6: Values, Ethics, and Legal Issues

Question 1

Values

Answer 1

standards for decision making that endure for a significant time in one’s life

Question 2

value system

Answer 2

a learned set of principles and rules organized into a hierarchy

Question 3

Attitude

Answer 3

one’s disposition toward an object or a situation.

Question 4

Beliefs

Answer 4

ideas that one accepts as true

Question 5

Behaviors

Answer 5

actions that can be perceived or noticed

Question 6

Two ways culture is learned in families

Answer 6

World view

Cultural value orientation

Question 7

World view

Answer 7

unquestioned framework or predominant set of assumptions through which people view life

Question 8

Cultural value orientation

Answer 8

a subset of ideas that helps to clarify components of one’s world view:
nature
time
activity
relationships

Question 9

nature orientation

Answer 9

Mastery: one believes that humans are masters of nature and values problem solving and intervention
Subjugation: one believes humans are subjugated to nature and values wonder, awe, or fate and focuses more on safety and survival
Harmony: one believes humans should act in harmony with nature and may value balance

Question 10

first-level preconventional stage

Answer 10

children learn to distinguish right from wrong and understand the choice between obedience and punishment

Question 11

Values clarification

Answer 11

a method of self-discovery by which people identify their personal values and their value rankings

Question 12

values inquiry

Answer 12

a method of examining social issues and the values that motivate human choices

Question 13

Ethics

Answer 13

a branch of philosophy dealing with standards of conduct and moral judgment

Question 14

Personal morality

Answer 14

set of beliefs about the standards of right and wrong that help a person determine the correct or permissible action in a given situation

Question 15

Personal values

Answer 15

ideas or beliefs a person considers highly important and are learned through interactions with social systems as described previously

Question 16

Professional ethics

Answer 16

values held by a group deemed as having generalizable application and standards of conduct to be upheld in all situations

Question 17

Institutional policies

Answer 17

guidelines developed by healthcare institutions to direct professional practice

Question 18

Principles

Answer 18

basic ideas that serve as starting points for both understanding and working through problems

Question 19

Beneficence

Answer 19

doing or promoting good

Question 20

nonmaleficence

Answer 20

to avoid doing harm, to remove from harm, and to prevent harm

Question 21

Autonomy

Answer 21

creating the conditions in which patients can make their own decisions

Question 22

capacity

Answer 22

mental or physical ability

Question 23

surrogate decision maker

Answer 23

Someone to act on patient behalf for infants, young children, people who are severely mentally handicapped or incapacitated, and people in a persistent vegetative state or coma

Question 24

advance directives

Answer 24

verbally participating in healthcare decision making and by employing written documents to specify what interventions patients would or would not want

Question 25

living will

Answer 25

advance directive that specifies the types of medical treatment patients do and do not want to receive

Question 26

proxy directive (AKA durable power of attorney for healthcare)

Answer 26

advance directive allows patients to designate another person to make decisions

Question 27

Justice

Answer 27

the foundation for decisions about resource allocations for societies or groups.

Question 28

six basic rights for patients

Answer 28

The right to self-determination

Question 29

ethical values that guide the behavior of healthcare professionals

Answer 29

Veracity: telling the truth Fidelity: being faithful to one’s commitments or promises Privacy: appropriately using patient information Confidentiality: information about a patient be kept private

Question 30

dilemma

Answer 30

a situation in which: ● Two or more choices are available. ● It is difficult to determine which choice is best. ● Available alternatives cannot solve the needs of all those involved. ● Each alternative may have both favorable and unfavorable features.

Question 31

Laws

Answer 31

rules or standards of human conduct established by government through legislative bodies and interpreted by courts to protect the rights of citizens

Question 32

Sources of Law

Answer 32

constitutions, legislative statutes, and common law

Question 33

Constitutions

Answer 33

foundation of the system of justice

Question 34

Legislative statutes

Answer 34

laws derived from a legislative body

Question 35

Common law

Answer 35

evolves from decisions of courts

Question 36

Civil law

Answer 36

It is the body of law that deals with relationships between private individuals subdivided into contract law and tort law.

