1. Values, Ethics, and Advocacy

2. Ethics
Ethics is the study of philosophical ideals of right and wrong behavior. It is the study of good conduct, character, and motives. (Iggy, pg.389)
Ethics is the study of social morality and philosophical reflection on society’s norms and practices. It is the practical application of moral philosophy and asks the question- “What should I do in this situation?” (Burkhardt, pg. 29)
Two different definitions, however, similar. The study of ethics is looking at behavior, practices, conduct, responding to situations. It is looking at right and wrong behavior in individual situations.

3. Ethical Terminology Autonomy- Refers to a person’s independence
Beneficence- Refers to taking positive actions to help others.
Nonmaleficence- “Do no harm”
Justice- Refers to fairness
Fidelity- Refers to keeping promises and commitments

4. Ethics and Nursing
Code of Ethics- Sets forth ideas of conduct within a group. They are a set of ethical principles that are agreed upon and accepted by members of a group.
Can include:
Expectations of group members
Standards by which members operate
Guidelines to help determine appropriate behavior and help with determine answers when questions arise.
What is the uses and limitations of a professional code of ethics?

5. Ethics and Nursing Nursing Code of Ethics
Has been formalized by at least 2 organizations, the American Nurses Association (ANA) and the International Council of Nurses (ICN). (Box 21-2, pg 391)
Both organization’s Code of Ethics include the same basic principles of responsibility, accountability, confidentiality, advocacy, and veracity.
Website for ANA-
Website for ICN-

6. Values
A value is a personal belief about the worth of a given idea, attitude, custom,or object that sets standards that influence behavior.
Values are ideals, beliefs, customs, modes of conduct, qualities, or goals that are highly prized or preferred by individuals, groups, or society.

7. Values Formation Values form and develop as a result of: Family
Religion
Social organizations
Community
Experiences
Family- People have had variations in child rearing, various values and behaviors were introduced and practiced in each family
Religion- Teaches and reinforces values
Social organization- What social groups do you belong to (school, work, friends/peer group, church groups). These groups again teach and reinforce values
Community- Each community has different values (compare the bigger communities of San Francisco and Bakersfield) (small town vs big metropolitan city)
Individual experiences- What we have experienced in life plays a significant role in what we see as valueable.

8. Values Clarification
The process of becoming more conscious of and naming what one values or considers worthy. It involves understanding how our values affect our thoughts and behaviors.
Outcome of values clarification= self awareness/ personal insight
When looking at your own values and understanding your own values look at cultural values that you hold. Cultural values are a result of the setting in which we live. Some people believe their beliefs and values are superior to others, this is called ethnocentrism. As nurses our values can become the measurement for our clients unless we are aware.

9. Bioethics
Bioethics is the practice of ethical considerations in health care situations
Give some examples of some health care situations that have caused ethical dilemmas, that have been in the news.
Next page has broad categories of situations. Maybe name some they have heard about on the news

10. Bioethical Issues Quality of life Genetic screening Futile care
Allocation of scarce resources: medical technologies
Allocation of scarce resources: the nursing shortage
Broad categories
Quality of life- very individual and personal for each one/ researcher have tried to develop quality of life measures to help determine the risk vs benefit in individual situations.
Genetic screening- Testing done to alert clients to conditions that are not yet evident. Again what are risks and benefits
Futile care- Using interventions that are unlikely to help the situation, unlikely to benefit the client
Allocation of scarce resources- Organ donation, should resources be used to find treatments or in prevention
Allocation of Scarec resources- Nurses Te nursing shortage produces difficult working conditions and affects client outcomes (increased medication errors, when does a nurse deem an assignment unsafe. Closing of beds California first state w/ ratios

11. Processing an ethical dilemma
1. Determine if issue is an ethical dilemma.
2. Gather data relevant to issue.
3. Examine and determine your own values on the issue.
4. Verbalize the problem.
5. Consider possible courses of action.
6. Negotiate the outcome.
7. Evaluate the action.

12. Advocacy
To advocate means to speak or write in support of something or someone. An advocate is someone who pleads another’s case.
As nurse’s we advocate:
By assisting client/ family in interpreting information
By offering assistance to the client in decision making and explaining the implications of the client’s decision
By ensuring that the client receives appropriate care