CHAPTER 4 Questions of Values and Ethics

1. CHAPTER 4Questions of Values and Ethics

2. OBJECTIVES • Describe the principles of ethics • Examine the relationship of critical thinking to the ethicaldecision-making process • Discuss how the Code of Ethics serves as a guideline to ethical decision making • Identify areas that are subject to frequent ethical dilemmasin the clinicalsetting • Discuss common areas of difficulty involved in making ethical decisions. • Differentiate between personal ethics and Professional ethics.

3. OBJECTIVES • Differentiate between values and personal/professional ethics. • Discuss methods in which values are formed. • Describe the process of values clarification. • Differentiate between morals and ethics. • Compare and contrast principles and rules of ethics. • Apply the eight basic ethical principles to an ethical issue. • Compare and contrast different types of ethics.

4. OBJECTIVES • Utilize the Code of Ethics for Nurses to critically think when making decisions in professional practice. • Utilize strategies to enhance ethical decisions in nursing practice. • Discuss the influence organizational ethics have on nursing practice • Examine the steps to ethical dilemma resolution. • Examine ethical dilemmas that the nurse may encounter in professional practice and in health care. • Apply critical thinking to client scenarios and NCLEX-style questions.

5. In the beginning… • There were no antibiotics • There were no ICUs • There were no CT scanners and MRIs • There were just physicians and nurses who cared for people in sickness and in health

6. 1960s • Technological advances allowed for the development of ICU • New biomedical developments • Advances in surgical techniques, such as open heart surgery

7. New Questions • The advances created new questions for health care professionals regarding the use of technology • The concepts of life and death

8. Bioethics • A subdiscipline of ethics • The study of medical morality

9. Concepts of Ethics • Values • Belief systems • Morality

10. Value Systems • A set of related values • Intrinsic values • Extrinsic values • Personal values • Professional values

11. Value Formation • Values are learned • Values change with maturity and experience • The number of values an individual holds is not as important as what values they consider important

12. Values Clarification • Choosing • Prizing • Acting

13. Belief Systems • These are organized ways of thinking about why people exist within the universe • Their purpose is to explain such concepts as • Life and death • Good and evil • Health and illness

14. Morals • An individual’s own code for acceptable behavior • They arise from an individual’s conscience • They act as a guide for individual behavior • Learned

15. Ethics • Ethics deals with the “rightness” or “wrongness” of human behavior • Concerned with the motivation behind the behavior • Bioethics is the application of these principles to life-and-death issues

16. Ethical Theories • Deontological • Teleological • Principalism

17. Ethical Principles • Autonomy • Nonmaleficence • Beneficence • Justice • Fidelity • Confidentiality • Veracity • Accountability

18. Autonomy • The freedom to make decisions about oneself • Nurses need to respect clients’ rights to make choices about health care

19. Nonmaleficence • Requires that no harm be caused to an individual, either unintentionally or deliberately • This principle requires nurses to protect individuals who are unable to protect themselves

20. Beneficence • This principle means “doing good” for others • Nurses need to assist clients in meeting all their needs • Biological • Psychological • Social

21. Justice • Every individual must be treated equally • This requires nurses to be nonjudgmental

22. Fidelity • Loyalty • The promise to fulfill all commitments • The basis of accountability

23. Confidentiality • Anything stated to nurses or health care providers by clients must remain confidential • The only times this principle may be violated are • If clients may indicate harm to themselves or others • If the client gives permission for the information to be shared

24. Veracity • This principle implies “truthfulness” • Nurses need to be truthful to their clients • Veracity is an important component of building trusting relationships

25. Accountability • Individuals need to be responsible for their own actions • Nurses are accountable to themselves and to their colleagues

26. Ethical Codes • These are formal statements of the rules of behavior for a particular group of individuals • Ethical codes are dynamic • Most professions have a “code of ethics” to guide professional behavior

27. Virtue Ethics • Focus on virtues or moral character • View helping others as charitable or benevolent

28. Organizational Ethics • Focus on the workplace • Ethical culture makes a difference • Senior leadership must promote an ethical culture

29. Ethical Dilemmas • Occur when a problem exists between ethical principles • Deciding in favor of one principle usually violates another • Both sides have “goodness” and “badness” associated with them

30. Resolving Ethical Dilemmas

31. Using the Nursing Process • Assessment • Planning • Implementation • Evaluation

32. Approach to Ethical Dilemmas Approach Assessment Planning Implementation Evaluation Work toward a mutually acceptabledecision Determinewhether desiredoutcomes havebeen reached Determine goalsof treatment Am I involved? Use of discussion and negotiation Identify decision-makers Collect the facts Re-evaluateas necessary What values are in conflict? List and rankthe options

33. Current Ethical Issues

34. Issues to Consider • Assisted suicide • Technology issues • Gene therapies • “Designer babies” • Organizational climate

35. Conclusion • An issue is not an ethical issue for the nurse unless he or she has been asked • Always gather the facts prior to decision-making • Consider your personal beliefs and values