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Ethical Issues

Ethical Issues. Professionalism in Faith Community Nursing. Objectives:. - Identify ethical issues in Faith Community Nursing practice. - Discuss the elements of ethical-decision making.

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Ethical Issues

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  1. Ethical Issues Professionalism in Faith Community Nursing

  2. Objectives: • - Identify ethical issues in Faith Community Nursing practice. • - Discuss the elements of ethical-decision making. • - Apply ethical decision-making to faith community nursing practice situations that involve ethical issues.

  3. Ethical Issues • What is an ethical issue? • Definitions: • An issue is a matter in dispute • An ethical issue is a matter in dispute because of a conflict of moral values • Resolutions needs ethical deliberation and/or ethical decision-making • Ethical issues are often controversial topics, value-laden

  4. Ethical Issues 3. An ethical issue is NOT an ethical dilemma or a situation of ethical uncertainty, or a situation of ethical distress. • Ethical issue – situation where 2 equal course of action/judgment, person uncertain which to pursue • Ethical uncertainty – ethical dimension of the situation are uncertain or unknown & unclear which moral values and ethical principles should be applied • Ethical dilemma – moral values are known, ethical principles are known, action has been decided, however, constraint prevents action

  5. Values • Definition – Values are worthwhile standards or qualities of a person or a social group. • Values come from many sources – culture, family, peer group, work, religious beliefs, education, etc. • Values are expressed in language or in standards of conduct that a person endorses. • Values represent a person’s set of beliefs about they believe to be true.

  6. How do our values influence us? Some values are more important to us than others. • We organize our values into some system of prioritization of importance to us • Some values get prioritized higher with our value system • Our value system is fairly stable, over time, but the system changes as a result of life experiences and reassessment of one’s values

  7. Values have motivational power • They guide a person’s choices. • Our choices, actions and judgments often protect our values. • The position we take on controversial issues is usually motivated by our values. • Understanding one’s values is the first step in preparing to make ethical decisions.

  8. Value Classifications • Moral values • Non-moral values • Cultural Values • Religious Values • Professional Values • Personal Values

  9. Values in FCN practice? • Conflicts of values… • End-of-life decisions • Termination of treatment • Deciding who should be proxy decision makers • Protecting of values… • Deciding when it is no longer safe for elderly parishioners to live at home • Protecting parishioner confidentiality • Protecting good will • Balancing ‘doing good’ vs. ‘doing harm’ • Unintended pregnancy • Assisted reproduction practices

  10. Values in FCN practice • Justice and equality… • Access to treatment or health care • Developing outreach to homeless • Treatment of LGBT parishioners • Treatment of HIV or AIDS parishioners

  11. Ethical Principles: • Beneficence • Nonmaleficence • Justice • Autonomy • Veracity • Fidelity • The sanctity of human life

  12. Elements of Ethical Decision Making: • Knowledge of personal values and beliefs: • Understand the nature of values and values conflict • Identify personal values and their origins • Knowledge of ethical principles: • Principles are guides to decision to take ethical action • Justify and provide sound moral reasons

  13. Elements of Ethical Decision Making: Knowledge of ethical concepts of nursing: Advocacy – speaking on behalf of or helping the patient discuss needs, interests, choices • Accountability– being answerable to someone for something one has done in a particular role. • Cooperation - active participation, collaboration and reciprocity with others to obtain or to achieve something. • Caring – involvement with another that expresses concern about how they are experiencing their world.

  14. Nursing Code of Ethics • Defined as “a conventionalized set of rules or expectations devised for a select purpose” • International Council of Nurses • Almost all codes of ethics for nurses in the world agree on: • Practice competence • Protection of patient confidentiality • Nondiscrimination of patients • Ethical accountability of the nurse

  15. Standards for ethical decisions: • Know church teaching/faith beliefs • Know FC position on ethical issues • Recognize congregants face decision that may conflict with faith teachings • Know what your role is: • Support and inform parishioners, provide the church’s presence at difficult times • FC/PN role is helped when: • Know your own faith beliefs • Acknowledge where own faith beliefs differ from the faith community served, seek counsel & guidance from faith leader, know when to remove yourself from a situation

  16. Integration of knowledge is necessary to begin ethical analysis and make ethical decisions.

  17. Ethical Analysis: One Method • 1. What is the “story” behind the value conflicts? • Discover how the conflicts are described by the parties experiencing the conflict: • Each of the parties describes the factual info (who did what) • Each of the parties describes their values (why the situation is seen as an ethical problem) • Each of the parties describes the conflicts of values they perceive • 2. Clarify the conflicts and the values involved: • The context within which the conflict arose • Interpretation of the conflicts and values involved • 3. Identify the moral values involved and where they conflict with other values.

  18. Ethical Analysis 4. What is the significance of the values involved? • Explore the meaning of values held, examine their values and values of others so negotiations can begin. • Identify the potential cultural, religious, personal, professional, and political origins of values • Respect each other values • Prioritize & preserve values The FC/PN should ask: • What does it mean to care for this patient? • What are my nursing responsibilities to this patient? • What are my FCN responsibilities to this patient? • Are there any legal questions that might need to be explored by a legal representative? • How do I, as a FCN maintain my ethical integrity in this situation?

  19. Ethical Analysis 5. What is the significance of this conflict to the parties involved? • Identify how the parties involved relate their values to the present situation. • Values are never static; they are dynamic in that they change over time • Value conflicts do not occur in a vacuum • Consider that the conflict of values might lead to a decision that affects several of the parties involved: • The quality of the patients life • How long the patient may live • The amount of guilt that others might experience • Emotional and psychological stress might experience. • Consider that the conflict of values might lead to the formulation of policy: • May prevent similar value conflicts • Significance to health professionals

  20. Ethical Analysis 6. What should be done? • Explore all the ways in which the conflict might be resolved – consensus “the right thing” • Recognize that there is seldom an “ethically correct” solution Ethical decisions are usually made based on: • Relevant info available • Moral weight of values • Best judgment of decision maker • Ethical stance of group Explore all options in light of: • Values held • Potential outcomes • Perceived moral rightness/wrongness

  21. Ethical Analysis • Choose a course of action based on: • Decision maker’s best judgment • Consideration of context of values conflict • Consideration of values • Consideration of ethical relevance • Assess the outcome of the situation & process that led to decision • Ethical analysis improved • Implication of ethical action implemented

  22. Analysis • Recognize same/similar value conflicts may recur • Result of similar value conflicts or cultural backgrounds • Result of personal or professional values of RN • Require policy recommendations • Require information of professional standards & position statements • Other considerations include: • Others may have different value system • Be mindful of your influence with another person or a family • Family members may have conflicting motives/feelings/religious beliefs • Some situation may require interventions by faith leaders, ethics committee, or ethicist • Complexity of value conflicts may increase when dealing with issues at the community or congregational level

  23. Evaluation of Learning: Case Study Work/Discussion: • Engage in small group discussions in projects forum with your teammate of the simulated situations involving conflicts of value. • Use ethical analysis method you learned this week to understand the value conflicts. • Propose ethical actions that the faith community nurse would implement in the case using a knowledge of ethical principles, ethical concepts of nursing, and ethical standards for nursing practice.

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