Ch. 6: Values, Ethics, and Advocacy

Value

a belief about the worth of something, about what matters, that act as a standard to guide one’s behavior

Value system

an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct

Professional Nursing Values

provide the foundation for nursing practice and guide the nurse’s interactions with patients, colleagues, and the public

• altruism

• autonomy

• human dignity

• integrity

• social justice

Altruism

concern for the welfare and well-being of others

Autonomy

the right to self determination

Human Dignity

respect for the inherent worth and uniqueness of individuals and populations

Integrity

acting according to code of ethics and standards of practice

Social Justice

upholding moral, legal, and humanistic principles

CTC ASN program values

• excellence

• caring

• relationship-centered care

• integrity

• civility

• holism

• accountability

• diversity and inclusion

Values clarification

process by which people come to understand their own values and value system

Choosing

choosing freely from alternatives after careful consideration of the consequences of each alternative

Prizing (treasuring)

involves pride, happiness, and public affirmation

Acting

combining choice into one’s behavior with consistency and regularity on the value

Nurse’s role in patient values

• value neutral/nonjudgemental

• do not assume your personal values are more correct than those of the patient

• use patient values to understand what motivates a patient’s decisions and behaviors

Morals

personal and communal standards of right and wrong

Ethics

a systematic study of principles of right and wrong conduct, virtue and vice, and good and evil as they relate to conduct and human flourishing

Bioethics

ethics related to life sciences

Nursing ethics

subset of bioethics: formal study of ethical issues that arise in the practice of nursing

Ethical theories

systems of thought that attempt to explain how we ought to live and why

Action-guided theories address what question?

“What should I do?”

Utilitarian

the rightness or wrongness of an action depends on the consequences of the action

Deontologic

an action is right or wrong independent of its consequences

Principle based approach elements

• autonomy

• nonmaleficence

• beneficence

• justice

• fidelity

autonomy (self-determination)

respect the rights of patients or their surrogates to make health care decisions

Nonmaleficence

avoid causing harm

Beneficence

benefits the patient, and balance health against risks/harms

Justice

give each heir due, ac fairly

Fidelity

keep promises

Care-Based Approach

an alternative to the principle-based approach and is centered around the nurse-patient relationship

focuses more on the individual patient within the context of their life narrative

Characteristics of the care perspective

• centrality of the caring relationship

• promotion of dignity and respect for patients as people

• attention to the particulars of the individual patient

• cultivation of responsiveness to others and professional responsibility

• a redefinition of fundamental moral skills to include virtues like kindness, attentiveness, empathy, compassion, reliability

Moral agency

the capacity to be ethical and to do the ethically right thing for the right reasons

Ethical dilema

two (or more) clear moral principles apply but support mutually inconsistent courses of action

Moral distress

occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action

Steps for making ethical decisions

1. Assess the situation

2. Diagnose the ethical problem

3. Plan

4. Implement your decision

5. Evaluate your decision

Advocacy

protection and support of another’s rights