unit 2: Ethics and Standards of Practice Issues

utlitarianism

Decisions must be made solely based upon outcomes that are useful and that lead to the greatest good for the greatest number.

libertarianism

giving resources to strongest individuals

egalitarianism

A belief in the equality of all people

ANA Code of Ethics

The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.

Beneficence

Doing good or causing good to be done; kindly action

nonmaleficence

do no harm

fidelity

faithfulness; loyalty

veracity

truthfulness

autonomy

(n.) self-government, political control

justice

fairness

Ethical Dilemmas

Obligations and duties to mother and fetus;

- prioritize mother

Jonsen model: "Four topics method"

• Medical indications;

what are the odds that this treatment is going to be successful?

• Patient preferences;

autonomy - are there advance directives

• Quality of life;

what is the likely treatment with/without? should palliative care to be considered? beneficience, nonmaleficence, autonomy

• Contextual features;

loyalty and justice.

Health Disparity

• Social determinants of health (SDOH)

• Health equity

• ANA Code of Ethics

Tervalon and Murray-Garcia (1998)

• Emphasizing critical self-reflection and lifelong learning

• Recognizing and mitigating inherent power imbalance

• Developing mutually beneficial nonhierarchical clinical and advocacy partnerships

• Creating institutional alignment and accountability

AWHONN

C; commitment to responsibilities

A; accountability

R; respect for diversity

I; integrity, simplifying the highest standards

N; nursing excellence

G; generation of knowledge

maternity is the most

litigious practice area

Evidence based practice is the gold standard/

"Failure to communicate" leads to most malpractice suits against nurses.

Fetal Heart Rate Monitoring

● Legally important: failure to assess correctly

● Safe and effective fetal heart rate (FHR) assessment

● Risk management issues

Guidelines and

Evidence-Based Practice

Agency for Healthcare Research and Quality

(AHRQ)/National Guideline Clearinghouse/National

Quality Measure Clearinghouse

EBP has been adopted to integrate all of this