ch 21 ethical and legal issues in nursing

Question 1

what is morality

Answer 1

is the beliefs abt what we think to be right or wrong in our actions and behaviours toward those around us and is in essence v similar to ethics

Question 2

what is ethics

Answer 2

• Ethics is the process of carefully thinking thru whats right or wrong in behave, decision aking and values.

isnt just ab thinking/reflecting on whats good but examining the norms, issues, foundations of our societies

Question 3

is morality or ethics more assoc with academic and philosophical study of right and wrong

Answer 3

ethics

Question 4

is ethics or morality more of an individual thing that reflects social norms

Answer 4

while morality is assoc more w indiv and more general social normas values and beliefs

Question 5

what is bioethics

and how does it differ from medical ethics

Answer 5

• Bioethics examines ethical issues about human lives, ehaltha nd illness eg euthania, stem cell research, mat-fetal conflict, MAID.

meanwhile medical ethics is concerned with the ethical dimensions of medical care

Question 6

what is applied ethics

Answer 6

where theories, principles and value judgements used to work thru ethical dilemmas in specific contexts

Question 7

do the general tragic situations of bioethics apply to realities of nursing ethical challenges

Answer 7

no. nurses epeirence everyday ethical challenges which are smaller than the typical tragic cases in bioethics but nonetheless challenging. They often aren’t genuine dilemmas

Question 8

t or f each act while nursing is a moral statement

Answer 8

true…

Question 9

what are these ethical concerns that nurses encounter referred to as

Answer 9

practice issues

practical problems

Question 10

what does nursing ethics see as central

Answer 10

relationships (bet nurse-pt, nurse-nurse etc etc)

Question 11

what are the 3 levels of moral response to ethical problems

Answer 11

• Expressive level-mgiht just state how we feel without rationale for those beliefs eg “Im against euthanasia bcuz killing is worng”
• Prereflective level –justify response w legal religious or professional norms without critically reflecting on those norms eg I oppose euthanasia cuz of professional duty to do no harm
• reflective level-justification for our position is based on principles or values weve reflected on and make decision to use s basis for our stance eg i oppose euthanasia as the sactit of life and do no harm taes precedence over autonomy. Reasoning at this level doesn’t guarantee easier resolution o agreement but it does provide more opportunity for discussion

Question 12

what are the two theories discussed in applied ethics

Answer 12

deontology and conseuentialism

Question 13

what is deontological ethic

Answer 13

• Deontological ethics-mostly involves duties to others.
o Consistency and following thru on duties to others makes actions morally right eg truth telling is absolute duty from respect of persons

Question 14

what are 3 challenges to deontology

Answer 14

 Often hard to see what duties are
 Oftenf ace multiple competeing duties w no advice on how to balance them
 To just pay attention to duties nd not consider the outcomes or consequences is in real life irresponsible and difficult

Question 15

what is consequentialism

Answer 15

• Consequentialist theories-rightness or wrongness of action is determined by outcomes of the action

Question 16

what is the most common theory under consequentialism

Answer 16

utilitarianism

Question 17

what is utilitarianism

Answer 17

what is the most common theory under consequentialism

Question 18

3 challenges to utilitrianism

Answer 18

 We cant predict outcomes well
 Meas abstract ideas like happiness is hard
 Matter of perspective whats good or bad

Question 19

as a response to the criticisms of these ethical theories ( therye hard to apply in reality, lack guidance of what principles to use for decisions)

what was devised and what is included in this

Answer 19

principlism

4 principles to guide healthcare as response to criticism: autonomy, beneficence, nonmaleficence and justice

Question 20

what errors do new earners often make with principlism

Answer 20

• Its easy to use but new learners often apply it pragmatically and inflexibly

Question 21

what is the criticism of principlism

Answer 21

limiting to think of ethical probs just w 4 principles. It also less applicable in other contexts (non-western)

Question 22

what outlines expectations of ethical practice

Answer 22

code of ethics

Question 23

who enforces a code of ethics

Answer 23

• Code cant be enforced by courts but profesion has legal right to sanction those who dont adhere to ethical duties

Question 24

who would sit on a provincial regulatory body committee

Answer 24

lay people and nurses

Question 25

what are the 3 legal obligations of nurses

Answer 25

o To have knowledge of legal boundaries of their jobs o To protect pt rights o Protect themselves from liability

Question 26

what is a fiduciary duty

Answer 26

-a trust based duty. Nurse must give reasonable/competent std of care.

Question 27

if in a fiduciary role are you allowed to place your own needs first

Answer 27

no

Question 28

in relation to professional competence when violating the following: professional misconduct, negligence, duty of care what is it called

Answer 28

unintentional torts

Question 29

what is a tort

Answer 29

o A tort is an act of wrongdoing that leads to harm or injury. After, the injured party makes claim for damages to deter future similar wrongs

Question 30

what are examples of intentional torts

Answer 30

battery, invasion of privacy, assault

Question 31

what are the 2 kind of unintentional torts

Answer 31

negligence-when any Tx or care is obviously below acceptable level and results in injury to pt liability (dictionary defn, being responsible for sometihng)

Question 32

what is a duty of care and what happens when this isnt met

Answer 32

obligation not to harm un or intentionally. If don’t meet this and injury results this is negligence and professional misconduct

Question 33

what 4 things are required for case of negligence

Answer 33

1. Duty of care must exist 2. Duty of are must be breached thru actions/conduct 3. Must be resultant injury/harm 4. Must be evident that harm/injury resulted directly from person w duty to care

Question 34

with unintentional negligence is the focus on punishment of the perp or on compensation

Answer 34

fous on compensation for injury

Question 35

what is moral distress and is it only caused by institutional constraints

Answer 35

• Moral distress-knowing right thing to do but unable to do it. If unaddressed can lead to moral residue the remains of unhealed moral wounds which build over time -can also be caused by issues n the moral agent (lac of knowledge etc)

Question 36

what is moral integrity

Answer 36

• Integrity often describe a person of good moral standing but can also mean wholeness completeness and being morally intact

Question 37

4 necessary elements of moral integrity

Answer 37

moral autonomy -fidelity to promise -steadfastness wholeness

Question 38

moral autonomy

Answer 38

1. . Moral autonomy  Our developing sense of who we are in r/t the values we hold. When young our parents have moral authority over us and our values are det by surroundings eg socioecon, culture, friends. With age we find our own ideas and take responsibility for them. W inc moral autonomy is inc integrity

Question 39

fidelity to promise

Answer 39

2. Fidelity to promise  2 aspect: making a promise and keeping it  Keeping a promise shows we abide by social norms, are trustworthy, reliable

Question 40

steadfastness

Answer 40

3. Steadfastness  Like sticking to moral guns  Often ongoing development of this as we lern to stand up for what we think is right  Eg of this: questioning order of futile Tx, student nurse telling nurses not to talk of pts in public, advocating for marginalized pt and fighting the system

Question 41

wholeness

Answer 41

4. Wholeness  All nurses have multiple roles in lives and it can be hard to be morally consistent eg friendly w pt but rude w parents  Integrity requires that we try to incorporate our values and beliefs across the many roles in our lives

Question 42

having a poor ethical climate at work is linked to what for nurses

Answer 42

• Having a poor ethical climate

Question 43

how can moral leadership be demonstrated

Answer 43

with commitment and moral courage (in practice this means advocating for others despite pressures to act differently)

Question 44

can moral courage be taught

Answer 44

yes since its a virtue it can