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Copyright © 2015. F.A. Davis Company
Questions of Values and Ethics
Chapter 4
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Copyright © 2015. F.A. Davis Company
Introduction
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Copyright © 2015. F.A. Davis Company
In the Beginning…There were no antibiotics.There were no
ICUs.There were no CT scanners or MRIs.There were just
physicians and nurses who cared for people in sickness and in
health.
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Copyright © 2015. F.A. Davis Company
1960sTechnological advances allowed for the development of
the ICU.New biomedical developmentsAdvances in surgical
techniques, such as open heart surgery
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Copyright © 2015. F.A. Davis Company
New QuestionsThe advances created new questions for health-
care professionals regarding the use of technology.The concepts
of life and death
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Copyright © 2015. F.A. Davis Company
BioethicsA subdiscipline of ethicsThe study of medical morality
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Copyright © 2015. F.A. Davis Company
Concepts of EthicsValuesBelief systemsMorality
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Copyright © 2015. F.A. Davis Company
Value SystemsA set of related valuesIntrinsic valuesExtrinsic
valuesPersonal valuesProfessional values
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Copyright © 2015. F.A. Davis Company
Value FormationValues are learned.Values change with maturity
and experience.The number of values an individual holds is not
as important as what values he or she consider important.
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Copyright © 2015. F.A. Davis Company
Values ClarificationChoosingPrizingActing
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Copyright © 2015. F.A. Davis Company
Belief SystemsThese are organized ways of thinking about why
people exist within the universe.Their purpose is to explain
such concepts asLife and deathGood and evilHealth and illness
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Copyright © 2015. F.A. Davis Company
Ethics and Morals
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Copyright © 2015. F.A. Davis Company
MoralsMorals are an individual’s own code for acceptable
behavior.They arise from an individual’s conscience.They act as
a guide for individual behavior.They are learned.
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Copyright © 2015. F.A. Davis Company
EthicsEthics deals with the “rightness” or “wrongness” of
human behavior.Concerned with the motivation behind the
behaviorBioethics is the application of these principles to life-
and-death issues.
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Copyright © 2015. F.A. Davis Company
Ethical TheoriesDeontologicalTeleologicalPrincipalism
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Copyright © 2015. F.A. Davis Company
Ethical
PrinciplesAutonomyNonmaleficenceBeneficenceJusticeFidelity
ConfidentialityVeracityAccountability
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Copyright © 2015. F.A. Davis Company
AutonomyThe freedom to make decisions about oneselfNurses
need to respect clients’ rights to make choices about health
care.
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Copyright © 2015. F.A. Davis Company
NonmaleficenceRequires that no harm be caused to an
individual, either unintentionally or deliberately.Requires
nurses to protect individuals who are unable to protect
themselves.
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Copyright © 2015. F.A. Davis Company
BeneficenceThis principle means “doing good” for
others.Nurses need to assist clients in meeting all their
needs.BiologicalPsychologicalSocial
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JusticeEvery individual must be treated equally.This requires
nurses to be nonjudgmental.
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Copyright © 2015. F.A. Davis Company
FidelityLoyaltyThe promise to fulfill all commitmentsThe basis
of accountability
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Copyright © 2015. F.A. Davis Company
ConfidentialityAnything stated to nurses or health-care
providers by clients must remain confidential.The only times
this principle may be violated areIf clients indicate harm to
themselves or othersIf the clients give permission for the
information to be shared
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Copyright © 2015. F.A. Davis Company
VeracityThis principle implies “truthfulness.” Nurses need to be
truthful to their clients.Veracity is an important component of
building trusting relationships.
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Copyright © 2015. F.A. Davis Company
AccountabilityIndividuals need to be responsible for their own
actions.Nurses are accountable to themselves and to their
colleagues.
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Copyright © 2015. F.A. Davis Company
Ethical CodesThese are formal statements of the rules of
behavior for a particular group of individuals.Ethical codes are
dynamic. Most professions have a “code of ethics” to guide
professional behavior.
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Copyright © 2015. F.A. Davis Company
Virtue EthicsFocus on virtues or moral character.View helping
others as charitable or benevolent.
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Copyright © 2015. F.A. Davis Company
Organizational Ethics
Focus on the workplace.Ethical culture makes a
difference.Senior leadership must promote an ethical culture.
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Copyright © 2015. F.A. Davis Company
Ethical DilemmasOccur when a problem exists between ethical
principlesDeciding in favor of one principle usually violates
another.Both sides have “goodness” and “badness” associated
with them.
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Copyright © 2015. F.A. Davis Company
Resolving Ethical Dilemmas
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Copyright © 2015. F.A. Davis Company
Using the Nursing
ProcessAssessmentPlanningImplementationEvaluation
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Copyright © 2015. F.A. Davis Company
Approach to Ethical Dilemmas
Approach
List and rank
the options.
What values are in conflict?
Use of discussion and negotiation.
Work toward
a mutually
acceptable
decision.
Implementation
Identify
decision makers.
Determine goals
of treatment.
Planning
Am I involved?
Collect the facts.
Re-evaluate
as necessary.
Determine
whether desired
outcomes have
been reached.
Evaluation
Assessment
*
Copyright © 2015. F.A. Davis Company
Current Ethical Issues
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Copyright © 2015. F.A. Davis Company
Issues to ConsiderAssisted suicideTechnology issuesGene
therapies“Designer babies”Organizational climate
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Copyright © 2015. F.A. Davis Company
ConclusionAn issue is not an ethical issue for the nurse unless
he or she has been asked.Always gather the facts prior to
decision making.Consider your personal beliefs and values.
