ethics for nurses

ETHICS For NURSES : 

ETHICS For NURSES BY ROSEMARY PALMER RN, RM, BSc Hons(Sport Science & Administration), ADM

ETHICS DEFINITIONS : 

ETHICS DEFINITIONS OBJECTIVISM/A division of REALISM:. accepting a situation as it is and being prepared to deal with it accordingly. The good of the society is more important than that of the individual. Permanent good over transitory good. Ethics are objective universals. Objects exist regardless of mind’s consciousness. HUMAN JUDGEMENT CREATES MORALITY Theories of REALISM ARE: Individualism Humanism Utilitarianism TELEOLOGY : = consequentialism informs the study of ethics Determinism Materialism Intuitionism

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SUBJECTIVISM/IDEALISM: contrasting with realism, objects of mind are held to be in some way dependent on the activity of the mind. Self is the basis of ethical decision making. HUMAN JUDGEMENT DISCOVERS MORALITY. Man is source of ethics, every person has equal importance.” I think therefore I am” Objects do not exist except in the mind. Theories of IDEALISM ARE: Justice Beneficience Non maleficence Fidelity Rights DEONTOLOGY= non-consequentialism Freedom of choice

Ethics definitions : 

Ethics definitions ETHICS: what you should be doing in a given situation. A system of moral standards guiding right & wrong. Guidelines only. ETHICAL DILEMMA: choice of two alternatives equally justifyable or there may be bad to get to good.

MORALS v ETHICS : 

MORALS v ETHICS Morals concerned with right or wrong behaviour in character and conduct within a society. A moral code =descriptively refers to codes of conduct, social mores –what is considered right or wrong only. Definitions of morality are based on value systems. Normative ethics = directly linked to right or wrong regardless of what specific individuals think. What should be done Descriptive ethics: what is actually done VALUE: ones judgment of what is important in life. A persons principles. Considered to be important or beneficial to that person. DOUBLE EFFECT: an action can have a good and a bad effect/ outcome. Must consider: act must be morally good/ neutral. Good effect must not be obtained via a bad effect. Good intent must be equal or greater than bad effect. Balance the effects. Can bad effect occur?

ETHICS COMMITTEE : 

ETHICS COMMITTEE Provide ethical consultation Facilitate education on clinical ethics Develop/ revise policies. GOALS: To promote the rights of the patient To promote shared decision making with client/ healthcare staff, be advocates To promote fair policies and procedures that maximize the achievement of good patient centred outcomes To enhance the ethical tenr of professionals and institutions

UN HUMAN RIGHTS CHARTER : 

UN HUMAN RIGHTS CHARTER All humans are born free & equal Everyone has the right to life, liberty and security Everyone is entitled to all the rights within this charter No one shall be held in slavery or servitude. No one shall be subjected to torture or degrading punishment Everyone has the right to recognition as a person before the law. All are equal before the law and entitled to equal protection before the law Everyone has a right to remedy if basic rights violated

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No one shall be subject to arbitary arrest or detention or exile Everyone is entitled to a full fair public hearing by an impartial tribunal to determine his rights, obligations and if there are any criminal charges against him. Innocent until proved guilty. No one can be held guilty for something that is not an offence under national / international law (unconstitutional laws) No interference with privacy, family, home, honour, reputation. Right to protection against interference. Right to freedom of movement within own country and right to leave and come back to own country. Right to seek asylum in another country to get away from persecution

UN charter : 

UN charter Everyone has the right to nationality and can change nationality Right to marry and have family. Men & women entitled to equal rights in marriage and its dissolution. Marriage is by mutual consent. Family is entitled to state and society protection Everyone ha the right to own property. No one shall be arbitarily deprived of property

UN charter : 

UN charter Everyone has the right to freedom of though, conscience and religion Everyone has he right to peaceful assembly and association. No one is compelled to join an association. Everyone has the right to take part in government, to access to public service. The will of the people shall be the basis of government expressed in periodic genuine elections Everyone has the right to social security Everyone has the right to work, to have freedom in choice of work and get equal pay for equal work. Everyone has the right to equitable pay and to join a union Everyone has the right to rest and leisure including limits to working hours and holiday with pay.

