Chapter 6 - Values Ethics and Advocacy

‭Common Modes of Value Transmission‬ ‭●‬ ‭Modeling: Children learn what is of high or low value by observing parents, peers, and‬ ‭significant others‬ ‭●‬ ‭Moralizing: Teaching a value system by parents or an institution‬ ‭○‬ ‭Allows little opportunity for them to weigh different values‬ ‭●‬ ‭Laissez-faire: Leaving children to explore and develop values on their own‬ ‭●‬ ‭Rewarding and punishing: Children are rewarded for demonstrating values held by‬ ‭parents and punishing for demonstrating unacceptable values‬ ‭●‬ ‭Responsible choice: Caregivers encourage children to explore competing values and to‬ ‭weight their consequences‬ ‭Three Main Activities of the Valuing Process‬ ‭●‬ ‭Choosing: Choosing freely from alternatives after careful consideration of the‬ ‭consequences of each‬ ‭●‬ ‭Prizing/treasuring: Involves pride, happiness, and public affirmation‬ ‭●‬ ‭Acting: Combining choice into one’s behavior with consistency and regularity on the‬ ‭value‬ ‭Professional Values‬ ‭●‬ ‭Altruism: Concern for welfare and well-being of others‬ ‭●‬ ‭Autonomy: Right to self-determination‬ ‭●‬ ‭Human dignity: Respect for inherent worth and uniqueness of individuals and‬ ‭populations‬ ‭●‬ ‭Integrity: Acting according to the code of ethics adn standards of practice‬ ‭●‬ ‭Social justice: Upholding moral, legal, and humanistic rights‬ ‭Two Categories of Action-Guiding Theories‬ ‭●‬ ‭Deontologic: An action is right or wrong independent of its consequences‬ ‭●‬ ‭Utilitarian: The rightness or wrongness of an action depends on its consequences‬ ‭Beauchamp and Childress’s Principle-Based Approach to Bioethics‬ ‭●‬ ‭Autonomy: Respect rights of patients to make heatlhcare deicsions‬ ‭●‬ ‭Nonmaleficence: Avoid causing harm‬ ‭●‬ ‭Beneficence: Benefit the patient‬ ‭●‬ ‭Justice: Give each his/her due and act fairly‬ ‭●‬ ‭Fidelity: Keep promises‬ ‭●‬ ‭Veracity, accountability, privacy, and confidentiality‬ ‭Characteristics of the Care-Based Approach to Bioethics‬ ‭●‬ ‭Centrality of the caring relationship‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭ romotion of dignity and respect for patients as people‬ P ‭Attention to the particulars of individual patients‬ ‭Cultivation of responsiveness to others‬ ‭Redefinition of fundamental moral skills to include virtues‬ ‭Seven Basic Tenets of Bill of Rights for RNs‬ ‭●‬ ‭Practice in a manner that fulfills obligations to society and to those receiving care‬ ‭●‬ ‭Practice in environments that allow them to act in accordance with professional standards‬ ‭and legally authorized scopes of practice‬ ‭●‬ ‭Work in an environment that supports and facilitates ethical practice, in accordance with‬ ‭the Code of Ethics for Nurses‬ ‭●‬ ‭Freely and openly advocate for themselves and their patients without fear of retribution‬ ‭●‬ ‭Receive fair compensation for their work consistent with their knowledge, experience,‬ ‭and professional responsibilities‬ ‭●‬ ‭Practice in a work environment that is safe for themselves and their patients‬ ‭●‬ ‭Negotiate the conditions of their employment, either as individuals or collectively, in all‬ ‭practice settings‬ ‭Ethical Experience and Decision Making/Ethical Problems‬ ‭●‬ ‭Ethical dilemma: Two (or more) clear moral principles apply but support mutually‬ ‭inconsistent courses of action‬ ‭●‬ ‭Ethical distress: Occurs when the nurse knows the right thing to do but either personal or‬ ‭institutional factors make it difficult to follow the correct course of action‬ ‭Using the Nursing Process to Make Ethical Decisions‬ ‭●‬ ‭Assess the situation (gather data)‬ ‭●‬ ‭Diagnose (identify) the ethical problem‬ ‭●‬ ‭Plan:‬ ‭○‬ ‭Identify options‬ ‭○‬ ‭Think ethical problem through‬ ‭○‬ ‭Make a decision‬ ‭●‬ ‭Implement decision‬ ‭●‬ ‭Evaluate decision‬ ‭Examples of Ethical Problems‬ ‭●‬ ‭Paternalism‬ ‭●‬ ‭Deception‬ ‭●‬ ‭Privacy‬ ‭●‬ ‭Confidentiality‬ ‭●‬ ‭Allocation of scarce nursing resources‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ alid consent or refusal‬ V ‭Conflicts concerning new technologies‬ ‭Unprofessional, incompetent, unethical, or illegal physician practice‬ ‭Unprofessional, incompetent, unethical, or illegal nursing practice‬ ‭Short staffing‬ ‭Beginning of life issues‬ ‭End-of-life issues‬ ‭Four Functions of Ethics Committees‬ ‭●‬ ‭Education‬ ‭●‬ ‭Policy making‬ ‭●‬ ‭Case review‬ ‭●‬ ‭Consultation‬ ‭●‬ ‭Occasionally research‬ ‭Areas of Concern for Patient Advocates‬ ‭●‬ ‭Representation of patients‬ ‭●‬ ‭Promotion self-determination‬ ‭●‬ ‭Whistle-blowing‬ ‭●‬ ‭Being politically active‬