Commitment to include clients in decision making process
When a commitment is made to include clients in the decision making process this is called?
Autonomy
A client needs a liver transplant but has been out of work for several months and does not have insurance or enough cash. A discussion about the ethics of this situation would predominanly involve which principle?
a. Justice
b. Ethics of care
c. accountability
d. respect for autonomy
Justice
What is Justice?
Fairness with the focus on fair distribution or resources.
Fairness with the focus on fair distribution of resources (e.g., as in deciding who will receive the organ needed for an organ transplant) is called?
Justice
The ability to operate independently; clients having the ability to determine their course of treatment, is called?
Autonomy
If you are on an organ donor list, and you take it upon yourself to "decide" whether or not you want that organ transplant, you are expressing __________?
Autonomy
When the HCT vows to "do no harm" to the patient, this is called?
Nonmaleficence
When the HCT provides the beast care possible to the patient they can provide this is called?
Beneficence
Taking positive actions to help others, ensuring no harm comes to a patient by providing the best course of care is called?
no harm = nonmaleficence
providing best source of care = beneficence
Avoiding harm or hurt; balancing the risks between the temporary pain of an immunization injection and the extended benefits of the immunization is an example of?
Nonmaleficence "doing no harm" But patient acts autonomously to decide if they want the immunization shot or not
Keeping promises made (e.g., working with a patient on how to manage their pain - deciding with them how you will manage - then keeping that promise to provide that care/pain mangement) is called?
Fidelity - keeping ones promises
Nurses agree to b e advocates for their clients. The practice of advocacy calls for the nurse to do which of the following?
1. seek out the nursing supervisor in conflicting situations
2. Work to understand the law as it applies to the client's clinical condition
3. Assess the client's point of view and prepare to articulate this point of view
5. Document all clinical changes in the mdical record in a timely manner
Assess the client's point of view...
As an advocate you need to understand the client's point of view and then be prepared to verbalize that point of view to others involved in the patients care
If you act responsibly, are accountable for your actions and keep information about your patients confidential, then you are floowing the____________?
Professional nursing code of ethics
A utilitarian system of ethics proposes what?
That the value of something is determined by its usefulness (e.g., a person receiving a liver transplant - who is an alcoholic - is determined based on the usefulness of whether that client deserves that transplant based on their chronic habit)
What is deontology?
Defines actions as right or wrong
Defines rightness or wrongness of a ethical situation (such as a doctor recommending a certain procedure and the parents stating they do not want that procedure performed on their child)...the deciding of who is right/wrong in this situation is called?
Deontology - actions of right and wrong
What is utilitarianism?
Proposes that the value of something is determined by its usefulness
When the value of something is determined by it's usefulness this is called?
Utliitarianism
What is Feminine ethics?
Focuses on the inequality between people
When the situation focuses on the inequality between people this is called?
Feminine ethics
The characteristics of an ethical problem include?
Lack of logical conclusion
lack of scientific support for either choice
differences in values that might result in harm
an answer that involves several areas of human concern - there will be problems
How do you process an ethical dilemma?
Ask if it is an ethical dilemma
gather all relevant information
clarify values
verbalize the problem
identify possible courses of action negotiate a plan
evaluzat the plan
Interventions unlikely to produce benefit for the client?
Futile care
What is futile care?
Interventions unliekly to prodcue benefit for the client
What consequences does a nursing shortage present?
Produces difficult working conditions and affects clients outcomes
A key issue in discussions about access to care?
Allocating scarce resources
Central to discussions about futile care, cancer therapy, physician-assisted suicide and DNR is called?
Quality of Life
Identify the basic principles of the code of ethics?
A set of guiding principles
A code that can settle questions/behaviors about the practice
Responsible/Accountable/Confidential/Ethical
The code spells RACE
responsible
accountable
confidnetial
ethical
What does it mean to separate values from values clarification?
As a nurse must be able to set personal beliefs/attitudes/customs/practices aside ("my values") and evaluate the situation based on value clarification ("hospital values"). If the two conflict, based on case and patient, asked to be reassigned.
This ethical philosophy defines actions of right vs. wrong? For example, if the act is good, righteous, acts to ensure fidelity then this represents the philosophy of ________? The focusing on the rightness does not mean focusing on "right" vs. "wrong" in your mind, but rightness vs. wrongness as it relates to autonomy, justice, fidelity and so on.
