Session 1 introduction to ethics converted
- 1. Introduction to Nursing Ethics Sohail Mohammad INS,KMU I
- 2. Objective Define key terms Discuss different concepts in ethics Discuss importance of ethics in nursing Identify key ethical principles Develop characteristics of a professional nurse.
- 3. Morals and Ethics Morals: is similar to ethics and many people use the two wards interchangeably (closely associated with the concept of ethics) Derived from the Greek word “mores”, means custom or habit. Morals: are based on religious beliefs and social influence and group norms Morality: usually refers to an individual’s personal standards of what is right and wrong in conduct, character, and attitude. Its subjective and Abstract.
- 4. Morals and Ethics Ethics is a branch of philosophy (the study of beliefs and assumptions) referred to as moral philosophy. Derived from the Greek word “ethos” which means customs, habitual usage, conduct and character. Ethics: usually refers to the practices, beliefs, and standards of behavior of a particular group such as nurses. It also refers to the method of inquiry that deals with conduct which is the guiding principles for good or bad. Its tangible , principle and standard. Its objective.
- 5. In ethics, value denotes the degree of importance of some thing or action, with the aim of determining what actions are best to do or what way is best to live, or to describe the significance of different actions. Principles or standards of behavior; one's judgment of what is important in life. "they internalize their parents' rules and values“ The value is a personal belief about the worth you hold for an idea, a custom, or an object. I value freedom of speech, I value my family Value
- 6. NURSING ETHICAL VALUES The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency.
- 7. Value Beliefs. Beliefs are opinion , interpretation or conclusions that people accept as true ( may it not be true) I believe if I study hard I will get a good grade Attitude Mental position or feelings towards a person , object or idea (compassion , acceptance) such as some clients may feel strongly about their need of privacy, where as others may dismiss it as unimportant.
- 8. Ethical dilemmas Ethical dilemmas, also known as a moral dilemmas, are a situations in which there is a choice to be made between two options, neither of which resolves the situation in an ethically acceptable fashion. ➢ Don’t resuscitate (DNR) ➢Euthanasia or Irreversible coma ➢Treatment of terminally ill patient like end stage Cancer, HIV etc.
- 9. Ethical dilemmas A decision that should "taken in one’s self interest, but which appears to violate a moral principle that you support. It is the imperative to act, combined with the uncertainty of which action to take, that causes a dilemma Doing morally right Doing morally wrong Bad outcome Good outcome In such a dilemma, choosing one moral will result in violating another; or, doing one thing could bring positive results but is morally wrong. A common example is “stealing from the rich to feed the poor.”
- 10. Ethical Dilemmas in Nursing • The challenge of decision making . • The quantity of life vs the quality of life. • Truth-telling A code of ethics in nursing basically states that nurses are responsible for respecting human rights and treating all patients with respect while promoting health, minimizing suffering, and preventing sickness.
- 11. Common Nursing Ethics Dilemmas 1. Informed consent Concerns that patients / subjects and their families have not been fully informed about their treatments or clinical prognosis is a common ethical concern of nurses, 2. Disclosing medical conditions/Confidentiality “Sometimes families request that patients not be told about their medical condition or diagnosis. “The nurse must consider the patient's right to know. How does the nurse know what the family is saying is true?” (Altman) 3.Negligence occurs when a person fails to perform according to the standards of care. It is the responsibility of the nurse to monitor the patient.
- 12. Cont: 4. Incompetence among peers • Another dilemma when a nurse notes incompetence in a fellow health care team member and struggles with speaking up or staying silent, such as protecting the patient on one hand and protecting the staff on the other. The principles to consider are nonmaleficence and fidelity. Example: it is the duty of a nurse to provide safe and competent care to the patients.
- 14. Dimension of Ethics Meta-Ethics We may define metaethics as the study of the origin and meaning of ethical concepts. Prescriptive Ethics (Normative Ethics) – which is again divided into Deontological Ethics, Teleological Ethics, and Virtue Ethics. What is wrong and right. Descriptive Ethics (Comparative Ethics) Applied Ethics – again divided into Bio-ethics, Cyber Ethics, Environmental Ethics, Personal Ethics, Professional Ethics, Public Ethics, International Ethics and so on.
- 15. Meta Ethics We may define meta ethics as the study of the origin and meaning of ethical concepts. Deals with question like ‘what is meant by being right?’ OR ▪‘What is meant by being wrong?’ ▪Deals with the definition of right and wrong. ▪Meta means about the thing itself. ▪So Meta-Ethics (Ethics about Ethics) that explore the status, foundation, and scope of moral values, properties and words.
