L8 - Ethical and bioethical issues encountered in nursing practice v2.ppt

Ethical and Bioethical Issues in Nursing and Health CareMosby items and derived items copyright © 2002 by Mosby, Inc.
Ethical and Bioethical Issues in Nursing and Health Care
Mosby items and derived items copyright © 2002 by Mosby, Inc.
Key Concepts
Relationship between ethics and morality in relation to nursing practice
Ethical decision-making model
Nursing Ethics
System of principles concerning the action of the nurse in relationships with patients, families, other health care providers, policy makers, and society
Code of Ethics
American Nurses Association (ANA)
ANA Code of Ethics
ICN Code for Nurses
Bioethics
Interdisciplinary field within health care that has evolved with modern medicine to address questions created as science and technology produce new ways of knowing
Physicians, nurses, social workers, psychiatrists, clergy, philosophers, and theologians are joining to address ethical questions in health care
Dilemmas for Health Professionals
Dilemmas Created by Technology
Illnesses once leading to mortality are now classified as chronic illnesses
Cost is a consequence of prolonging life with technology
Ethical Decision Making
Answering difficult questions
What does it mean to be ill or well?
What is the proper balance between science and technology and the good of humans?
Where do we find balance when science allows us to experiment with the basic origins of life?
Balancing Science and Morality
Nurses must examine life and its origins, as well as its worth, usefulness, and importance
What does it mean to be ill or well?
What is the proper balance between science and technology and the good of humans?
Nurses must understand their own values and seek to understand the values of others
Health Care Decisions
Values Formation and Moral Development
Value: Personal belief about worth that acts as a guide to behavior
Value system: Entire framework on which actions are based
Values clarification: Process by which people examine personal values and how the values function as part of the whole
Values Formation and Moral Development—cont’d
Moral development: Forming a world view and value system in an evolving, continuous, dynamic process that moves along a continuum of development
Examining Values Systems
Nurses must commit to a virtuous values system
World View
Learning Right and Wrong
No concept of right or wrong
If basic need for trust is met, will develop foundation for secure moral thought
School-age children
Have learned that good behavior is rewarded and bad behavior is punished
Begin to make choices based on an understanding of good and bad
Learning Right and Wrong—cont’d
Adolescents
Become aware of contradictions in adults’ values systems
Adults
Develop own morals and values
Begin to make choices based on internalized set of principles
Moral Development Theory
Kohlberg’s theory
Most widely accepted
Rules imposed by authority
Conformity to expected social and religious mores
Autonomous thinker strives for a moral code beyond the issues of authority and reverence
Essential Values for the Professional Nurse
Altruism
Equality
Esthetics
Freedom
Ethical Theories
Greatest good for the most people
Assumes that an action is right if it leads to the greatest balance of good consequences or to the fewest possible bad consequences
Deontology
Decision is right if it conforms to an overriding moral duty and wrong if it violates that moral duty
Purpose of Ethical Principles
Establish common ground between nurse, patient, family, other health care professionals, and society to discuss ethical questions and make ethical decisions
Permit people to take a consistent position on specific or related issues
Provide an analytical framework by which moral problems can be evaluated
Autonomy
Unconditional intrinsic value for all
People are free to form judgments and actions as long as they do not infringe on others
Concepts of freedom and informed consent are grounded in this principle
Beneficence
To promote goodness, kindness, and charity
To abstain from injuring others and to help others further their well-being by removing them from harm
Common bioethical conflict results from an imbalance between the demands of beneficence and those of the health care delivery system
Nonmaleficence
– To help others further their own well-being by removing harm
Veracity
Consumers expect accurate and precise information
For trust to develop between providers and patients, there must be truthful communication
The challenge is to mesh the need for truthful communication with the need to protect
Ethical Decision-Making Model
Situation assessment procedure: 1. Identify ethical issues and problems 2. Identify and analyze available alternatives 3. Select one alternative 4. Justify the selection
Identify Ethical Issues and Problems
What is the issue?
What are the complexities of the situation?
Is anything being overlooked?
Identify and Analyze Available Alternatives
What are the reasonable possibilities for action?
How do different parties want to resolve the problem?
What ethical principles are required for each alternative?
What assumptions are required, and what are their implications for future actions?
What additional ethical problems do alternatives raise?
Identify and Analyze Available Alternatives—cont’d
Select One Alternative
Justify the Selection
Understand the shortcomings of the justification
Anticipate objections to the justification
Bioethical Dilemmas
Ethical Challenges

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L8 - Ethical and bioethical issues encountered in nursing practice v2.ppt