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Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 4. ETHICAL RESPONSIBILITIES. Ethics. The branch of philosophy concerned with the distinction of right from wrong on the basis of a body of knowledge rather than on just opinions.

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ethics
Ethics
  • The branch of philosophy concerned with the distinction of right from wrong on the basis of a body of knowledge rather than on just opinions.
  • Ethics looks at human behavior - things people do under different types of circumstances.
bioethics
Bioethics
  • The application of ethical principles of health care.
why is ethics an increasing issue for health care
Why is Ethics an Increasing Issue for Health Care?
  • an increasingly technological society with complicated issues that never had to be considered before.
  • the changing fabric of society, particularly in terms of family structure.
  • health-care has become a consumer-driven system based on clients becoming more knowledgeable.
ethical principles
Ethical Principles
  • Codes that direct or govern actions.
basic ethical principles
Basic Ethical Principles
  • Autonomy - The respect for individual liberty
  • Justice - The equitable distribution of potential benefits and risks
  • Fidelity - The duty to do what one has promised
  • Nonmaleficence - The obligation to do or cause no harm to another
  • Beneficence - The duty to do good to others
  • Veracity - The obligation to tell the truth
ethical theories
Ethical Theories
  • Teleology - the value of a situation is determined by its consequences.
  • Deontology - the intrinsic significance of an act itself as the criterion for the determination of good.
  • Situational Theory - holds that there are no set rules or norms. Each situation must be considered individually.
  • Caring-Based Theory - focuses on emotions, feelings, and attitudes.
values
Values
  • Values are different from principles, in that they influence the development of beliefs and attitudes, rather than behaviors. They may, however, indirectly influence behaviors.
value system
Value System
  • An individual’s collection of inner beliefs that guides the way the person acts and helps determine the choices made in life.
value clarification
Value Clarification
  • The process of analyzing one’s own values to better understand those things that are truly important in life.
value clarification1
Value Clarification
  • The process of analyzing one’s own values to better understand those things that are truly important in life.
self reflection
Self-Reflection
  • Because ethics and values are so closely associated, nurses must explore their own values in order to acknowledge the value systems of their clients.
ethical codes
Ethical Codes
  • Codes are used to help nurses act ethically.
  • These have been developed by nursing organizations such as the NFLPN, the ICN and the ANA.
the patient s bill of rights
The Patient’s Bill of Rights
  • A document designed to guarantee ethical care of clients in terms of their decision making about treatment choices and other aspects of their care.
ethical dilemma
Ethical Dilemma
  • A conflict between two or more ethical principles.
  • In an ethical dilemma, there is no “correct” decision.
major types of ethical dilemma
Major Types of Ethical Dilemma
  • Euthanasia.
  • Refusal of Treatment.
  • Scarcity of Resources.
euthanasia
Euthanasia
  • Intentional action or lack of action that causes the merciful death of someone suffering from a terminal illness or incurable condition.
refusal of treatment
Refusal of Treatment
  • Based on the principle of autonomy.
  • A client’s rights to refuse treatment and to die often challenge the values of most health care providers.
scarcity of resources
Scarcity of Resources
  • The allocation of scarce resources (e.g. organs, specialists) is emerging as a major medical dilemma.
ethics committees
Ethics Committees
  • Many health care agencies now recognize the need for a systematic manner whereby to discuss ethical concerns.
  • Multidisciplinary committees offer dialogue regarding ethical dilemmas.
  • Ethics committees can lead to the establishment of policies and procedures for the prevention and resolution of dilemmas.
nurse as client advocate
Nurse as Client Advocate
  • When acting as client advocate, the nurse’s first step is to develop a meaningful relationship with the client.
  • The nurse is then able to make decisions with the client based on the strength of the relationship.
nurse as whistleblower
Nurse as Whistleblower
  • Whistleblowing refers to calling attention to unethical, illegal, or incompetent actions of others.
  • Whistleblowing is based on the ethical principles of veracity and nonmaleficence.
  • Federal and state laws (to varying degrees) provide protection, such as privacy, to whistleblowers.
questions for whistleblowers
Questions for Whistleblowers
  • Whose problem is this?
  • Must I do anything about it?
  • Is it my fault?
  • Who am I to judge?
  • Do I have the facts straight?