- 16. Prescriptive Ethics (Normative Ethics) Prescriptive ethics explained as hat action is right or wrong. More practical task. Deontology: focus on action and duty Teleological : focus on out come. Utilitarianism - John Stuart Mill. ◦ Most prominent consequence-based theory. Principle of utility(what action has the greatest utility - use/benefit/positive outcome) is a type of consequentialism ◦Greatest happiness for the greatest number
- 17. Cont: Virtue Ethics: Moral or good characteristics of a person carrying out an action (honesty, courage, fairness). The Golden Rule is a classic example of a normative principle: We should do to others what we would want others to do to us.
- 18. Descriptive ethics What society think about right and wrong. People believe about morality . How many among you think that it is wrong to kill a person. Descriptive ethics studies the history of evolution of ethics. it gives a record of certain taboos, customs or conventions. for example it states the history of various institutions like family or marriage .
- 19. Applied Ethics Applied ethics refers to the practical application of moral considerations. It is ethics with respect to real-world actions and their moral considerations in the areas of private and public life, the professions, health, technology, law, and leadership. For example, the bioethics community is concerned with identifying the correct approach to moral issues in the life sciences, such as euthanasia, the allocation of scarce health resources, or the use of human embryos in research.
- 20. Why Ethics in Nursing?? Provides ◦ A frame of reference for decision making and action to be taken in a complex situation. ◦ With the rules and principles to ethical decision making. ◦ A base for regulating the relationship between nurse, patient, coworkers, society and profession. e.g. Dilemma, Abortion, Euthanasia.. etc It gives us standards of practice and profession.
- 21. Cont: ➢ Promotes the sense of fundamental responsibilities of nursing care as to promote health, to restore health, to prevent illness and to alleviate suffering. ➢ Promotes an environment in which the values, customs and religious believes are respected. ➢ Hold in confidence personal information and to use judgment in sharing this information where necessary.
- 22. Cont: ➢ Nurses frequently have to make difficult decisions for which there is not always a quick, easy or ‘correct’ answer Can Mrs X be discharged yet? Can Mr Y manage his own medications safely?
- 23. What is an ethical issue? When to judge what is right or wrong Choosing between options Deciding whether to do something or do nothing Should I or shouldn’t I? Weighing up the potential impact of your decisions or actions A dilemma – making a difficult choice
- 24. Ethical issues in health care Question to be asked ➢ Definition of life ➢ What is a person ➢ Quality of life, Prolonging life, Ending life. ➢ Human rights But day to day ethical issues can involve Respecting people Treating people with dignity Treating people fairly Supporting patient’s choices These ‘principles’ are encompassed in the NMC code The code is a useful source of ethical principles in health care
- 25. Characteristics of a Professional Nurse 25 ❖Maintain ethical standards in practice ❖Encourage peer to follow the same ❖Follows policies and procedures defined by the institution ❖Maintains ethical conduct ❖Responsible for their actions and safe enviroment
- 26. Discuss these subjects from all possible moral points of view. Abortion Genetic engineering. Animal rights. Plastic surgery for beauty Exercise for discussion
- 27. Ethical Principles Bioethicis often refer to the four basic principles of health care ethics when evaluating the merits and difficulties of medical procedures. Ideally, for a medical practice to be considered "ethical", it must respect all four principles: Autonomy Justice Beneficence Non-maleficence.
- 28. Autonomy Respect a person’s right to make their own decisions Teach people to be able to make their own choices Support people in their individual choices Do not force or coerce people to do things Informed Consent is an important outcome of this principle
- 29. Beneficence (to do good) Actions must aim to ‘benefit’ people – health, welfare, comfort, well- being, improve a person’s potential, improve quality of life Benefit should be defined by the person themselves. Act on behalf of ‘vulnerable’ people to protect their rights Prevent harm Create a safe and supportive environment Help people in crises
- 30. Non – Maleficence (to do no harm) DO NOT Cause pain or suffering Deprive someone of their legal capacity Cause offence/illegal or unlawfull act Deprive people Kill
- 31. Justice Treating people fairly Not favouring some individuals/groups over others Acting in a non–discriminatory / non-prejudicial way Respect for peoples rights Respect for the law
- 32. Four Rules of Ethical Decision-Making Utilitarian Rule: An ethical decision should produce the greatest good for the greatest number of people. Moral Rights Rule: An ethical decision should maintain and protect the fundamental rights and privileges of people. Justice Rule: An ethical decision should distribute benefits and harm among people in a fair, equitable, and impartial manner. Practical Rule: An ethical decision shouldbe one that a manger has no hesitation about communicating to people outside of the company because the typical person in a society would think the decision is acceptable.