Professional Nursing Ethics Nurs 310

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PROFESSIONALNURSING ETHICS

NURS 310MRS. PRISCILLA ADUMOAH ATTAFUAH

Nursing Department

Valley View UniversityOyibi-Ghana


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AGENDAOUnderstanding the need to

consider ethics in human

services

O Introductory concepts

ODistinction between these

concepts


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Introduction to ethicsO Our care for patients should be based on sound

judgement

(or evidence based practice!!)

O ..some of this judgement is about having a strongsense of what is right or wrong

O ..having a strong sense of what we should bedoing and shouldnt be doing as nurses

O ..having a strong sense of what our priorities oughtto be


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As you deliver human

servicesO Situations will arise which you my be unsure about

the appropriate action to take

O You will be in ethical dilemmas

O Even though education and training in human servicesthat emphasize the values of confidentiality,

acceptance, individualism, self determination, andtolerance situations will be inevitably occur in whichsimply possessing these values will not be enough todetermine the right course of actions


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O What is a profession?

O What is nursing?

O What are ethics?

O What are values?

O What are morals?

O Differentiate between e,

v &m

O What are professional

ethics?


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Profession- what it is."Profess": a public declaration, vow on entering a

religious order. a commitment (vows) to serve for a

good end.

A narrow definition of professional is a self-regulating occupational group capable of legally

prohibiting others from practising.


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Profession and

professionalismO Nursing is a profession.

O A profession is a calling that requires specialknowledge and skilled preparation. A

profession is generally distinguished fromother kinds of occupation by:

a) Its requirement of prolonged specializedtraining

acquiring a body of knowledge pertinent to therole

to be performed and

b) An orientation of the individual to wardservice, ether to community or organization.


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Criteria of a professionO Professional status is achieved when an occupation

involves practice,

O A profession carries great individual responsibility and

based up on theoretical Knowledge.

O The privilege to practice is granted only after theindividual was completed a standardized program of

highly specialized education and has demonstrated an

ability to meet the standards for practice.

O The body of specialized knowledge is continually

developed and Evaluated through research.O The members are self organized and collectively

assume the responsibility of establishing standards for

education and practice.


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Comparison between Profession and Occupation

Occupation Profession

1. Training may occur on

job

2. Length of training varies

3. Value, beliefs and Ethics are notProminent features of

preparation

4. Commitment & personal

identification are strong

5. Works are autonomous

6. People unlikely to changejobs

7. Accountability rests with

Individual

Education takes place in

College and university

Education is definite and

prolonged

Value beliefs, and Ethics areintegral part of preparation

Commitment & personal

Identification vary

Works are supervised

Peoples often change Jobs

Accountability rests with

employees


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WHAT IS NURSING?O Florence Nightingale defined nursing

over 100 years ago as "the act of utilizing

the environment of the patient to assist

him in his recovery( Nightingale,1860).

ONightingale considered a clean, well-

ventilated, and quiet environment

essential for recovery.


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NURSING ContdO Virginia Henderson wrote. "The unique function

of the nurse is to assist he individual, sick or well,

in the performance of those activities contributing

to health or its recovery(or to peaceful death)that

he would perform unaided if he had the necessarystrength, will, or knowledge, and to do this is

such a way as to help him gain independence as

rapidly as possible"(Henderson,1966,p.3).

O Like Nightingale, Henderson described nursing inrelation to the client and the client's environment.


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EthicsO Ethics is the philosophical ideals of right and wrong

behaviour.The basic concepts and fundamental

principles of right human conduct.

O Ethics are standards of right and wrong, good and bad.

They are concerned with what one has to do to fulfillones moral duty. There are two aspects to ethics:

1. Being able to determine what is right or wrong, good

or bad

2. Committing to doing what is right and good.The latter aspect means that being ethical is more than

understanding what the right thing is to do; it means that

one must do ethical actions . one must walk the talk.


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Basic ethical concepts

4 Key Ethical

Principles

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1. Rights

2. Autonomy

3. Beneficence andNonmaleficence

4. Justice

5. Fidelity

6. Veracity7. The standard of

best interest

O

autonomyO beneficence

O non-maleficence

O justice

4 ethical rules

Veracitytruth telling, informedconsent, respect for autonomy

Privacya persons right to remainprivate, to not disclose information

Confidentialityonly sharingprivate information on a need to

know basis Fidelityloyalty, maintaining the

duty to care for all no matter whothey are or what they may havedone


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ETHICAL CONCEPTSO Avoiding harm: this is perhaps the

most basic and easily understood

ethical concept and it underpins good

healthcare practice.

O Moral obligations and duties:

identifying moral rules (that implyethical duties) can help in deciding on

the right thing to do. For example, if

truth-telling is considered to be a

rule actions can subsequently be

determined by adherence to this rule.

O Assessing the consequences ofactions: it could be claimed that the

rightness of an action is determined

most effectively by calculating its

potential outcomes.

O Autonomy and rights: tobe autonomous is to beself-determining, freefrom the controllinginterference of others.

O Respect for autonomy is afundamental principleethically and legally thatinfluences healthcaredecisions, such as thoseconcerning informed

consent. What do we meanwhen we talk about rights?Which, if any, rights dowe possess?


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O

Best interests: identifying(and acting) in the best

interests of others often

provides ethical

justification for an action

or decision.

O Values and beliefs: from

these we formulate general

ethical principles that

provide guidance to

ethical decisions and

actions.

O

Emotions, relationshipsand context: is ourethical viewpointaffected if the matterconcerns ourselves orthose close to us? Do

specific circumstancesinfluence ethicaldecisions?

O Moral character: is theresuch a thing as a good

person? Is he or shemore likely to know theright way to act?


