Ethical Principles
Respecting patients' rights to make informed decisions about their care
What is Autonomy?
The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person
What is Provision 1?
Document that allows a patient to state their wishes for end-of-life care in advance
What is an advance directive?
The U.S. federal law enacted in 1996 that protects patient health information
What is HIPAA?
Case 2: A 56 year old man with new dx of lung cancer, demonstrates understanding of treatment plan (surgery) and refuses to undergo surgery to remove the tumor.
What is an example of autonomy over beneficence?
Acting in the best interest of patients to promote well-being
What is Beneficence?
The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care
What is Provision 3?
The ability of a patient to make an informed, voluntary and consistent decision.
What is decision-making capacity
A multidisciplinary group within a healthcare institution that provides guidance, consultation, education and policy development on ethical issues that arise in clinical care
Case 3: A 71 year old man with severe COPD, pneumonia/respiratory failure, intubated/vasopressors, sepsis, kidney failure; discussing d/c of "clinically nonbeneficial interventions"
What is an example of futility?
Avoiding harm while providing care
What is Nonmaleficence?
A nurse's primary commitment is to the recipients(s) of nursing care, whether an individual, family, group, community or population
What is Provision 2?
A specific person who is designated to make medical decisions on a patient's behalf if they become incapacitated
What is a healthcare proxy (or durable power of attorney for healthcare)
The U.S. government study from 1932-1972 that withheld treatment from Black men with syphilis without their knowledge.
What is the Tuskegee Syphilis Study?
Case 5: 45 year-old woman, recent laparotomy and cholecystectomy, post-op pain/fevers, tx with antibiotics and still febrile, exploration found a sponge; patient autonomy includes disclosing information to patient
What is an example of truth telling?
Ensuring fairness, equity, and advocacy for vulnerable populations
What is Justice?
Nurses have authority over nursing practice and are responsible and accountable for their practice consistent with their obligations to promote health, prevent illness, and provide optimal care
What is Provision 4?
This order instructs medical staff not to perform CPR if a patient's heart stops
What is a Do Not Resuscitate (DNR) order?
Case 6: 74 year-old woman hx of strokes and lives in ALF AND 22 year-old man, both dx with COVID-19; both in respiratory failure and need ventilator (only one available, at the height of COVID-19 pandemic)
What is an example of allocation of scarce resources?
The moral obligation to protect sensitive information from unauthorized access, use, or disclosure
What is Confidentiality?
Maintaining competence, integrity, and personal well-being, recognizing that self-care directly impacts patient care quality
What is the nurse's duty to self?
The practice of intentionally ending a life to relieve suffering, and is legal in a small number of U.S. states
What is Medical Aid in Dying (MAID)?
This committee reviews research proposals to ensure the protection of human subjects before a study can begin
What is an Institutional Review Board (IRB)?
Demonstrate that the individual is competent to understand and decide, receives full disclosure and understands this, acts voluntarily and consents to the proposed action.
What is Informed Consent?