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7/27/2019 PPT_Ethical Aspects of Nursing.-nu 204pptx
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ETHICAL ISSUES IN NURSING
NU 204
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INTRODUCTION TO ETHICALISSUES IN NURSING
Since early time we have soughta logical approach to questions ofhuman conduct.
What constitutes good and evil,ethical, unethical?
On a day to day basis, nurses are
faced with ethical problems inregard to their own actions andthose of the health team.
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ETHICAL TERMINOLOGY
Ethics:A branch of philosophyreferred to as moral philosophy
Morals: Basic standards forwhat we consider right andwrong
Morality: The relationships
between human beingsEthical Dilemma: When anindividual must choose betweentwo unfavorable alternatives
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Values:Abstract standards thatgive a person a sense of what isright and wrong. These differ fromindividual to individual.
Values conflict: Occurs when wemust choose between two things,both of which are important to us
Values Clarification: The processof becoming more conscious of andnaming what one values orconsiders worthy
ETHICAL TERMINOLOGY (CONT)
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ETHICAL THEORIES
NATURAL LAW
St Thomas Acquinas
action right if in accord with our nature
promote good; avoid evil
ethics grounded in concern for human good
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ETHICAL THEORIES (cont)
DEONTOLOGY (DUTY-ORIENTED)
Immanuel Kant
Right and wrong is based on onesduty or obligation to adhere to
universal values.
abortion/euthanasia wrong as violatesduty to respect life
lying wrong as violates duty to tell the
truth
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ETHICAL THEORIES (cont)TELEOLOGICAL/UTILITARIANISM
(CONSEQUENCE-ORIENTED)
Jeremy Bentham & John Stuart Mills
act is right when it results in a good end
end justifies the means
abortion is okay because it gets rid of
unwanted babies
euthanasia is okay because it reduces
suffering
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ETHICAL THEORIES (cont)SITUATIONAL
Joseph Fletcher
no prescribed rules
each situation creates its own set of rules and
principles
love is the only norm
decision in one situation cannot be
generalized to another
euthanasia may be an act of love
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ETHICAL THEORIES (cont)
SOCIAL EQUITY AND JUSTICE
John Rawls
supports justice and equal rights for all
veil of ignorance on part of decision-
makers (no specific information) thus most
disadvantaged would be supported.
all social and economic positions open for
results of a decision.
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ETHICAL THEORIES (cont)IDEAL OBSERVER
Raymond Firth
Decisions be made from a dispassionate,
disinterested, consistent viewpoint with
full information about the situation
full information about the consequences
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Factors That Influence EthicalDecision-MakingCodes for Nurses
ANA Code for Nurses
International Code for Nurses
Standards of Practice
ANA Standards of Practice for
RNs
The Patient Bill of Rights (AHA)
Social and Cultural Attitudes
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Factors That Influence EthicalDecision-Making (contd)Science and Technology
Legislation
Judicial Decisions
Funding
Personal Religious andPhilosophic Viewpoints
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Factors in the Work Place ThatAffect Ethical Decision MakingStatus as an Employee
Collective Bargaining Contracts
Collegial Relationships
Authoritarian and PaternalisticBackgrounds
Ethics Committees in Health Care
Consumer Involvement in HealthCare
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Basic Ethical ConceptsAutonomy:Involves the rightof self-determination,independence, and freedom
Beneficence: The obligation todo good, not harm
Nonmaleficence: The
prohibition of intentionalharm
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Ethical Concepts (contd)Justice: The obligation to be fairto all people.
Fidelity: The obligation to befaithful to agreements,commitments, and responsibilities
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Ethical Concepts (contd)Veracity: Refers to telling thetruth or not intentionally
deceiving or misleading patients
The Standard of Best Interest:
Making a decision for one who isunable to make a decision basedon what is best for that individual
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FRAMEWORK FOR ETHICALDECISION-MAKING
Identify and clarify the ethical problem
Gather data
Identify options
Make a decision
Act
Evaluate the outcomes
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BIOETHICAL ISSUES INHEALTH CARERELATED TO BEGINNING OF LIFE
Abortion
Prenatal testing
In vitro fertilization
Artificial insemination
Surrogate mothers
Sperm banks
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BIOETHICAL ISSUES INHEALTH CARE (cont)RELATED TO END-OF-LIFE
Death defined
Euthanasia
Physician-assisted suicide
Right-to-die
Withdrawing/withholding treatments
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BIOETHICAL ISSUES INHEALTH CARE (cont)RELATED TO QUALITY OF LIFE ISSUES
Organ transplantation
Human genome project
Gene therapy
Stem cell research
to tell or not to tell (provider truth-telling)
Rationing of health care