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Arts and Humanities
Roles Exam 2
Terms in this set (92)
what are the 3 general types of ethics?
2) normative ethics
3) applied ethics
focuses on universal truth
focuses on the moral standards that regulate behaviors
focuses on specific difficult issues such as euthanasia, capital punishment, abortion, and health disparities
what are some more dramatic ethical issues for nurses?
assisting families, making end-of-life decisions, allocating care in emergency situations (triage), managing pain near the end of life with large doses of narcotics, and advocating for patient.
attitudes, ideals, or beliefs that an individual or a group holds and uses to guide behavior
provide standards of behavior that guide the actions of an individual or social group and are established rules of conduct to be used in situations where a decision about RIGHT and WRONG must be made
an example of a moral standard
"one should not lie"
a term used to reflect what actions an individual should take and my be "codified" as in the ethical code of a profession
the application of ethical theories and principles to moral issues or problems in health care
bioethics is concerned with
determining what should be done in a specific situation by applying ethical principles
what issues have advances in science and medical technology caused in ethical decision making?
they sometimes create ethical dilemmas for health care providers
a critical attribute of providing care in a professional setting is that
professional ethics override personal morals and values
code of ethics
a hallmark of mature professions and a social contract through which the profession informs society of the principles and rules by which it functions
provision 2 of the Nurses Code of Ethics
describes the nurse's primary commitment to the patient
provision 5 of the Nurses Code of ethics
describes the responsibility of nurses to maintain their own integrity
why is it important for nurses to be clear about their own personal values and morals?
by understanding their personal values, nurses can anticipate situations in which their personal morals and professionals values may be in conflict
critical analysis of one's morals, beliefs, and actions is a process through which a person develops and maintains moral integrity
a response to a situation when nurses are faced with ethical dilemmas but also encounter institutional constraints that limit their actions
moral distress in other words
the pain or anguish affecting the mind, body or relationships in response to a situation in which the person is aware of a moral problem, acknowledges moral responsibility, and makes a moral judgement about the correct action
can be experiences when nurses attempt to sort out their emotions when they find themselves in situations that are morally unsatisfactory or when forced beyond their control prevent them from influencing or changing these perceived unsatisfactory moral situations
when doing the right thing is not easy; our capacity to befriend our fear and stand up for our core values or principles (ex: filing an official report)
Why did Gilligan think that Kholberg's Stages of Moral Reasoning were wrong?
Gilligan felt that Kohlberg's inattention to gender differences meant that his theory was inadequate in explaining women's moral development.
Kholberg's 3 Stages of Moral Reasoning
1) pre conventional
3) post conventional
pre conventional level
- the individual is inattentive to the norms of society when responding to moral problems
- the individual wants or needs takes precedence over right and wrong
pre conventional level (stage 1)
responds to punishment
pre conventional level (stage 2)
responds to personal reward
characterized by moral decisions that conform to the expectations of one's family, groups, or society
conventional level (stage 3)
- focuses on pleasing others
conventional level (stage 4)
- makes choices based on society
- follow family or cultural group norms
post conventional level (stage 5 & 6)
- involves more independent modes of thinking than previous stages
- individual has developed the ability to define his or her own moral values
Gilligan's levels of moral development
1) orientation to individual survival
2) a focus on goodness with recognition of self-sacrifice
3) the morality of caring and being responsible for others, as well as self
- means "obligation to duty"
- Immanuel Kant
they determine the right thing to do by gathering all the facts and then making a decision
emphasize that principles guide our actions
- in all situations, the rule is to be followed
- deontologists are not concerned with the consequences of adhering to certain rules or actions
based on a fundamental belief that moral rightness of its action is determined solely by its consequence
- "what makes an action right or wrong is its utility, with useful actions bringing out the greatest good for the greatest number of people"
- ex: triage
example of Utilitatrianism
triage- in which the sick or injured are classified by the severity of their condition to determine priority of treatment
what is an issue of Utilitarianism?
the interests of benefitting the majority, the interests of the individual or minority, who also deserve help, may be overlooked
tendencies to act, feel, and judge that develop through appropriate training but come from natural tendencies
- individuals actions are built from a degree of inborn moral virtue
provide the means to analyze and act on ethical dilemmas in health care in the United States
individuals have the right to determine their own actions and the freedom to make their own decisions
example of autonomy
- a patient deciding to refuse treatment or procedures
- giving consent for treatment or procedures
- obtaining information regarding results of diagnostic tests, diagnosis, and treatment options
- defined as "the doing of good"
- not required of general public
example of beneficence
- advocating for increase in pain medication when they are still in pain, turning the bed around every 2 hours so that they don't get bed sores
the duty to do no harm
the concept that justifies risking harm is referred to as the principle of
equals should be treated the same and that unequals should be treated differently
- patients with the same diagnosis and health care needs should receive the same care and those with greater or lesser needs should receive care that is appropriate to their needs
faithfulness or honoring one's commitments or promises
- nurses must be faithful in keeping their promises of respecting all individuals, upholding the Code of Ethics for Nurses, practicing within the scope of nursing practice, keeping nursing skills current, abiding by an employer's policies and keeping promises to patients
telling the truth or not lying
; telling the truth is fundamental to the development and continuance of trust among human beings
2 exceptions to veracity (telling the truth)
1) the nurse can under the ethical principles of beneficence and nonmaleficence, withhold the truth
2) if a patient is mentally incompetent, autonomy and the capacity for self-determination are diminished; therefore justifying withholding of health care information
what ethical theory goes with putting fluoride in drinking water?
