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Critical Thinking

Moral and Ethical Reasoning Challenges. Treatment advancesLonger life spansGreater emphasis on patient rights and autonomy . Moral and Ethical Reasoning . Questions center around:End-of-life careGenetic advancesQuality of life issuesResource allocation Informed consentPatient Self Determination ActAdvanced Directives .

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Critical Thinking

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    1. Critical Thinking Moral and Ethical Reasoning

    2. Moral and Ethical Reasoning Challenges Treatment advances Longer life spans Greater emphasis on patient rights and autonomy

    3. Moral and Ethical Reasoning Questions center around: End-of-life care Genetic advances Quality of life issues Resource allocation Informed consent Patient Self Determination Act Advanced Directives

    4. Definitions Moral Reasoning “Refers to judgments made based on personal standards of right and wrong”. Ethical Reasoning “Refers to judgments made by applying standards derived from the formal study of what criteria ought to be used to determine whether actions are justified, and therefore morally right or wrong.

    5. Categories of Moral and Ethical Problems Moral uncertainty Unsure which moral principles or values apply Moral dilemma Faced with situation with two or more undesirable choices Moral distress Know what is right but institution prohibits action

    6. What are Values? “Personal beliefs about the worth of a given idea, attitude, custom, or object that set standards that influence behavior.”

    7. How are Values Formed? Begins in early childhood Influenced by upbringing Influenced by experiences outside the family Occur within context of community Influenced by individual experiences Understanding of differences leads to respect

    8. What is Values Clarification? “process of self-discovery that helps a person gain insight into values.”

    9. Three Steps of Values Clarification Freely choosing your beliefs and behaviors Prizing your beliefs and behaviors Acting on your beliefs

    10. Moral and Ethical Decision Making Decisions require knowledge of ethical principles and codes. “Learning to apply basic principles of moral and ethical reasoning will help you feel more confident and be more competent when faced with ethical quandries.”

    11. Speak the Language (Ethical Principles) Autonomy Beneficience Nonmalificience Justice Fidelity Veracity Confidentiality Accountability Responsibility

    12. What is a Code of Ethics? “set of ethical principles that are accepted by all members of a profession” Collective statement about expectations and standards of behavior Guidelines to assist when questions arise about correct practice or behaviors

    13. Code of Ethics for Nurses States nurse will: Maintain client confidentiality Act as client advocate Deliver care in nonjudgmental and nondiscriminatory manner that’s sensitive to client diversity Preserves/Protects client autonomy, dignity and rights Seeks resources to help formulate ethical decisions

    14. What is an Ethical Dilemma? A choice between two equally undesirable actions

    15. How Do We Process an Ethical Dilemma? Systematic approach Similar to the steps in critical thinking

    16. Ethical Decision Making Model Determine if it is an ethical dilemma Gather relevant information. . . Client, family, institutional and social perspectives Examine your own values Verbalize the problem. . . may be difficult, but next step cannot take place if this is not done

    17. Ethical Decision Making Model (continued) Consider all possible courses of action. . . Think about ethical principles, philosophical approaches Negotiate the outcome. . . ethics committees are helpful with this step Evaluate the action

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