moral or ethical agency for nurses: ability to base their practice on professional standards of ethical conduct and to participate in ethical decision making
nurses have choices and are responsible for their actions
ethnical agent must be able to do the following:
perceive the difference between right and wrong
understand abstract ethical principles
reason and apply ethical principles to make decisions weigh alternatives, and plan sound ways to achieve goals
decide and choose freely
act according to choice (this assumes both the power and capability to act)
nurses' ethical problems are immediate, serious, and frequent
nurses have multiple obligations and relationships that can create conflicting loyalties
employees with a relationship with the agency
professionals with a special relationship with clients and inter-professional team members
nurses expected to follow the provider's presciptions for client care, although the provider is not the nurse's employer
most orgs providers are higher on the power and status hierarchy than are nurses
ethnical dilemmas arise when nurses experience conflicts in their loyalties to clients, families, providers, and other nurses
nurses as ethnical agents
know the diff b/w right and wrong
understand abstract ethnical principles
apply ethnical principles in decision making
weigh alternative principles in decision making
decide and choose freely
act acccording to choice
consider value neutrality
attempt to understand our own values regarding an issue and to know when to put them aside, if necessary, to become nonjudgemental when providing care
it requires significant insight to recognize how your value-laden perspective impacts your perceptions and thus conclusion abt a situation
values
belief about the worth of something
highly prized ideals, customs, goals
freely chosen
learned through observation and experience
vary from person to person
can change
expressed through behaviors, feelings, knowledge, and decisions
factors in moral decision making
attitudes
feelings toward person, idea, object
includes thinking (cognitive), feeling (affective), & doing (behavioral) component
what a person thinks
beliefs
something that one accepts as true
not always based on fact, sometimes based on facts
may or may not involve values
ethnical principles
autonomy: person's right to choose and ability to act on that choice
based on respect for human dignity
demonstrated when you:
treat pt w/ considersation
believe pt stories abt course & symptoms of their illnesses
protect those who are unable to decide for themselves
protect privacy and confidentiality
nonmaleficence: duty to do no harm and to prevent harm
refers to:
actual harm
risk of harm
intentional harm
unintentional harm: can occur bc lack of knowledge, skill, or ability
beneficence: duty to do or promote good
do no harm, prevent harm, remove harm, bring abt positive good
paternalism: treating others like children
can have neg outcome even though you think you are acting in their best interest
fidelity (faithfulness): duty to keep promises
basic part of every pt care situation
veracity: duty to tell the truth
justice: obligation to be fair
equal treatment of all pts
professional guidelines for ethnical decision making
code of ethnics for nurses purposes:
inform the public abt the profession's minimum standards
demonstrate nursing's commitment to the public it serves
outline major ethnical considerations of nursing
provide general guidelines for professional behavior
guide the profession's self-regulating functions
remind us of the special responsibility we assume in caring for the sick
international council of nurses (ICN)
first adopted its code of ethics for nurses in 1953
has since served as the standard for nurses worldwide
stresses respect for human rights, including cultural rights, the right to life and choice, the right to dignity, and right to be treated with respect
american nurses association (ANA)
revised code of ethnics in 2015
relevant in many practice settings and reflects current ethnical situations
standards of care
patient care partnership
american hospital association (AHA) published a document: patient care partnership (2003)
instead of using "rights," it is written in terms of pt expectations and responsibilities
encourages healthcare providers to be more aware of the need to treat pts in an ethnical manner and to protect their rights
the joint commission: contains sections on org ethics and individual rights
requires ethnical behavior in care, treatment, services, and business practices
pts values, preferences, need for information, & other factors that promote autonomy must be considered in their plan of care
includes statement abt the need for meeting pt needs in the event care must be denied in the institution while you must also consider the org legal responsibility
processes for ethnical practice
clarify your values: the process of becoming conscious of and naming ones values
if you clear abt ur values, u will be more able to make good decisions & to avoid imposing your values on others
