Chapter 22: Ethics and Values

Overview

• Ethics: Study of right and wrong within our conduct.
• Morals: Judgments about behavior based on beliefs.
• Values: Deeply held beliefs about worth or importance of ideas, customs, or objects.

Key Ethical Concepts in Healthcare

• Autonomy:

  • Definition: Freedom from external control.
  • Application: Respect for patients' autonomy.

• Beneficence:

  • Definition: Taking positive action to help others.
  • Importance: Fundamental to nursing practice; prioritizes patients' best interests over self-interest.

• Non-maleficence:

  • Definition: Avoidance of harm or hurt.
  • Balance: Commitment to do good and do no harm.

• Justice:

  • Definition: Fairness and distribution of resources.
  • Discussion: Often related to access to healthcare and distribution of scarce resources.

• Fidelity:

  • Definition: Faithfulness or agreement to keep promises.
  • Duty: Nurses must be faithful to patients, institutions, and themselves.

Professional Ethics

• Code of Ethics: Set of guiding principles accepted by all members of a profession.
• Advocacy: Using skills and knowledge for the benefit of others.
• Responsibility: Willingness to respect professional obligations and to follow through.
• Accountability: Answering for one's actions and ensuring they are explainable.
• Confidentiality: Obligation to respect patient privacy; fundamental to nurse-patient relationships.

Ethical Dilemmas

• Nature: Occurs when values conflict; involves distinguishing fact from opinion.

• Resolution: Requires clarification of personal and others' values.

  • Importance of recognizing strong emotions as signs of threatened values.

• Approaches to Ethics:

  • Deontology: Focus on right or wrong.
  • Utilitarianism: Value determined by usefulness.

Case Study Considerations

• Recognizing who may need further healthcare and understanding patients' mental health processes.
• Nurses’ unique role due to prolonged and intimate interactions with patients.
• Family and patient comfort in sharing personal information with nurses.

Ethical Problem Processing

• Recognition: Identifying that an ethical problem exists.

• Hospital Ethics Committees:

  • Composition: Multidisciplinary backgrounds.
  • Roles: Provide consultations, develop policies, facilitate education.

• Ethical Issues in Nursing:

  • Considerations of social media, quality vs. quantity of life, disparities in healthcare access.

Practical Application

• Withholding Medication Scenario:

  • Principle: Accountability for decisions based on patient conditions.

• Steps for Processing Ethical Dilemmas:

  • Review and apply sequential steps in processing ethical dilemmas.
  • Gather relevant information and reflect on personal values and opinions.