CHAPTER 4 QUESTIONS OF VALUES AND ETHICS

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CHAPTER 4QUESTIONS OF VALUES AND ETHICS
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INTRODUCTION
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In the beginning

• There were no antibiotics
• There were no ICUs
• There were no CT scanners and MRIs
• There were just physicians and nurses who cared
  for people in sickness and in health

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1960s

• Technological advances allowed for the
  development of intensive care units
• New biomedical developments
• Advances in surgical techniques, such as open
  heart surgery

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New Questions

• The advances created new questions for
  health-care professionals regarding the use of
  technology
• The concepts of life and death

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Bioethics

• A subdiscipline of ethics
• The study of medical morality

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Concepts of Ethics

• Values
• Belief systems
• Morality

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Value Systems

• A set of related values
• Intrinsic values
• Extrinsic values
• Personal values
• Professional values

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Value Formation

• Values are learned
• Values change with maturity and experience
• The number of values an individual holds is not
  as important as what values they consider
  important

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Values Clarification

• Choosing
• Prizing
• Acting

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Belief Systems

• These are organized ways of thinking about why
  people exist within the universe
• Their purpose is to explain such concepts as
• Life and death
• Good and evil
• Health and illness

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ETHICS AND MORALS
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Morals

• An individuals own code for acceptable behavior
• They arise from an individuals conscience
• They act as a guide for individual behavior
• Learned

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Ethics

• Ethics deals with the rightness or wrongness
  of human behavior
• Concerned with the motivation behind the behavior
• Bioethics is the application of these principles
  to life-and-death issues

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Ethical Theories

• Deontological
• Teleological
• Principalism

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Ethical Principles

• Autonomy
• Nonmaleficence
• Beneficence
• Justice
• Fidelity
• Confidentiality
• Veracity
• Accountability

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Autonomy

• The freedom to make decisions about oneself
• Nurses need to respect clients rights to make
  choices about health care

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Nonmaleficence

• Requires that no harm be caused to an individual,
  either unintentionally or deliberately
• This principle requires nurses to protect
  individuals who are unable to protect themselves

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Beneficence

• This principle means doing good for others
• Nurses need to assist clients in meeting all
  their needs
• Biological
• Psychological
• Social

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Justice

• Every individual must be treated equally
• This requires nurses to be nonjudgmental

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Fidelity

• Loyalty
• The promise to fulfill all commitments
• The basis of accountability

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Confidentiality

• Anything stated to nurses or health-care
  providers by clients must remain confidential
• The only times this principle may be violated
  are
• If clients may indicate harm to themselves or
  others
• If the client gives permission for the
  information to be shared

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Veracity

• This principle implies truthfulness
• Nurses need to be truthful to their clients
• Veracity is an important component of building
  trusting relationships

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Accountability

• Individuals need to be responsible for their own
  actions
• Nurses are accountable to themselves and to their
  colleagues

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Ethical Codes

• These are formal statements of the rules of
  behavior for a particular group of individuals
• Ethical codes are dynamic
• Most professions have a code of ethics to guide
  professional behavior

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Virtue Ethics

• Focus on virtues or moral character
• View helping others as charitable or benevolent

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Organizational Ethics

• Focus on the workplace
• Ethical culture makes a difference
• Senior leadership must promote an ethical culture

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Ethical Dilemmas

• Occur when a problem exists between ethical
  principles
• Deciding in favor of one principle usually
  violates another
• Both sides have goodness and badness
  associated with them

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Resolving Ethical Dilemmas
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Using the Nursing Process

• Assessment
• Planning
• Implementation
• Evaluation

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Approach to Ethical Dilemma
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Current Ethical Issues
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Issues to Consider

• Assisted suicide
• Technology issues
• Gene therapies
• Designer babies
• Organizational climate

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Conclusion

• An issue is not an ethical issue for the nurse
  unless he or she has been asked
• Always gather the facts prior to decision-making
• Consider your personal beliefs and values