Basic Concepts in Ethics
The attitudes, ideals, or beliefs that an individual or a group holds and uses to guide behavior. Indicates what an individual considers important.
What are values?
Two important theorists in moral development and reasoning.
What is Kohlberg and Gilligan?
-Kohlberg's suggested that certain conditions might stimulate higher levels of moral development. Ex. students stimulated higher levels of moral reasoning through participating in courses in moral discussion and ethics.
-Gilligan- moral development is focused on care. The moral person is one who responds to need and demonstrates consideration of care and responsibility in relationships.
The act was moral if its motives or intentions were good, regardless of the outcomes.
What is deontology?
Individuals have the right to determine their own actions and the freedom to make their own actions and the freedom to make their own decisions.
What is autonomy?
Ex. The right of a patient to refuse medication based on a belief
The steps in ethical decision making.
What is clarify the ethical dilemma, gather additional data, identify options, make a decision, act, and evaluate?
The standards of behavior that guide the actions of an individual or social group, and are established rules of conduct to be used in situations where a decision about right and wrong must be made. An example of a standard is "One should not lie."
What are morals?
-Morals are learned over time and are influenced by life experiences and culture.
Kohlberg proposed three levels of moral reasoning as a function of cognitive development.
What is the pre-conventional level, conventional level, and post-conventional level?
A nursing student was providing care to an elderly man who was dying and who had been estranged from his son for many years. He asked her to call his son for a final visit. The nursing student was able to fulfill the patient's final wishes. This is known as which ethical theory?
What is deontological?
The doing of good. Nurses should always consider one's actions in the context of the patient's life and situation.
What is beneficence?
Ex. School nurse teaching school-aged children about fire safety.
Examples of dilemmas regarding patient rights.
What is the patient self-determination act and ethical issues related to immigration and migration?
Ex.
Patient self-determination- advance directives
Immigration/migration-communication/language problems between patients and health care providers and the migration of nurses
To reflect what actions an individual should take. Process-oriented and involve critical analysis of actions.
What is Ethics
Kohlberg's stage of moral reasoning: The individual is inattentive to the norms of society when responding to moral problems. The individual's perspective is self-centered.
What is the pre-conventional level?
-At this level what the individual wants or need takes priority
-Ex. shoplifter
The moral rightness of an action is determined solely by its consequences. Useful actions bringing about the greatest good for the greatest number of people.
What is utilitarianism?
Ex. Triage in a disaster requires decisions to be made on how to do the greatest good for the greatest number of people.
The ethical principle of human dignity and respect to do no harm.
What is nonmaleficence?
Ex. A nurse turns bedfast a patient to prevent pressure ulcers. The patient complains the process is painful. The nurse explains the reason for the turns. Not turning the patient will cause actual harm.
An example of the patient self-determination act.
What are advance directives?
-To ensure individuals the rights of autonomy, refusal of medical intervention, and death with dignity.
-Advance directives are legal documents that indicate the wishes of individuals in regard to end of life issues.
The application of ethical theories and principles to moral issues or problems in health care.
What is Bioethics?
-
Kohlberg's Stage of Moral Reasoning: it is characterized by moral decisions that conform to the expectations of one's family, group, or society. It is the rule of society.
What is a conventional level?
-People functioning at this level follow family or cultural group norms
-According to Kohlberg, most people function at this level. Because it's the law is a common explanation of people operating at this level
Emphasizes the character of the decision-maker.
What is virtue ethics?
Patients with the same diagnosis and health care needs should receive the same care, and those with greater or lesser needs should receive care that is appropriate to their needs. This is an example of which ethical principle.
What is justice?
Ex. Nurse advocates for a patient to lengthen hospital stay based on need
An example of ethical issues related to immigration and migration.
What is Communication/language problems between health care providers and immigration and migration?
-Nurses who are not bilingual or fluent in medical terminology should defer to a professional medical interpreter for the explanation of procedures, diagnoses, obtaining informed consent, and other complex healthcare-related issues.
-
The response to a situation when nurses are faced with ethical dilemmas but also encounter institutional constraints that limit their actions.
What is moral distress?
Kohlberg's Stages of Moral Reasoning: involves more independent modes of thinking than previous stages. The individual has developed the ability to define his or her own moral values. They may ignore both self-interest and group norms in making moral choices.
What is the post-conventional level?
-People may sacrifice themselves for a group..passengers from 9/11/01 decided to take control of a plane and prevent it from being used for mass destruction. They acted despite grave danger to themselves.
The theory that uses key ethical principles of beneficence, nonmaleficence, autonomy, and justice in the resolution of ethical conflicts or dilemmas.
What is principalism?
Faithfulness or honoring one's commitments or promises.
What is fidelity?
Ex. Bringing the patient a promised warm blanket and sprite.
An example of a dilemma created by institutional and social issues.
What are the Centers for Medicare and Medicaid Services (CMS?
-Nurses may experience moral dilemmas when they disagree with the policies of their institutions.
-Nurses experience moral distress when the correct course of action is known but they are unable to implement the ethically correct action because institutional policies constrain them.
The nurse demonstrates professionalism by providing foot care to homeless clients in the community. This delivery of care exhibits the basic concept.
What are values?
-Attitudes, ideals, beliefs that an individual or a group holds and uses to guide behavior.
-Values are expressed as one professional should behave.
-Values are freely chosen and indicate what the individual considers important, such as honesty and hard work.
The theorist who was concerned that women's experiences were inadequately recognized in the development of moral reasoning.
What is Gilligan?
-Gilligan described a moral development perspective focused on care.
-She believed that women's and girls' relational orientation to the world shaped their moral reasoning differently from that of boys and men.
Which of the following ethical theories is illustrated by the example of triage in disaster nursing?
Wha is utilitarianism?
Telling the truth, or not lying.
What is veracity?
What is an example of dilemmas created by patient data access issues?
What is an electronic health record?
-Access to health care information comes with a responsibility to protect information from unauthorized use.
You hear nurses in the lounge making off-color jokes about a patient. You are afraid to speak up for fear of retaliation.
What is moral distress?
-Moral distress-is distress that results from form participating in perceived moral wrongdoing due to situational constraints despite attempting to make a moral choice.
The levels of Moral Development in Gilligan's Stages of Moral Reasoning.
What are the three levels?
1.Orientation to individual survival,
2. A focus on goodness with recognition of self-sacrifice.
3. The mortality of caring and being responsible for others, as well as self.
The ethical theories that describe behaviors in terms of moral implications.
What is deontology?
What is utilitarianism?
What is virtue ethics?
What is Principalism?
Answering a terminally ill child's questions about his or her condition honestly is based on which ethical principle.
What is veracity?
Decision Making: Assessment, Diagnosis, Planning, Implementation, Evaluation
What is the nursing process?