ethics is the study or examination of morality through a variety of different approa 2921001

ethics is the study or examination of morality through a variety of different approaches. Societal Ethics

Organizational Ethics

Bioethics/Clinical ethics/Research ethics

Professional ethics

Personal Ethics Scope of Ethics Ethical sensitivity helps us recognize when there is an ethical problem or dilemma; Ethical Principles Codes that direct or govern nursing actions ethical reflection and analysis nable us to think critically to rank our ethical obligations and priorities ethical decision making method for ensuring that the action we take is well reasoned and can be justified. Morality behavior in accordance with customs or tradition, usually reflecting personal or religious beliefs Description the branch of philosophy concerned with the distinctions between right and wrong on the basis of a body of knowledge, not only on the basis of opinions metaethics the branch of philosophy that considers fundamental questions about the nature, source, and meaning of concepts such as good and bad or right and wrong. Normative ethics deals with very specific judgments about right and wrong in everyday actions. Language of ethics

Factual information

Prior experience

Common values and beliefs

Acceptable standards of behavior Normative Ethics takes into consideration: applied ethics refers to the process of applying ethical theory and reasoning to daily life. practical ethics provides the justification for actions taken based upon ethical reflection and reasoning. Ethical and Religious Directives for Catholic Health Care Services a publication that establishes certain boundaries of practice with which some nurses and other health care professionals may disagree Code of Ethics for Nurses establishes clear priorities in the ethical practice of nursing, such as compassion, respect, and primary commitment to the patient as well as advocacy for patient rights. Societal Ethics ~Society provides a normative basis for ethical

behavior with laws and regulations.

~Law is the minimum standard of behavior to

which all members of society are held. Clinical standards of care



Malpractice In nursing, legal standards include: Organizational ethics ~Formal and informal principles and values

guide the behavior, decisions, and actions taken by members of an organization.

~Directs all aspects of an organization. bioethics deals broadly with ethical questions surrounding the biological sciences and technology, especially as applied in health care. Ex: Robotic surgery, stem cell research, cloning, abortion clinical ethics is involved primarily with decision making at the bedside and other patient-specific issues. Ex: drug administration, Research ethics is a specialized field within bioethics that examines the ethical conduct of research using human subjects and animals. Ex: Tuskegee research Organizational Ethics Formal and informal principles and values guide the behavior, decisions, and actions taken by members of an organization. Professional Ethics ~Ethical standards and expectations of a particular profession

~Held to a higher standard because of privileged role in society

~Code of conduct

~Aimed at the highest ideals of practice Personal Ethics ~Describes an individual’s own ethical foundations and practice.

~Continuously intersect with other categories of ethics.

~Sources of ethics are not static and change

over time. Family






Personal experiences Sources of Ethics Utilitarian

Rights based

Duty based (deontology)

Common good

Virtue Ethical Frameworks include: Respect for persons






Autonomy Ethical Principles include: Respect for persons simply maintains that human beings have an unconditional moral worth that requires us to treat each individual person with great value, dignity, and respect.

Closely tied to autonomy

Promotes ability of individuals to make autonomous choices

Is preserved through advanced directives and other means autonomy based on the assertion that a patient has the right to express their wishes and can make informed decisions about their treatment

Respect for an individuals right to self-determination veracity the obligation to tell the truth

Never lie

Never deceive anyone Nonmaleficence is a complicated term that simply means we should act in ways that avoid harm to others, including even the risk of harm

Ex: ER patient comes in and nurse does CPR Beneficence is an obligation to do good by acting in ways that promote the welfare and best interests of others.

can be accomplished by promoting good and preventing and removing harm

Ex: vaccinations and chemotherapy Justice the equitable distribution of potential benefits and tasks determining the order in which clients should be cared for fairness, distribution of resources, access, quality

Equally disbursed according to:



Merit Fidelity is the principle that requires us to act in ways that are loyal. includes keeping your promises, doing what is expected of you, performing your duties, and being trustworthy Duty to be faithful Includes implicit and explicit promises

Make a promise, follow it through Implicit Those promises that are implied, not verbally communicated Explicit Those that are verbally communicated ethics of duty is based on the ethical approach of deontology deontological theory moral duties are seen as self-evident, needing no further justification. Teleologic theory theory of morality that derives duty or moral obligation from what is good or desirable as an end to be achieved. Utilitarianism a moral action is one that results in the greatest good for the greatest number

“What action will promote the greatest good with the least harm?” Moral action is based on acting according to a specific duty simply because it is the right thing to do. ethic of consequences is based on a teleological view that moral actions are defined entirely on the basis of the outcomes or consequences of an action. Virtue Ethics (ethics of character) relies on the character of the individual as the primary source of moral action. Virtues are character traits that predispose a person with good intentions to do the right thing Respect, honesty, sympathy, charity, kindness, loyalty, and fairness Moral Virtues include Intelligence, patience, prudence, and shrewdness Practical Virtues include ethical problem a problem with an ethical dimension.

have a reasonably clear solution. ethical dilemma involves a problem for which in order to do something right you have to do something wrong.

In other words, it is not possible to meet all of the ethical requirements in the situation ethical question is a question that challenges you to consider a particular ethical concept, principle, or perspective in your analysis. • Do I have a duty to tell the truth?

• What is the greater harm?

• To whom is my primary loyalty?

• What are the best interests of my patient? examples of ethical questions: • Protecting patients’ rights and human dignity

• Respecting/not respecting informed consent to treatment

• Providing care with possible risk to the nurse’s health

• Using/not using physical or chemical restraints

• Working with staffing patterns that limit patient access to nursing care most frequent ethical issues experienced by RNs: •Coping with staffing patterns that limit patient access to nursing care

•Prolonging the living/dying process with inappropriate measures

•Not considering the quality of a patient’s life

•Implementing managed care policies that threaten quality of care, and

•Working with unethical/impaired colleagues. Those issues that RNs find most disturbing include the following: Moral distress occurs when you are unable to act upon what you believe is the morally appropriate action to take or when you otherwise act in a manner contrary to your personal and professional values reactive distress or moral residue, is characterized by lingering feelings that can accumulate over time with each subsequent situation in which moral distress is experienced Clinical standards of care



Malpractice In nursing, legal standards include Ethics of Character Is based on life experiences and a willingness to reflect on our actions. Ethics of Relationship Is the nature and obligation inherent in human relationships. ethic of justice has a focus on justice, rights, and the development of universal rules to ensure fairness Ethic of care is focused on emotion and relationships in the context of a particular situation Serious and potentially dangerous errors

Personal stress

Professional burnout Failure to act or respond in an ethically appropriate way has been linked to: ~Awareness of own beliefs, values, and morals

~Observance of others’ behavior

~Always act in best interest of client Nurse’s Challenges Nurse’s Rights ~Refuse to participate in giving care to a client

~Upheld by the ANA

~Must assure client is not abandoned

~The Joint Commission requirement for employers ANA Code of Ethics Provision One Practice with compassion and respect ANA Code of Ethics Provision Two Primary commitment is to client/family ANA Code of Ethics Provision Three Promotes/advocates to protect clients ANA Code of Ethics Provision Four Responsible and accountable for practice ANA Code of Ethics Provision five Same duties to self as to others ANA Code of Ethics Provision Six Establish/maintain/improve healthcare environments ANA Code of Ethics Provision Seven Participates in advancement of profession ANA Code of Ethics Provision Eight Collaborates with other healthcare professionals and the public ANA Code of Ethics Provision Nine Profession is responsible for nursing values

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