Week 11/12

Question 1

What are ethics?

Answer 1

• Branch of philosophy
• Several subsets:
  a. descriptive-behavioural
  b. metaethics-right vs wrong
  c. normative-principles/rules
  d. applied-practical*

Question 2

Ethics vs mortality

Answer 2

• used interchangeably
• study of ethics
• impact of morality

Question 3

critically inquire and reflect about ethics

Answer 3

• What are your values and beliefs?
• How do you determine right and wrong?
• What are your implicit biases?
• How do you keep these in check?

Question 4

What is an ethical dilemma?

Answer 4

“Choice between two mutually exclusive courses of action, neither of which preferable nor unilaterally acceptable” (choices conflict and neither are perfect)

Question 5

Some factors that contribute to ethical dilemmas in nursing?

Answer 5

• Personal morals
• Age of the patient (e.g., pediatric consent 16yrs)
• Staffing
• Resources
• Social determinants of health
• Technology

Question 6

What is moral distress?

Answer 6

A “disconfirming experience that a nurse encounters when prevented from doing what they believe is right” (usually the effect/consequence of an ethical dilemma).

Question 7

What are everyday ethics?

Answer 7

“Day-to-day ethical choices of nurses that involve the development of moral perspectives and decisions that are made in relationship with patients, families, colleagues, communities, and the environment at large”

Question 8

Why are nursing ethics important?

Answer 8

1. self-responsibility of establishing values and beliefs
2. to guide reflection and decision making
3. to ensure ethical practice
4. commitment to doing good
   (up to you to ensure/regulate your ethical practice)

Question 9

What are normative ethics?

Answer 9

• Concerned with providing a moral framework
• Used to determine what actions are good and bad
• Three main traditions:
  a. virtue ethics
  b. demonology
  c. consequentialism

Question 10

What is virtue ethics?

Answer 10

• Focuses on the character of the person rather than the action
• Theorizes that the person completing a task must be good in order to maintain good moral and ethical behavior.

Question 11

What is Deontology

Answer 11

• Acts are intrinsically right or wrong and are the product of reason. (focuses on the act and not the person).

Question 12

What are consequentialism and utilitarianism?

Answer 12

• Moral status of an act is determined by its consequences or the end result and thus is future-oriented.
• Good for all. The greatest good for the greatest amount of people

Question 13

What is bioethics?

Answer 13

• Provides medicine with practical guidance in moral questions
  Six principles:
  1. autonomy
  2. beneficence
  3. nonmaleficence
  4. justice
  5. veracity
  6. fidelity

Question 14

Bioethics principles: Autonomy

Answer 14

• That a capable person has the right to act on their
  own accord
• Make informed decisions rather than being forced
• May be more influential in certain cultures where
  certain family roles are responsible for decision
  making

Question 15

Bioethics principles: Beneficence

Answer 15

• Obligation to act in the best interest of patient or to do good.
• The basis of nursing care

Question 16

Bioethics principles: nonmaleficence

Answer 16

TO DO NO HARM

Question 17

Bioethics principles: justice

Answer 17

• Fairness
• Distribution of benefits and burdens
• Impact of social justice and implicit bias
  (highly influenced by social norms, politically, socially, and culturally)

Question 18

Bioethics principles: Veracity

Answer 18

• Values of truth-telling as it relates to the autonomy
  of others.
• Informed decision making
  (want the full truth)

Question 19

bioethics principles: fidelity

Answer 19

• Maintaining promises and nurse-patient
  relationships
• Therapeutic relationships versus duty to report
• Climate of healthcare and demands on nurses
  (never say “I promise”)

Question 20

Feminist ethics

Answer 20

• Values social justice, collaboration community, and
  the uniqueness of person.
• Acknowledged power differentials

Question 21

Relational ethics

Answer 21

• Built upon feminist ethics
• Acknowledged interdependence of embodiment,
  mutuality, engagement, and noncoercion.

Question 22

Common situations with ethical dilemmas

Answer 22

• Mental health and consent
• Dementia and consent
• MAiD
• Polysubstance use and child health
• Age of pediatric consent
• Allocation of funding and resources
• Staffing levels and skill mix

Question 23

What does ethical care look like?

Answer 23

• Critical thinking
• Not black and white
• Looking at the whole picture
• Check-in on yourself
• Self-reflection
  THERE IS NO ONE PICTURE OF ETHICAL CARE

Question 24

What is the Canadian Nurses Association Code of Ethics?

Answer 24

“A statement of the ethical values of registered nurses and nurses licensed in extended roles, such as nurse practitioners. It demonstrates nurses’ commitment to persons with health-care needs and persons receiving care”

Question 25

What are the primary goals/values of the CNA code of ethics?

Answer 25

1. Accountability 2. Safe, competent, and ethical care 3. Health and well-being 4. Choice-informed decision making 5. Dignity 6. Privacy and confidentiality 7. Justice/social justice

Question 26

Why is ethics important?

Answer 26

It is about how we make decisions in ethical situations on a daily basis as well as in crisis situations.

Question 27

What does the most recent code of ethics focus on (2017)?

Answer 27

Focus on ethical care, promoting health and well-being, informed decisions making, preserving and maintaining dignity, privacy and confidentiality, justice, and being accountable to persons receiving care.

Question 28

Code of ethics and regulation

Answer 28

The code is to be used in conjunction with professional standards, laws, and regulations. Codes inform nurses, and the public of the ethical values and standards nurses are expected to uphold.

Question 29

Structure of the code

Answer 29

- Part 1: nursing values and ethical responsibilities (seven primary values with accompanying responsibility/value statement). - Part 2: ethical endeavors related to broad societal issues.

Question 30

What is confidentiality?

Answer 30

“The requirement or promise to maintain the privacy of any information provided and to prevent the unauthorized release of the information” (Code of Ethics - BCCNM Practice Standards - Legislation) - The ethical duty is to maintain the privacy and confidentiality of patients. Nurses are entrusted to maintain patient confidentiality.

Question 31

Read through the BCCNM confidentiality principles

Answer 31

slides 41-42 of week 11/12 PowerPoint

Question 32

Resources for decision making

Answer 32

1. Education on ethical frameworks and theories. 2. Mentorship 3. Ethical Dialogue 4. A strong moral culture

Question 33

Why acknowledge ethical challenges?

Answer 33

1. Nurse burnout 2. Decreased communication 3. Poor quality of patient care

Question 34

In summary, the role of a nurse is to?

Answer 34

1. Do no harm 2. Duty to report 3. Therapeutic relationships 4. Maintain privacy and confidentiality