PN1001 – Session 4
Values
A strong personal belief
An ideal or standard that a person or group believes
has merit, which individuals and professions strive to
uphold
Reflect cultural and social influences, relationships,
and personal needs
Varies among people; develops and changes over
time
Value Formation
Family experience
Moral development
Cultural, ethnic, and religious communities (cultural
values)
Individual experiences
Ethics
Study of good conduct, character, and motives
Philosophical ideals of right and wrong
A reflection of what matters most to people or
professions
Nurses in Canada guided by the Canadian Nurses
Association’s Code of Ethics (2008)
Code of Ethics
Is a set of guiding principles accepted by all
members of a profession
Helps professional groups settle questions about
practice or behaviour
Includes responsibility, accountability, and advocacy
CNA Code of Ethics
Providing safe, compassionate, competent, and
ethical care
Promoting health and well-being
Promoting and respecting informed decision making
Preserving dignity
Maintaining privacy and confidentiality
Promoting justice
Being accountable
Ethical Theory
Deontology
Defines actions as right or wrong
Utilitarianism (consequentialism)
Proposes that the value of something is determined by its
usefulness
Bioethics
Obligation(-) and reason-based, outcome-oriented
Feminist ethics
Focuses on inequalities between people
Relational ethics
Emphasizes the importance of understanding relationships,
especially as they are revealed in personal narratives
Relational Ethics
“What should I do?” and “What should I do for
others?”
Core elements:
Engaged interactions
Mutual respect
Embodied knowledge
Uncertainty
Vulnerability
Interdependent environment
Bioethics
Autonomy
Justice
Beneficence
Nonmaleficence
Autonomy
Freedom and the right to choose what will happen to
one’s own person
Informed consent
Criticism: that autonomy can lead to a focus on the
rights of one at the expense of others; mitigated by
enactment of relational ethics
Best promoted through social change rather than
through protecting individual freedom of choice
Justice
The concept that everyone should be treated equally
and fairly
Moral justice
Distributive justice
Social justice
Beneficence
The concept that actions should do good
Reflected in provision of quality of care based on
competent, compassionate practice
Nonmaleficence
The concept that actions should do no harm
Reflected in practice, administration, education, and
research
Competent practitioners
Safe work environment
Ethical Dilemma
Step 1: Determine whether the issue is an ethical
dilemma.
Step 2: Gather all relevant information.
Step 3: Examine and determine your own values on
the issues.
Step 4: Verbalize the problem.
Step 5: Consider possible courses of action.
Step 6: Reflect on the outcome.
Step 7: Evaluate the action and the outcome.
Ethical Committee
Present in most health care organizations
Provides structure and guidance for clinical ethical
decisions and fulfill a patient advocacy role
Involved in conflict resolution
Provides ethical review of research proposals
Ethical Issues
Patient care issues
Informed consent
Futile care
Advance directives
Withdrawal of food and hydration
Issues of safety in the work environment
Review Question #1
The patient states that she needs to exercise regularly,
watch her weight, and reduce her fat intake. What
does this demonstrate about the patient?
1. She believes she will have a heart attack.
2. She values health promotion activities.
3. She believes she will not become sick.
4. She has unrealistic expectations for herself.
Review Question #2
Which one of the following is an example of ethical
responsibility?
1. Delivery of competent care
2. Formation of interpersonal relationships
3. Application of the nursing process
4. Evaluation of new computerized technologies
Review Question #3
The nurse stops at an accident scene to provide
emergency care to the victims. Ethically, how would
these actions best be labelled?
1. Respect for persons
2. Beneficence
3. Maleficence
4. Triage
Review Question #4
As the nurse prepares to take Mrs. Jones to the
operating room for surgery, Mrs. Jones states, “I wish I
knew what was going to happen to me when I am put
to sleep.” Which initial action by the nurse is most
appropriate?
1. Notify the physician.
2. Explain the procedure to the patient.
3. Ask the patient if she would like to postpone
surgery.
4. Document the comment on the patient’s chart.
Any Questions?
Ethical Practice
Values
Value Formation
Ethics
Code of Ethics
CNA Code of Ethics
Ethical Theory
Relational Ethics
Bioethics
Autonomy
Justice
Beneficence
Nonmaleficence
Ethical Dilemma
Ethical Committee
Ethical Issues
Review Question #1
Review Question #2
Review Question #3
Review Question #4
Any Questions?
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