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CHAPTER 4 QUESTIONS OF VALUES AND ETHICS. INTRODUCTION. In the beginning…. There were no antibiotics There were no ICUs There were no CT scanners and MRIs There were just physicians and nurses who cared for people in sickness and in health. 1960s.
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In the beginning… • There were no antibiotics • There were no ICUs • There were no CT scanners and MRIs • There were just physicians and nurses who cared for people in sickness and in health
1960s • Technological advances allowed for the development of intensive care units • New biomedical developments • Advances in surgical techniques, such as open heart surgery
New Questions • The advances created new questions for health-care professionals regarding the use of technology • The concepts of life and death
Bioethics • A subdiscipline of ethics • The study of medical morality
Concepts of Ethics • Values • Belief systems • Morality
Value Systems • A set of related values • Intrinsic values • Extrinsic values • Personal values • Professional values
Value Formation • Values are learned • Values change with maturity and experience • The number of values an individual holds is not as important as what values they consider important
Values Clarification • Choosing • Prizing • Acting
Belief Systems • These are organized ways of thinking about why people exist within the universe • Their purpose is to explain such concepts as: • Life and death • Good and evil • Health and illness
Morals • An individual’s own code for acceptable behavior • They arise from an individual’s conscience • They act as a guide for individual behavior • Learned
Ethics • Ethics deals with the “rightness” or “wrongness” of human behavior • Concerned with the motivation behind the behavior • Bioethics is the application of these principles to life-and-death issues
Ethical Theories • Deontological • Teleological • Principalism
Ethical Principles • Autonomy • Nonmaleficence • Beneficence • Justice • Fidelity • Confidentiality • Veracity • Accountability
Autonomy • The freedom to make decisions about oneself • Nurses need to respect clients’ rights to make choices about health care
Nonmaleficence • Requires that no harm be caused to an individual, either unintentionally or deliberately • This principle requires nurses to protect individuals who are unable to protect themselves
Beneficence • This principle means “doing good” for others • Nurses need to assist clients in meeting all their needs • Biological • Psychological • Social
Justice • Every individual must be treated equally • This requires nurses to be nonjudgmental
Fidelity • Loyalty • The promise to fulfill all commitments • The basis of accountability
Confidentiality • Anything stated to nurses or health-care providers by clients must remain confidential • The only times this principle may be violated are: • If clients may indicate harm to themselves or others • If the client gives permission for the information to be shared
Veracity • This principle implies “truthfulness” • Nurses need to be truthful to their clients • Veracity is an important component of building trusting relationships
Accountability • Individuals need to be responsible for their own actions • Nurses are accountable to themselves and to their colleagues
Ethical Codes • These are formal statements of the rules of behavior for a particular group of individuals • Ethical codes are dynamic • Most professions have a “code of ethics” to guide professional behavior
Virtue Ethics • Focus on virtues or moral character • View helping others as charitable or benevolent
Organizational Ethics • Focus on the workplace • Ethical culture makes a difference • Senior leadership must promote an ethical culture
Ethical Dilemmas • Occur when a problem exists between ethical principles • Deciding in favor of one principle usually violates another • Both sides have “goodness” and “badness” associated with them
Using the Nursing Process • Assessment • Planning • Implementation • Evaluation
Issues to Consider • Assisted suicide • Technology issues • Gene therapies • “Designer babies” • Organizational climate
Conclusion • An issue is not an ethical issue for the nurse unless he or she has been asked • Always gather the facts prior to decision-making • Consider your personal beliefs and values