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Ethics

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Ethics

  1. 1. ETHICAL AND LEGAL ISSUES IN COMMUNITY HEALTH NURSING Presented by
  2. 2. ` Ethics is a system of moral principles and rules of conduct recognized in respect to a particular class of human actions or to a particular group of people.
  3. 3.  Ethics are a branch of philosophy dealing with values relating to human conduct with respect to the rightness and wrongness of certain actions and to the goodness and badness of the motives and ends of such actions.
  4. 4. CLIENT RIGHTS  earliest recognitions of clients rights concerning health was made by the national convention on the French revolution in 1973.  health and the right to health care as extensions of basic human rights rights to informed consent  refuse treatment  privacy
  5. 5. RIGHT TO HEALTH .
  6. 6. RIGHT TO HEALTH CARE The right to health is a negative right to a illness  The right to health care is a positive right to goods and services in order to maintain and improve whatever state of health exists
  7. 7. OTHER RIGHTS Consideration of privacy. Obtain complete medical information. Consideration and respectful care. Receive information necessary for giving informed consent. Refine treatment
  8. 8. OTHER RIGHTS Expect reasonable continuity of care. Confidential treatment of personal information and medical records. Information on other institution and individuals related to care and treatment. Refuse participation in research projects.
  9. 9. PROFESSIONAL RESPONSIBILITIES
  10. 10. ETHICS IN NURSING  . It is the systematic study of what a person’s conduct and actions ought to be with regard to self, other human beings, and the environment. Many nurses envision ethics as dealing with principles of morality and what is right or wrong (Yoder-Wise, 2007
  11. 11. ETHICS IN NURSING  In a nursing perspective, ethics is that ethics is concerned with motives and attitudes and the relationship of these attitudes to the overall care of the individual. It is the justification of what is right or wrong, and the study of what one’s life and relationships ought to be, not what they are (Marquis & Huston, 2006).
  12. 12. Morality concerns the social nature of the community, codes of behavior, and community expectations (Hall, 2000; Perle, 2004)
  13. 13. CODE OF ETHICS The professional code of ethics for nurses prescribes moral behavior and actions based on moral principles.  Some of the rules may even have legal ties to licensure requirements concerning professional acts
  14. 14. CODE OF ETHICS Professional code of ethics is statements encompassing rules that apply to persons in professional role.
  15. 15. DUTY OF VERACITY Truthfulness has long been regarded as fundamental to the existence of trust among human beings. Persons have a duty of veracity to all the truth and don’t lie or deceive people.
  16. 16. RULE OF CONFIDENTIALITY If health care professionals did not follow rule of confidentiality, clients might not sought help when they needed it. Eg. The family planning services
  17. 17. DUTY OF ADVOCACY  advocacy in the care or safety of clients is concerned.  As the code of nurses states,  the nurse must be  alert to and take appropriate action regarding any instances of incompetent  any action on the part of others that places the rights or best interests of the client in jeopardy.
  18. 18. DUTY OF ADVOCACY  Role of an advocate is difficult for the community health nurses.  It must be recognized that clients should always determine what is in their best interests.  The duty of advocacy extends to population at risk, which may bring the community health nurses into conflict with health policy or established professional practices within a community or institution.
  19. 19. ACCOUNTABILTY In the code for nurses accountability, it is defined as being answerable to someone for something one has done. It includes providing an explanation to one’s self, to the client, to the employing agency and to the nursing
  20. 20. ETHICAL PRINCIPLES IN COMMUNITY HEALTH
  21. 21. PRINCIPLE OF BENEFICENCE  “we ought to do well and prevent or avoid doing harm”. It includes the idea that beneficence is a duty to help others gain what is of benefit to them but does not carry the obligation to risk one’s own welfare or interiors in helping others
  22. 22. APPLICATION OF PRINCIPLE OF BENEFICENCE IN COMMUNITY HEALTH It can be applied for balance harms and benefits to client population. Cost beneficial analysis is a specific application of this principle. To measure the benefits and costs of alternative approaches to a problem or to decide how to distribute health programme funds.
  23. 23. PRINCIPLE OF AUTONOMY Autonomy refers to freedom of action, as chosen by individual persons who are autonomers and are capable of choosing and acting on plans they themselves have decided about.
  24. 24. APPLICATION IN COMMUNITY HEALTH  Respect for persons,  The protection of privacy  The provision of informed consent.  Freedom of choice including treatment refusal.  The protection of diminished autonomy.  The client should be given a choice or even considered in the treatment plan.
  25. 25. NONMALEFICENCE States that a person should do no harm  Health care providers often use the concept of a detrimental-benefit analysis when the issue of non mal eficence is raised.
  26. 26. PRINCIPLE OF JUSTICE The formal principle of justice claims that equals should be treated equally and that those who are unequal should be treated differently
  27. 27. APPLICATION IN COMMUNITY HEALTH  UTILITARIAN THEORY:  distribute resources among the citizenry to decide how expenditure or the use of resources will achieve the greatest net total of good and serve the largest number of people.  this method of distribution is appealing.
  28. 28. ENTITLEMENT THEORY:  everyone is entitled to whatever they get in the natural lottery at birth and there is no responsibility for government or it’s agencies to improve the lot of those less fortunate than others.  inequalities between individuals in matters of health, position and wealth are tolerated. Only aggression or harms against others.
  29. 29. THE PRIORITY OF ETHICAL PRINCIPLES  places a great emphasis on the observation of principles of autonomy and beneficence than the principle of justice in most nursing actions.  . The ethical principle of beneficence is given slightly less emphasis in the code for nurses  . The principle of justice is not strongly emphasized in the professional code of ethics.
