Ethical Practice

Question 1

Ethical Principles

Answer 1

1. Autonomy: right to make one’s own decisions
   - A nurse is caring for a client who decides not to have surgery despite significant blockages in his
   coronary arteries. The nurse understands that this client’s choice is an example of autonomy.
2. Beneficence: the obligation to do good for others
   - A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse
   understands that this aspect of care delivery is an example of beneficence.
3. Confidentiality: The obligation to observe the privacy of another and maintain strict confidence
   - A nurse does not share the lab results to a family member who is calling to check in. This is an example of confidentiality.
4. Fidelity: The obligation to be faithful to agreements and responsibilities, to keep promises
   - a nurse who told their patient they were coming back in 30 minutes to check on their pain, would either come back, or delegate somebody else to come back if they got tied up is an example of fidelity.
5. Justice: The obligation to be fair to all people
   - A nurse is instructing a group of nursing students about the responsibilities involved with organ
   donation and procurement. When the nurse explains that all clients waiting for a kidney transplant have
   to meet the same qualifications, the students should understand that this aspect of care delivery is an
   example of justice.
6. non-maleficence: The obligation to not harm others
   - A nurse questions a medication prescription as too extreme in light of the client’s advanced age
   and unstable status. The nurse understands that this action is an example of non-maleficence.
7. Paternalism: Assuming the right to make decisions for another
   - A patient’s family does not know the patient’s end-of-life care preferences, but assumes that they know what is best for the patient under the circumstances. This assumption reflects paternalism
8. Advocacy: protecting the client and supporting the client’s decision
   - A patient receives an inaccurate diagnosis, unsafe accommodation, and unclear instructions for self-care. The nurse then alerts the doctor or medical facility and communicate the issue. This is an example of advocacy.
9. Veracity: To tell the truth and be honest
   - if a patient was starting chemotherapy and asked about the side effects, a nurse practicing veracity would be honest about the side effects they could expect with chemotherapy

Question 2

Advance Directives

Answer 2

1. Living will: legal document that allows the patient to instruct health care providers and family members what life-sustaining treatment they want if they are unable to make that decision at any point
2. Durable Power of Attorney: Legal document that allows the patient to designate another person to make decisions for the patient when they are unable to

Question 3

Informed Consent

Answer 3

• all information regarding the surgery or procedure to be performed
• consent is obtained only if the client understands the potential benefits and risks of the procedure, if not, nurse has to inform provider to explain it again, the nurse cannot do that
• nurse witnesses the client sign the consent