Health care providers like midwives and nurses face complex ethical issues in their work with women of reproductive age due to interactions with patients and advanced technology. Knowledge of ethics helps nurses make decisions based on codes of ethics and understand their responsibilities to patients. Some key ethical principles that guide nurses include respecting patient autonomy and dignity, doing no harm, being fair, keeping promises, and protecting the vulnerable. Nurses may encounter ethical dilemmas when caring for patients undergoing procedures like abortion given their own moral beliefs, or when the rights of the mother and fetus conflict. Incident reports and informed consent are important tools to document any issues, protect legal rights, and ensure safe, ethical care.

2.  Health care givers, particularly midwives, perinatal and
neonatal nurses, face multiple and complex ethical issues
because of their interactions with women in the
reproductive age groups and due to advanced technology.

3.  ● ensuring the ethical delivery of care with respect
and dignity.
● practicing safe and evidence-based nursing care that
is responsive to the needs of women and families

4.  Knowledge of ethics enables the nurse to make
decisions based on the code of ethics.
● Knowledge of learning about ethics helps the nurse to
understand her/his responsibility toward the care
provided to the patient.

5.  Ethics came from the Greek word {Ethos} which means:
(custom, habit, conduct, character).
 Ethics involves determining what is good, right and fair.
 rules or principles which govern correct conduct

6.  Nursing care involves judgement and action with the aim
of maintaining, promoting and restoring balance in human
system.
 The need for judgement and action brought about the moral
questions of right or wrong of duty.

7.  Ethical principles are a set of rules that can be applied to all
situations. They provide a framework for helping nurses and
others to evaluate ethical issues.

8.  Respect: you must respect pt.'s autonomy and dignity .
 Beneficence: Obligation to do good
 Non maleficence: "To do no harm"
 Justice: Is to be fair, and equitable to all pts Regardless of
any service you want to give .
 Fidelity: Faithfulness or obligation to keep promises
 Paternalism: Is to protect the weak person.
 Veracity: Is the obligation to tell the truth

9.  right to refuse treatment that may be
beneficial to the pregnancy outcome for the
foetus

10.  Veracity is disclosing to women and their
families accurate information regarding the
relative risks and benefits of health
management

11.  Conflict between the right of any woman to
make decisions about her reproductive
functions based on her own moral and ethical
beliefs
 Feeling that abortion is murder and deprives
the fetus of the basic right to life

12.  The ANA’s Code of Ethics for Nurses upholds
the nurse’s right to refuse to care for a client
undergoing an abortion if the nurse ethically
opposes the procedure

13.  A dilemma has been described as a situation requiring a
choice between what appears to be equally desirable
and/or undesirable alternatives. (conflict.)
 Ethical dilemma refers to when there is difficulty in
deciding which action takes

14. • Withdrawal of life support
 In vitro fertilization and decisions for disposal
of remaining fertilized ova
• Ovum or sperm donation
• Fetal surgery )Treatment of genetic disorders(
• Using organs from an anencephalic infant
• Surrogacy
• Preconception gender selection

15. • Genetic engineering
• Cloning
• Substance abuse in pregnancy
• Borderline viability: to resuscitate or not
• Maternal rights versus fetal rights
• refusal to follow the advice of caregivers
 Selective reduction in multifetal pregnancy

16.  Induced abortion

17.  Invitro fertilization (IVF)

18.  surrogacy mothers

19.  There are two approaches for Ethical dilemma
when clinical situations arise and where ethical
principals conflict with each other.
 1- The Rights Approach: The focus is on the
individual’s/ or family rights to choose, the right to
privacy, to know the truth and to be free from injury or
harm .


20.  2-The Utilitarian Approach: This approach provide the
greatest balance of benefits over risks as well as,
provides the greatest good for the greatest numbers.

21.  Informed consent
 Confidentiality
21

22.  major and minor surgery; invasive
 procedures such as amniocentesis, internal
foetal
 monitoring, lumbar puncture (LP), or bone
marrow
 aspiration; treatments placing the client at
higher risk, such as chemotherapy or
radiation therapy;
 procedures or treatments involving research.

23.  Health care teams including nurses have access to a large
amount of sensitive patient information that may include
diagnosis, insurance concerns, and family issues. Failure
to keep patients confidentiality are serious.
 This issues could result not only in job loss but also legal
action. Patient’s information should never be discussed
with other persons, Such as make copies of records for
unauthorized individuals or for doing a researches.

24.  The patient is the owner of the information within the
medical record, and it should not be released without
express written permission from the patient and/or
family members.

25. Brain storming 5 mints
 Many legal issues are involved in case of mother and
her newborn. The common causes of lawsuits against
the nurse. Give examples

26.  The common causes of lawsuits against the nurse
include:
 Problems of medication: Nurses are authorized to
administer medication. So many allegations against nurse
regard to medication are their like improper patient
identification, wrong medication dosages, route or time,
failure to monitor side effects, e.g. nurses are involved in
administration of oxytocin in augment of the labor.

27.  Failure in adequate client monitoring: Nurse is
required to monitor the client at appropriate
time interval that depends upon the client
condition. E.g the delivering mother must be
adequately monitor to prevent maternal
complication related to uterine contraction,
check fetal condition during labor and
continuous observation of mother and fetus
during first 24 hours after delivery can lead to
maternal morbidity and mortality . ( negligence
)

28.  Failure to adequate assess the client: Nurse
in all specialty areas must maintain higher
level of assessment skill. They are
responsible for minute by minute evaluation
of client progress.
 Failure to report changes in client: Whenever
the nurse’s assessment indicates that the
client condition has changed, the nurse must
notify the physician.

29.  Nursing care of the new-born: There are
certain legal requirements in providing
nursing care of new-born, such as properly
identify the infant mother pair as soon as
possible with foot print, wrist band or
obtaining blood samples for hypotheriodism
testing when required by law.

31. Usually described though job
description.
 Every individual has the rights to receive treatment by
competent heath care provider who knows to handle just
situation quite well..

32.  Individual requires the health services
promotes their right to make their own
decision about the options for treatment or
other related issues. The process of obtaining
permission called informed consent. E.g In case
of sterilization for male/female it is essential to Get
the informed consent signed by both the husband
and wife.
 during procedures or before any surgery or as a
participant in research process.

33. Is a tool used by health care
institutions to document the
occurrence of anything "out of
ordinary" that results in or has the
potential to harm the patients or
employee .

34.  Incidents reports aims to improve the
management and treatment of patient by
identifying high-risk patterns and
initiating in-service training programmers
to prevent future similar problems or
mistakes.
 Ignorance of mistakes can cause more
harm than good.

35.  The complete name of the person or persons involved in
the incident and the names of all witnesses.
 A complete factual account of the incident.
 Date, time and place of the incident.
 pertinent characters of the person or persons involved
(alert, ambulatory, asleep)
 Any other variables believed to be important to the
incident.

36. Considered the most important items in the nursing field,
because it protects the nurse from mistakes and law as well
as to enhances continuity of nursing care.

37.  Legal issues can occur anytime during the service period in
the working field due to negligence, malpractices or any
violation of the code of the ethics.
 It is very important for all nurses to follow all the standards
of care in order to provide competent care and avoid any kind
of ethical /legal issues during their work period .

38. Thank You All
Any Question ??????