essentials of nursing leadership & management, 4th edition chapter 4 questions of values and...

Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition

CHAPTER 4

QUESTIONS OF VALUES AND ETHICS

INTRODUCTION

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

Technological advances allowed for the development of intensive care units

New biomedical developments Advances in surgical techniques, such as

open heart surgery

New Questions

The advances created new questions for health-care professionals regarding the use of technology

The concepts of life and death

Bioethics

A subdiscipline of ethics The study of medical morality

Concepts of Ethics

Values Belief systems Morality

Value Systems

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

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

Values Clarification

Choosing Prizing Acting

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

ETHICS AND MORALS

Morals An individual’s own code for acceptable

behavior They arise from an individual’s conscience They act as a guide for individual behavior Learned

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

Ethical Theories

Deontological Teleological Principalism

Ethical Principles Autonomy Nonmaleficence Beneficence Justice Fidelity Confidentiality Veracity Accountability

Autonomy

The freedom to make decisions about oneself

Nurses need to respect clients’ rights to make choices about health care

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

Beneficence This principle means “doing good” for

others Nurses need to assist clients in meeting all

their needs Biological Psychological Social

Justice

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

Fidelity

Loyalty The promise to fulfill all commitments The basis of accountability

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

Veracity

This principle implies “truthfulness” Nurses need to be truthful to their clients Veracity is an important component of

building trusting relationships

Accountability

Individuals need to be responsible for their own actions

Nurses are accountable to themselves and to their colleagues

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

Virtue Ethics Focus on virtues or moral character View helping others as charitable or

benevolent

Organizational Ethics

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

culture

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

Resolving Ethical Dilemmas

Using the Nursing Process

Assessment Planning Implementation Evaluation

Approach to Ethical Dilemma

W h at V alu es are in con flict

C ollectth e facts

A m I in volved

A ssessm ent

L is t andR an k th e op tions

Id en tifyD ecis ion-M akers

D eterm in e goa lsof treatm ent

P lan n in g

U se ofd iscu ss ion and

n egotia tion

W ork tow ardsa m u tu ally

accep tab le d ecis ion

Im p lem en tation

R e-evaluate as necessary

D eterm in ew h eth er d es ired

ou tcom es h ave b eenreach ed

E valu ation

A p p roach

Current Ethical Issues

Issues to Consider

Assisted suicide Technology issues Gene therapies “Designer babies” Organizational climate

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

essentials of nursing leadership & management, 4th edition chapter 4 questions of values and...

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