Ethics
What are bio-ethics and name them
Bioethics is the study of ethical, social, and legal issues
Autonomy, Beneficence, Non-Maleficence & Justice
Personal Health Information Protection Act (PHIPA) , 2004
Balances a person’s right to privacy and organizations that provide health care?
Ways nurses obtain authorization to perform a controlled act?
Orders & Delegation
Two types of Orders:
Direct Order: client-specific regarding an activity. It may be written or verbal (verbal only in emergency situations or when prescriber cannot document)
Directive: an order for an activity or series of activities that may be implemented for a number of clients when specific conditions are met and specific circumstances exist. A directive is always written by a regulated health professional who has the legislated authority to order the activity
If someone is a SDM for a pt. Name at least 4 things the are applicable to the SDM role
SDM must be capable
SDM must be willing to make decisions on behalf of the patient (what the pt would have wanted)
SDM must be 16 years of age +
SDM must be available when decisions need to be made
SDM is only responsible for personal care & property that the pt is incapable of
What is the main difference between the HCCA and PHIPA in relation to consent?
HCCA – governs treatment decisions; PHIPA governs information. Treatment law takes precedence.
This type of ethical framework focuses on relationships
Relational Ethics
Substitute Decisions Act (SDA), 1992
Deals with decisions around property and decisions about personal care for the incapable person
What is delegation
Delegation occurs when a regulated health professional (delegator), who is legally authorized and competent to perform a controlled act, temporarily grants their authority to perform that act to another individual (delegatee).
Delegation by nurses– a nurse that is authorized to perform controlled acts can delegate to certain individuals
Delegation to nurses - Nurses can receive delegation for controlled acts that they are not authorized to perform
It can fluctuate, it can be treatment specific to name a few. What is it?
capacity
What is a form 4?
(Certificate of Renewal)
-- form issued when a patient continues to meet criteria for an involuntary admission after a Form 3 expires
This type of ethical framework focuses on the greatest good for the greatest number of people
Utilitarian Ethics
Intentional Tort
A willful act that violates another person's rights (ie assault, invasion of privacy etc)
Torts can be intentional or unintentional (accidental)
Name the key concepts required to meet the standards of CNO scope of practice
Authority: Nurses must know their legislated scope of practice, including controlled acts, and authorizing mechanisms
Context : Nurses must determine if their practice environment or setting supports the performance of an activity and has the available resources to support safe client care
Competence: Nurses must ensure they have the individual knowledge, skill and judgment to perform an activity
Name the order of the SDM hierarchy
Court appointed guardian
POA
Representative from the Capacity & Consent Board
Family (a.spouse; b.Child 16yr+ or custodian parent; c. non-custodial parent; d.sibling; e.other relative
Public Guardian & Trustee
A manager of a healthcare facility wants an UCP to administer a fleet enema to a patient. Can this allowed?
Yes--if all the parameters of delegation are met and it is a routine activity of daily living for the patient
When two or more ethical values apply to a situation but these values support diverging courses of action
Ethical Dilemma
False Imprisonment
Detaining someone unlawfully and preventing them from exiting.
Must be voluntary, specific to treatment/care/procedure & person must be capable
Consent
What are the 5 controlled acts authourized to RNs & RPNS (list in order)
1. Performing procedure below dermis or mucus membrane
2. Injection or inhalation
3. Inserting hand/finger/instrument beyond natural opening
4. Psychotherapy
5. Dispensing medication
What is the difference between teaching, delegating, assigning & supervising
Teaching: provide instruction
Delegating: transferring authority
Assigning: allocating responsibility of care to an individual
Supervising: monitoring and directing
What is this and where is this found:
Nurses provide safe and competent care
CNO Code of Conduct (2025) Principles*:
1. Nurses respect clients’ dignity.
2. Nurses provide inclusive and culturally safe care by practicing cultural humility
3. Nurses provide safe and competent care
4. Nurses work respectfully with the health care team to best meet clients’ needs.
5.Nurses act with integrity in clients’ best interest.
6.Nurses maintain public confidence in the nursing profession
Health Care Consent Act (HCCA), 1996
Explicit Rules about when consent is required, who can give consent and when consent is required from SDA
According to HCCA:
1.Consent is required for any treatment except treatment provided in certain emergency situation
2.Consent to admission to a care facility (required by law) except in a crisis situation.
3.Consent to personal assistance Services (CNO includes this as a nurse’s accountability requirement)
If a nurse assigns a task to a UCP. What are they accountable for
•assessing the client’s condition, the environment and any associated risks involved with the activity or procedure
•ensuring the UCP has the competence to perform the task
•supervising &/or teaching the UCP,
•and following up with the UCP once the task is performed.
If a client is on a form 1 what other form must be given to the client and what is the form about
Form 42 must always be given to a client if there are on a form 1--informs them of reason for form 1 and their rights
Note: Form 1 - is a mental health assessment hold for 72hrs (not treatment)
Who can nurses accept direct orders from
physician, midwife, dentist, chiropodist, NP or nurse with prescribing authority