  30. 30. ACCOUNTABILITY IN COMMUNITY HEALTH NURSING  The application of this principle indicates that how a community health nurses morally provide health services so as to provide maximize total net health of population .
  31. 31. PROFESSIONAL ETHICS  Professional etiquette, good manners based on loyalty.  Knowing the lines of authority and responsibility.  Each person should be treated with dignity and responsibility  When death occurs they need empathy, support and understanding. More practice is needed in an isolated area.
  32. 32. PROFESSIONAL ETHICS  Should know what others are doing and be faithful in supporting each other.  Co ordinate with all  Have partnership and co operation with physician.  Good communication based giving and receiving  Without open criticism, incompetence of person should be reported  The nurse relates in the community as a worker and to improve health standards
  33. 33. A rule established by authority, society or custom The body of rules governing the affairs of people, communities, states, corporations and nations. A set of rules or customs governing a discrete field or activity
  34. 34. COMMON LAW Common law is derived from principles rather than rules and regulations. Common law is based on justice, reason, and common sense. It represents law made by judges through decisions in specific cases
  35. 35. CIVIL LAW,  Also called continental law, is the predominant system of law in the world. In contrast to common law, civil law was promulgated after the French Revolution in France and is based on rules and regulations that became normative principles
  36. 36. CONSTITUTIONAL LAW The major constitutional power of the state’s relating to population centered nursing practice is the states’ rights to intervene in a reasonable manner to protect the health, safety and welfare of the citizens.
  37. 37. THE STATE CAN ISOLATE AN INDIVIDUAL UNDER THE FOLLOWING CONDITIONS There is a compelling state interest in preventing an epidemic. The isolation is necessary to protect the health, safety, and welfare of individuals in the community or the public as a whole. The isolations are done in a reasonable manner.
  38. 38. JUDICIAL AND COMMON LAW Judicial law is based on court decisions. The opinions of the courts are referred to as case law. The court uses other types of laws to make its decisions including previous court decisions. Precedent one principle of common law, this means that judges are bound by previous decisions unless they are convinced that the older law is no longer relevant or valid.
  39. 39. LAWS SPECIFIC TO NURSING PRACTICE The first is the statutory authority for the profession and its scope of practice and the second is the professional negligence and malpractice
  40. 40. SCOPE OF PRACTICE  The issue of scope of practice involves defining nursing, setting its credentials, and then distinguishing between the practices of nurses, physicians and other health care providers. The issue is especially important to nurses in community settings, who have traditionally practiced with much autonomy.
  41. 41. CUSTOMARY PRACTICES OF NURSING CAN IDENTIFIED BY  Content of nursing educational programmes  Experience of other practicing nurses  Statements and standards of nursing professional organizations  Policies and procedures of agencies employing nurses  Needs and interests of the community.  Updated literature, including research, books, texts and journals.
  42. 42. SCOPE OF PRACTICE  Health care practitioners are subject to the laws of the state in which they practice, and they can practice only with license.  The nurse practice act of each state accomplishes at least four functions;  defining the practice of professional nursing, identifying the scope of nursing practice,  setting educational qualification and other requirements for licensure,  and determining the legal titles nurses may use to identify themselves.
  43. 43. PROFESSIONAL NEGLIGENCE/ MALPRACTICE  Professional negligence or malpractice is defined as an act that leads to injury of a client. To recover money damages in a malpractice action, the client must prove all the following,  the nurse owed a duty to the client or was responsible for the clients care.  the duty to act the way a reasonable, prudent nurse would act in the same circumstances was not fulfilled.  the failure to act reasonably under the circumstances led to the alleged injuries.
  44. 44. LEGAL ISSUES AFFECTING HEALTH CARE PRACTICES  Specific legal issues of nursing vary depending on the setting where care is delivered. The law, including legislation and judicial opinions, significantly affects each of the following areas of nursing practice. Nurses responsible for setting and implementing programme priorities need to identify and monitor laws related to each special area of practice.
  45. 45. SCHOOL AND FAMILY HEALTH Nurses employed by health departments may deliver school and family health nursing. School health legislation establishes a minimum of services that must be provided to children in public and private schools. Children must have had a physical examination at least onetime before entering school.
  46. 46. INDUSTRIAL NURSING  Of special concern are the state workers compensation statutes, which provide the legal foundation for claims of workers injured on the job.  Access to records, confidentiality and the use of standing orders are legal issues that have great practice significance to nurses employed in industries.
  47. 47. HOMECARE AND HOSPICE SERVICES  Homecare and hospice services rendered by nurses are shaped through state statutes and have specific nursing requirements for licensure and certification.  Compliance with these laws is directly linked to the method of payment for the services.  many states have passed laws requiring nurses to report elder abuse to the proper authorities, as is done with children and youths.
  48. 48. LEGISLATIVE ACTION  The legislative process begins with ideas that are developed in to bills. After a bill is drafted, it is introduced to the legislature, given a number, read and assigned to committee, amends it as necessary and votes on it.  . Many professional nursing associations have legislative committees made up of volunteers, governmental relations staff professionals and sometimes political action committees, all engaged in efforts to monitor, analyze and shape health policy.
  49. 49. NURSES ROLE IN THE POLICY PROCESS  Statement of a healthcare problem.  Statement of policy options to address the health problem.  Adoption of a particular policy option.  Implementation of the policy product  Evaluation of the policy’s intended and unintended consequences in solving the original health problem

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