Ethical Issues. Objectives By the end of the lecture students should be able to: Define common ethical terminologies Analyze personal values that influence.

Ethical Issues

Objectives

By the end of the lecture students should be able to:Define common ethical terminologiesAnalyze personal values that influence the

approach to ethical issuesDiscuss moral implications of N/M and ICN

codes of ethicsDiscuss the role of the nurse in ethical health

care issue

Ethics

Principles of right and wrong behaviours, beliefs and values(Thompson et al (2007)

Ethics is essentially concerned with our life as members of a community and how we behave and function in society

Discipline that deals with the rightness or wrongness of actions

Ethics is the study of conduct and characterLaw and ethics overlap in so many areas

Definition of Terms

Values- Ideals or concepts that give meaning to an individual’s life. Mostly derived from social norms, religion and family orientation

Ideas and beliefs that you hold in highest regard

Activity

List ten values that guide your daily interactions

Discuss with your partner each of the values you listed and how they guide your interactions

Compare your list of values with your partner and discuss similarities and differences

Prioritize your list and discuss why you think some are more important than others

Definition CONT’D

Advance directives- written statement of a person’s wishes about how he/she would like his health care decisions to be made if he or she loses the ability to make such decisions independently

Bioethics-Ethics concerning life (euthanasia ,abortion)

Durable power of attorney for health care- spoke person

Definitions CONT’D

Ethical dilemma-situation involving competing rules or principles that appears to have no satisfactory solution

Choice between two or more equally undesirable alternatives

Morals- fundamental standard of right and wrong that an individual learns and internalizes

Definitions CONT’D

Moral and ethical principles- fundamental values and assumptions about the way humans should be treated and cared for

Moral reasoning-A process of considering and selecting approaches to resolve ethical issues

Moral uncertainty-situation that exist when the individual is unsure which moral principles or values apply in a given situation

Definitions CONT’D

Code of ethics-written list of a profession’s values and standards of conduct

It provides a frame work for decision making for a profession

Needs to be oriented to the day to day decisions made by members of the profession

Moral/Ethical Principles

Autonomy: Patient’s right to self determination without outside control

Implies freedom to make choices and decisions about one’s own care without interference even if the health care team does not agree

Or the decisions may not be in the client’s best interest

Principle CONT’D

Justice- The duty to treat all patients fairly, without regard to age, socioeconomic status or other variables

obligation to be fair to all people

Allocation of scarce and expensive health care resources

All patient with the same diagnosis should receive the same level of care

Principle CONT’D

Fidelity-Duty to be faithful to commitments

Individuals obligation to be faithful to commitments made to self and others

Professional faithfulness and loyalty

Keeping information confidential and maintaining trust and privacy

Agreement to keep one’s promise to the client about care that was offered

Principle CONT’D

Beneficence-Duty to actively do good to patients

Doing good for patients under your care

Good- holistic

Agreement that the care given is in the best interest of the client

Taking positive actions to help the client

Principle CONT’D

Non-maleficence- Duty to prevent or avoid doing harm, whether intentional or unintentional

Health care providers do no harm to their patients either intentionally or unintentionally

Protect from harm those who cannot protect themselves

Avoidance of pain or harm as much as possible when giving treatments

Principle CONT’D

Veracity- The duty to tell the truth

Requires that health care providers tell the truth and not intentionally deceive or mislead patients

Principle CONT’D

Paternalism- practices that limit the liberty of individuals without their consent

Knowing better what is good for the patient

Takes away autonomy

Principle CONT’D

Rationalism-basis for how things or conditions appear for decision making

Focuses on logical sequencing

Principle CONT’D

Pragmatism-process of clarifying ideas objectively through problem solving

Principle CONT’D

Standard of best interest-decision made about individual patient’s health care when they are unable to make informed decisions for their own care

Based on what the family and health care providers agree upon

Respect the individuals expressed wishes either written or unwritten

Principle CONT’D

Obligations-demands made on individuals, professions, society or government to fulfill and honor the rights of others

Two CategoriesLegal- formal statements of Law and are

enforced under the lawMoral- based on moral and or ethical

principles but not enforce under the law

Principle CONT’D

Rights- defined as just claims or titles or as something that is owed to an individual according to just claims, legal guarantees or moral and ethical principles

TypesWelfare/legal: legal entitlement to some good

or benefitEthical/moral: moral or ethical principles

Rights CONT’D

Option –based on fundamental belief in the dignity and freedom of human beings

Freedom of choice and the right to live as you choose

Principle CONT’D

Responsibility- execution of duties associated with the nurse’s particular role.

Principle CONT’D

Accountability- being answerable for one’s own actions

Professional accountability serve the following purposes:

1. Evaluate new professional practices and reassess existing ones

2. Maintain standards of health care

3. Facilitate personal reflection, ethical thought and personal growth

4. Provide a basis for ethical decision making

Moral Reasoning

Different approaches to moral reasoning

Factors that affect our moral reasoning :Emotions

Legal considerations

Personal held religious or spiritual convictions

Ethical Decision Making

Three models that are commonly applied are:

Deantological -moral

Teleological- utilitarianism

Situational

Deantological - Moral

System of ethical decision making that is based on moral rules and unchanging principles

Formalistic principles, principle system or duty based ethics

Ethical absoluteness of the principle regardless of the consequences of the decision

Derived fro Judeo-Christian originsIntrinsic good that are absolutes revealed from

GodAll person are worthy of respect

Teleological- utilitarianism

Ethical system of utilityOutcome focus and place emphasis on results

Based on two underlying principles:

Greatest good for the greater numberEnd justifies the means

Situational

There are no prescribe rules, norms or majority results that must be followed

Situations creates its own set of rules and principles that should be considered in that particular situation

Ethical Decision Making Process I

Collect, analyze and interpret data

State the dilemma

Consider the choices of action

Analyze the advantages and disadvantages of each Course of action

Make a decision

Ethical Decision Making Process II

Presume good will- wanting to find the good

Identify all important persons

Gather relevant information

Identify important ethical principles

Propose alternative course of action

Take action

Read on the Following

Institutional Ethics Committees and their functions

Role of the nurse in such committees

Questions

Summary

Thank you