Basic Nursing: Foundations of

Skills & Concepts

ETHICAL
Chapter 7
RESPONSIBILITIES

Ethics

Thebranchofphilosophyconcernedwith
thedistinctionofrightfromwrongonthe
basisofabodyofknowledgeratherthanon
justopinions.
Ethics looks at human behavior- things
people do under different types of
circumstances.

Bioethics

Theapplicationofethicalprinciplesof
healthcare.

WhyisEthicsanIncreasingIssue
forHealthCare?

anincreasinglytechnologicalsocietywithcomplicated
issuesthatneverhadtobeconsideredbefore.

thechangingfabricofsociety,particularlyintermsof
familystructure.

healthcarehasbecomeaconsumerdrivensystembased
onclientsbecomingmoreknowledgeable.

EthicalPrinciples

Codesthatdirectorgovernactions.

BasicEthicalPrinciples

AutonomyTherespectforindividualliberty
JusticeTheequitabledistributionofpotentialbenefits
andrisks
FidelityThedutytodowhatonehaspromised
NonmaleficenceTheobligationtodoorcausenoharmto
another
BeneficenceThedutytodogoodtoothers
VeracityTheobligationtotellthetruth

EthicalTheories

Teleologythevalueofasituationisdeterminedbyits
consequences.
Deontologytheintrinsicsignificanceofanactitselfas
thecriterionforthedeterminationofgood.
SituationalTheoryholdsthattherearenosetrulesor
norms.Eachsituationmustbeconsideredindividually.
CaringBasedTheoryfocusesonemotions,feelings,and
attitudes.

Values

Valuesaredifferentfromprinciples,inthat
theyinfluencethedevelopmentofbeliefs
andattitudes,ratherthanbehaviors.They
may,however,indirectlyinfluence
behaviors.

ValueSystem

Anindividualscollectionofinnerbeliefs
thatguidesthewaythepersonactsand
helpsdeterminethechoicesmadeinlife.

ValueClarification

Theprocessofanalyzingonesownvalues
tobetterunderstandthosethingsthatare
trulyimportantinlife.

ValueClarification

Theprocessofanalyzingonesownvalues
tobetterunderstandthosethingsthatare
trulyimportantinlife.

SelfReflection

Becauseethicsandvaluesaresoclosely
associated,nursesmustexploretheirown
valuesinordertoacknowledgethevalue
systemsoftheirclients.

EthicalCodes

Codesareusedtohelpnursesactethically.

Thesehavebeendevelopedbynursing
organizationssuchastheNFLPN,theICN
andtheANA.

ThePatientsBillofRights

Adocumentdesignedtoguaranteeethical
careofclientsintermsoftheirdecision
makingabouttreatmentchoicesandother
aspectsoftheircare.

EthicalDilemma
Aconflictbetweentwoormoreethical
principles.
Inanethicaldilemma,thereisnocorrect
decision.

MajorTypesofEthicalDilemma

Euthanasia.

RefusalofTreatment.

ScarcityofResources.

Euthanasia

Intentionalactionorlackofactionthat
causesthemercifuldeathofsomeone
sufferingfromaterminalillnessor
incurablecondition.

RefusalofTreatment

Basedontheprincipleofautonomy.

Aclientsrightstorefusetreatmentandto
dieoftenchallengethevaluesofmost
healthcareproviders.

ScarcityofResources

Theallocationofscarceresources(e.g.
organs,specialists)isemergingasamajor
medicaldilemma.

EthicalDecisionMaking
ASSESSMENT
Determination of claims and parties
ANALYSIS & DIAGNOSIS
Identification of problem: Statement of ethical dilemma
PLANNING
Consideration of priorities of claims
Consideration of consequences of alternatives
IMPLEMENTATION
Carrying out selected moral actions
EVALUATION
Evaluation of outcome of moral actions
"Were the actions ethical?" "What were the consequences?"

EthicsCommittees

Manyhealthcareagenciesnowrecognizetheneedfora
systematicmannerwherebytodiscussethicalconcerns.

Multidisciplinarycommitteesofferdialogueregarding
ethicaldilemmas.

Ethicscommitteescanleadtotheestablishmentof
policiesandproceduresforthepreventionandresolution
ofdilemmas.

NurseasClientAdvocate

Whenactingasclientadvocate,thenurses
firststepistodevelopameaningful
relationshipwiththeclient.

Thenurseisthenabletomakedecisions
withtheclientbasedonthestrengthofthe
relationship.

NurseasWhistleblower

Whistleblowingreferstocallingattentiontounethical,
illegal,orincompetentactionsofothers.

Whistleblowingisbasedontheethicalprinciplesof
veracityandnonmaleficence.

Federalandstatelaws(tovaryingdegrees)provide
protection,suchasprivacy,towhistleblowers.

QuestionsforWhistleblowers
Whoseproblemisthis?
MustIdoanythingaboutit?
Isitmyfault?
WhoamItojudge?
DoIhavethefactsstraight?