Principles of Ethics-Lecture

8/6/2019 Principles of Ethics-Lecture

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Principles of Ethics



� Objectives:

� At the end of the end of the lecture the student should be able to:

� Define ethics

� Discuss the ethical reasoning



Definitions

� Ethical principles

� Autonomy

� Non ±maleficence� Justice

� Beneficence



Descriptions

� Patients¶ rights

� Nurses rights



At the end of the lecture you should

be able to :

� Understand and relate ethical principals toyour nursing practices.



REFERENCES

� Thomson, Ian, E., Melia,Kath, M., Boyd,Kenneth,M (2003) Nursing Ethics,4th edition,Elsevier, Science Limited,Philadelphia , US A.

� Crisp &Taylor (2005) Potter & Perry¶sFundamentals of Nursing 2nd ed., Elsevier, Australia.

� Presenter: Sr., Uma Lal 22/03/11



ETHICS

� Ethics is concerned with the studies and

practice of what is good and right for

human beings. In ethics we seek todetermine what conditions will promote

what is good or bad for the betterment of

individuals,communities,businesses and

organizations.



ETHICS TO NURSES

� Values and means to ensure the wellbeing

,health ,prosperity and happiness of

people with identifying the kind of things

that are likely to prevent this happening.

This was recognized in the ICN code for

nurses: Ethical concepts applied to

nursing (ICN 1973).



FOUR FUNDAMENTAL

RESPONSIBILITY OF A NU

RSE

� A) To promote health

� B)To prevent illness

� C) To restore health� D) To alleviate suffering

� The need for nursing is universal



CORE COMPONENT OF

NUR

SING CAR

E� A) Respect for life

� B) Dignity and rights of human being

� C) Unrestricted by considerations of Nationality,race,creed,color,

age,sex,politics or social status.



Core component of nursing care

� Nurses render health services to the

individual, the family,and the community.

They coordinate their services with those

of related groups.



ETHICS IS CONCERNED WITH

� Formation of rules defining what is right or

wrong, eg to state what regulations are

necessary to monitor (oversee) individual

and community wellbeing and what is

required to protect the safety /integrity of

individuals ,communities and

organizations.



Ethics is concerned with

� Fundamental responsibility of nurses is to hold

in confidence personal information and use

judgment in sharing this information.

� To maintain the highest standards of nursingcare possible within the reality of a specific

situation.

� Maintain personal and professional conduct atall times to uphold nursing profession (ICN

1973).



Nurses role in safeguarding Human

R

ights (ICN 1983) asserts that:� Health care is a right of all individuals.

� Everyone should have access to health

care regardless of financial ,political,geographic, racial or religious

backgrounds.

� Nurses must make sure that they deliver

impartial and adequate treatment within

available resources.



SUMM ARY-what ethic is?

� Commitment to positive values to ensurethe wellbeing and flourishing of individualsand society.

� Communal activity of applying rationalprinciples and universal standards tosocial life.

� Our active participation in a moralcommunity and ownership of the policies itdevelops.



Summary of what ethic is

� Problem solving activity based on

knowledge of ethical principles and their

skilled application to life.

� Educational process in which by

experience we learn what it means to be

responsible moral agents.



Autonomy

� Principles of self rule, of clients makingdecisions about their own lives.

� An individual who is able to exercise somedegree of self determination in terms of understanding the requirement of membershipof the moral community to he/she belongs.

� A person who is free and able to act ,to exercisehis or her rights and to recognize his or her

duties to others.� Respect for persons also requires that we also

respect his independence for self determination.



NON M ALEFICIENCE

� Not to do harm-the duty to do good and to avoidharm to others.

� The duty of care ,to protect the weak and the

vulnerable.� The duty of advocacy, depending on the rights of

those incompetent or temporarily unable todefend their own.

� The golden rule says:� DO UNTO OTHERS AS YOU WOULD HAVE

THEM DO UNTO YOU.



BENEFICENCE

� To do good, it is the protective duty of care

the strong owe to the weak. Patient

advocacy, defending the rights of the

vulnerable patient or acting on behalf of

those unable to assert their rights.



Beneficence

� Principle of beneficence is indispensible in

cases of dependent ,severely disabled or

helpless people in need of support or

urgent care and attention.



Beneficence

� This duty of care towards one another

should make us realize that we all need

others to speak for us ,to do things for us,

or to defend our rights when we are too

weak to do so for ourselves.



Beneficence

� But if knowledge is power ,the power of

the true carer is aimed at sharing

knowledge and skills with vulnerable

individuals so as to empower them to

reassert control over their own lives, if this

is humanly possible (May,

1983,Campbell,1984,&1985).



JUSTICE

� The demand for universal fairness in terms of respect for the rights of individual persons ,theexercise of individual rights such as freedom of

movement, or association.� Equal opportunity to benefit from ,or have

access to, preventative medicine and treatmenthealth services and the outcome of research.

� Equality of outcomes for different ethnic groupsin terms of fair distribution and access to healthresources by sound research and policydevelopment.



The right to know

� The normal expectation of clients is that

carers will discuss their problem with them

and give an opinion as to its nature ; that

they will discuss the proposed course of

treatment or management of the problem

;and they will discuss the possible options

and outcomes.



The right to privacy

� The right to respect for the dignity of the person in terms of physicalprivacy

� Respect for the persons secret in terms of maintaining strictconfidentiality of the information disclosed.

