ethical concepts in nursing

7/27/2019 Ethical Concepts in Nursing

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Ethical Concepts in

Nursing

Judy Brandell, RN, MSN

FALL, 2012


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Definitions

Values: attitudes, ideals, belief system ofindividuals/groups that are used to guidebehavior.

Morals: established rules of conduct andstandards of behavior: guide behavior tomake decisions about what is right and wrong

in a situation.


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Values freely chosen, influenced by upbringing,life experiences, evolve with maturity. Representmy beliefs that I hold with high regard.

Values clarification important to knowingoneself.

Brainstorm with classtheir most importantvalues use board (what values guide yourdaily interactions?)

Mine integrity, humility, authenticity, respect,quality, responsibility/accountability, courage,compassion, continuous improvement, hard work,


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Morals:

examples.

Always tell the truth one should not lie.Keep your promises. Do not steal.

"The difference between ethics and moralscan seem somewhat arbitrary to many, butthere is a basic, albeit subtle, difference.

Morals define personal character, while ethicsstress a social system in which those moralsare applied. In other words, ethics point tostandards or codes of behavior expected bythe group to which the individual belongs.This could be national ethics, social ethics,


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Moral Development

Refers to the growth of a persons value and

moral system from childhood to adulthood

and beyond.

There are many influencing factors.

Moral reasoning is part of moraldevelopment.


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Kohlbergs Stages

Postconventional

6. Human rights

5. Independent thinking

Conventional

4.Pleasing to society

3.Pleasing to others

Preconventional

2. Responds to reward

1. Responds to punishment


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Gilligans Stages

Theory of female moral

development: care

based

May be a difference

between men and

women (justice vs. care)

Points to need for

rigorous EBP

Principle of nonviolence:

Do not hurt others or self

Self sacrifice is goodness

Goal is individual survival


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Ethics

Ethics is concerned with which actions to take

in a situation.

Ethics is aprocess requiring clarification of

situations.

Bioethics: application to situations in health

care.


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Ethical Theories 1

Deontology: Kant

Moral if intent/motive good, regardless ofoutcome

DutyAct Deontology - gather facts

Rule Deontology - principles guide actions

Example: good Samaritan law

Problems?


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Ethical Theories 2

Utilitarianism: Hume/Bentham/Mill

Moral rightness determined by consequence

Greatest good for the greatest number

Examples: triage, healthcare money

Problems?


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Ethical Theories 3

Virtue Ethics: Plato/Aristotle Inborn tendencies that develop through training

Emphasizes the character of the decision maker

Character traits regarded as virtues:

Honesty, courage, compassion, fairness, integrity, etc.

Example: perseverance for patient advocacyhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.html

Problems?
http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.htmlhttp://www.nursingworld.org/FunctionalMenuCategories/MediaResources/legal/Fighting-for-Nurses-Who-Speak-Up-for.html


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Principalism

Use of ethical principles to guide behavior:

Beneficence

Nonmaleficence

Justice

Fidelity

Veracity

Autonomy (refer to PSDA, 1991)

Paternalism (deciding for another)


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Moral Distress

What is it?

How are nurses in particular susceptible?

Where are you most susceptible?

What is moral outrage?


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Moral Courage

Can be defined as taking action to do what is

right in spite of possible repercussions.

The phrase moral courage suggests there isdanger or fear associated with taking a right

action, because of the possible personal

sacrifice.


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Code of Ethics for Nurses

Every profession needs a code of ethics.

Is an implied contract with society.

The Code of Ethics for Nurses with

Interpretive Statements (ANA, 2001) is the

most recent revision.

Refer to the back cover of Chitty & Black


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Nursing Process and the Ethical

Decision-Making Model Nursing Process

Assess

Analyze

Plan

Implement

Evaluate

Ethical Model

Clarify Dilemma

Gather Data

Identify options

Make a decision

Act

Evaluate


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Dilemmas

Related to personal value systems

Involving other professionals

Regarding patient rights

PSDA (1991)

Related to immigration

Related to migration

Institutional issues

Technology


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Case Studies

Divide into 6 groups

Discuss assigned case study

Present discussion to class

ethical concepts in nursing

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