Professional Nursing Ethics Sacred Heart University NU 305 DL
Ethics • Judgments of good, right, and wrong • Our moral duty and obligation relative to these judgments • The use of moral principles or ethical theory by which to anchor our moral viewpoint
Ethical Principles • Principle of Autonomy • Principle of Veracity • Principle of Confidentially • Principle of Beneficence and Nonmaleficence • Principle of Justice • Principle of Fidelity • Principle of the Sanctity of Human Life
Principle of Autonomy • Self directing freedom and moral independence in which the individual is free to choose and implement their decision • Paternalism • Informed Consent
Principle of Justice • Fairness • Equality • Distributive Justice – equal access to health care for all citizens
Principle of Fidelity • Trust relationship between the nurse and client • Remain faithful to one’s commitments • Accountability
Principle of Beneficence and Nonmaleficence • Beneficence- to do good • Standard of Best Interest • Nonmaleficence- refrain from doing harm • Intentionally or Unintentionally • Protect those who can’t protect themselves
Principle of Veracity • To tell the truth • Full disclosure • Withholding information • Lying
Principle of Confidentiality • Privacy- patients right • Confidentiality- the nurses duty
Principle of Sanctity of Human Life • Obligation to not infringe on the sacredness of human life • Obligation not to take human life
Ethical Theory • Normative Ethics-based on authoritative standards or norms for human conduct • Deontology • Utilitarianism • Values-Oriented Ethics- does not prescribe norms but emphasizes a person’s morality, virtue, and sense of goodness and care
Utilitarianism • Focuses on what constitutes “good” • Principle of Utility--”greatest good for the greatest number” & “the ends justify the means” • (+)Rules change depending on circumstance • (-) Minority groups have no claim • Use in allocation of scarce resources
Deontology(Normative Ethics) • Unconditional respect for the person as a human being • Value of caring underlies all the principles • Promote good and well being • Be just and fair • “All persons are of equal value” • Standards(rules) are fixed – do not change with situation
Deontology • Moral rightness or wrongness of human actions • Do no harm • Tell the truth • Keep promises and confidentiality
Critique of DeontologicalPerspective • Ethical Dilemma- a situation in which all options for resolution are equally unsatisfactory • Deontological principles are not prioritized • Difficult to provide guidance in complex situations • Disregard for consequences of actions can pose problems
Values-OrientedEthics • How should I act in this situation if I have the capacity to act morally? • Person’s morals strengthen and illuminate normative ethics • Important to Nursing • Caring • Moral Sense Inherent in Practice
Ethical Obligations of Nursing • Advocacy • Caring • Accountability • Cooperation
Caring • Fundamental to the role of the nurse • Being there for the patient • Respecting the patient • Feeling with and for the patient • Closeness with the patient
Advocacy • Person has the proper information • Person understands the information in order to make a decision • Nurse reports infringements • Nurse prevents infringements.
Accountability • Answerability • How one has promoted, protected, and met the health needs of the patient
Cooperation • Active participation with others to obtain quality care for patients • Collaboration in designing approaches to nursing care • Reciprocity with those with whom nurses identify professionally
Provision 1 • 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.
Provision 2 • The nurse’s primary commitment is to the patient, whether an individual, family, group, or community
Provision 3 • The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
Provision 4 • The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.
Provision 5 • The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. • See under provision 5: Professional growth and maintenance of competence. Discusses why to continue education and maintaining credentialing. Lends itself nicely to this class’ topics.
Provision 6 • The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action. • Discussed work conditions and administrative issues
Provision 7 • The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
Provision 8 • The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.
Provision 9 • The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.
Common Ethical Issuesin Nursing Practice • Cost containment issues • End of life decisions • Providing “futile” care • ANA Center for Ethics and Human Rights, 1994 • Breaches of patient confidentially • Incompetent, unethical or illegal practices • Pain management issues
Common Ethical Issuesin Nursing Practice • Use of advanced directives • Informed consent for procedures • Access to health care • Management: Staffing & Delegation • Issues in care of patients with HIV/AIDS; Organ Transplants & Stem Cell Transplants
Resolving Ethical Dilemmas • Discuss with other health professionals involved to resolve • Discuss with supervisor • Request ethical consultant • Refer to Ethics Committee • Does your organization have one? If yes, how do you access it?