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Chapter 4

Chapter 4. Questions of Values and Ethics. Introduction. In the Beginning…. There were no antibiotics. There were no ICUs. There were no CT scanners or MRIs. There were just physicians and nurses who cared for people in sickness and in health. 1960s.

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Chapter 4

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  1. Chapter 4 Questions of Values and Ethics

  2. Introduction

  3. In the Beginning… There were no antibiotics. There were no ICUs. There were no CT scanners or MRIs. There were just physicians and nurses who cared for people in sickness and in health.

  4. 1960s Technological advances allowed for the development of the ICU. New biomedical developments Advances in surgical techniques, such as open heart surgery

  5. New Questions The advances created new questions for health-care professionals regarding the use of technology. The concepts of life and death

  6. Bioethics A subdiscipline of ethics The study of medical morality

  7. Concepts of Ethics Values Belief systems Morality

  8. Value Systems A set of related values Intrinsic values Extrinsic values Personal values Professional values

  9. Value Formation Values are learned. Values change with maturity and experience. The number of values an individual holds is not as important as what values he or she consider important.

  10. Values Clarification Choosing Prizing Acting

  11. Belief Systems • These are organized ways of thinking about why people exist within the universe. • Their purpose is to explain such concepts as • Life and death • Good and evil • Health and illness

  12. Ethics and Morals

  13. Morals Morals are an individual’s own code for acceptable behavior. They arise from an individual’s conscience. They act as a guide for individual behavior. They are learned.

  14. Ethics Ethics deals with the “rightness” or “wrongness” of human behavior. Concerned with the motivation behind the behavior Bioethics is the application of these principles to life-and-death issues.

  15. Ethical Theories • Deontological • Teleological • Principalism

  16. Ethical Principles Autonomy Nonmaleficence Beneficence Justice Fidelity Confidentiality Veracity Accountability

  17. Autonomy The freedom to make decisions about oneself Nurses need to respect clients’ rights to make choices about health care.

  18. Nonmaleficence Requires that no harm be caused to an individual, either unintentionally or deliberately. Requires nurses to protect individuals who are unable to protect themselves.

  19. Beneficence • This principle means “doing good” for others. • Nurses need to assist clients in meeting all their needs. • Biological • Psychological • Social

  20. Justice Every individual must be treated equally. This requires nurses to be nonjudgmental.

  21. Fidelity Loyalty The promise to fulfill all commitments The basis of accountability

  22. Confidentiality • Anything stated to nurses or health-care providers by clients must remain confidential. • The only times this principle may be violated are • If clients indicate harm to themselves or others • If the clients give permission for the information to be shared

  23. Veracity This principle implies “truthfulness.” Nurses need to be truthful to their clients. Veracity is an important component of building trusting relationships.

  24. Accountability Individuals need to be responsible for their own actions. Nurses are accountable to themselves and to their colleagues.

  25. Ethical Codes These are formal statements of the rules of behavior for a particular group of individuals. Ethical codes are dynamic. Most professions have a “code of ethics” to guide professional behavior.

  26. Virtue Ethics Focus on virtues or moral character. View helping others as charitable or benevolent.

  27. Organizational Ethics Focus on the workplace. Ethical culture makes a difference. Senior leadership must promote an ethical culture.

  28. Ethical Dilemmas Occur when a problem exists between ethical principles Deciding in favor of one principle usually violates another. Both sides have “goodness” and “badness” associated with them.

  29. Resolving Ethical Dilemmas

  30. Using the Nursing Process Assessment Planning Implementation Evaluation

  31. Approach to Ethical Dilemmas Approach Assessment Planning Implementation Evaluation Work toward a mutually acceptabledecision. Determinewhether desiredoutcomes havebeen reached. Determine goalsof treatment. Am I involved? Use of discussion and negotiation. Identify decision makers. Collect the facts. Re-evaluateas necessary. What values are in conflict? List and rankthe options.

  32. Current Ethical Issues

  33. Issues to Consider Assisted suicide Technology issues Gene therapies “Designer babies” Organizational climate

  34. Conclusion An issue is not an ethical issue for the nurse unless he or she has been asked. Always gather the facts prior to decision making. Consider your personal beliefs and values.

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