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MDC Institute for Ethics In Health Care Presents:

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1 MDC Institute for Ethics In Health Care Presents:
Ethics And Prematurity: The Nurse As A Moral Agent Dr. Carol Petrozella RN, & Dr. Kate Callahan RN

2 Organizational Ideas and Actions
Although “everyone does it”, (Group Think) it still comes down to an individual’s decision about how one is going to act using or not using ethical principles.

3 Organizational Ideas and Actions
Although “everyone does it”, (Group Think) it still comes down to an individual’s decision about how one is going to act using or not using ethical principles.

4 Objectives To: Identify the common terms and principles of modern bioethics. Explain how the Code of Ethics guides Maternal Child nursing practice . Discuss Ethical Issues that currently impact Health Care Environment. Discuss the conflicts that arise when Ethical Principles & Healthcare practices collide.

5 Ethical Principles Conflict is inevitable. Ethical principles provide the framework/ tools which may facilitate individuals and society to resolve conflict in a fair, just and moral manner.

6 Ethical Dilemma: Situations necessitating a choice between two equal (usually undesirable) alternatives.

7 What Are Ethical Principles, and How Do They Help With Decision Making?

8 Ethical Principles Autonomy/Freedom Veracity Privacy/Confidentiality
Beneficence/Nonmaleficence Fidelity Justice

9 Autonomy The right to participate in and decide on a course of action without undue influence. Self-Determination: which is the freedom to act independently. Individual actions are directed toward goals that are exclusively one’s own.

10 Veracity The duty to tell the truth. Truth-telling, honesty.

11 Privacy/Confidentiality
Respecting privileged knowledge. Respecting the “self” of others.

12 Beneficence/Nonmaleficence
The principle and obligation of doing good and avoiding harm. This principle counsels a provider to relate to clients in a way that will always be in the best interest of the client, rather than the provider.

13 Fidelity Strict observance of promises or duties.
This principle, as well as other principles, should be honored by both provider and client.

14 Justice The principle that deals with fairness, equity and equality and provides for an individual to claim that to which they are entitled. Comparative Justice: Making a decision based on criteria and outcomes. ie: How to determine who qualifies for one available kidney. 55 year old male with three children versus a 13 old girl. Noncomparative Justice: ie: a method of distributing needed kidneys using a lottery system.

15 Cultural Values Influence Decision Making

16 Diversity & Bioethics Contemporary bioethical principles are all derived, directly or indirectly from the principle of autonomy. Within the world, no two people are exactly alike. Therefore, their values, motivations, moral beliefs, and moral characters may differ much more than their physical appearances. All Chinese have very similar physical appearances, however, their views about their government and procreation may differ.

17 Respect for the Individual
In our pluralistic society individuals often misunderstand each other. Even when they do understand each other, it is possible for them to disagree. The Healthcare arena, in common with every other segment of society has found it necessary to find ways to create understanding and agreement.

18 How to Create Understanding and Agreement?
Common ground must be created or found. A function of Ethics, in our society, is to make agreement possible. As healthcare professionals and patients meet, they meet as strangers from diverse backgrounds therefore, their ways of looking at and approaching the world are usually quite different.

19 Creating Harmony is Difficult In The Healthcare Arena.
Power Self esteem Communication Personality/Attitude Education Level Socioeconomic Class Culture (which constitutes the most profound difference). Values I need a note.

20 Ethics and Morality Ethics is a set of moral principles and a code for behavior that govern an individual’s actions with other individuals and within society. Morality is what people believe to be right and good, while ethics is a critical reflection about morality. Different cultures have different moral codes. Thus, there are no universal truths in ethics because it is difficult to say that customs are either correct or incorrect.

21 Nurses as Moral Agents Act for the welfare of their patients
Most time spent with patients Develop Caring Relationships “Knowing the patient” Code of Ethics – Caring & Patient Advocacy Nurses’ Integrity Lack the Power to Act = Moral Distress Risk Taking

22 Organizational Ideas and Actions
Although “everyone does it”, it still comes down to an individual’s decision about how one is going to act using or not using ethical principles.

23 Distributive Justice The right of Liberty & Justice for all which in the Health policy perspective relates to the provisions of equal access to health care to all and equitable allocation of scarce resources

24 Ethics Exercise: Starting at the life boat exercise, the small group activity should take about an hours time. This exercise can be used by itself and can be expanded. At the end of the exercise, some questions and reflections to focus on may be: How did decision making and consensus building occur within the groups/class. Who is the leader, how did that happen? Are you requiring 100% consensus or majority rule? Have the student who had the minority opinion explain how he/she felt? How and why did the student acquiesce? Examine the individual values of the group as to why they choose the survivors. During the process explore whether students changed their minds, and why?

25 Welcome George Soros and his $$$$$$$$$$
$1,000,000 March of Dimes Grant

26 Who Gets the $$$$$$ & Why
1.Primary Preventive Services 2.Direct Patient Care Social Services for Families 3.Economic Supplements to Families 4. Research for orphan drugs/diseases 5.Technology/New Equipment 6.Staffing (ratios) 7.Team Building 8.Education

27 Rules for the Grant: $$ must be used under one category
Must identify specific uses for the $$ Must be used for Peri/Neonatal Care Must provide JUSTIFICATIONS for the use of the $$

28 Ethics Exercise $$$ Keeping an Anencephalic child alive for organ harvesting Prolonging life for family members to fly in to say good-bye Provide resources for organ transplantation with and or without on-going care Provide fertility services Provide genetic studies Provide on-going bereavement care Day to day operations in healthcare facilities are impacted by this law. Examples of potential violations of the law include: Unauthorized personnel overhearing telephone conversations and leaving client records unattended in visual sight of unauthorized personnel. Student or professional abuses may include the unauthorized duplication of client records and inappropriate discussion of client data. Teaching rounds can create potential violations.

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