2. Ethical sensitivity

Overview of the Lecture

• Topics Covered:

  • The ethical nature of nursing care

  • Importance of ethical awareness

  • Blocks to ethical decision-making

Ethical Nursing Care

• Ethical nursing care encompasses the foundational principles of good nursing practice.

• It aligns with the nursing profession's commitment to promote health and alleviate suffering by addressing the unique needs of each individual.

• This care exists within various systemic and contextual issues impacting both patients and healthcare providers.

Ethical Sensitivity

• Definition: The capacity to make informed and compassionate decisions in uncertain care situations.

  • Draws on critical understanding from:

    • Codes of ethical conduct

    • Clinical experiences

    • Academic learning

    • Self-knowledge

• Involves anticipating consequences and having the courage to take action.

• This concept is outlined by Weaver, Morse, and Mitcham in their analysis on ethical sensitivity in professional practice (2008).

Responsibilities in Nursing Ethics

• Ethical responsibility extends beyond just facing ethical dilemmas.

• Nurses are accountable for every action and decision, whether taken or not, and this applies to all aspects of care—both routine and complex (Milliken and Grace, 2017).

Developing Ethical Awareness

• Ethical sensitivity requires an understanding of:

  • How individual actions impact others

  • The presence of moral issues in various situations

  • The unique situations of patients and their moral significance

  • The innate obligation of the nursing profession to understand these moral implications (Milliken and Grace, 2017).

Ethical Obligations in Nursing

• These obligations are articulated in nursing codes of practice, reflecting the relational nature of nursing practice.

• The primary aim is to achieve patient 'good' in alignment with both patient and professional goals.

• Professional goals focus on humanization, meaning, quality of life, and healing, which nurses identify through building relationships with patients (Milliken and Grace, 2017).

Components of Moral Action

• Four Components Model:

  • Ethical or moral sensitivity

  • Moral judgment

  • Moral motivation

  • Moral character

• Reference: Rest J. in Manual of Child Psychology (1983).

Blocks to Effective Decision-Making

• Some barriers include:

  • The patient/client's capacity and competence

  • The practitioner's own capacity and competence

  • Presence of fallacious reasoning or bad arguments

Personal Bias and Values

• Personal feelings and values can act as significant barriers to ethical decision-making.

  • Bias can cloud moral judgment.

  • Nurses must engage in self-awareness to recognize how personal values affect decision-making, particularly regarding stigmas and biases.

Definitions of Values

• Moral Values:

  • Derived from significant moral interests of individuals.

• Ethics:

  • The application of moral values to human actions and behaviors.

Types of Values

• Different categories of values include:

  • Cultural Values: Learned from religious or cultural contexts

  • Religious Values: Individual beliefs that shape attitudes and behavior

  • Personal Values: Ultimate standards upheld by social groups (e.g., professional codes of ethics)

  • Professional Values: Standards expected from profession, guiding practice.

Values Conflicts in Nursing

• Conflicts can arise between:

  • Values within individuals and those upheld by others

  • Personal values and professional obligations

• Professional guidelines provide direction in instances of values conflicts.

Social Stigma

• Refers to the mark of disgrace that leads to exclusion and discrimination, impacting moral perception of issues (WHO, 2013).

Emotional Presence in Nursing

• Definition: Maintaining openness to emotions and being attuned to personal feelings during care.

• Awareness of personal emotional states is crucial to ensure appropriate care delivery.

• Reflecting on daily experiences and engaging with colleagues about feelings can foster emotional presence and effective care.

Effects of Stress on Nursing Practice

• Stress can manifest in various physical, mental, and emotional symptoms:

  • Physical: Headaches, infections, muscle tension

  • Mental: Impaired judgment, muddled thinking

  • Emotional: Increased irritability, depression

Self-Care Strategies

• Understand role expectations clearly and engage with line managers when uncertain.

• Reflect on feelings and support team members in setting boundaries to prevent emotional exhaustion.

Module Assessment

• Assignment: Moral case deliberation related to personal practice.

• Length: 2,000 words.

• Submission Deadline: April 14, 2025, at 4:00 pm.