important to appreciate how other's values influence their decisions
identify moral dilemmas: only problems that pose a question between competing & equally valuable interests are true dilemmas
use a decision making model
M O R A L
Massage the dilemma
Outline the options
Resolve the dilemma
Act by applying the chosen option
Look back and evaluate
look for a compromise
a good compromise: one that preserves the integrity of all parties
discussions are carried out in a spirit of mutual respect - all view points are respected and considered
compromise solution itself is ethnically sound
participate on an ethnics committee
develop guidelines ad policies, provide education and counseling, and in the case of ethnical dilemmas, review the case and provide a forum for the expression of the diverse perspectives of those involved
usually follow one of three models when discussing a dilemma
autonomy model
patient benefit model
social justice model
improve your ethnical decision making
nurses tend to use conventions as criteria for decision making rather than pt personal needs and well-being
full-spectrum nurse must move from conventional (rules-bound) to the post-conventional (reasoning) stage of moral development
use theoretical knowledge
review nursing & other literature for discussion of cases and experiences of other nurses
use self knowledge
examine your personal value system
explore the influences of your religion, cultural beliefs, and personal experiences
use practical knowledge
ask to attend either ethnical rounds or an ethnics committee meeting
consult reliable sources
attend ethnics education programs & discuss issues w healthcare providers, attorneys, ethicists, and clergy to obtain perspective of others
share
regularly engage in discussions w the staff on ur unit to determine differences in value systems & to collaborate proactively to identify methods to effectively resolves ethnical dilemmas
evaluate
Module 2: ethics
morals and ethnics
morals: private, personal, or group standards of right and wrong
moral behavior reflects personal moral beliefs
"in general, is it wrong to steal?"
ethics: study of right and wrong conduct
formal process for making consistent and logical moral decisions
uses specific rules, theories, principles, and perspectives to inquire into the justification of an individual's actions in a particular situation
"what should i do in a given situation?" (is it wrong to steal if you have to do it to feed your children?)
nursing ethics
ethical questions that arise of nursing practice
what will your level of participation be in a given ethnically challenging situation?
can you support clients' decisions based on their ethnical beliefs?
what are your feelings about the results of decisions made by others?
you are responsible for deciding the nature and extent of your own involvement in each situation
must support pts who are making ethnical decisions or perhaps coping with the results of decisions made by others
moral or ethical agency
moral distress can occur when nurses are unable to act as moral agents
nurses experience moral outrage when they perceive that others are behaving immorally
sources of ethical problems: societal factors, the nature of nursing work
moral or ethical agency for nurses: ability to base their practice on professional standards of ethical conduct and to participate in ethical decision making
nurses have choices and are responsible for their actions
ethnical agent must be able to do the following:
perceive the difference between right and wrong
understand abstract ethical principles
reason and apply ethical principles to make decisions weigh alternatives, and plan sound ways to achieve goals
decide and choose freely
act according to choice (this assumes both the power and capability to act)
nurses' ethical problems are immediate, serious, and frequent
nurses have multiple obligations and relationships that can create conflicting loyalties
employees with a relationship with the agency
professionals with a special relationship with clients and inter-professional team members
nurses expected to follow the provider's presciptions for client care, although the provider is not the nurse's employer
most orgs providers are higher on the power and status hierarchy than are nurses
ethnical dilemmas arise when nurses experience conflicts in their loyalties to clients, families, providers, and other nurses
nurses as ethnical agents
know the diff b/w right and wrong
understand abstract ethnical principles
apply ethnical principles in decision making
weigh alternative principles in decision making
decide and choose freely
act acccording to choice
consider value neutrality
attempt to understand our own values regarding an issue and to know when to put them aside, if necessary, to become nonjudgemental when providing care
it requires significant insight to recognize how your value-laden perspective impacts your perceptions and thus conclusion abt a situation
values
belief about the worth of something
highly prized ideals, customs, goals
freely chosen
learned through observation and experience
vary from person to person