*

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Copyright © 2015. F.A. Davis CompanyQuestions of Values.docx

  • 1. Copyright © 2015. F.A. Davis Company Questions of Values and Ethics Chapter 4 * Copyright © 2015. F.A. Davis Company Introduction * Copyright © 2015. F.A. Davis Company In the Beginning…There were no antibiotics.There were no ICUs.There were no CT scanners or MRIs.There were just physicians and nurses who cared for people in sickness and in health. *
  • 2. Copyright © 2015. F.A. Davis Company 1960sTechnological advances allowed for the development of the ICU.New biomedical developmentsAdvances in surgical techniques, such as open heart surgery * Copyright © 2015. F.A. Davis Company New QuestionsThe advances created new questions for health- care professionals regarding the use of technology.The concepts of life and death * Copyright © 2015. F.A. Davis Company BioethicsA subdiscipline of ethicsThe study of medical morality * Copyright © 2015. F.A. Davis Company Concepts of EthicsValuesBelief systemsMorality
  • 3. * Copyright © 2015. F.A. Davis Company Value SystemsA set of related valuesIntrinsic valuesExtrinsic valuesPersonal valuesProfessional values * Copyright © 2015. F.A. Davis Company Value FormationValues are learned.Values change with maturity and experience.The number of values an individual holds is not as important as what values he or she consider important. * Copyright © 2015. F.A. Davis Company Values ClarificationChoosingPrizingActing * Copyright © 2015. F.A. Davis Company
  • 4. Belief SystemsThese are organized ways of thinking about why people exist within the universe.Their purpose is to explain such concepts asLife and deathGood and evilHealth and illness * Copyright © 2015. F.A. Davis Company Ethics and Morals * Copyright © 2015. F.A. Davis Company MoralsMorals are an individual’s own code for acceptable behavior.They arise from an individual’s conscience.They act as a guide for individual behavior.They are learned. * Copyright © 2015. F.A. Davis Company EthicsEthics deals with the “rightness” or “wrongness” of human behavior.Concerned with the motivation behind the behaviorBioethics is the application of these principles to life- and-death issues.
  • 5. * Copyright © 2015. F.A. Davis Company Ethical TheoriesDeontologicalTeleologicalPrincipalism * Copyright © 2015. F.A. Davis Company Ethical PrinciplesAutonomyNonmaleficenceBeneficenceJusticeFidelity ConfidentialityVeracityAccountability * Copyright © 2015. F.A. Davis Company AutonomyThe freedom to make decisions about oneselfNurses need to respect clients’ rights to make choices about health care. *
  • 6. Copyright © 2015. F.A. Davis Company NonmaleficenceRequires that no harm be caused to an individual, either unintentionally or deliberately.Requires nurses to protect individuals who are unable to protect themselves. * Copyright © 2015. F.A. Davis Company BeneficenceThis principle means “doing good” for others.Nurses need to assist clients in meeting all their needs.BiologicalPsychologicalSocial * Copyright © 2015. F.A. Davis Company JusticeEvery individual must be treated equally.This requires nurses to be nonjudgmental. * Copyright © 2015. F.A. Davis Company
  • 7. FidelityLoyaltyThe promise to fulfill all commitmentsThe basis of accountability * Copyright © 2015. F.A. Davis Company ConfidentialityAnything stated to nurses or health-care providers by clients must remain confidential.The only times this principle may be violated areIf clients indicate harm to themselves or othersIf the clients give permission for the information to be shared * Copyright © 2015. F.A. Davis Company VeracityThis principle implies “truthfulness.” Nurses need to be truthful to their clients.Veracity is an important component of building trusting relationships. * Copyright © 2015. F.A. Davis Company AccountabilityIndividuals need to be responsible for their own actions.Nurses are accountable to themselves and to their
  • 8. colleagues. * Copyright © 2015. F.A. Davis Company Ethical CodesThese are formal statements of the rules of behavior for a particular group of individuals.Ethical codes are dynamic. Most professions have a “code of ethics” to guide professional behavior. * Copyright © 2015. F.A. Davis Company Virtue EthicsFocus on virtues or moral character.View helping others as charitable or benevolent. * Copyright © 2015. F.A. Davis Company Organizational Ethics Focus on the workplace.Ethical culture makes a difference.Senior leadership must promote an ethical culture.
  • 9. * Copyright © 2015. F.A. Davis Company Ethical DilemmasOccur when a problem exists between ethical principlesDeciding in favor of one principle usually violates another.Both sides have “goodness” and “badness” associated with them. * Copyright © 2015. F.A. Davis Company Resolving Ethical Dilemmas * Copyright © 2015. F.A. Davis Company Using the Nursing ProcessAssessmentPlanningImplementationEvaluation * Copyright © 2015. F.A. Davis Company
  • 10. Approach to Ethical Dilemmas Approach List and rank the options. What values are in conflict? Use of discussion and negotiation. Work toward a mutually acceptable
  • 11. decision. Implementation Identify decision makers. Determine goals of treatment. Planning Am I involved? Collect the facts. Re-evaluate as necessary. Determine whether desired outcomes have been reached. Evaluation Assessment * Copyright © 2015. F.A. Davis Company Current Ethical Issues
  • 12. * Copyright © 2015. F.A. Davis Company Issues to ConsiderAssisted suicideTechnology issuesGene therapies“Designer babies”Organizational climate * Copyright © 2015. F.A. Davis Company ConclusionAn issue is not an ethical issue for the nurse unless he or she has been asked.Always gather the facts prior to decision making.Consider your personal beliefs and values. *