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

Copyright © 2015. F.A. Davis Company
Questions of Values and Ethics
Chapter 4
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Introduction
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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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1960sTechnological advances allowed for the development of
the ICU.New biomedical developmentsAdvances in surgical
techniques, such as open heart surgery
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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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BioethicsA subdiscipline of ethicsThe study of medical morality
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Concepts of EthicsValuesBelief systemsMorality

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Value SystemsA set of related valuesIntrinsic valuesExtrinsic
valuesPersonal valuesProfessional values
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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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Values ClarificationChoosingPrizingActing
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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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Ethics and Morals
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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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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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Ethical TheoriesDeontologicalTeleologicalPrincipalism
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Ethical
PrinciplesAutonomyNonmaleficenceBeneficenceJusticeFidelity
ConfidentialityVeracityAccountability
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AutonomyThe freedom to make decisions about oneselfNurses
need to respect clients’ rights to make choices about health
care.
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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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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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FidelityLoyaltyThe promise to fulfill all commitmentsThe basis
of accountability
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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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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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AccountabilityIndividuals need to be responsible for their own
actions.Nurses are accountable to themselves and to their

colleagues.
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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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Virtue EthicsFocus on virtues or moral character.View helping
others as charitable or benevolent.
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Organizational Ethics
Focus on the workplace.Ethical culture makes a
difference.Senior leadership must promote an ethical culture.

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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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Resolving Ethical Dilemmas
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Using the Nursing
ProcessAssessmentPlanningImplementationEvaluation
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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
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Current Ethical Issues

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Issues to ConsiderAssisted suicideTechnology issuesGene
therapies“Designer babies”Organizational climate
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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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