unit i - ethics

7/24/2019 Unit I - Ethics

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Ethics is defned as thestandards or principles omoral judgment oractions. It provides a

methodical system indierentiating right romwrong based on certainbelie.

"Ethics is very muchconcerned with the eectso our behavior on others,"


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Etiquette is a code o behavior thatdelineates e!pectations or socialbehavior according to contemporary

conventional norms withina society, social class, or group.


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alues are operational belies anindividual chooses as the basis orbehavior which can change over time.#hese belies serve as the building bloc$s

o moral and ethical development. %orals are personal opinion or principle

that a particular action or behavior isabsolutely right or wrong in all situations.&sually a person is reluctant or unwillingto change his personal opinions onspecifc issues o a moral nature.


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'ioethics is the study o typicallycontroversial ethics brought about byadvances in biology and medicine. It is

also moral discernment as it relates tomedical policy, practice, and research.'ioethicists are concerned with theethical questions that arise in the

relationships among lie sciences,biotechnology, medicine, politics, law,and philosophy.


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( disciplinedealing with theethical

implications obiologicalresearch andapplications

especially inmedicine


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Ethics re)ects the standards thatgovern a proper conduct in a particularproession. *or instance, the nurse on

duty $nows that she is obligated to actor the good o the client and toprevent any incident to harm the

patient. #his principle o doing no harmto the client is the intervention o$nowing the ethics in nursing.


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+ursing ethics provides the standards oproessional behavior or nurses and theprinciples o $nowing right rom a wrong

conduct during implementation onursing duties and responsibilities. #hrough this set o standards, nursing

duties and responsibilities o nurses

towards their clients, cowor$ers,proession and community is made$nown.


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- #ypes

escriptive / comparative ethics 0rescriptive / +ormative ethics %etaethics (pplied ethics


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Descriptive ethics1escriptive ethics, also

$nown as comparative ethics, is the study opeople2s belies about morality. #his categoryo ethics is the easiest to understand itsimply involves describinghow peoplebehave and/or what sorts o moral standards

they claim to ollow. Metaethics1#he category o metaethics, alsooten reerred to as analytic ethics, is perhapsthe most di3cult o the three tounderstand.is the study o what ethical termsand theories actually reer to. #he center othis type is on reasonable and justifable

judgments. It is basically concerned withtheoretical issues o meaning and its

justifcation.


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Normative ethics1 prescriptive or normative ethicsis the study o ethical theories that prescribe howpeople ought to act . #he category o normativeethics involves creating or evaluating moralstandards. #hus, it is an attempt to fgure out whatpeople shoulddo or whether their current moralbehavior is reasonable. 4ith this classifcation, a

question is raised about what is right or wrong.5omething should be done in a situation that callsor an ethical decision. *or instance, a teenagerwho is maintaining a scholarship is pregnant. 5heis to decide whether she will abort the baby to

avoid issues and being $ic$ed out o the school orsustain the pregnancy and deliver the baby.


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#he ollowing e!amples o questions thatmight be considered in each feld illustratethe dierences between the felds6

escriptive ethics6 4hat do people thin$ isright7

+ormative 8prescriptive9 ethics6 :owshould people act7

%etaethics6 4hat does 2right2 even mean7 (pplied ethics6 :ow do we ta$e moral

$nowledge and put it into practice7


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#he ethical principles provide aoundation or nursing practice.Ethical principles are defned as basis

or nurse;s decisions on considerationo consequences and o universalmoral principles when ma$ing clinical

judgments. #he most undamental othese principles is the respect orpersons.


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#he primary and basic ethicalprinciples are the ollowing6

(utonomy +onmalefcence 'enefcience


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(ccording to the (merican +urses(ssociation 8(+(9, the mostundamental principle o proessionalbehavior is the respect or persons. #hisprinciple not only applies to the clinicalsettings but to all lie;s situations. #hisprinciple emphasi>es that all peopleshould treat others as a worthy

individual. In nursing practice thisprinciple should be simplifed. #hus,respect or persons generally meansrespecting a client;s autonomy.