i make the choices for you, you haven't necessarily given me the right to make them
What ethical principle states that all patients with chest pain should receive morphine
justice (ALL patients)
This occurs when a husband makes medical decision for his wife?
paternalism (whenever someone makes a choice over a patient)
this element of malpractice would be met if a patient had to have their leg amputated due to the nurse not assessing it.
4 points of malpractice:
- breech of duty
failing to act as a reasonably prudent person would act in a given situation
for this document to be legal the patient must complete it voluntarily, be given complete and accurate information, understand the information and be competent to sign it
this law prevents my health insurance company from denying my coverage based on my genetic information
this document tells health care providers what I want done regarding end of life decisions
what was the first public evidence of an ethical code in nursing?
The Florence Nightingale Pledge
what is the purpose of the Code of Ethics for Nurses
it is the nursing profession's expression of its ethical values and duties to the public
the ANA's Nursing Scope and Standards of Practice purpose
it defines standards of practice and standards of professional performance
what is the "heart of nursing's social contract"?
the self regulation of the of the ethical practice of nursing through the Code of Ethics
ethical dilemmas arise from conflicts in
- personal value systems
- professional values
- peer and other's behaviors
- patient's rights
- institutional and societal issues
ethical dilemmas can occur among:
health care providers, families, patients, and people in communities about the right thing to do when ethics, values and perceptions collide
- comes from a change in your personal value system
Ethical Decision making model
1) Clarify the Ethical Dilemma
2) Gather Additional Data
3) Identify options
4) Make a decision
Clarify the ethical dilemma
what is the specific issue in question? who should actually make the decision? who is affected by the dilemma? Determine the ethical principle or theory related to the dilemma. Are there value conflicts? what is the time frame for the decision?
Gather additional data
after the ethical dilemma is clarified, in most instances, more information needs to be collected. Clarity is enhanced when you have as many facts as possible about the situation. Make sure you are up to date on any legal cases or precedents related to the situation, because ethical and legal issues often overlap
most ethical dilemmas have multiple solutions, some of which are more feasible than others. The more options that are identified, the more likely it is that an acceptable solution can be identified. Brainstorm with others, and consider every possible alternative that you can come up with
Make a decision
think through the options that you identified, determine the impact of each option, Ethical principles and theories as well as universal basic human values, may help determine the significance of each option. When a nurse is confronted with an ethical dilemma, an active decision should be made, as opposed to refusing to make a decision (being nonactive), which is irresponsible professional behavior
once a course of action has been determines, the decision must be carried out. implementing the decision usually involves working collaboratively with others
did your choice solve the problem?
ethical decision making is
- based on ethical principles and civil law
ethical decision making IS NOT based on:
- fixed policies
questions to consider while making ethical decisions
- How does the action align with your values?
- How does it align with the ANA code of ethics?
- What are the likely consequences of action or inaction? Cost? Benefit?
- What decision can you live with?
conflict can evolve because of
differing value systems, cultures, education levels, or a variety of other factors
unethical actions results when health care workers
break basic norms of conduct toward others, especially the patient, whatever the reason.
nurses face 2 serious ethical challenges in today's sociocultural context
1) the use of social media
2) substance use/abuse
the widespread use of social media has created 2 distinct problems
1) the transmission of potentially identifiable patient information
2) the blurring of professional and personal boundaries
patient self-determination act
a safeguard for patients' rights, giving patients the legal right to determine how vigorously they wish to be treated in life-or-death situations, and calls for the hospitals to abide by the patient's advance directives.
(encourages individuals to think about the type of medical and nursing treatment they would want if they were to become critically injured or ill)
in a professional setting is a goal in which one's professional beliefs and actions are assessed and analyzed so that professional ethics continue to mature and respond to changes in practice
something owed to an individual
patients have the right to
- self determination (right to decide (autonomy))
ethical issues related to nursing
- commitment to patient
- commitment to employer
- commitment to colleagues
- self evaluation
boundary violations are characterized by
excessive personal disclosure by the nurse, secrecy, or even reversal of roles
underinvolvement by the nurse is characterized by
distancing, disinterest and neglect
the key to avoiding boundary crossings
continual alertness, self-evaluation, emphasis on the patient's best interest
pillow angel Ethical Theory
Pillow Angel Ethical Principles:
beneficence: wanted her to have good quality life
paternalism: parents made the decision
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