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as c urs ng: oun a ons o
Skills & Concepts
ETHICALRESPONSIBILITIES
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Ethics
The branch of philosophy concernedwith the distinction of right from wrongon the basis of a body of knowledgerather than on just opinions.
Ethics looks at human behavior - thingspeople do under different types ofcircumstances.
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Bioethics
The application of ethical principles ofhealth care.
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Why is Ethics an IncreasingIssue for Health Care?
an increasingly technological society with
complicated issues that never had to be consideredbefore.
the changing fabric of society, particularly in terms of
family structure.
health-care has become a consumer-driven systembased on clients becoming more knowledgeable.
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Ethical Principles
Codes that direct or govern actions.
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Basic Ethical Principles
Autonomy -The respect for individual liberty
Justice -The equitable distribution of potentialbenefits 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
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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 consideredindividually. Caring-Based Theory- focuses on emotions,
feelings, and attitudes.
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Values
Values are different from principles, inthat they influence the development ofbeliefs and attitudes, rather thanbehaviors. They may, however,
indirectly influence behaviors.
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Value System
An individuals collection of inner beliefsthat guides the way the person acts andhelps determine the choices made inlife.
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Value Clarification
The process of analyzing ones ownvalues to better understand thosethings that are truly important in life.
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Value Clarification
The process of analyzing ones ownvalues to better understand thosethings that are truly important in life.
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Self-Reflection
Because ethics and values are soclosely associated, nurses must exploretheir own values in order toacknowledge the value systems of their
clients.
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Ethical Codes
Codes are used to help nurses actethically.
These have been developed bynursing organizations such as theNFLPN, the ICN and the ANA.
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The Patients Bill of Rights
A document designed to guaranteeethical care of clients in terms of theirdecision making about treatmentchoices and other aspects of their care.
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Ethical Dilemma
A conflict between two or more ethicalprinciples.
In an ethical dilemma, there is nocorrect decision.
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Major Types of Ethical Dilemma
Euthanasia.
Refusal of Treatment.
Scarcity of Resources.
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Euthanasia
Intentional action or lack of action thatcauses the merciful death of someonesuffering from a terminal illness orincurable condition.
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Refusal of Treatment
Based on the principle of autonomy.
A clients rights to refuse treatment and
to die often challenge the values ofmost health care providers.
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Scarcity of Resources
The allocation of scarce resources (e.g.organs, specialists) is emerging as amajor medical dilemma.
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Ethical Decision Making
EVALUATIONEvaluation of outcome of moral actions
"Were the actions ethical?" "What were the consequences?"
IMPLEMENTATION
Carrying out selected moral actions
PLANNINGConsideration of priorities of claims
Consideration of consequences of alternatives
ANALYSIS & DIAGNOSISIdentification of problem: Statement of ethical dilemma
ASSESSMENTDetermination of claims and parties
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Ethics Committees
Many health care agencies now recognize the need
for a systematic manner whereby to discuss ethicalconcerns.
Multidisciplinary committees offer dialogue regardingethical dilemmas.
Ethics committees can lead to the establishment ofpolicies and procedures for the prevention andresolution of dilemmas.
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Nurse as Client Advocate
When acting as client advocate, thenurses first step is to develop ameaningful relationship with the client.
The nurse is then able to makedecisions with the client based on thestrength of the relationship.
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Nurse as Whistleblower
Whistleblowingrefers to calling attention to unethical,
illegal, or incompetent actions of others.
Whistleblowing is based on the ethical principles ofveracity and nonmaleficence.
Federal and state laws (to varying degrees) provideprotection, such as privacy, to whistleblowers.
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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?