can change
expressed through behaviors, feelings, knowledge, and decisions
factors in moral decision making
attitudes
feelings toward person, idea, object
includes thinking (cognitive), feeling (affective), & doing (behavioral) component
what a person thinks
beliefs
something that one accepts as true
not always based on fact, sometimes based on facts
may or may not involve values
ethnical principles
autonomy: person's right to choose and ability to act on that choice
based on respect for human dignity
demonstrated when you:
treat pt w/ considersation
believe pt stories abt course & symptoms of their illnesses
protect those who are unable to decide for themselves
protect privacy and confidentiality
nonmaleficence: duty to do no harm and to prevent harm
refers to:
actual harm
risk of harm
intentional harm
unintentional harm: can occur bc lack of knowledge, skill, or ability
beneficence: duty to do or promote good
do no harm, prevent harm, remove harm, bring abt positive good
paternalism: treating others like children
can have neg outcome even though you think you are acting in their best interest
fidelity (faithfulness): duty to keep promises
basic part of every pt care situation
veracity: duty to tell the truth
justice: obligation to be fair
equal treatment of all pts
professional guidelines for ethnical decision making
code of ethnics for nurses purposes:
inform the public abt the profession's minimum standards
demonstrate nursing's commitment to the public it serves
outline major ethnical considerations of nursing
provide general guidelines for professional behavior
guide the profession's self-regulating functions
remind us of the special responsibility we assume in caring for the sick
international council of nurses (ICN)
first adopted its code of ethics for nurses in 1953
has since served as the standard for nurses worldwide
stresses respect for human rights, including cultural rights, the right to life and choice, the right to dignity, and right to be treated with respect
american nurses association (ANA)
revised code of ethnics in 2015
relevant in many practice settings and reflects current ethnical situations
standards of care
patient care partnership
american hospital association (AHA) published a document: patient care partnership (2003)
instead of using "rights," it is written in terms of pt expectations and responsibilities
encourages healthcare providers to be more aware of the need to treat pts in an ethnical manner and to protect their rights
the joint commission: contains sections on org ethics and individual rights
requires ethnical behavior in care, treatment, services, and business practices
pts values, preferences, need for information, & other factors that promote autonomy must be considered in their plan of care
includes statement abt the need for meeting pt needs in the event care must be denied in the institution while you must also consider the org legal responsibility
processes for ethnical practice
clarify your values: the process of becoming conscious of and naming ones values
if you clear abt ur values, u will be more able to make good decisions & to avoid imposing your values on others
important to appreciate how other's values influence their decisions
identify moral dilemmas: only problems that pose a question between competing & equally valuable interests are true dilemmas
use a decision making model
M O R A L
Massage the dilemma
Outline the options
Resolve the dilemma
Act by applying the chosen option
Look back and evaluate
look for a compromise
a good compromise: one that preserves the integrity of all parties
discussions are carried out in a spirit of mutual respect - all view points are respected and considered
compromise solution itself is ethnically sound
participate on an ethnics committee
develop guidelines ad policies, provide education and counseling, and in the case of ethnical dilemmas, review the case and provide a forum for the expression of the diverse perspectives of those involved
usually follow one of three models when discussing a dilemma
autonomy model
patient benefit model
social justice model
improve your ethnical decision making
nurses tend to use conventions as criteria for decision making rather than pt personal needs and well-being
full-spectrum nurse must move from conventional (rules-bound) to the post-conventional (reasoning) stage of moral development
use theoretical knowledge
review nursing & other literature for discussion of cases and experiences of other nurses
use self knowledge
examine your personal value system
explore the influences of your religion, cultural beliefs, and personal experiences
use practical knowledge
ask to attend either ethnical rounds or an ethnics committee meeting
consult reliable sources
attend ethnics education programs & discuss issues w healthcare providers, attorneys, ethicists, and clergy to obtain perspective of others
share
regularly engage in discussions w the staff on ur unit to determine differences in value systems & to collaborate proactively to identify methods to effectively resolves ethnical dilemmas
