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Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 4

Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 4. ETHICAL RESPONSIBILITIES. Ethics. The branch of philosophy concerned with the distinction of right from wrong on the basis of a body of knowledge rather than on just opinions.

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Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 4

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  1. Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 4 ETHICAL RESPONSIBILITIES

  2. Ethics • The branch of philosophy concerned with the distinction of right from wrong on the basis of a body of knowledge rather than on just opinions. • Ethics looks at human behavior - things people do under different types of circumstances.

  3. Bioethics • The application of ethical principles of health care.

  4. Why is Ethics an Increasing Issue for Health Care? • an increasingly technological society with complicated issues that never had to be considered before. • the changing fabric of society, particularly in terms of family structure. • health-care has become a consumer-driven system based on clients becoming more knowledgeable.

  5. Ethical Principles • Codes that direct or govern actions.

  6. Basic Ethical Principles • Autonomy - The respect for individual liberty • Justice - The equitable distribution of potential benefits 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

  7. 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 considered individually. • Caring-Based Theory - focuses on emotions, feelings, and attitudes.

  8. Values • Values are different from principles, in that they influence the development of beliefs and attitudes, rather than behaviors. They may, however, indirectly influence behaviors.

  9. Value System • An individual’s collection of inner beliefs that guides the way the person acts and helps determine the choices made in life.

  10. Value Clarification • The process of analyzing one’s own values to better understand those things that are truly important in life.

  11. Value Clarification • The process of analyzing one’s own values to better understand those things that are truly important in life.

  12. Self-Reflection • Because ethics and values are so closely associated, nurses must explore their own values in order to acknowledge the value systems of their clients.

  13. Ethical Codes • Codes are used to help nurses act ethically. • These have been developed by nursing organizations such as the NFLPN, the ICN and the ANA.

  14. The Patient’s Bill of Rights • A document designed to guarantee ethical care of clients in terms of their decision making about treatment choices and other aspects of their care.

  15. Ethical Dilemma • A conflict between two or more ethical principles. • In an ethical dilemma, there is no “correct” decision.

  16. Major Types of Ethical Dilemma • Euthanasia. • Refusal of Treatment. • Scarcity of Resources.

  17. Euthanasia • Intentional action or lack of action that causes the merciful death of someone suffering from a terminal illness or incurable condition.

  18. Refusal of Treatment • Based on the principle of autonomy. • A client’s rights to refuse treatment and to die often challenge the values of most health care providers.

  19. Scarcity of Resources • The allocation of scarce resources (e.g. organs, specialists) is emerging as a major medical dilemma.

  20. Ethical Decision Making

  21. Ethics Committees • Many health care agencies now recognize the need for a systematic manner whereby to discuss ethical concerns. • Multidisciplinary committees offer dialogue regarding ethical dilemmas. • Ethics committees can lead to the establishment of policies and procedures for the prevention and resolution of dilemmas.

  22. Nurse as Client Advocate • When acting as client advocate, the nurse’s first step is to develop a meaningful relationship with the client. • The nurse is then able to make decisions with the client based on the strength of the relationship.

  23. Nurse as Whistleblower • Whistleblowing refers to calling attention to unethical, illegal, or incompetent actions of others. • Whistleblowing is based on the ethical principles of veracity and nonmaleficence. • Federal and state laws (to varying degrees) provide protection, such as privacy, to whistleblowers.

  24. 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?

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