2513 Midterm 1
Virginia Henderson (1966) Beliefs
Patients should be individualized and goal is to live as normally as possible
Human needs are central to nursing
Nurses should take care of the patient until they can take care of themselves
Sister M.simone Roach (1980) Beliefs
Developed the first code of ethics in nursing
Janet Strorch (1982) Beliefs
Ethical and legal issues
Expectations are based on consumer rights
Sara Fry (1989) Beliefs
Caring as a core ethical value
Differentiation of ethics
Focuses on people rather than abstract ideas and idealizations
Spiritual and Religious influences
Donate wealth and time to serve
People were more likely to accept treatment through religious intervention
Women status declined due to the idea of witchcraft
The Contractual model
Negotiating moral parameters
A contract that serves as a guide for whatever ethical choice
The Patient Advocate model
Ensuring that patients are aware of their own rights
Advocating for patients when they cant for themselves
Oughtness
when making a judgment, the standpoint is what we "ought" or "ought not to be"
NO IF'S
Moral Complexity
Disagreement of moral norms or how the applications of a moral norm is
Ethics
Careful and systematic reflection and analysis of moral norms and how they bear practical issues
Ensures that all relevant considerations are entertained
3 categories of ethics
MetaEthics- origin and meaning of values
Applied- constructs solutions
Normative- Analyzes moral standards
what is Moral Philosophy
Philosophical discussion of what is considered to ve good or bad, right or wrong in terms of moral issues
Ethical Theory: Utilitarianism
Stewart Mill (1806-1873)
Emphasizes outcome
considers the cost-benefit analysis
The ends justifies the mean
Considers the utility principle
Ethical Theory: Deontological Ethics
Kant (1724-1804)
Emphasis is on actions and principles
Considers the moral agent
the belief that moral duties are not imposed
Categorical Imperative
The maxim that someone develops if they are thinking on doing something
Universal rule
A test to guide behaviour
What are critics of the deontological theory?
What theory rectifies this critique?
No moral conflict and conflict of duty is acknowledged
Pluralistic Deontology: allows for dury and moral weight
what are critiques of the Utilarnism Theory
Hard to measure happiness
Morally Demanding
What are the steps in making moral decisions
Project possible consequences of each action
Calculate the amount of happiness or unhappiness produced
select action that results in optimal happiness
What are concepts that rectify Utilitarianism
Act and Rule
Virtue Ethics
Aristotle (384-332 BCE)
father of ethics
Practicing virtuous behavior goodness of character
Biomedical ethics
type of virtue ethics
The reasoning that physicians use
Four principles of healthcare ethics
Oberle & Bouchal
1) Autonomy
2) Beneficence
30 nonmaleficence
4) Justice
5 Focal Virtues
1) compassion
2) discernment
3) trustworthiness
4) integrity
5) conscientiousness
What are the three stages of moral development
Pre conventional (primitive)
Conventional
Post concventional
who created the ethic of care
carol gilligan
Relational Nursing & Four Themes
Bergum
focuses on interactions between people and not decision-making
1) Environment
2) Embodiment
3) Engagement
4) Mutual Respect
what is the 5th theme added to the four themes of relational ethics?
uncertainty by pollard
What is Autonomy
An individual's freedom or determination to make independent choices
What is Beneficence & two components
doing good for someone well well-being
1) doing good
2) preventing harm
what is non-maleficence
First do no harm
what is veracity & components
moral value of telling the truth
1) truth and trust
2) truth and autonomy
how to communicate bad news
SPIKES & PEWTER
what is collusion
practice in which family members withhold information from the patient
circle of care
nurses cannot confirm diagnosis but can share results
what is a value
highly desired concept by individuals
can be consciously or unconsciously learned
CORE values do not change
can be directly or indirectly expressed
what is axiology
the study of value/worth
what is moral autonomy
process of reflecting on the approach used to determine and rejecting values that are not ours
what is value clarification
exercise that is used to make one aware of their own values
helos us decide if we want to keep them or modify them
what is the differnce between moral authority and moral integrity
moral authority: maintaining our moral norms
Moral integrity: upholding a moral norm
self-awareness and how to manage it
grounded in the ability to reflect
manage through
1) controlling emotions
2) introspection and continious reflection
Institutional values
implicit or explicit
Theory of transcultural nursing- Madeline Leininger
sunrise enabler
values are learned and shared by a group
what are the stages of cognitive development- piaget (1963)
sensorimotor:
preoperational stage
concrete operational stage
formal operational stage
Levels of moral response- Thomas & gedge
1) Expressive
2) Pre-reflective
3) reflective
What is moral Uncertainty
Being aware of a moral issue but not knowing the right course of action gut feeling
what is a moral dilemma
where there are both favourable and unfavorable claims that have equal weight to a solution
what is moral distress
no moral conflicts
the answer is usually clear
nurse feels a responsibility and restraints make the job difficult to be done
what is a practical dilemma
moral claims that compete with non moral claims
what is a moral residue
compromising values
what is moral disengagement
lack of compassion and engagment
no power to alter a situation
what is moral outrage
nurse may be indirectly involved
Moral courage
advocacy in adversity
Moral Resilience
tolerating threats and challenges while maintaining integrity
Steps of Ethical Decision-Making
1) gather data
2) identify key participants
3) determine perspective and phase
4) outcome
5) options
5) act on choice
7) evaluate outcome
Types of Moral Sensitivity
1) rational control
2) control precedence
3) well being to self
4) well being to others
What is the difference between Ethics and the Law?
Ethics are rules that guide behavior and are formed from the laws of society
General and formed through moral thinking
The law is enforced rules that maintain and provide conflict resolution
They are legally binding and systematic
what is the common goal between ethics and law
to protect
What are the four sources of law
1)constitutional
2) statutory
3) administrative
4) common
What is the constitutional law
Complex as it describes the power of government and the rights of people in formal rules
What is the Constitution Act?
1982
1) charter rights of freedom
2) Canada act
what is the legislative (statutory) law
laid down by the parliament
consists of federal bills of bills moving to a law
What is private law & the types?
The dispute is between two citizens
Types:
TORT: Unintentional and intentional
CONTRACT: Compensation for something that may happen
contracts made to prevent
What is Public Law?
Dispute between citizens and government
includes:
1) criminal
2) Legislative (statutory)
3) Administrative
4) Common
What is Administrative Law
Legal Powers granted to administrative agencies to guide rules or laws?
what are indicatable offenses & summary offenses
highest level of punishment and crime
Summary: misdemeanors
The Judicial system
Courts and Judges
BNA act (1867) at the federal and provincial level
The Administrative system
The system that is applied to a legislative body to create laws
What is the Duty of care
Does not refer to fulfilling duties
Professional obligation to act or not to act to prevent harm
what is fiduciary
a persons authority to act on another person's legal behalf