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Fundamentals of Nursing Chapter 22
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Terms in this set (21)
Autonomy
Commitment to include patients in decisions about care.
Beneficence
The best interests of the patient remain more important than self-interest.
Nonmaleficence
Avoidance of harm or hurt.
Justice
Fairness
Fidelity
The agreement to keep promises and the unwillingness to abandon patients.
Identify the four basic principles of the code of ethics
1. Advocacy
2. Responsibility
3. Accountability
4. Confidentiality
Define Value:
Is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior.
Define Values clarification:
Is the need to distinguish among values, facts, and opinions.
Deontology:
Is a system of ethics that defines actions as right or wrong based on their "right-making characteristics such as fidelity to promises, truthfulness, and justice." It does not look at the consequences of actions.
Utilitarianism:
Is when the value of something is determined by its usefulness; the main emphasis is on the outcome or consequences of actions.
Feminist ethics:
Focus on inequalities between people; they look to the nature of relationships for guidance.
Ethics of care:
Focuses on understanding relationships, especially personal narratives.
Casuistry:
Case-based reasoning turns away from conventional principles of ethics as a way to determine best actions and focuses instead on an "intimate understanding of particular situations"
List the key steps in the resolution of an ethical dilemma:
a. Gather information relevant to the case.
b. Clarify values.
c. Verbalize the problem.
d. Identify possible causes of action.
e. Negotiate a plan.
f. Evaluate the plan over time.
Identify the purposes of the ethics committee:
It provides education, policy recommendations, and case consultation.
Quality of life:
Quality-of-life measures the value and benefits of certain medical interventions, which is central to discussions in futile care, cancer therapy, and do not resuscitate (DNR).
Disabilities:
Antidiscrimination laws enhance the economic security of people with physical, mental, or emotional challenges.
End of life care:
Almost any intervention beyond symptom management and comfort measures is seen as futile.
A health care issue often becomes an ethical dilemma because:
1. Decisions must be made based on value systems.
2. The choices involved do not appear to be clearly right or wrong.
3. Decisions must be made quickly, often under stressful conditions.
4. A patient's legal rights coexist with a health professional's obligations.
Answer: 2. The choices involved do not appear to be clearly right or wrong.
Rationale: Ethical problems come form controversy and conflict.
Which statement about an institutional ethics committee is correct?
1. The ethics committee would be the first option in addressing an ethical dilemma.
2. The ethics committee replaces decision making by the patient and health care providers.
3. The ethics committee relieves health care professionals from dealing with ethical issues.
4. The ethics committee provides education, policy recommendations, and case consultation.
Answer: 4. The ethics committee provides education, policy recommendations, and case consultation.
Rationale: The ethics committee is an additional resource for patients and health care professionals.
The nurse is working with the parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is:
1. Exploring reasonable courses of action.
2. Identifying people who can solve the difficulty.
3. Clarifying values related to the cause of the dilemma.
4. Collecting all available information about the situation.
Answer: 4.
Rationale: Incorporate as much information as possible form a variety of sources such as laboratory and test results; the clinical state of the patient; current literature about the condition; and the patient's religious, cultural, and family situation.
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