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#he principle o autonomy is based on theassertion that individuals have the right todetermine their actions and the reedom toma$e their own decisions.

(utonomy reers to the control individualshave over their own lives. ?espect orindividual is the cornerstone o the principle.

(utonomy applies both to decisions andactions. (utonomous decisions are based on

8@9 individual values, 8A9 (dequateinormation, 8B9 *reedom rom corcion, and8-9 reason and deliberation. (utonomousactions results rom autonomous decisions.


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?especting a client;s rights, values andchoices is synonymous to respecting aperson;s autonomy.

Inormed consent is a method that

promotes and respects a person;sautonomy. *or a client to ma$e anautonomous decision and action, he or shemust be oered enough inormation andoptions to ma$e up his or her mind ree ocoercion or e!ternal and internal in)uences.

In clinical settings, this is promoted byproving inormed consent to the client.


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In clinical situations nurses respect apatients autonomy, where the patient isallowed the freedom of choice regarding

treatment, such as in deciding whetherhe/she wishes to be intubated during anexacerbation of !"D, or deciding whenhe/she wishes to forgo further dialysis# If

a patient lac$s capacity for such adecision and has an advance directive,the person who has the durable powerof attorney can ma$e the decision#


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'enefcence is doing or active promotiono good. (ccording to *ran$ena 8@CDD9,benefcience involves our duties6

@.+ot to in)ict harm or evilA.

#o prevent harm or evilB.#o remove harm or evil, and-.#o promote or do good.'enefcence is done by6 0roviding health benefts to the clients. 'alancing the benefts and ris$s o harm. =onsidering how a client can be best

helped.


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%n elderly patient falls at home andhas a fractured hip# In the emergencyroom, the nurse acts to provide pain

medication as soon as possible in anact of bene&cence#


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+onmalefcence means duty to do no harm.#his principle is the oundation o the medicalproession;s :ipocaratic oath it is li$ewisecritical to the nursing proession.

#his is promoted by doing the ollowingnursing interventions6

@. (voiding deliberate harm, ris$ o harm thatoccurs during the perormance o nursing

actions.A. =onsidering the degree o ris$ permissible.B. etermining whether the use o technological

advances provides benefts that outweighris$s.


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'hen this elderly person above received painmedication (an act of bene&cence) there arecomplications that could arise# "ractitionersrecogni*e that using a narcotic may cause

confusion# 'hen obtaining the consent forher hip surgery, we want to ma$e certain thatthe patient is alert enough to understand theris$s and bene&ts of the procedure# 'e mustbalance the bene&cence of providing the

medication +uic$ly with the possiblemale&cence of obtaining a consent whenpatient does not have the capacity to ma$ethe decision for surgery#


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% hospital organi*ation wishes todonate low or nocost pediatricdental services to the community#

-here are openings for . childrenper month# 0ustice re+uires a fairmethod, that is free from bias, to

determine who will receive theseservices#


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efned as duty to Ftell the truthG. It is necessary to basic communication,

and societal relationships are built on

the individual;s right to $now the truth. :ealth care proessionals are not

responsible or alse inormation given

to them by their patients. #hey areresponsible, however, or inormationthat they give topatients.


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uty to respect privileged inormation. #he prohibition o some disclosures o

inormation gained in certainrelationships without the consent o the

original source o the inormation. ( nurse should be trusted. 5ince patientsare required to confde to the nursesabout what really happened to them,

nurses are not allowed to tell otherpeople about these unless it is neededby the physician. +urses have no right totell other nurses what the healthcondition o their patient really is.


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?eers to aithulness 8duty to $eeppromises, agreements andcommitments made9.

#he nurse is required to remain aithul

in seriously considering all ethicalmandates related to the practice o theproession.

4hen the nurse accepts licensure and

becomes a part o the proession, it ismandated that he or she accept certainresponsibilities as part o the contractwith society.