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MORALSO Morals are values which we attribute to a system ofbeliefs, typically a religious system, but it could be

a political system of some other set of beliefs.

O These values get their authority from somethingoutside the individual- a higher being or higher

authority (e.g. society).

O By that definition one could categorize the values

listed above (honesty, integrity, compassion ) asmoral values - values derived from a higher

authority.


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Morals and Ethics

O Morals: is similar to ethics and manypeople use the two wards interchangeably

(closely associated with the concept of

ethics)

O Derived from the Latin mores, meanscustom or habit.

O Morality: usually refers to an individuals

personal standards of what is right and

wrong in conduct, character, and attitude.O Morals: are based on religious beliefs and

social influence and group norms


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Morals and Ethics (continued)O Ethics is a branch of philosophy (the

study of beliefs and assumptions)referred to as moral philosophy.

O Derived from the Greek word ethos

which means customs, habitual usage,

conduct and character.O Ethics: usually refers to the practices,

beliefs, and standards of behavior of a

particular group such as nurses. It also

refers to the method of inquiry thatassists people to understood the morality

of human behavior (study of morality)


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ValuesO Values are our fundamental beliefs.

O They are our standards. They are the principles we use

to define what is right, good and just.

O Values provide guidance as we determine the right

versus the wrong, the good versus the bad.

O Values are the social principles, ideals, or standards

held by an individual, class, or group that give meaning

and direction to life.

Typical values include honesty, integrity, compassion,courage, honour, responsibility, patriotism, respect and

fairness.


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Professional valuesO THESE are reflections of personal values.

They are acquired during socialization intonursing. Some of the important values of

nursing are: Strong commitment to service

Belief in the dignity and worth of each

person

Commitment to education Autonomy


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Some values to consider when

in a moral dilemma1. Integrity

2. Respect for persons

3. Justice4. Compassion

5. Beneficence and non-maleficence

6. Responsibility


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Ethical theories1- Teleology

2- Deontology

3- Institutionism - summarized as the notion that people

inherently know what is right or wrong; determining what isright is not a matter or rational thought or learning (e.g. thenurse inherently knows it is wrong to strike a client, thenurse does not need to be taught this or to reason it out)

4- Ethic of caring it is based on relationships.

Caring is a force for protecting and enhancing client dignityCaring is of central importance in the client-nurse relationship(e.g. nurses use trust-telling to affirm clients as a personsrather than objects and to assist them to make choices andfind meaning in their illness experiences)


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Two Major Types, Teleological

And DeontologicalO Utilitarian theories are teleological.

O In Greek, telos means goal or aim and

deon means duty.O In deontology, the emphasis on acts

rather than (as in utilitarianism) on

outcomes.


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COMPARISONO Deontology (Duty or

rule-Based theory)

O This theory proposesthat the rightness orwrongness of an actiondepends on the natureof the act rather than itsconsequences.

O The theory denotes that

duties and rights are thecorrect measuring rodsfor evaluating action.

O Teleology (utilitarianor end based theory)

O This theory looks to theconsequences of anaction in judgingwhether that action isright or wrong.

O According to theutilitarian school of

thought right action isthat which has greatestutility or usefulness.


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Ethical

theories..(continued)Example:

Teleology approach/abortion: saving the

mothers life (the end, or consequence)

justifies the abortion (the mean, or act)

Deontology approach/abortion: consider any

termination of life as a violation of the rule

do not kill and therefore, would not abort

the fetus, regardless of the consequences tothe mother


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O You can have professional ethics, but you seldom hearabout professional morals. Ethics tend to be codified into a

formal system or set of rules which are explicitly adopted

by a group of people.

O Thus you have medical ethics. Ethics are thus internally

defined and adopted, whilst morals tend to be externallyimposed on other people.

O If you accuse someone of being unethical, it is equivalent

of calling them unprofessional and may well be taken as a

significant insult and perceived more personally than if you

called them immoral (which of course they may also notlike).


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FIRST ASSIGNMENT


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QUESTION

BOYE has been the nurse manager of a unit for the past five

years and is highly regarded by the hospitals administration.

For the past several months, however, he has been feeling lesssatisfied with his work because of staffing cuts and other

institutional decisions. Providing quality nursing care has

always been the most rewarding part of his job. However,

recently he feels he is forced to attend more to the needs of the

organization. He considers leaving, but he has good benefits inthe organization and two children to support.

1. Identify values evident in this situation. Which of these

reflect your personal values?

2. What conflicts might arise from these values?

3. If you were in Boyes position, what beliefs, ideals, or goals

would guide you in making a decision to stay or leave?

Identify potential consequences of each choice.


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REFERENCESO Brincat, C. A. and Wike, V.S. (2000), Morality

and the Professional Life: Values at Work.Prentice Hall Inc.

O

Woodside, M, and McClam, T. (2002).Anintroduction to human services. Belmont, CA:Brooks/Cole.

O http://www.businessdictionary.com/definition/ethics.html#ixzz2JUxDNnpD

O http://www.ncbi.nlm.nih.gov/pmc/articles/PMC

1625587/?page=1O http://www.ncbi.nlm.nih.gov/pmc/articles/PMC

1625587/?page=2
http://www.businessdictionary.com/definition/ethics.htmlhttp://www.businessdictionary.com/definition/ethics.htmlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1625587/?page=1http://www.businessdictionary.com/definition/ethics.htmlhttp://www.businessdictionary.com/definition/ethics.htmlhttp://www.businessdictionary.com/definition/ethics.htmlhttp://www.businessdictionary.com/definition/ethics.htmlhttp://www.businessdictionary.com/definition/ethics.html


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Professional Nursing Ethics Nurs 310

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