UN charter : 

UN charter Everyone has the right to standards of living adequate for health and wellbeing of self and family –food clothing housing medical care social services security. Motherhood and childhood require special care & assistance. All children must have equal social protection whether illegitimate or not. Everyone is entitled to education, free in primary school and shall be compulsory in primary school. Other higher education shall be available and accessible. Parents have the right to choose the type of education for their children Everyone has duties to his/ her community. Laws must be obeyed but they must be just and democratic. Private acts that violate public interest are unconstiutional No state individual or group shall act to destroy the Charter rights or freedoms

ETHICS branches : 

ETHICS branches NORMATIVE: ‘ theory’ (prescriptive. Recommendations for behaviour. The practical means of determining the course of action. Philosophers view =what we should do in a situation. “who aught to …….” –nursing Qualitative. Branches of normative ethics are: Objectivism and Subjectivism Teleology = consequentialism. The ends matter Deontology= non- consequentialism. The actions matter DESCRIPTIVE: what we actually do. Observation of behaviour. “how to….” doctors. Quantitative. Value free What ethical codes applied to various groups.

ETHICAL THEORIES : 

ETHICAL THEORIES These do not solve ethical dilemmas but give guidelines on approach/ clarification UTILITARIANISM: the outcome of action, greatest amount of happiness for the most. Community orientated – each individual equal. EGOISM: a solution best for oneself. The client comes second. DEONTOLOGY :The nature of the act itself and the rules involved. Duty, obligation. “do unto others…” Nonconsequentialism FAIRNESS:= justice. Principles must apply to everyone. What if everyone complies? Must be publically recognised and generalisable to all. Opposite to Egoism

ETHICAL DILEMMA SOLUTION MODEL : 

ETHICAL DILEMMA SOLUTION MODEL Collect, analyse & interpret data on situation Make a clear statement of situation. STATE DILEMMA Consider options of choices of action Analyse advantages or disadvantages Make a decision. IT IS THE CLIENT & CLIENT FAMILY DECISION NOT YOURS as a nurse.

ETHICAL PRINCIPLES - Thiroux : 

ETHICAL PRINCIPLES - Thiroux The value of life – abortion, euthanasia, killing in self- defence, war, capital punishment, suicide. Quantity of life more important than quality. Goodness or rightness: life, consciousness, truth, knowledge, beauty, self expression. Good must be in relation to other human beings e.g. sadists ‘good’ different from nuns ‘good. prevent ba

THIROIX cont : 

THIROIX cont JUSTICE or fairness: e.g should donor kidneys only go to ‘good’ people? HONESTY and truth telling: communication vital so it must be trusted. One speaks one hears. What is heard and perceived is important. Body language is also communication. Tell it at the right time and right circumstances, truth is not just a statement. INDIVIDUAL FREEDOM: up to individual to express the above principles and consequences for themselves. Freedom to act morally.

ETHICAL PRINCIPLES: Gillon : 

ETHICAL PRINCIPLES: Gillon Autonomy : of action, will & thought. Beneficience: often do harm in order to get good results Non-maleficience: do minimal harm to get good. (see double effect) Justice Respect for persons: desire to avoid suffering what is a person? when is someone not a person?

ETHICAL PRINCIPLES: GILLON : 

ETHICAL PRINCIPLES: GILLON Autonomy : of action, will & thought. Beneficience: often do harm in order to get good results Non-maleficience: do minimal harm to get good. (see ethical dilemma model) Justice in ethics: equal human rights, man discovers rights that are applicable to all. Man source of ethics. Everyone has a right to be happy. Respect for persons: desire to avoid suffering what is a person? when is someone not a person?