PROFESSIONAL NURSING ETHICS NURS 310

MRS. PRISCILLA ADUMOAH ATTAFUAH Nursing Department Valley View University Oyibi-Ghana

AGENDA
O Understanding the need to

consider ethics in human services O Introductory concepts O Distinction between these concepts

Introduction to ethics
O Our care for patients should be based on sound

judgement

(or evidence based practice!!)

O ..some of this judgement is about having a strong

sense of what is right or wrong

O ..having a strong sense of what we should be

doing and shouldnt be doing as nurses to be

O ..having a strong sense of what our priorities ought

As you deliver human services

O Situations will arise which you my be unsure about

the appropriate action to take

O You will be in ethical dilemmas

O Even though education and training in human services

that emphasize the values of confidentiality, acceptance, individualism, self determination, and tolerance situations will be inevitably occur in which simply possessing these values will not be enough to determine the right course of actions

O What is a profession? O What is nursing? O What are ethics? O What are values? O What are morals? O Differentiate between e,

v &m O What are professional ethics?

Profession- what it is.

"Profess": a public declaration, vow on entering a religious order. a commitment (vows) to serve for a good end. A narrow definition of professional is a selfregulating occupational group capable of legally prohibiting others from practising.

Profession and professionalism

O Nursing is a profession.
O A profession is a calling that requires special

knowledge and skilled preparation. A profession is generally distinguished from other kinds of occupation by: a) Its requirement of prolonged specialized training acquiring a body of knowledge pertinent to the role to be performed and b) An orientation of the individual to ward service, ether to community or organization.

Criteria of a profession
O Professional status is achieved when an occupation O O

involves practice, A profession carries great individual responsibility and based up on theoretical Knowledge. The privilege to practice is granted only after the individual was completed a standardized program of highly specialized education and has demonstrated an ability to meet the standards for practice. The body of specialized knowledge is continually developed and Evaluated through research. The members are self organized and collectively assume the responsibility of establishing standards for education and practice.

Comparison between Profession and Occupation

Occupation 1. Training may occur on job 2. Length of training varies 3. Value, beliefs and Ethics are not Prominent features of preparation 4. Commitment & personal identification are strong 5. Works are autonomous 6. People unlikely to change jobs 7. Accountability rests with Individual Profession Education takes place in College and university Education is definite and prolonged Value beliefs, and Ethics are integral part of preparation Commitment & personal Identification vary Works are supervised Peoples often change Jobs Accountability rests with employees

WHAT IS NURSING?
O Florence Nightingale defined nursing

over 100 years ago as "the act of utilizing the environment of the patient to assist him in his recovery( Nightingale,1860). O Nightingale considered a clean, wellventilated, and quiet environment essential for recovery.

NURSING Contd
O Virginia Henderson wrote. "The unique function

of the nurse is to assist he individual, sick or well, in the performance of those activities contributing to health or its recovery(or to peaceful death)that he would perform unaided if he had the necessary strength, will, or knowledge, and to do this is such a way as to help him gain independence as rapidly as possible"(Henderson,1966,p.3). O Like Nightingale, Henderson described nursing in relation to the client and the client's environment.

Ethics
O Ethics is the philosophical ideals of right and wrong

behaviour.The basic concepts and fundamental principles of right human conduct. O Ethics are standards of right and wrong, good and bad. They are concerned with what one has to do to fulfill ones moral duty. There are two aspects to ethics: 1. Being able to determine what is right or wrong, good or bad 2. Committing to doing what is right and good. The latter aspect means that being ethical is more than understanding what the right thing is to do; it means that one must do ethical actions . one must walk the talk.

4 Key Ethical Principles

Basic ethical concepts
O autonomy O beneficence

1.
2. 3. 4. 5. 6.

7.

Rights Autonomy Beneficence and Nonmaleficence Justice Fidelity Veracity The standard of best interest

O non-maleficence
O justice

4 ethical rules Veracity truth telling, informed consent, respect for autonomy Privacy a persons right to remain private, to not disclose information Confidentiality only sharing private information on a need to know basis Fidelity loyalty, maintaining the duty to care for all no matter who they are or what they may have done
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ETHICAL CONCEPTS
O Avoiding harm: this is perhaps the

O Autonomy and rights: to most basic and easily understood be autonomous is to be ethical concept and it underpins good self-determining, free healthcare practice. from the controlling O Moral obligations and duties: interference of others. identifying moral rules (that imply O Respect for autonomy is a ethical duties) can help in deciding on fundamental principle the right thing to do. For example, if ethically and legally that truth-telling is considered to be a influences healthcare rule actions can subsequently be decisions, such as those concerning informed determined by adherence to this rule. consent. What do we mean O Assessing the consequences of when we talk about rights? actions: it could be claimed that the Which, if any, rights do rightness of an action is determined we possess? most effectively by calculating its potential outcomes.

