nursing ethics
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Ethical Issues in NursingEthical Issues in NursingMr.Upendra Yadav Mr.Upendra Yadav Assistant ProfessorAssistant Professor
Child Health NursingChild Health NursingCollege of Nursing, College of Nursing,
B.P.Koirala Institute of Health Sciences B.P.Koirala Institute of Health Sciences Dharan Nepal. Dharan Nepal.
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ObjectivesObjectives
Terms: Ethics, Bioethics, Values, MoralsTerms: Ethics, Bioethics, Values, Morals Ethical principles Ethical principles CNA Code of Ethics and primary values CNA Code of Ethics and primary values Nursing Standards definitionNursing Standards definition 6 standards of nursing practice 6 standards of nursing practice Framework for processing an ethical Framework for processing an ethical
dilemmadilemma
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Values and ethics Values and ethics
Values and ethics are inherent in all Values and ethics are inherent in all nursing acts. nursing acts.
A value is a strong personal belief; an A value is a strong personal belief; an ideal that a person strives to uphold.ideal that a person strives to uphold.
Your values reflect cultural and social Your values reflect cultural and social influences, relationships and influences, relationships and personal needs. Vary among people personal needs. Vary among people and develop and change over time.and develop and change over time.
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What is Ethics?What is Ethics?
Branch of philosophy concerned with Branch of philosophy concerned with determining right and wrong in relation to determining right and wrong in relation to people’s decisions and actions.people’s decisions and actions.
Morals and ethics are often used Morals and ethics are often used interchangeably but morals are often interchangeably but morals are often stated as private, personal standards of stated as private, personal standards of what is right and wrong, ethics reflect a what is right and wrong, ethics reflect a commitment to standards beyond personal commitment to standards beyond personal preferences.preferences.
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Nursing EthicsNursing Ethics
An expression of how nurses ought to An expression of how nurses ought to conduct themselves. Refers to conduct themselves. Refers to ethical standards that govern and ethical standards that govern and guide nurses in everyday practice guide nurses in everyday practice such as “being truthful with clients” such as “being truthful with clients” “respecting client confidentiality” “respecting client confidentiality” and “advocating on behalf of the and “advocating on behalf of the client.”client.”
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Ethical PrinciplesEthical Principles
AutonomyAutonomy NonmaleficenceNonmaleficence BeneficenceBeneficence JusticeJustice
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Ethical PrinciplesEthical Principles
AutonomyAutonomy- refers to a person’s - refers to a person’s independence, self-determination, independence, self-determination, self-reliance. A patient has the right self-reliance. A patient has the right to make decisions about her/her to make decisions about her/her care. Ex. Signing a consent form for care. Ex. Signing a consent form for surgerysurgery
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Ethical PrinciplesEthical Principles
NonmaleficienceNonmaleficience - - refers to the refers to the avoidance of causing any harm to clients. avoidance of causing any harm to clients. Try to balance the risks and benefits of a Try to balance the risks and benefits of a plan of care, while striving to do no harm. plan of care, while striving to do no harm. Ex: bone marrow transplant promises to Ex: bone marrow transplant promises to bring a cure but there may be a long bring a cure but there may be a long period of pain and suffering.period of pain and suffering.
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Ethical PrinciplesEthical Principles
BeneficenceBeneficence- - means promoting good means promoting good or doing good for others. Take positive or doing good for others. Take positive steps to help others. It helps to guide steps to help others. It helps to guide difficult decisions where the benefits of a difficult decisions where the benefits of a treatment maybe challenged by the risk to treatment maybe challenged by the risk to the client’s well-being or dignity. The best the client’s well-being or dignity. The best interests of the client must be upheld. Ex: interests of the client must be upheld. Ex: immunizationimmunization
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Ethical PrinciplesEthical Principles
Justice- Justice- refers to fairness or equity. refers to fairness or equity. Clients need to be treated in a manner Clients need to be treated in a manner that they deserve. Ex. Both clients receive that they deserve. Ex. Both clients receive the same treatment when being admitted the same treatment when being admitted for surgery, fair resources etc. for surgery, fair resources etc.
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What does a code of ethics do?What does a code of ethics do?
Gives guidance for decision making Gives guidance for decision making about ethical matters by providing a about ethical matters by providing a set of values that are basic to set of values that are basic to nursing practice.nursing practice.
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The Code of Ethics The Code of Ethics
Provide rules of ethical or moral Provide rules of ethical or moral behavior for every circumstance.behavior for every circumstance.
Offer guidance about which values Offer guidance about which values should take priority or how they can should take priority or how they can be balanced in practice.be balanced in practice.
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Values and The Code of EthicsValues and The Code of EthicsPrimary values that are central to ethical Primary values that are central to ethical
nursing practice. nursing practice. The 7 values include: The 7 values include: 1.1. Providing safe, Providing safe, 2.2. Compassionate competent and Compassionate competent and 3.3. Ethical care, Ethical care, 4.4. Promoting health and well-being,Promoting health and well-being,5.5. Promoting and respecting informed Promoting and respecting informed
decision-making, decision-making, 6.6. Maintaining privacy and confidentiality, Maintaining privacy and confidentiality, 7.7. Promoting justice and being accountable Promoting justice and being accountable
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Providing Safe, Compassionate Providing Safe, Compassionate Competent and Ethical CareCompetent and Ethical Care
Nurses value the Nurses value the ability to provide ability to provide safe, compassion, safe, compassion, competent and competent and ethical care that ethical care that allows them to fulfill allows them to fulfill their ethical and their ethical and professional professional obligations to the obligations to the people they serve.people they serve.
