information comes from medical records, health care literature, consultation with colleagues, or consultation with the client and the client's family.
2. It is perplexing. You cannot easily think logically or make a decision about the problem. 3. The answer to the problem will have a profound relevance for areas of human concern. |
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What are the steps to process an ethical dilemma?
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Step 1. Ask the question: Is this an ethical dilemma? If a review of scientific data does not resolve the question, the question is perplexing, and the answer will have relevance for areas of human concern, then an ethical dilemma probably exists.
Step 2. Gather information relevant to the case. Client, family, institutional, and social perspectives are important sources of relevant information. Step 3. Clarify values. Distinguish between fact, opinion, and values. Step 4. Verbalize the problem. A clear, simple statement of the dilemma is not always easy, but it helps to ensure effectiveness in the final plan and facilitates discussion. Step 5. Identify possible courses of action. Step 6. Negotiate a plan. Negotiation requires a confidence in one's own point of view and a deep respect for the opinions of others. Step 7. Evaluate the plan over time. |
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What is the purpose of an ethics committee?
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1. Education
2. Policy recommendation 3. Case consultation |
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What does quality of life take into account?
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1. The age of the client
2. The client's ability to live independently 3. The client's ability to contribute to society in a gainful way |
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What is Huntington's disease?
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An inherited degenerative neurological disease, incurable at this time. The disease affects cognitive and emotional function, as well as physical function. Symptoms usually do not appear until the third or fourth decade of life. If a parent or grandparent has the disease, offspring are at risk for developing the disease.
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What is futile?
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Something that is “useless; hopeless; serving no useful purpose"
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How many people are uninsured in the U.S.?
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The number of uninsured in the United States grew from 39 million people in 2000 to more than 45.5 million people by 2004.
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What population groups make up the uninsured?
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Many of the uninsured are women or children. And although two thirds of the uninsured are poor, over 80% come from working families.
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What was California the first state to do?
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Pass mandated staffing ratios (1 nurse : 5 patients)
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What competes with ethical concerns about beneficence, maleficence, and justice?
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Professional issues of advocacy and client abandonment
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What does professional nursing promote?
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1. Accountability
2. Responsibility 3. Advocacy 4. Confidentiality |
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What helps nurses to explore values and feelings and to decide how to act on personal beliefs?
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The process of values clarification
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Where do ethical problems come from?
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The differences in values, changing professional roles, technological advances, and social issues that influence quality of life
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What helps health care providers resolve conflict about right actions?
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A standard process for thinking through ethical dilemmas
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In the United States, access to health care usually depends on a client's ability to pay for health care, either through insurance or by paying cash. The client the nurse is caring for needs a liver transplant to survive. This client has been out of work for several months and does not have insurance or enough cash. A discussion about the ethics of this situation would involve predominately the principle of:
1. Accountability, because you as the nurse are accountable for the well-being of this client 2. Respect for autonomy, because this client's autonomy will be violated if he does not receive the liver transplant 3. Ethic of care, because the caring thing that a nurse could provide this client is resources for a liver transplant 4. Justice, because the first and greatest question in this situation is how to determine the just distribution of resources |
4. Justice, because the first and greatest question in this situation is how to determine the just distribution of resources
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It may seem redundant that health care providers, including professional nurses, agree to “do no harm” to their clients. The point of this agreement is to reassure the public that in all ways the health care team will not only work to heal clients, they agree to do this in the least painful and harmful way possible. The principle that describes this agreement is called:
1. Beneficence 2. Accountability 3. Nonmaleficence 4. Respect for autonomy |
3. Nonmaleficence
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A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and for society, outweigh the temporary discomforts. This involves the principle of:
1. Fidelity 2. Beneficence 3. Nonmaleficence 4. Respect for autonomy |
2. Beneficence
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If a nurse assesses a client for pain and then offers a plan to manage the pain, the principle that encourages the nurse to monitor the client's response to the plan is:
1. Fidelity 2. Beneficence 3. Nonmaleficence 4. Respect for autonomy |
1. Fidelity
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Nurses agree to be advocates for their clients. Practice of advocacy calls for the nurse to:
1. Seek out the nursing supervisor in conflicting situations 2. Document all clinical changes in the medical record in a timely manner 3. Work to understand the law as it applies to the client's clinical condition 4. Assess the client's point of view and prepare to articulate this point of view |
4. Assess the client's point of view and prepare to articulate this point of view
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Successful ethical discussion depends on people who have a clear sense of personal values. When many people share the same values, it may be possible to identify a philosophy of utilitarianism, which proposes that:
1. The value of something is determined by its usefulness to society 2. The value of people is determined solely by leaders in the Unitarian Church 3. The decision to perform a liver transplant depends on a measure of the moral life that the client has led so far 4. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or health care provider |
