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Sacred Heart University NU 305 DL Professional Nursing Ethics
Sacred Heart UniversityNU 305 DL
Professional Nursing Ethics
Ethics
Judgments of good, right, and wrong
Our moral duty and obligation relative to these judgments
The use of moral principles or ethical theory by which to anchor our moral viewpoint
Ethical Principles
Principle of Autonomy Principle of Veracity Principle of Confidentially Principle of Beneficence and Nonmaleficence Principle of Justice Principle of Fidelity Principle of the Sanctity of Human Life
Principle of Autonomy
Self directing freedom and moral independence in which the individual is free to choose and implement their decision– Paternalism– Informed Consent
Principle of Justice
Fairness Equality Distributive Justice – equal access to health
care for all citizens
Principle of Fidelity
Trust relationship between the nurse and client Remain faithful to one’s commitments Accountability
Principle of Beneficence and Nonmaleficence
Beneficence- to do good– Standard of Best Interest
Nonmaleficence- refrain from doing harm– Intentionally or Unintentionally
Protect those who can’t protect themselves
Principle of Veracity
To tell the truth– Full disclosure– Withholding information– Lying
Principle of Confidentiality
Privacy- patients right
Confidentiality- the nurses duty
Principle of Sanctity of Human Life
Obligation to not infringe on the sacredness of human life
Obligation not to take human life
Ethical Theory
Normative Ethics-based on authoritative standards or norms for human conduct– Deontology– Utilitarianism
Values-Oriented Ethics- does not prescribe norms but emphasizes a person’s morality, virtue, and sense of goodness and care
Utilitarianism
Focuses on what constitutes “good” Principle of Utility--”greatest good for the greatest number” &
“the ends justify the means”
(+)Rules change depending on circumstance (-) Minority groups have no claim Use in allocation of scarce resources
Deontology (Normative Ethics)
Unconditional respect for the person as a human being
Value of caring underlies all the principles Promote good and well being Be just and fair “All persons are of equal value” Standards(rules) are fixed – do not change
with situation
Deontology
Moral rightness or wrongness of human actions
Do no harm Tell the truth Keep promises and confidentiality
Critique of DeontologicalPerspective
Ethical Dilemma- a situation in which all options for resolution are equally unsatisfactory
Deontological principles are not prioritized Difficult to provide guidance in complex
situations Disregard for consequences of actions can
pose problems
Values-OrientedEthics
How should I act in this situation if I have the capacity to act morally?
Person’s morals strengthen and illuminate normative ethics
Important to Nursing– Caring– Moral Sense Inherent in Practice
Ethical Obligations of Nursing
Advocacy Caring Accountability Cooperation
Caring
Fundamental to the role of the nurse Being there for the patient Respecting the patient Feeling with and for the patient Closeness with the patient
Advocacy
Person has the proper information Person understands the information in order to
make a decision Nurse reports infringements Nurse prevents infringements.
Accountability
Answerability How one has promoted, protected, and met the
health needs of the patient
Cooperation
Active participation with others to obtain quality care for patients
Collaboration in designing approaches to nursing care
Reciprocity with those with whom nurses identify professionally
American Nurses AssociationCode of Ethics
for Nurses
Provision 1
The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
Provision 2
The nurse’s primary commitment is to the patient, whether an individual, family, group, or community
Provision 3
The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
Provision 4
The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.
Provision 5
The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
See under provision 5: Professional growth and maintenance of competence. Discusses why to continue education and maintaining credentialing. Lends itself nicely to this class’ topics.
Provision 6
The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.
Discussed work conditions and administrative issues
Provision 7
The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
Provision 8
The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.
Provision 9
The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.
Common Ethical Issuesin Nursing Practice
Cost containment issues End of life decisions Providing “futile” care
– ANA Center for Ethics and Human Rights, 1994 Breaches of patient confidentially Incompetent, unethical or illegal practices Pain management issues
Common Ethical Issuesin Nursing Practice
Use of advanced directives Informed consent for procedures Access to health care Management: Staffing & Delegation Issues in care of patients with HIV/AIDS;
Organ Transplants & Stem Cell Transplants
Resolving Ethical Dilemmas
Discuss with other health professionals involved to resolve
Discuss with supervisor Request ethical consultant Refer to Ethics Committee
– Does your organization have one? If yes, how do you access it?
