Values Ethics and Legal Concerns

Values

beliefs about worth of something

“What matters”

prioritize

life principles that are most important to people

usually share thoughts, feelings and ultimately their action

Enduring ideas about what a person considers to be good the right thing to do as well as the opposite.

Value System

Influence beliefs about human needs, health and illness

Practice of health behavior

Values Clarification

Process people come to understand their own values and value system

Beneficial to the nurse

Value Conflicts

Very likely to happen

Can be resolved by acknowledging patient’s value as well as nurse’s

Increase self awareness and decisions

Delineated in the Nursing Code of Ethics-ANA

set of principles that reflect the primary goal, values, and obligations of the profession

Example of principles

Altruism

Autonomy

Human Dignity

Integrity

Social Justice

Altruism

Concern for the welfare of others

Autonomy

Respects the patient’s rights

Right to self-determination

Human Dignity

Treat as being of worth

Respect for inherent worth and uniqueness, not only to individual, but population

Integrity

Provides care based on the Code of Ethics

Acting in accordance with the appropriate code of ethics and accepted standards of practice

Social Justice

Fairness, Equal access and treatment they need and deserve to all

Ethics

Standards of conduct and moral judgment

Professional ethics involve principles and values with universal application and standards of conduct to be maintained in all situations

Guide to human behavior

Concerned with determining what is good and valuable

Often viewed as what society views good or wrong

Nursing Code of Ethics

Ethical obligations and duties of every nurse

Profession’s non negotiable ethical standard

Understanding of its commitment to society

Embrace them! Become a part of who we are

Virtues of Nursing (11)

Competence

Compassionate

Subordination of self-interest to patient interest

Self-effacement

Trustworthy

Conscientious

Intelligence

Practical Wisdom

Humility

Courage

integrity

Theories of Ethics (2)

Utilitarianism

Deontology

Utilitarianism

Greated good for the greatest number of people

Focuses on the effect of an action

ex) immunization

Deontology

Focuses on the rights of the individual

Does not consider the greater good or consequences of specific actions on others

Right or wrong based on rules or rights of the individual

ex) COVID 19 vaccine became a very personal choice

Principle-Based Approach (6)

Beneficence

Nonmaleficence

Autonomy

Justice

Veracity

Fidelity

Beneficence

Doing good or promoting good on behalf of others

Taking positive action for others

Nonmaleficence

Avoidance of doing harm; preventing harm to others

do no harm, no testing just because

Autonomy

Respect for a person’s right to make their own decisions

patient have right to refuse any treatment

Justice

Fairness in equity, excess, throughout healthcare

Veracity

Telling the truth; commitment to honesty

obligated to be truthful to patient

Fideltiy

Commitment to keep promises

Examples of Ethical Problems

Deception

Unprofessional, incompetent, unethical, or illegal physician practice/nurse practice

Beginning of life issues

End of life issues

Privacy/confidentiality/social media

Example of deception

When patient asks a nursing student if this is their first IM injection, answer with honesty

Example of unprofessional, incompetent, unethical, or illegal physician practice/nurse practice

Nurses are obligated to report differences you see and report making mistakes in surgery

Exaple of Privacy ethical problems

HIPAA

Nurses and Ethic Committees

Nurses strong background in interpersonal communication allow us to contribute unique knowledge about the patient and family to the discussion

Advocacy

Protection and support of another person’s rights

Nurses value patient advocacy by supporting patient’s right to make decisions

“Year of Advocacy”

The ANA declared 2018 the “Year of Advocacy”- featured members advocation for their patients and the profession in various roles and settings

Legal Guidelines for Practice (2)

Statutory Law

Administrative Law

Statutory Law

Created by elected legislative bodies

ex) Nurse Practice Acts (Vary from state to state)

• Standards of Care- legal scope of practice

• licensure

Administrative Law

State Legislatures gives authority to state boards of nursing

• Rules and regulations established by State Boards of Nursing

• Protects the public from harm

Example of Administrative Law

Drug and alcohol abuse is most common

• Can revoke or suspend license

Physical, mental impairment

Felony

Practicing with expired license

State Boards of Nursing

Make sure people are practicing the law

Punish if Nurse Practice Act is broken

Nurse Practice Act

Legal scope of practice

obtain a copy from state board of nursing

Standards

Minimum requirement for providing safe patient care

Credentialing

Professional competence is maintained

accreditation

licensure:NCLEX

certification

Accreditation

Education programs evaluated (CCNE: Commission on Collegiate Nursing Education)

Ensure quality and integrity

Certification

Demonstrate advanced proficiency in nursing - CCRN

Criminal Laws

Prevent harm to society

Provide punishment

Felony

Prison sentence >1 year

Misdemeanor

Lesser crime

fine or <1 year in prison

Intentional torts

Did the act willfully

Assault

BAttery

Defamation of character

False imprisonment

Assault

Threat of harm

Threatening patient to put in restraints

Battery

Actually carrying out of threat

Touching without consent

can be justified if considered danger to harm to self or others

Defamation of Character

Injury to person’s reputation

Slander-oral

Libel-printed

ex) identity theft, stealing SSN

Slander-oral

Verbal

Libel-printed

Read and printed

newspaper, email

False imprisonment

Unjustified retention

Can’t force patient to stay hospitalized

Unintentional Torts

Did not mean to cause harm but did caused harm

Negligence

Malpractice

Negligence

Practice below standard of care

Lack of knowledge, did something responsible nurse would not do

ex) pusing K, not turing patient who is risk for pressure injury

Malpractice

Nurse acted outside scope of practice or standard of care

• patient choking, nurse decides to perform a tracheostomy

• failed to meet standards of care

• patient injured

Intent to injure need not be shown

Student Legal Responsibilities

Being prepared for clinical

Duty to notify clinical instructor if you feel unprepared to carry out a nursing procedure

For no reason should a student attempt a procedure if you are unsure of the correct steps involved

How to prove Malpractice and examples

Attorney does not need to show whether your intent was not to do harm,k raqther, did your actions harm the patient. The nurse acted outside the standard of care

ex) failure to monitor and report

• improper technique

• medication errors

• failing to follow procedures

How to pass electrolyte medications

NEVER IV push

dilute into larger volumes of solution

Safeguards to Competent Practice

Respect Legal boundaries of practice

Follow institution’s policies and proceudre

Owning personal strengths and weaknesses

Evaluating proposed assignments

Keep current in nursing knowledge and skills

Respect patient’s rights

Careful documentation

Euthanasia

Euthanasia occurs when someone other than the patient administers medication in ay form with the intention of hastening the patient’s death

Euthanasia is inconsistent with the core commitments of the nursing profession and profoundly violates public trust

Medical Aid in Dying

Nurses are ethically prohibited form administering medical aid in dying medication

Yet they must be comfortable supporting patients with end of life conversations, assessing the context of a medical aid in dying request, advocating optimized palliative and hospice acare services, and knowing about aid in dying laws and how those affect practice.

Good Samaritan Laws

Protect health care professionals practicing within standards of care

Provide legal immunity after providing appropriate assistance in an emergency

May require nurses in some states to stop and help in an emergency

Providing emergency care outside of a nure’s place of employment is not legally requried in the State of Ohio