O Best interests: identifying

O Emotions, relationships

(and acting) in the best interests of others often provides ethical justification for an action or decision. O Values and beliefs: from these we formulate general ethical principles that provide guidance to ethical decisions and actions.

and context: is our ethical viewpoint affected if the matter concerns ourselves or those close to us? Do specific circumstances influence ethical decisions? O Moral character: is there such a thing as a good person? Is he or she more likely to know the right way to act?

MORALS
O Morals are values which we attribute to a system of

beliefs, typically a religious system, but it could be a political system of some other set of beliefs. O These values get their authority from something outside the individual- a higher being or higher authority (e.g. society). O By that definition one could categorize the values listed above (honesty, integrity, compassion ) as moral values - values derived from a higher authority.

Morals and Ethics

O Morals: is similar to ethics and many

people use the two wards interchangeably (closely associated with the concept of ethics) O Derived from the Latin mores, means custom or habit. O Morality: usually refers to an individuals personal standards of what is right and wrong in conduct, character, and attitude. O Morals: are based on religious beliefs and social influence and group norms
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Morals and Ethics (continued) O Ethics is a branch of philosophy (the study of beliefs and assumptions) referred to as moral philosophy. O Derived from the Greek word ethos which means customs, habitual usage, conduct and character. O Ethics: usually refers to the practices, beliefs, and standards of behavior of a particular group such as nurses. It also refers to the method of inquiry that assists people to understood the morality of human behavior (study of morality)
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Values
O Values are our fundamental beliefs. O They are our standards. They are the principles we use

to define what is right, good and just. O Values provide guidance as we determine the right versus the wrong, the good versus the bad. O Values are the social principles, ideals, or standards held by an individual, class, or group that give meaning and direction to life. Typical values include honesty, integrity, compassion, courage, honour, responsibility, patriotism, respect and fairness.

Professional values
O THESE are reflections of personal values.

They are acquired during socialization into nursing. Some of the important values of nursing are: Strong commitment to service Belief in the dignity and worth of each person Commitment to education Autonomy

Some values to consider when in a moral dilemma

1.
2. 3. 4. 5. 6.

Integrity Respect for persons Justice Compassion Beneficence and non-maleficence Responsibility

Ethical theories
1- Teleology 2- Deontology 3- Institutionism - summarized as the notion that people inherently know what is right or wrong; determining what is right is not a matter or rational thought or learning (e.g. the nurse inherently knows it is wrong to strike a client, the nurse does not need to be taught this or to reason it out) 4- Ethic of caring it is based on relationships. Caring is a force for protecting and enhancing client dignity Caring is of central importance in the client-nurse relationship (e.g. nurses use trust-telling to affirm clients as a persons rather than objects and to assist them to make choices and find meaning in their illness experiences)

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Two Major Types, Teleological And Deontological

O Utilitarian theories are teleological.
O In Greek, telos means goal or aim and

deon means duty. O In deontology, the emphasis on acts rather than (as in utilitarianism) on outcomes.

COMPARISON
O Deontology (Duty or O Teleology (utilitarian

rule-Based theory) O This theory proposes that the rightness or wrongness of an action depends on the nature of the act rather than its consequences. O The theory denotes that duties and rights are the correct measuring rods for evaluating action.

or end based theory) O This theory looks to the consequences of an action in judging whether that action is right or wrong. O According to the utilitarian school of thought right action is that which has greatest utility or usefulness.

Ethical theories..(continued)
Example: Teleology approach/abortion: saving the mothers life (the end, or consequence) justifies the abortion (the mean, or act) Deontology approach/abortion: consider any termination of life as a violation of the rule do not kill and therefore, would not abort the fetus, regardless of the consequences to the mother
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O You can have professional ethics, but you seldom hear

about professional morals. Ethics tend to be codified into a formal system or set of rules which are explicitly adopted by a group of people. O Thus you have medical ethics. Ethics are thus internally defined and adopted, whilst morals tend to be externally imposed on other people. O If you accuse someone of being unethical, it is equivalent of calling them unprofessional and may well be taken as a significant insult and perceived more personally than if you called them immoral (which of course they may also not like).

FIRST ASSIGNMENT

QUESTION
BOYE has been the nurse manager of a unit for the past five years and is highly regarded by the hospitals administration. For the past several months, however, he has been feeling less satisfied with his work because of staffing cuts and other institutional decisions. Providing quality nursing care has always been the most rewarding part of his job. However, recently he feels he is forced to attend more to the needs of the organization. He considers leaving, but he has good benefits in the organization and two children to support. 1. Identify values evident in this situation. Which of these reflect your personal values? 2. What conflicts might arise from these values? 3. If you were in Boyes position, what beliefs, ideals, or goals would guide you in making a decision to stay or leave? Identify potential consequences of each choice.

REFERENCES
O Brincat, C. A. and Wike, V.S. (2000), Morality
O

O O

and the Professional Life: Values at Work. Prentice Hall Inc. Woodside, M, and McClam, T. (2002). An introduction to human services. Belmont, CA: Brooks/Cole. http://www.businessdictionary.com/definition/e thics.html#ixzz2JUxDNnpD http://www.ncbi.nlm.nih.gov/pmc/articles/PMC 1625587/?page=1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC 1625587/?page=2