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Ethical Issues in Patient Care

Definitions
Motacki Chapter 8
Beneficence-duty to do good to

Definitions

others; not just an attempt to avoid harm IRB-group formally designated to approve, monitor, and review biomedical and behavioral research involving humans Non-maleficence-principle of doing no harm; prohibits deliberate harm and weighs risks with benefits
Autonomy- self determination Ethics- science that deals with the

principles of right and wrong and good and bad; based on personal beliefs and values

Definitions
Justice- principle of fairness treat

Ethical decision making

all parties equally; individuals are given what they deserve or can legitimately claim Morality-in accordance with custom or tradition; usually reflects personal or religious beliefs

Required when there is an ethical

dilemma. Dilemma occur when there is a conflict between two or more ethical principles.

Common ethical principles include

Traditional Ethical Theories

beneficence, nomaleficence, justice, autonomy, fidelity, respect for others, veracity

Box 8-1 p. 103 Utilitarianism-the greatest good

ANAs code of Ethics for Nurses

for the greatest number of people Teleology (consequentialist theory)-value is determined by consequences (alls well that ends well) Deontology (formalism)-an act is good only if it springs from good will

Patient advocate is the primary

action 1. Practices with compassion and respect 2. is committed to the patient 3. promotes, advocates for and strives to protect the health, safety, and rights of the patient 4. responsible and accountable
5. duty to self 6. participates in establishing,

maintaining, and improving health care environments and conditions of employment 7. participates in the advancement of the profession 8. collaborates with other health professionals and the public 9. responsible for articulating values and maintaining integrity

International Code of Ethics for Nurses


Inherent: respect for human

rights, including the right to life, dignity, and to be treated with respect 1. people 2. practice 3. profession 4. coworkers
Specialty nursing organizations

and hospitals also have codes of ethical behavior Ethics Committees


Education Policy and guideline recommendations Case review

End of life/Organ donation


Advance Directives (living Will):

patients desires for care in certain situations are made known corneas, bone, kidney, heart, liver, pancreas. The greatest number of children who need organ donations are waiting for kidneys.

Organ donation list includes skin,

Futility of Care

DNR/AND (allow a natural death) Not receiving aggressive medical

treatment is not the same as withholding all medical care. Palliative care-helps the patient remain as comfortable as possible

Hospice care

Joint Commission: Patient rights and Organizational Ethics


Patients have a fundamental

right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values obligated to uphold the following patient rights to :

Hospitals are legally and ethically


Participate in treatment decisions Provide informed consent to treatment Receive considerate and respectful

care Review records Be informed of hospital policies Expect reasonable and appropriate continuity of care after hospitalization

Research
IRBdetermine that the rights and welfare of human subjects are protected Risks to subjects are outweighed by potential benefits Selection of subjects is equitable Informed consent will be obtained and documented

Review
NCLEX Questions, p. 110-111

Selected Case Reviews