� The right to privacy does not mean the right to have a private wardor the right to private medicine although in some case it may includethat eg an elderly lady who has never shared a room with another person may be emotionally distressed at having to be nursed in apublic ward . She might prefer to pay extra health insurance toensure that she can get privacy that is very important to her.

� Most people might expect some general loss of privacy which oftencomes as a shock to realize how little privacy they have.



Right to privacy

� Hospital staff often show very little consideration

for people¶s sensitivities or need for privacy, the

needs of those who are dying.

� Generally people are prepared to expose their secrets ,expose their bodies and reveal their

vulnerabilities when they need help and when

they feel that they can TRUST the person from

whom they are seeking help.



Right to privacy

� Sensitive carers will respect the patient¶s

confidences and privacy.

� The carers will also recognize that theinformation is to be used ONLY for the

benefit of the patient, and that they acquire

duties of advocacy, to protect the rights

and interests of their patients in the light of what they have learnt about them .



The right to care and treatment

� Every person who has been taken on by a

doctor or nurse as a patient has a right to

expect proper care and treatment. The

doctor or nurse is employed to provide a

service, or offers a service on a fee- for

service basis ,and patients are entitled to

treatment in fulfillment of the deal madewith the carer to whom they have

entrusted themselves.



Right to care and treatment

� Malpractice and negligence are not

confined to being incompetent but also for failure to provide due in fulfillment of the

contract to-care.



Nurses Rights

� Nurses have the right to practice in

accordance with the Nursing legislation

of the country in which they work.

� They adopt the ICN code for nurses or

their own national ethical code-

� Nurses &Midwives Board Fi ji ±Code of

ethics &Code of conduct for Fi ji Nurses

1999.



Nurses rights

� Right to practice in an environment that provides

personal safety ,freedom from abuse and

violence, threats or intimidation.

� National nurses associations need to ensure aneffective mechanism through which nurses can

seek confidential advice , counsel, support and

assistance in dealing with difficult human rights

situations.`



Relating Ethical Principle To

Nursing Practices

� Nurses have an obligation to safeguard

people¶s health rights at all times and in all

places. This includes assuring that

adequate care is provided within the

resources available and in accordance

with nursing ethics.



Relating ethical principle to nursing

practices

� The nurse is obliged to ensure that

patients receive appropriate information

prior to consenting to treatment or

procedures, including participation in

research if you do one in future.



Relating ethical principle to nursing

practices

� As professionals, nurses are accountablefor their own action in safeguarding their

patients rights in every sense of their care.



Limitations

� In all aspects of their professional role

nurses deal with human rights issues

everyday .Nurses may be pressured to

apply their knowledge and skills in ways

that are detriment to patients and others.



Limitations

� There is a need for increased vigilance ,

and a requirement to well informed ,abouthow new technology and experimentation

can violate these human rights.



Limitations

� Furthermore nurses are increasinglyfacing complex human rights issues,arising from conflict situations within

jurisdictions, political upheaval and wars.The application of human rights protectionshould emphasize vulnerable groups suchas women,children,elderly people,

refugees and stigmatized groups.



Limitations

� ICN has developed a Health and Human

rights fact sheet ,addressing the ma jor areas where human rights impact on the

health of populations, including public

health, health care reform, access to care

and gender perspectives



Home work

� Read ICN publications on their website:

� http://www.icn.org>

� (ICN endorsed the Universal Declarationof Human Rights ,adopted by the United

Nations General assembly in 1984).



Discussion activity

Get into groups of five and discuss how you

are going to relate the above ethical

principles to your daily nursing practices.

� What are some of the limitations that you

are going to come across in applying

these ethical principles ?



Bill of rights ±( American Hospital

Association 1973,revised 1992)

� 1.The patient has the right to considerate

and respectful care.

� 2. The patient has the right to obtainunderstandable information concerning

diagnosis,treatment and prognosis.



Bill of Rights

� 3.The patient has the right to makedecisions about the plan of care prior toand during the course of treatment.

� 4.The patient has the right to have anadvance directive such as a living will,health care proxy ,or durable power of attorney for health care.

� 5.The patient has the right to everyconsideration of privacy.



Bill of rights

� 6.The patient has the right to

confidentiality.

� 7.The patient has the right to review his/her records pertaining to his health care.



Bill of rights

� 8.The patient has the right to expect that

,within its capacity and policies a hospital

will make reasonable response to his /her

request.

� 9.The patient has the right to ask and be

informed of the people and other health

care agencies which influences his healthcare.



Bill of rights

� 10.The patient has the right to consent or

refuse in any kind of research studies or

human experimentation affecting his care

and treatment.



Bill of rights

� 11.The patient has the right to expect

reasonable continuity of care when

appropriate and to be informed by the

physicians and other care givers of

available and realistic patient care options

when hospital care is no longer

appropriate.



Bill of rights

� 12.The patient has the right to be informed

of hospital policies and practices thatrelate to his /her care ,treatment and

responsibilities.



IMPORTANT NOTE:

� Remember your primary role as a nurse is

to provide competent nursing care

promoting an environment in which the

values ,customs,and spiritual beliefs of the

individuals are respected. Maintain

confidentiality in holding personal

information and use your judgment insharing this information .



Important Note

� ³DO UNTO OTHERS WHAT YOU W ANT OTHERS TO DO TO YOU´.

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Principles of Ethics-Lecture

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