NCM 120 REPORTING for nursing students .pptx

REport

1. CULTURAL COMPETENCE IN ETHICAL DECISION-MAKING Presented by: Group 9

2. INTRODUCTION Ethical dilemmas in nursing often involve navigating diverse cultural, socioeconomic, and organizational factors. Nurses must make care decisions considering not only their clients' values but also those of healthcare providers and institutions. The disparities in health outcomes tied to social inequities demand a culturally competent approach to care, one that incorporates ethical principles grounded in human rights and social justice.

3. Moral philosophy consists of beliefs and assumptions about right and wrong, forming the basis of ethics, which prescribes proper actions in given situations. These beliefs are shaped by social, historical, and cultural experiences and may not be shared outside a specific cultural group. Contrasting Social C onstructions of Morality

4. Western and Non-Western Perspectives Western Concept of Reason: Western cultures emphasize the capacity for reason and action, assuming it is universal among all humans. Ethical dilemmas are approached with the belief that rational decisions can be made by compensating for individual deficits (e.g., cognitive, motivational, informational). Western traditions like universalism and rationalism focus on individual autonomy in moral reasoning. Non-Western and Religious Influences: In some cultures, especially religious ones like devout Muslims, Hindus, Jews, and Jehovah's Witnesses, ethical decisions are heavily influenced by spiritual beliefs. Religious views impact decisions on organ donation, euthanasia, and medical interventions like blood transfusion.

5. Cultural Differences in Ethical Decision-Making (Collectivist vs. Individualist Cultures) INDIVIDUAL CULTURE In the West, the individual is seen as independent, self-motivating, and responsible for making personal decisions. COLLECTIVIST CULTURE Collective decisions made by extended family or community leaders are common, especially in life-and-death situations.

6. IMPACT ON HEALTH CARE PRACTICES Autonomy in Western Healthcare The Patient Self-Determination Act (1991) mandates health care providers to ensure patients' autonomy through advance directives. However, this emphasis on self-determination may conflict with cultural beliefs where fate or collective decision-making plays a larger role. Health Information Privacy (HIPAA) The Health Insurance Portability and Accountability Act (HIPAA, 1996) ensures the confidentiality of health information. This may conflict with collectivist cultures, where family members expect to manage health information and decisions for the patient.

7. ETHICAL DIVERSITY AND MORAL PHILOSOPHIES ETHICAL DIVERSITY Abound in organization, diverse beliefs

8. Ethical Relativism A theory that holds the morality is relative to the norms of a particular culture or one’s culture. It emphasizes the need to examine the context of the decision because sociocultural differences influence whether an act is moral.

9. Ethical Relativism Ethical relativism is unlike universalistic moral philosophies such as; Deontology- It upholds the existence of universal truths and unbreakable moral rules applicable to all situations (Butts & Rich, 200f1) Teleology- It judges the morality of an act based on its consequence or outcome.

10. Feminist Theory Supports ethical relativism in that it does not support universal truths and requires examination of the context of the situation before making a decision. Ethics of Care - emphasizes the need for health care practitioners to develop empathy, compassion, and relationships that promote trust, growth, and the well-being of others (Edwards, 2011). Communitarian Ethic of Care - It upholds collective decision making over individual autonomy.

11. Principle - Based Ethics ( Principlism ) Principlism aims to reconcile the differences between teleological and deontological models. It bases ethical principles on scientific findings rather than universal rules, following the pragmatic philosophy of William James.

12. Principle - Based Ethics ( Principlism ) The Principle of Fidelity- It is the obligation to remain faithful to one's commitments. The P rinciple of Veracity- It upholds the virtues of being honest and telling the truth. The Principle of Autonomy- It upholds the capacity of individuals to act intentionally without controlling influences by others and from personal limitations that prevent meaningful choice.

13. Ethics and Health Disparities Globalization has heightened the awareness of health inequities across population groups in local, national, and global contexts (Population Reference Bureau, 2010fl Labonté , 2012). Social determinants (WHO, 2013) - The conditions in which people are born, grow, live, work and age that are shaped by the distribution of money, power, and resources at global, national,and local levels which are mostly responsible for Health inequities Health disparity (U. S. Department of Health and Human Services, 2009)

14. Ethics and Health Disparities These obstacles stem from characteristics historically linked to discrimination or exclusion such as: Race or ethnicity Religion Socioeconomic status Gender Mental health Sexual orientation Geographic location Others characteristics include: cognitive, sensory, or physical disability

15.   Social Determinants of Health Carter- Pokras and Baquet (2002) define health disparity as a chain of events signified by a difference in: Environment Access to, utilization of and quality of care Health status or a particular health outcome The seminal study of British civil servants by Marmot, Rose, Shipley, and Hamilton (197fi) found a social gradient in health among Caucasians who are not poor and have equal access to health services. Marmot labeled this phenomenon the "status syndrome"

16.   Social Determinants of Health Social Patterns and Health: Krieger (2012) has suggested that societal patterns of disease are the biological consequences of life conditions produced by a society's economic and political structure. Which is linked with sustained high levels of cortisol and other stress hormones that increase one's susceptibility to chronic diseases such as: Hypertension Cardiac disease Diabetes Cancer Increased incidence of preterm births

17. The Affordable Care Act (ACA) The Patient Protection and Affordable Care Act or the Affordable Care Act (ACA) was signed into law by President Obama on March 23, 2010, to provide access to health coverage to more than 40 million Americans. The ACA provides free access to most preventive services and drug coverage for eligible seniors. Individuals can add or keep their children on their health insurance policy until they reach age 26.

18. Competent Ethical Decision Making To promote health equity, this model serves as a pathway for culturally competent ethical decision making. It is built from compassion that motivates or forces people to act on behalf of others. Advocacy involves partnership and collaboration with different health sectors will help the individual and community by improving their life and work condition.

19. Competent Ethical Decision Making Vulnerable Populations People who experience risk of poverty and social exclusion greatest risks of health . H istorically linked to discrimination such as race, ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographic location

20. Competent Ethical Decision Making Universal Declaration of Human Rights 1948 Treating every human being with dignity as an end by itself. Focuses on poor vulnerable, and neglected populations

21. ANY QUESTIONS?

22. Thanks! Please keep this slide for attribution