Module 1 D: legal and ethical critical care nursing

Morals

involve personal beliefs about right and wrong, influenced by culture,

ethics

is the study and inquiry into moral life, helping to guide professional decisions. 

Moral Distress in Nursing

Arises when nurses recognize the right course of action but are prevented from taking it due to factors like institutional policies or power dynamics. 

Moral Courage

The ability to act despite moral distress, applying frameworks like the 4A’s (Ask, Affirm, Assess, Act) to address distress. 

Autonomy

• Respect for Persons

• Recognizing and supporting patients' rights to make their own healthcare decisions. 

Beneficence

The duty to do good and promote the well-being of patients. 

Non-maleficence

The principle of “do no harm,” ensuring care that minimizes harm. 

Veracity

The commitment to truth-telling and transparency. 

Fidelity

Maintaining trust, confidentiality, and loyalty to patients. 

Justice

Ensuring fairness in the distribution of healthcare resources and treatments. 

Informed Consent

Essential in critical care where patients may be incapacitated, and consent may need to be provided by a surrogate. 

End-of-Life Care

Involves decisions on life-sustaining treatments, DNR orders, and the role of advanced directives. 

Professional Malpractice

Involves negligence that breaches the duty of care owed to the patient, leading to harm. 

Tort Law

Covers civil wrongs, including negligence and intentional acts like assault or battery.

Withholding/Withdrawing Treatment

Involves ethical considerations when life support is no longer beneficial, always guided by patient wishes or advance directives. 

Negligence

Failing to meet the standard of care, leading to harm, with four elements: duty, breach, causation, and damages. 

Malpractice

A specific form of negligence involving professional duties, requiring proof of breach, harm, and causation. 

Documentation

Accurate and detailed records are crucial for defending against malpractice claims and ensuring quality care. 

Advance Directives

Legal documents like living wills or durable power of attorney that specify a patient's preferences regarding life-sustaining care. 

Futile Treatment:

Treatment deemed to have no reasonable chance of benefiting the patient, ethically challenged in cases where family desires continue aggressive treatment. 

Organ donation

Ethical issues regarding _________ include respect for persons, justice, and fairness in distribution, and complex decisions about brain death.

Cardiopulmonary Resuscitation (CPR)

Ethical issues arise regarding whether to perform _____________ based on patient wishes or medical futility. 

Clinical Judgment:

Emergency nurses must use critical thinking to rapidly assess patients, apply ethical principles, and work collaboratively with the team to make decisions under pressure. 

Cultural Sensitivity

Nurses must consider cultural beliefs when making ethical decisions and involve families in decision-making where appropriate.