Terms/Concepts to remember

Quiz#2
Autonomy:

(respect, free will independence)

Self-governing
The autonomous person is respected,
Is able to determine personal goals,
Able to decide on a plan,
Able to act upon their choices
o Value of autonomy is culturally dependent
o Respect for autonomy does not require respect for all autonomous
decisions
Respect the principle rather than each action or choice
Ex. Muslim women not allowed to speak without their husband
there

Informed consent:

legal protection of personal autonomy

Advocacy:

ensures the patients welfare and respects the patients

autonomy because it aims to act according to the patients values

Paternalism:

places power in the hands of the person who is making

the decision for the patient. Implies that the decision maker knows what is best

Beneficence:

(do good)
The act of doing good, preventing harm, removing evil/harm
o *Mrs. Pulito
Preventing harm
o Ask yourself: what instances might a nurse be compelled to prevent harm?
Maybe restraints with a patient- making sure there is no harm done
Remove evil/harm

Veracity:

(truth)
The practice of telling the truth
This is controversial at times
o Discussion: is there an acceptable situation for not telling the truth?
Veracity, confidentiality and privacy go hand in hand
Confidentiality requires information be kept private

o Limitations?
Mandatory reporting
Documents for court
Suicide risk

Non-maleficence:

(do no harm)
Related to beneficence (prevent harm/ do good)
Refrain from causing harm (do no harm) including:
o Harm that occurs during the performance of beneficial acts

Confidentiality:

Veracity, confidentiality and privacy go hand in hand

Confidentiality requires information be kept private
o Limitations?
Mandatory reporting
Documents for court
Suicide risk

Justice:

appropriate treatment in light of what is due or owed to persons

Fidelity:

faithfulness/promise keeping
o Nurses must faithfully
Uphold the professions code of ethics
Practice within established scope of practice (PA dept of state
website)
Practice competently
Keep promises to patients (Ill be back in 5 min)

Moral Dilemma:

a problem
Requires a choice between two equally unfavorable and mutually exclusive
options
i.e. it is morally right to preserve life however, many would agree that it is wrong
to prolong suffering
a moral dilemma occurs when solutions to a problem include conflicting moral
claims
Evidence indicates that an act is morally right and other evidence indicates that
the act is morally wrong, but no evidence is conclusive.
o Preserve life or end suffering in the Mrs. Pulito case- refer to week 3
One moral rule supports one course of action and another moral rule supports
another course of action, yet the two actions are mutually exclusive.

Moral Distress:

arises when one knows the right thing to do, but

institutional constraints make it nearly impossible to pursue the right course of action.
.. nurses participate in the action that they have judged to be morally wrong.
o Ex. Terminally ill patients wanting to participate in voluntary euthanasia.

More likely to occur in highly stressful situations or when dealing with more
vulnerable patients.
o Factors:
Ethical and working climate in the facility
Relationships- especially with physicians and role expectations
Stressors resulting from nursing shortage
Results in psychosocial, physical and emotional consequences for
nurses
When it occurs it is unfavorable for nurses and patients and can
have a long-term impact.
Ex. Pennsylvania has no patient to nurse ratio. This causes
stress to nurse and patient-patients may even complain of
nurse or hospital for a long time
Ex. Patient doesnt want to come see Dr. for a cold and
ends up with pneumonia. Patient didnt want to come to
hospital because of friends treatment or what they hear

Moral Reckoning:

encompasses moral distress and moral outrage

may last a lifetime

is a three-stage process- moral reckoning in nursing
o a stage of ease (becoming, professionalizing, institutionalizing [on the job,
diff. hospitals have different methods], working)
o a stage of resolution (giving up or make a stand)
o a stage of reflection (remembering, telling the story, examining conflicts,
living with consequences)

Accountability:

answerable for the actions- goes along with autonomy

Nursing Code:

Include ethical principles and expand with threads or themes

Throughout the code.
It addresses the nurses responsibility to participate in professions effort to implement and
improve nursing standards
a way to ensure accountability
Purpose is to protect the patient from harm and to allow the full benefits of patient care.

Nurse Practice Act:

considered a form of nursing standard

Foremost legal statute regulating nursing

o
o
o
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formulated by each state

protects the public
defines the boundaries of nursing practice
establishes standards for nurses
protects the domain of nursing
o each state independently develops, updates and interprets its own
practice act