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Promoting Health and Well Promoting Health and Well BeingBeing
Nurses value health Nurses value health promotion and well being promotion and well being and assist persons to and assist persons to achieve their optimum achieve their optimum level of health in level of health in situations of normal situations of normal health, illness, injury, health, illness, injury, disability or at the end of disability or at the end of life.life.
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Promoting and Respecting Promoting and Respecting Informed Decision-MakingInformed Decision-Making
Nurses provide Nurses provide persons with persons with appropriate appropriate information and information and services so they can services so they can make informed make informed decisions. Ensure decisions. Ensure nursing care is given nursing care is given with informed with informed consentconsent
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Preserving DignityPreserving Dignity
Recognize and respect the inherent Recognize and respect the inherent worth of each person and advocate worth of each person and advocate for respectful treatment of all for respectful treatment of all persons.persons.
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Maintaining Privacy and Maintaining Privacy and ConfidentialityConfidentiality
Nurses safeguard the trust Nurses safeguard the trust of clients that information of clients that information learned in the context of a learned in the context of a professional relationship is professional relationship is shared outside the health shared outside the health care team only with the care team only with the clients permission or as clients permission or as legally required or where legally required or where failure to disclose would failure to disclose would cause significant harm.cause significant harm.
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Promoting JusticePromoting Justice
Nurses apply and promote principles Nurses apply and promote principles of equity and fairness to assist clients of equity and fairness to assist clients in receiving unbiased treatment (social in receiving unbiased treatment (social justice) and a share of health services justice) and a share of health services and resources proportionate to their and resources proportionate to their needs. Safeguard human rights.needs. Safeguard human rights.
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Being AccountableBeing Accountable
Nurses act in a manner consistent Nurses act in a manner consistent with their professional responsibilities with their professional responsibilities and standards of practice and are and standards of practice and are answerable for their practice.answerable for their practice.
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Definition of Nursing StandardsDefinition of Nursing Standards
Describes the desirable and achievable Describes the desirable and achievable level of performance expected of level of performance expected of registered nurses in their practice against registered nurses in their practice against which performance can be measuredwhich performance can be measured
Benchmark for assessing the professional Benchmark for assessing the professional conduct of all registered nurses.conduct of all registered nurses.
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Six Standards of Nursing PracticeSix Standards of Nursing Practice
AccountabilityAccountability Continuing CompetenceContinuing Competence Application of Knowledge, Skills and Application of Knowledge, Skills and
JudgmentJudgment Professional Relationships and AdvocacyProfessional Relationships and Advocacy Professional LeadershipProfessional Leadership Self-RegulationSelf-Regulation
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Standard 1 and 11Standard 1 and 11
AccountabilityAccountability Accountable to the Accountable to the
public to ensure that public to ensure that clients receive clients receive competent, safe, competent, safe, and ethical care.and ethical care.
Continuing Continuing CompetenceCompetence
The registered nurse The registered nurse attains and maintains attains and maintains competence relevant to competence relevant to their own scope of their own scope of
nursingnursing practicepractice
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Standard III, IVStandard III, IV
Application of Application of Knowledge, Skills and Knowledge, Skills and JudgmentJudgment
The registered nurse The registered nurse demonstrates demonstrates competencies relevant competencies relevant to their own scope of to their own scope of nursing practice.nursing practice.
Professional Professional Relationships and Relationships and AdvocacyAdvocacy
Establishes a Establishes a professional professional therapeutic therapeutic relationship and is an relationship and is an advocate for clients.advocate for clients.
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Standard V, VIStandard V, VI
Professional Professional LeadershipLeadership
Demonstrates Demonstrates leadership when leadership when providing quality providing quality nursing care and health nursing care and health
care services to clientscare services to clients..
Self-RegulationSelf-Regulation Personally accountable to Personally accountable to
practice nursing in a practice nursing in a competent and ethical competent and ethical mannermanner..
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Ethical Decision Making ProcessEthical Decision Making Process
Guide for ethical discussion Guide for ethical discussion within the context of health within the context of health care practice. It care practice. It incorporates theories, incorporates theories, principles and codes into the principles and codes into the decision making process.decision making process.
An ethical dilemma often An ethical dilemma often forces a choice between one forces a choice between one or more ethical principlesor more ethical principles
Deciding in favor of one Deciding in favor of one principle can often violate principle can often violate another principle another principle
There is often no clear There is often no clear answer/decision in resolving answer/decision in resolving ethical dilemmasethical dilemmas
Often ethical dilemmas pose Often ethical dilemmas pose more questions than provide more questions than provide answersanswers
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How to Process an Ethical How to Process an Ethical DilemmaDilemma
1) Is this an ethical 1) Is this an ethical dilemma?dilemma?
2) Gather all the 2) Gather all the information relevant to information relevant to the casethe case
3) Examine and 3) Examine and determine your own determine your own values on the casevalues on the case
4) Verbalize the 4) Verbalize the problemproblem
5) Consider 5) Consider possible courses of possible courses of actionaction
6) Negotiate the 6) Negotiate the outcomeoutcome
7) Evaluate the 7) Evaluate the actionaction
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SummarySummary
Terms: Ethics, Values, MoralsTerms: Ethics, Values, Morals Ethical principles Ethical principles Code of Ethics and primary valuesCode of Ethics and primary values Nursing Standards definitionNursing Standards definition 6 standards of nursing practice 6 standards of nursing practice Framework for processing an ethical Framework for processing an ethical
dilemmadilemma