1. The value of something is determined by its usefulness to society
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The philosophy sometimes called the ethic of care suggests that ethical dilemmas can best be solved by attention to:
1. Clients 2. Relationships 3. Ethical principles 4. Code of ethics for nurses |
2. Relationships
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In most ethical dilemmas the solution to the dilemma requires negotiation among members of the health care team. The nurse's point of view is valuable because:
1. The principle of autonomy guides all participants to respect their own self-worth 2. Nurses have a legal license that encourages their presence during ethical discussions 3. Nurses develop a relationship to the client that is unique among all professional health care providers 4. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about client care |
3. Nurses develop a relationship to the client that is unique among all professional health care providers
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Ethical dilemmas often arise over a conflict of opinion. Once the nurse has determined that the dilemma is ethical, a critical first step in negotiating the difference of opinion would be to:
1. Consult a professional ethicist to ensure that the steps of the process occur in full 2. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma 3. Ensure that the attending physician or health care provider has written an order for an ethics consultation to support the ethics process 4. List the ethical principles that inform the dilemma so that negotiations agree on the language of the discussion |
2. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma
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What is a moral?
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1. Basic standards for what we consider right or wrong
2. Based on religious beliefs, and to some extent, social influence and norms |
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What is the purpose of the professional code of ethics?
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1. Provides guidelines for safe and compassionate care. Defines a profession.
2. Provides accountability and responsibility in our professional practice |
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What is the American Nurse’s Association (ANA)?
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National organization that establishes professional nursing practice. Higher standard than legal definitions.
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What are the modes of value transmission?
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1. Modeling
2. Moralizing 3. Laissez-Faire 4. Responsible Choice 5. Reward and Punishment |
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What is modeling?
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Values are acquired from role models
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What is moralizing?
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Standards of right and wrong are rigidly forced and child is made to conform to their sets of values
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What is Laissez-Faire?
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Values are acquired without any guidelines or restrictions
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What is responsible choice?
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There is balance of freedom and restriction
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What is values clarification?
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1. The process of self-discovery that helps a person gain insight or awareness of personal values
2. It can promote a consciousness raising through which one gains an awareness of personal priorities, identify ambiguities in values and resolve major conflicts between values and behavior |
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What are the steps in values clarification?
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1. Choosing one’s beliefs and behaviors
2. Prizing one’s beliefs and behaviors 3. Acting on one’s beliefs |
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What is choosing one’s beliefs and behaviors?
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1. Choosing from alternatives
2. Considering all consequences 3. Choosing freely |
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What is prizing one's beliefs and behaviors?
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1. Prizing and cherishing the choice
2. Publicly affirming the choice |
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What is acting on one's belief?
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1. Making the choice part of one’s behavior
2. Acting with a pattern of consistency and repetition |
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What are the reasons for identifying patient values?
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1. To assist patients in making decisions
2. To individualize nursing care based on client’s values 3. To resolve conflicts between values and behavior 4. To help clients gain insight into their own personal values |
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What is deontology?
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Approaches ethical dilemmas using the concepts of justice, autonomy, veracity and beneficence without consideration of consequences
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What is utilitarianism?
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Approaches ethical dilemmas based on consequence or final product. Greatest good for greatest number of people.
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What is the feminist approach to ethics?
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Approach a ethical dilemma base on social relevance and relationships. Look at inequities within society.
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What is the ethic of care?
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Approach based on caring as central and personal relationships with focus on individual story
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What is an ethical dilemma?
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1. Can not be solved solely by examining scientific data
2. It is perplexing 3. Not a logical solution 4. Often no right or wrong answer 5. Resolution has a profound influence on another |
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What are the steps to process an ethical dilemma?
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1. Clarify if the issue is an ethical dilemma
2. Gather data from multiple sources 3. Examine your own values 4. Verbalize the problem 5. Consider possible sources of action 6. Negotiate the outcome 7. Evaluate the action |
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What is the underlying basis of ethical principles?
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Respect
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What is autonomy?
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The freedom of the individual to choose their own life plan and ways of being moral. Allows for refusal.
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What is veracity?
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Telling the truth, or not intentionally deceiving or misleading patients
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