Safeguarding Your Ethical Responsibility

Lorraine Kelley, MSN, BSHA-HIS, RN&

Objectives

• Know the definition of and differences between the terms: Ethics, Values, Morals, & Laws

• Discuss Code of Ethics: ANA and ICN• Discuss ethical principles and concepts• Name the steps in the ethical decision-making

process and apply it• Discuss Nursing Standards

Ethics

• In health care, actions related to preserving and enhancing life

• Doing the right thing, at the right time, for the right reason

• Ensure individual’s rights are protected• A system of morals for a group

Values

• Concepts that give meaning to an individual’s life

• Derived from social norms, religion and family• Help the individual make decisions and take

certain actions• Value conflicts are part of life• Example: Work versus sick child

Morals

• Fundamental standards of right & wrong• Learned in childhood• In accordance with group’s norms, customs, &

traditions• Example: Mormonism

Laws

• Rules of social conduct to protect society• Fairness & Justice• Laws protect rights of individuals• Enforceable by authority• Example: Euthanasia is illegal

1. The nurse practices with compassion and & respect for the dignity, worth, & uniqueness of every individual

2. Primary commitment is to the patient (community, group, or population)

3. Promotes & advocates to protect the health, safety, & rights of the patient

4. Responsible & accountable for nursing practice

5. Owes same duty to oneself as to others

ANA Code of Ethics

ANA Code of Ethics, cont’d6. Improves health care environments and

employment7. Participates in advancement of the

profession8. Collaborates with other health care

professionals to meet health needs9. The profession of nursing is responsible for

articulating nursing values, maintaining the integrity of nursing practice, &

shaping social policy

International Council of Nurses(ICN)

1. Nurses and people2. Nurses and practice3. Nurses and the profession4. Nurses and co-workers

Ethical Principles & ConceptsAutonomy-Self determination, freedomJustice-Fairness to all people. Equal

treatmentFidelity-Faithful to commitments made to self

and othersBeneficience-Doing goodNonmaleficence-Do not harmVeracity-Truthfulness

CAN YOU THINK OF EXAMPLES?

The point of the ethical principal to “do no harm” is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement?

A. BeneficenceB. NonmaleficenceC. AccountabilityD. Respect for Autonomy

Beneficence

Nonmaleficence

Accountabilit

y

Respect

for A

utonomy

0% 0%0%0%

Areas of Ethical Dilemmas

• Genetics and Genomics (DNA sequencing & structure)

• Protecting against identity theft• Technology• Organ donation/transplantation

A precise definition for the word quality is difficult to articulate when it comes to quality of life. Why? (Select all that apply.)A. Quality of life is measured by potential

income, and average income varies in different regions of the country.

B. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult.

C. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging.

D. Community values are subject to change, and communities influence definitions of “quality.”

Quality

of life is

measu

re...

Individual experie

nces i

n...

Placing m

easurable valu...

Community va

lues are

su...

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1. Collect, analyze, & interpret information2. State the ethical dilemma3. Consider the courses of action4. Consider advantages and disadvantages of

course of action5. Make a decision

Sound like the Nursing Process & Critical Thinking?

Steps to Ethical Decision Making

Nursing Standards

• Form basis of competent, high-quality safe care

• “Yardstick” for legal actions• Skill, care, & diligence• Fidelity to profession• TJC, ANA, state law, facility policies• Incompetence, gross negligence, negligence,

malpractice

What is the best example of the nurse practicing patient advocacy?

A. Seek out the nursing supervisor in conflicting procedural situations

B. Document all clinical changes in the medical record in a timely manner

C. Work to understand the law as it applies to an error in following standards of care

D. Assess the patient's point of view and prepare to articulate it

Seek out t

he nursing s

up...

Document a

ll clin

ical c

h...

Work

to underst

and the...

Assess

the patient's

point ..

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The ANA code of nursing ethics articulates that the nurse “promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” This includes the protection of patient privacy. On the basis of this principal, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you deleted all patient identifiers?

A. Yes because patient privacy would not be violated as long as the patient identifiers were removed

B. Yes because respect for autonomy implies that you have the autonomy to decide what constitutes privacy

C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work

D. No because the principal of justice requires you to allocate resources fairly

Yes beca

use patient p

riva..

Yes beca

use re

spect

for ..

.

No because

, eve

n thoug...

No because

the prin

cipal ..

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Group ActivityUsing the provided ethical dilemmas, use the decision-making process to determine the best course of action. Use the provided flow chart.Share with the class.

American Nurses Association. ANA Code of Ethics. Retrieved from www.ANA.org

Husted, G. L., & Husted, J. H. (2001). Ethical decision making in nursing and healthcare (3 ed.). New York, N.Y.: Springer Publishing.Liaschenko, J., & Peter, E. (2004). Nursing ethics and conceptualizations of nursing: profession, practice and work. Journal of Advanced Nursing, 46(5), 488-495. doi:10.1111/j.1365- 2648.2004.03011.xInternational Council of Nursing (2012). ICN Code of Ethics. Retrieved from http://www.icn.ch/images/stories/documents/about/ic ncode_english.pdfInternational Council of Nursing (2010). International Council of Nursing. (2010). Genetics and Genomics. Retrieved from http://www.icn.ch/publications/ethicsPotter, P., Perry, A., Stockert, P., & Hall, A. (2013). Fundamentals of nursing. 8th Ed. Elsevier Mosby. St. Louis, MO.

References