Question 37

Criminal law

Answer 37

public law that deals with the public’s safety and welfare divided into felonies and misdemeanors

Question 38

Licensure

Answer 38

the legal ability to practice as a nurse in a certain state

Question 39

Standards of care

Answer 39

comprise the expected level of performance or practice as established by guidelines, authority, or custom

Question 40

tort

Answer 40

Private wrong for which the law provides a remedy resulting in money damages paid to the victim

Question 41

crime

Answer 41

Any wrong punishable by the state. Results in prison term, fine, or short jail sentence to punish offender

Question 42

Assault

Answer 42

the THREAT of touching another person without his or her consent

Question 43

Battery

Answer 43

the actual carrying out of touching another person without his or her consent

Question 44

Felony

Answer 44

``` Premeditated killing (first-degree murder) Impulsive or unintentional killing (second-degree murder; manslaughter, rape, arson, treason, kidnapping, burglary, bribery, child abuse, drug trafficking, fraud, and terrorism) ```

Question 45

Misdemeanor

Answer 45

An offense punishable by imprisonment of less than 1 year or a fine of less than $1,000. Does not amount to a felony.

Question 46

Intentional

Answer 46

``` Assault and battery Defamation of character Fraud Invasion of privacy False imprisonment ```

Question 47

Unintentional

Answer 47

Negligence—mistake or failure to be prudent Malpractice—negligence in the practice of a profession (e.g., failure to assess a significant change in condition, failure to act appropriately in treating a patient, error in sponge counts, causing a burn, failure to use aseptic technique, falls, medical errors, misadministration of blood)

Question 48

Defamation of character

Answer 48

false communication that results in injury to a person’s reputation by means of print (libel) or spoken word (slander)

Question 49

libel

Answer 49

printed false communication

Question 50

slander

Answer 50

spoken false communication

Question 51

Fraud

Answer 51

purposeful misrepresentation of self or an act that may cause harm to a person or property

Question 52

false imprisonment

Answer 52

Prevention of movement or unjustified retention of a person without consent

Question 53

four elements of Negligence

Answer 53

duty breach of duty proximate cause damages.

Question 54

Malpractice

Answer 54

Negligence on the professional’s part To prove malpractice, four elements are necessary: ● A duty to the plaintiff ● A failure to meet the standard of care, or a breach of duty, which may be an act of omission ● Causation (i.e., that the breach of duty produced the injury in a natural and continuous sequence) ● Damages, which require a physical, emotional, financial, or other injury to the patient

Question 55

plaintiff

Answer 55

the person bringing suit

Question 56

defendant

Answer 56

the person being sued

Question 57

Breach of duty

Answer 57

failure to conform to the standard of practice, thus creating a risk for a person that a reasonable person would have foreseen

Question 58

Proximate Cause

Answer 58

Causation must be proven for the courts to find negligence

Question 59

res ipsa loquitur (“the thing speaks for itself”)

Answer 59

When it is obvious that the patient’s injury resulted from someone’s negligence but it is impossible to prove who was at fault

Question 60

Liability

Answer 60

denotes legal responsibility to pay damages

Question 61

respondeat superior (“let the master answer”)

Answer 61

The hospital, clinic, or community nurse service may be held responsible for a nurse’s negligence

Question 62

active euthanasia

Answer 62

deliberately hastening a person’s death and is considered murder

Question 63

Terminal sedation

Answer 63

legally and ethically permissible to provide analgesia to a level that produces light sedation, even though this is likely to hasten death somewhat secondary to resulting immobility

Question 64

Good Samaritan laws

Answer 64

legal im- munity for healthcare professionals who assist in an emergency and render reasonable care under such circumstances

Question 65

Act of omission

Answer 65

neglecting to do something that a reasonably prudent person would do

Question 66

Commission

Answer 66

doing something that a reasonably prudent person would not do

Question 67

A nurse is working in an organization that prescribes and supports Plan B (“the morning after pill”) as a form of contraception. In analyzing her role and moral values, the nurse should consider which of the following? Select all that apply: a. Is she affirming the patient’s desires? b. Is she upholding the ethics of the profession? c. What are the nurse’s beliefs/biases related to this medication? d. What are the consequences and alternatives of giving or not giving this medication?

