ETHICAL ISSUES IN HEALTH AND NURSING PRACTICE Present by: Dr.Amira Yahia
UNDERSTANDING CONCEPTS OF ETHICS Morals: basic standards for what is considered right and wrong. Values: ideals, beliefs, custom, mode of conduct, qualities or goals that are highly prized or preferred by individuals, groups or society. Ethics : specific area of study of morality that concentrates on human conduct and human values. Ethical dilemma : occurs when an individual must choose between two unfavorable alternatives.
BASIC ETHICAL CONCEPTS Autonomy: right of self-determination or choice, independence, and freedom Beneficence: obligation to do good, not harm, to other people Nonmaleficence: prohibition of intentional harm Justice: fairness, obligation to treat like cases similarly
Fidelity: Obligation to be faithful to the agreements, commitments, and responsibilities that one has made to oneself and others. It is the foundation of the concept of accountability Veracity: Telling the truth, not intentionally deceiving or misleading patients. Confidentiality
ETHICAL THEORIES 1. Natural Law Actions are morally right when they are in accord with our nature and end as human beings Good should be promoted, evil avoided, and ethics grounded in our concern for human good 2. Deontology Based on moral rules and unchanging principles considered separately from the consequences Unconditional commands that must be applied in all situations without exception
3. Utilitarianism An act is right when it is useful in bringing about a desirable or good end Allows the end to justify the means Fits well into Western society’s values regarding work ethic and the behavioristic approach to education, philosophy, and life
4. Social Equity and Justice Allows social and economic positions to be to everyone’s advantage and open to all Introduces a “veil of ignorance” whereby persons making choices would not have any specific information regarding those involved, thus choosing the alternative that supported the most disadvantaged person Supports justice and equal rights for everyone
EXAMPLES OF ETHICAL PROBLEMS: NURSES & PATIENTS: Paternalism (acting for patients without their consent to secure good or prevent harm) Deception Confidentiality Allocation of scarce nursing resources, etc. NURSES & PHYSICIANS: Disagreements about the proposed medical regimen Conflicts regarding the scope of Nurse’s role Unprofessional, incompetent or illegal nurse practice
NURSES & OTHER NURSES Claims of loyalty Unprofessional, incompetent or illegal nurse practice NURSES & INSTITUTIONAL AND PUBLIC POLICY Short staffing and whistle blowing Healthcare rationing
ETHICAL DECISION MAKING PROCESS: provides a method for nurses to answer KEY QUESTIONS about ethical dilemmas & to organize their thinking in a more logical & sequential manner. FRAMEWORK FOR ETHICAL DECISION-MAKING Identifying and clarifying the ethical problem Gathering data Identifying options Making a decision Acting and assessing
FACTORS INFLUENCE ETHICAL DECISION-MAKING 1. Code for nurses 2. The patient’s rights 3. Social and cultural factors 4. Science and technology 5. Legislation 6. Judicial decisions 7. Funding 8. Personal religious & philosophic viewpoints
FACTORS IN THE WORK ENVIRONMENT THAT AFFECT ETHICAL DECISION-MAKING 1. Status as an employee 2. Collective bargaining contracts with trade unions 3. Collegial relationships 4. Authoritarian and paternalistic backgrounds 5. Institutional supports for ethical behavior 6. Consumer involvement in health care
WHISTLE-BLOWING Serious situation when using chain of command and there is no response to voiced concerns Used to bring attention to the circumstances Should be used as a last resort because of possible ramifications to the individual blowing the whistle
BOUNDARY VIOLATIONS Situation in which the nurse moves beyond a professional relationship and becomes involved with patients and their families Represents a violation of the trust relationship that exists between the patient and the nurse