1. Chapter 9 Ethical Aspects of Gerontological Nursing

2. Terms to Know
Autonomy: to respect individual freedoms, preferences, and rights
Beneficence: to do good for patients
Confidentiality: to respect the privacy
Ethics: a system of moral principles that guides behaviors
Fidelity: to respect our words and duty to patients
Justice: to be fair, treat people equally
Nonmaleficence: to prevent harm to patients
Veracity: truthfulness

3. Introduction
Professional ethics: principles guiding right and wrong conduct
Must understand ethics of nursing profession and own personal ethics
Many ethical dilemmas facing gerontological nurses today

4. Philosophies Guiding Ethical Thinking
Utilitarianism: good acts benefitting greatest number of people
Egoism: morally acceptable benefit for oneself
Relativism: right and wrong relative to situation
Absolutism: specific truths to guide actions

5. Question Which statement best describes relativism?
Good for the greatest number of people
Greatest benefit to oneself
Situational ethics
Specific truths

6. Answer C. Situational ethics
Rationale: Relativism can be referred to as situational ethics, in that right and wrong are relative to the situation.

7. Ethics in Nursing Internal ethical standards: ANA code of ethics
External ethical standards
Federal, state, and local standards: regulations
Joint commission: standards
Agency specific: philosophy, goals, and objectives
Individual nurses: values for ethical thinking

8. Ethical Principles Beneficence: do good Nonmaleficence: prevent harm
Justice: fair, treat equally
Fidelity: respect and duty
Veracity: truthful
Autonomy: respect freedom, preferences, and rights
Confidentiality: to respect the privacy

9. Question
Which actions best describes the ethical principle of veracity?
Preventing a medication error from occurring
Telling a patient bad news in a honest and truthful manner
Making a health-related decision for an older adult
Treating each patient equally while providing care

10. Answer B. Telling a patient bad news in a honest and truthful manner
Rationale: Veracity is truthfulness. This principle is central to all nurse–patient interactions because the quality of the relationship depends on trust and integrity.

11. Ethical Dilemmas Facing Gerontological Nurses
Most clinical situations not simple, clear-cut ethical decisions
Conflicts with nurses’ values
External systems affecting decisions
Conflicts with rights of patient and nurses’ responsibility

12. Question Is the following statement true or false?
Increasing ethical dilemmas for nurses often occur as there is a wider scope of nursing practice, combined with higher salaries and greater status that has increased the accountability and responsibility of nurses for the care of patients.

13. Answer
True
Rationale: The expanded role of nurses has introduced new areas of ethical dilemmas to nursing practice as nurses now perform sophisticated assessments, diagnose nursing problems, monitor and give complicated treatments, and increasingly make independent judgments about patients’ clinical conditions.

14. Changes Increasing Ethical Dilemmas for Nurses
Expanded role of nurses
Medical technology
New fiscal constraints
Conflicts of interest
Greater numbers of older adults
Assisted suicide

15. Measures to Help Nurses Make Ethical Decisions
Encourage patients’ expression of desires
Identify significant others who impact and are impacted
Know yourself
Read and discuss
Form an ethics committee
Consult experts
Share and evaluate decisions