Answer 67

a. Is she affirming the patient’s desires? b. Is she upholding the ethics of the profession? c. What are the nurse’s beliefs/biases related to this medication? d. What are the consequences and alternatives of giving or not giving this medication?

Question 68

A patient with esophageal cancer is no longer able to consume foods by mouth and is now fed via a gastric feeding tube. She is withdrawn and states, “My family used to have big dinners with friends, family, lots of laughter, and loud conversation.” Which of the patient’s values are apparent and best describe her behavior? a. Independence and individuality b. Family role c. Socialization d. Human nature

Answer 68

c. Socialization

Question 69

A nurse is caring for a patient with necrosing leg ulcers. The nurse assesses that these are related to venous stasis, but when asked, the patient reports that “there is a man shooting lasers through the floor of her apartment.” In order to progress with wound treatment, what must the nurse understand about resolving value conflicts? Select all that apply: a. It is necessary to establish common ground about therapy goals. b. Further exploration of the patient’s belief system may be needed to identify beliefs related to care. c. The nurse may need to answer patient questions related to care. d. The nurse may need to examine his or her values related to mental health and care goals.

Answer 69

a. It is necessary to establish common ground about therapy goals. b. Further exploration of the patient’s belief system may be needed to identify beliefs related to care. c. The nurse may need to answer patient questions related to care. d. The nurse may need to examine his or her values related to mental health and care goals.

Question 70

A nurse in the transplant ICU is caring for a teenager following a liver transplant as a result of a Tylenol overdose. The patient also superseded another ICU patient (reformed alcoholic) who subsequently died without the transplant. The patient is now noncompliant with treatment, stating that she just wants to die. The nurse questions the principles of healthcare ethics in this case. Which principle would be most in question? a. Beneficence b. Nonmaleficience c. Autonomy d. Justice

Answer 70

d. Justice: patient is not willing to receive medical therapies to support the transplanted liver after another patient died waiting to receive the same organ

Question 71

A nurse fails to observe and document a patient’s change in neurologic status, ultimately resulting in the patient’s death from a stroke. Which type of malpractice is most relevant? a. Fraud b. Breach of duty c. Negligence by commission d. Battery

Answer 71

b. Breach of duty: failure to conform to the standard of practice

Question 72

assisted suicide

Answer 72

Providing the client with a means to end life, but not the direct action that results in death

Question 73

brain death

Answer 73

Irreversible cessation of heart and lung functions or an irreversible loss of all functions of the entire brain

Question 74

community-based no code order

Answer 74

Document that requires the signatures of the primary physician or nurse practitioner and the client or legal surrogate and allows emergency medical personnel, if called, to provide care and support to client and family without resuscitation

Question 75

confidentiality

Answer 75

Practice of keeping client information private

Question 76

do not resuscitate (DNR) orders

Answer 76

Orders not to provide resuscitation in the event of a cardiopulmonary arrest

Question 77

fidelity

Answer 77

Being faithful to one’s commitments and promises

Question 78

negligence

Answer 78

Failure to do something that a reasonably prudent person would do, or doing something that a reason- ably prudent person would not do

Question 79

no code order

Answer 79

Order not to provide resuscitation in the | event of a cardiopulmonary arrest

Question 80

privacy

Answer 80

Patient confidentiality

Question 81

resuscitation

Answer 81

Act of reviving after apparent death or unconsciousness

Question 82

veracity

Answer 82

Principle of telling the truth, essential to the integrity of the client-provider relationship