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% patient as$s the nurse not to reveal thefact that she is dying or give her diagnosisto his family# -he nurse as$s why she doesnot want her family advised# -he patient

explains that her family is very emotionaland has stated they would do everything to$eep her alive, even if it re+uired longtermmechanical ventilation# -he patient hasexplained multiple times that she does not

want mechanical ventilation# -he nurserecogni*es that $eeping of this informationin con&dence, while supporting the family, isan example of exercising &delity#


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@. =onsequentialism / #eleologyA. eontologismB. +atural Haw-. irtue Ethics


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Ethical theories that all under theclassifcation o consequentialism positthat the rightness or wrongness o anyaction must be viewed in terms o theconsequences that the action produces.

In other words, the consequences aregenerally viewed according to the e!tentthat they serve some intrinsic good.

#he most common orm o

consequentialism is utilitarianism 8socialconsequentialism9 which proposes thatone should act in such a way to producethe greatest good or the greatestnumber.


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#he utilitarian ethical theory is ounded on theability to predict the consequences o an action.#o a utilitarian, the choice that yields thegreatest beneft to the most people is the choicethat is ethically correct. ne beneft o this

ethical theory is that the utilitarian can comparesimilar predicted solutions and use a pointsystem to determine which choice is morebenefcial or more people. #his point system

provides a logical and rationale argument oreach decision and allows a person to use it on acasebycase conte!t.


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#here are two types o utilitarianism, actutilitarianism and rule utilitarianism. (ct utilitarianismadheres e!actly to the defnition o utilitarianism asdescribed in the above section. In act utilitarianism, aperson perorms the acts that beneft the mostpeople, regardless o personal eelings or the societalconstraints such as laws. ?ule utilitarianism, however,

ta$es into account the law and is concerned withairness. ( rule utilitarian see$s to beneft the mostpeople but through the airest and most just meansavailable. #hereore, added benefts o ruleutilitarianism are that it values justice and includes

benefcence at the same time


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eontologism is a position based,predominately, on the wor$ o Immanuel Jant.%ost simply, deontologism suggests that anact must be perormed because the act in

some way is characteri>ed by universality 8i.e.appropriate or everyone9 or that it conormswith moral law 8ormal rules used or judgingthe rightness or wrongness o an act9.

(ccording to this theoretical position, therightness or wrongness o some acts areindependent o the consequences that itproduces and the act may be good or evil inand o itsel.


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#he deontological theory states that peopleshould adhere to their obligations and dutieswhen analy>ing an ethical dilemma. #his meansthat a person will ollow his or her obligations toanother individual or society because upholding

one2s duty is what is considered ethicallycorrect. *or instance, a deontologist will always$eep his promises to a riend and will ollow thelaw. ( person who ollows this theory will

produce very consistent decisions since theywill be based on the individual2s set duties.


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#his theoretical position suggests thatone may, through rational re)ection onnature 8especially human nature9,discover principles o good and bad thatcan guide our actions in such a waythat we will move toward humanulfllment or )ourishing.

#his position suggests that humanbeings have the capacity withinthemselves or actuali>ing theirpotential.


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#he virtue ethical theory judges aperson by his character rather than byan action that may deviate rom hisnormal behavior. It ta$es the person2s

morals, reputation and motivation intoaccount when rating an unusual andirregular behavior that is considered

unethical. ne wea$ness o this ethical theory isthat it does not ta$e into considerationa person2s change in moral character.


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irtue ethics consists o two diering

approaches to ethics and can, thereore,be conusing to understand.

ery brie)y, the frst approach to ethicsin this theoretical orientation proposes

that there are certain dispositionalcharacter traits 8virtues9 that areappropriate and praiseworthy in generaland or in a particular role.

%ore ormally, virtue ethics represents a"systematic ormulation o the traits ocharacter that ma$e human behaviorpraiseworthy or blameworthyF.


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unit i - ethics

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