UNIT- 03- Ethical principles and theories.pptx

These notes are aimed to provide basic knowledge about nursing ethics for BS Nursing students

1. UNIT- 03 ETHICAL PRINCIPLES & THEORIES Sadiq Ali Chandio BSN , DIPLOMA IN GENERL NURSING , P.B DIPLOMA IN PEDIATRIC NURSING P.B DIPLOMA IN WARD ADMN

2. Objectives Discuss Ethical Principles in health care in the light of ethical theories. Discuss the ethical Dilemmas face by nurses & Clients Discuss the strategies to resolve ethical dilemma in daily nursing practice. List steps of Ethical Decision making.

3. ETHICS : Ethics are philosophical ideas of right or wrong behavior. It is science of ideal human behavior. Ethics is moral philosophy concerned with what is good and bad and morally right or wrong .

4. Ethical principles 1.Respect for person 2.Respect for autonomy 3. Respect for freedom 4. Respect for beneficence(doing good) 5. Respect for non-malfeasance (avoiding harm) 6.Respect for veracity(truth telling) 7. Respect for justice( fair and equal treatment) 8.Respect for rights 9. Confidentiality 10. Respect for fidelity (fulfilling promises and commitments)

5. Ethical principles 1. Justice : Justice is fairness. Nurses must be fair when they distribute care, for example, among the patients in the group of patients that they are taking care of. Care must be fairly, justly, and equitably distributed among a group of patients. 2. Autonomy : The respect for individual liberty to take decision. ‘Informed Consent’ is an important outcome of this principle.

6. 3. Beneficence: Beneficence is doing good and the right thing for the patient. Our actions must aim to ‘benefit’ people – health, welfare, comfort, well-being, improve a person’s potential, improve quality of life. 4. Non Maleficence : (To do no harm) No Maleficence is doing no harm. do not cause pain or suffering do not incapacitate (injure) and kill do not deprive people

7. 5. Accountability : Accountability is accepting responsibility for one's own actions. Nurses are accountable for their nursing care and other actions. They must accept all of the professional and personal consequences that can occur as the result of their actions.

8. 6. Fidelity : Fidelity is keeping one's promises. The nurse must be faithful and true to their professional promises and responsibilities by providing high quality, safe care in a competent manner. 7. Veracity : Veracity is being completely truthful with patients; nurses must not withhold the whole truth from clients even when it may lead to patient distress.

9. Discuss ethical theories An ethical theory provides a frame work within which agents can reflect on the acceptability of action & can evaluate moral judgments & moral characters. Teleology Deontology Intutionism Ethics of caring Situational theory

10. Ethical theories 1.Teleology: ( Consequentialism) the value of a situation is determined by its consequences. Teleology looks to the consequences of an action in judging whether that action is right or wrong. It emphasizes duty, rationality and obedience to rules. The difference between teleology and deontology can be seen when each approach is applied to the issue of abortion.

11. Ethical theories.. 2.Deontology: People should adhere to their obligations and duties. In deontology rule is more important than the consequences : As in case of abortion, deontology approach says termination of life is a violation of rule “do not kill” and therefore would not abort the foetus, regardless of the consequences to the mother. The difference b/w teleology and deontology can be seen to the issue of abortion.

12. Ethical theories .. 3 . Intitutionism : The notion that people inherently know what is right or wrong It resolves ethical dilemmas by appealing to one's intuition, a moral faculty of a person which directly knows what is right or wrong ( A gut feeling of knowing what is right)

13. Ethical theories .. 4. Ethics of caring: Caring-Based Theory ( Virtue ethics) It focuses on emotions, feelings, and attitudes. Virtue ethics are also called “ethics of love” All human are dependent upon themselves : Children are dependent upon parents and elders are dependent upon their children and handicapped are dependent on care givers. 5. Situational Theory - holds that there are no set rules or norms. Each situation must be considered individually.

14. Ethical codes Codes are used to help nurses act ethically. These have been developed by nursing organizations such as the ICN and the ANA.

15. Dilemma VS Ethical dilemma Dilemma Ethical Dilemma A dilemma is defined as a situation requiring a choice between two equally desirable or undesirable alternatives A conflict between two or more ethical principles. Ethical dilemmas arise every day in clinical practice and it might be challenging to find a good solution. i )Truth VS loyalty ii) Justice VS mercy

16. Major types of ethical dilemma 1. Euthanasia .( Merciful death/ intentional death of patient suffering from terminal stage of disease) 2. Refusal of Treatment .(A client’s rights to refuse treatment and to die often challenge the values of most health care providers) 3. Scarcity of Resources. ( The allocation of scarce resources (e.g. organs, specialists) is emerging as a major medical dilemma)

17. Situations of ethical dilemma faced by nurses Abortions Disclosure of HIV/ AIDS status to spouse Sterilization Genetic research on congenital malformations in fetus Age for written consent Resuscitation Euthanasia Unsafe nurse – patient ratio

18. Ethical Issues In Practice Nurses have the responsibility to identify ethical issues that affect staff members and patients; and they also have the responsibility to inform staff members and affected clients of ethical issues that can and do affected client care. For example, providing nursing care for clients undergoing an abortion may raise ethical and moral concerns and issues for some nurses; and some patients may be affected with a liver transplant rejection because donor livers are not abundant enough to meet the needs of all patients who request it.

19. Although a rare occasions, a patient may, at times, ask you to do something that is not ethical. For example, a patient may ask a nurse to assist in their suicide at the end their life

20. Some other Examples of Ethical Dilemmas: 1.Honesty vs. withholding information : Family members may want to withhold medical information from sick patients to protect their emotions. However, patients have the right to know about their medical conditions. Deciding how to share this information, especially if it goes against the family’s beliefs, can be a touchy situation. ANA advocates for truth telling, or veracity, as a key factor in nurse patient relationships.

21. Examples of ethical dilemma … 2. Science vs. spirituality : Healthcare , which is science-based and results driven, can impede religious or personal beliefs. Some religions restrict medical interventions and lifesaving techniques. Nurses focus on providing medical care to reduce suffering and to allow patients to concentrate on self-care. For patients or their families with strong religious or spiritual convictions, the focus may be on adhering to a strict set of guidelines

22. 3. Autonomy vs. Beneficence: Nurses are required to administer prescribed medicine, but patients, at the same time, can refuse them. Patient autonomy can go against medical directives, despite clearly defined needs. Patients have a right to refuse all medical care.

23. STEPS OF ETHICAL DECISION MAKING Identify the ethical problem 2. Collect relevant information 3.Consider alternatives 4. Make a decision 5. Implement

24. Ethical Decision Making Identify Problem : Problem definition is the clear description of the ethical dilemma and the circumstances revolving around it. Collect data : During this phase of the ethical decision making process includes a review of ethical codes, published evidence based practices, declaratory statements, professional position papers and the professional literature

25. Data Analysis. The collected data is then organized and analyzed. Identify and explore possible solutions of problem. Explore all possible alternatives to Consider alternatives . All potential solve ethical dilemma. solutions and alternatives are considered and then the best and most ethical action is taken.

26. Make a decision: of Action to Resolve the Ethical Dilemma. Implement: . Take actions to resolve ethical issues which are evaluated and measured in terms of their effectiveness to resolve the ethical dilemma.