Deontology
The example is...a child is sick, a course of action is recommended to the parents - they refuse the course. The ethical dilemma focuses on the respect for the autonomy BUT whose autonomy is it is the dilemma (the parents or the child's). In this situation, the rightness is to focus on the autonomy as the guiding principle which is an example of this ethical philosophy?
Deontolgy
However...this example does not answer all the ethical dilemmas around this case, it just guides the nurse in focusing in on the rightness - autonomy and not the wrongness - focusing in on personal beliefs of what's best for the child
This ethical philosophy focuses on the greatest good for the greatest amount of people______________? other names include...
Utilitarianism.
consequentialism and eleology
True or false:
Utilitarianism provides guidance but does not guarantee agreement?
True...you the HCP may not agree, but if it's for the greater good (utilitarianism), based on the rightness vs. wrongness (deontology)then it is what it will be on those ethical guiding philosophies
This ethical philosophy focuses on relationships and inequality between people; however not the best ethical philosophy based on the arguement it has no universal guiding principles but more on is based on situation to situation basis...this philosophy is the ___________?
Feminist ethics...not a strong ethical philosophy
This ethical philosophy states that if you focus on the patient's narrative story and use that as your guiding basis for making decisions, you will have followed this __________?
The ethic of care philosophy; emphasizes the importance of understanding relationships, especially as they are revealed through personal narrative
This ethical philosophy emphasizess the importance of understanding relationships, especially as they are revealed in personal narratives?
Ethic of care
An example of this ethical term is: a client signs a consent form, the HCT has ensure/respected the clients decision about all aspects of care because they received this signed consent. This example illustrates ____________?
Autonomy...committment to include the client in the decision-making of their own care
Committment to letting the client be a part of and make decisions regarding their own care is called _____________?
Autonomy
When the best interest of the client remains more important than your own interest, this is an example of _______________?
Beneficence
An example of this ethical term is...a child ask for their pill to be crushed up and mixed into their favorite food. You know they can swallow the pill, but you are taking positive actions to help this child feel more comfortable and are putting their wishes ahead of yours for their best interest....this is called?
Beneficence
When you evaluate the barriers to benefit...for example, a bone marrow transplant may involve a period of suffering, but long-term offers many beneficial side effects, this is an example of ________?
Nonmaleficence...avoidance of harm or hurt
Avoidance of harming or hurting a client while weighing the benefits to barriers of each situation is called?
Nonmaleficence
Many patients are on a waiting list for liver transplants. When distributing them to base that distribution on a lottery system based on need evaluation vs. being given to the individual who has the most money is called ________ or fairness to the client?
Justice
If you assess a client for pain, promise to keep their pain at a level 3 by giving them continous pain med every 2 hours this is called what in regards to agreeing to keep your promise _______?
Fidelity - agreement to keep promises
How do you process an ethical dilemma?
Ask - is this an ethical dilemma
Gather relevant info
Clarify values
Verbalize problem
Identify possible courses of action
Negotiate a plan
Evaluate plan
If a client has terminal brain cancer, the client is in end-of-stage life; however the doctor says not to discuss a DNR with this client because he states the client is not ready, how do you proccess this ethical dilemma (the steps involved to process this situation)?
1. Ask yourself - is this an ethical dilemma
2. Gather all the information about the case you can
3. Clarify values - your values about what is occuring in this situation
4. Verbalize the ethical dilemma/situation
5. Identify possible courses of action to take
6. Negotiate a plan
7. Evaluate the plan
This bioethical issue deals with discussions regarding futile care, cancer therapy, experimental therapy, physician-assisted suicide and DNR discussions?
Quality of Life
This bioethical issue deals with interventions that are unlikely to produce benefit for the client...for example, a women wants a mastectomy based on the possibility (with her families history) she could have breast cancer without concrete evidence it's there. The physician does not believe this surgery is necessary based on the associated risks that outweigh any potential for benefits based on the situation. This bioethical issues is called ______?
Futile care - the doctor believes the procedure would be futile (not worth the effort as the risks are too great to perform a surgery like this on a patient based soley on history vs. actual diagnosis
When a nurse has to decide how to care for patients based on workload there is a bioethical issue surrounding what?
Allocation of scarce resources
This bioethical issue produces difficult working conditions and affects client(s) outcomes?
