Values, Ethics & Advocacy

feminist ethics

type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor

nonmaleficence

principle of avoiding evil

beneficence

principle of doing good

advocacy

protection and support of another's rights

d) Failure to reflect own values Explanation: Many role models fail to reflect on their own values and, as a result, model conflict and confusion.

A parent teaches his or her children not to drink and drive; however, the parent does drink and drive. This action causes a) Insecurity and lack of safety b) Disruption in consistency c) Conflict with society d) Failure to reflect own values

c) Autonomy Explanation: Autonomy essentially means independence and the ability to be self-directed.

A woman age 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle? a) Justice b) Nonmaleficence c) Autonomy d) Veracity

b) Standards of conduct Explanation: Ethics is the branch of philosophy dealing with standards of conduct and moral judgment.

Ethics is best defined as a) Basis for moral reasoning b) Standards of conduct c) Dealing with conflict d) Decision making

a) Integrity Explanation: The nurse is demonstrating integrity, which is defined as acting in accordance with an appropriate code of ethics and accepted standards of practice. Seeking to remedy errors made by self or others is an example of integrity. Altruism is a concern for the welfare and being of others. Social justice is upholding moral, legal, and humanistic principles. Human dignity is respect for the inherent worth and uniqueness of individuals and populations.

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which of the following professional values? a) Integrity b) Human dignity c) Altruism d) Social justice

d) The promotion of the dignity and respect of clients as people Explanation: The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of patients and people. The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences.

Which of the following is a characteristic of the care-based approach to bioethics? a) The need for an orientation toward service b) The need to emphasize the relevance of clinical experience c) The rightness or wrongness of an action is independent of its consequences d) The promotion of the dignity and respect of clients as people

d) Ethical practice requires a skill set that must be conscientiously learned and nurtured. Explanation: Ethical agency must be cultivated in the same way that nurses cultivate the ability to do the scientifically right thing in response to a physiologic alteration. It is inaccurate to assume that it will passively develop from the presence of other ethical practitioners, or from years of experience. It is not an innate characteristic of personality.

Which of the following statements best conveys the concept of ethical agency? a) A nurse's understanding and execution of ethical practice is primarily a result of increased years of experience. b) Individuals who enter the nursing profession often innately possess ethical characteristics. c) Ethical practice is best learned and fostered by surrounding oneself with people who exhibit ethical character. d) Ethical practice requires a skill set that must be conscientiously learned and nurtured.

ethical agency

the ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do

b) Fidelity Explanation: Fidelity is keeping one's promises and never abandoning a client entrusted to your care without first providing for the client's needs. Autonomy respects the rights of clients or their surrogates to make health care decisions. Nonmaleficence is avoiding causing harm. Justice involves giving each client his or her due and acting fairly.

A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the cliient that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? a) Nonmaleficence b) Fidelity c) Justice d) Autonomy

d) Nonmaleficence Explanation: Nonmaleficence is a principle of bioethics and is defined as the obligation to prevent harm. Advocacy, morals, and values are not principles of bioethics.

A home health nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm to the patient is acting in accord with which of the following, a principle of bioethics? a) Advocacy b) Values c) Morals d) Nonmaleficence

d) Protecting clients from a chemically impaired practitioner Explanation: Protecting clients from a chemically impaired practitioner is an appropriate example of nonmaleficence. Nonmaleficence means to avoid doing harm, to remove from harm, and to prevent harm. Performing dressing changes to promote wound healing, providing emotional support to clients who are anxious, and administering pain medications to a client in pain are examples of beneficence, which means doing or promoting good.

A nursing instructor is teaching a class about ethical principles to a group of nursing students. The instructor determines that the teaching was successful when the students give which of the following as an example of nonmaleficence? a) Performing dressing changes to promote wound healing b) Administering pain medications to a client in pain c) Providing emotional support to clients who are anxious d) Protecting clients from a chemically impaired practitioner

d) Laissez-faire Explanation: This situation demonstrates laissez-faire value transmission, which is characterized by allowing the adolescent to explore values on his own and the development of a personal value system. The laissez-faire approach involves little or no guidance and can lead to confusion and conflict. Through modeling, children learn which is of high or low value by observing parents, peers, and significant others. The moralizing mode of value transmission teaches a complete value system and allows little opportunity for the weighing of different values. Responsible choice encourages children to explore competing values and to weigh their consequences while support and guidance are offered.

A parent of a high school student age 17 years is allowing the child to make the decision on the college he will attend. When the child requests direction from the parent in making this decision, the parent responds by informing him that he will need to make this decision on his own. This is an example of which type of value transmission? a) Modeling b) Responsible choice c) Moralizing d) Laissez-faire

a) Delineates nurses' conduct and responsibilities Explanation: The ANA recently revised the Code of Ethics for Nurses that delineates the conduct and responsibilities expected of all nurses in their nursing practices.

What is the function of the American Nurses Association's Code of Ethics for Nurses? a) Delineates nurses' conduct and responsibilities b) Plays an important role in legal proceedings c) Serves as a guideline for all health care practice d) Serves to establish personal ethics for nurses

a) Deontologic Explanation: Deontologic frameworks emphasize roles or responsibilities that one is morally obligated to fulfill.

When a nurse refuses to compromise a client's right to privacy, even when the nurse is threatened, the nurse is expressing an ethical framework termed what? a) Deontologic b) Justice c) Nonmaleficence d) Utilitarian

b) Autonomy Explanation: Autonomy refers to self-rule, or self-determination; it respects the rights of patients or their surrogates to make health care decisions. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality is related to the concept of privacy. Nonmaleficence is the duty not to inflict harm, as well as to prevent and remove harm.

Which of the following ethical principles is related to the idea of self-determination? a) Confidentiality b) Autonomy c) Beneficence d) Nonmaleficence

paternalism

an action that is based on what a parent would do

deontologic

ethical system in which actions are right or wrong independent of the consequences they produce

bioethics

ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world

fidelity

keeping promises and commitment made to others

morals

like ethics, concerned with what constitutes right action; more informal and personal than the term ethics

ethical distress

occurrence 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

b) Respecting the client's desire to have the uncle make choices on her behalf Explanation: The right to self-determination (autonomy) means that it should never be forced on anyone. The client has the autonomous right to defer her decision-making to another individual if she freely chooses to do so.

A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. By which of the following is the client's right to self-determination best protected? a) Teaching the client about her right to autonomy b) Respecting the client's desire to have the uncle make choices on her behalf c) Revisiting the decision when the uncle is not present at the bedside d) Holding a family meeting and encouraging the client to speak on her own behalf

a) Respect for life Explanation: In this situation, the nurse values respect for life more important than anything else. Choice, accountability, and esthetics are not considered important in this situation. The nurse who values choice as most important would let the client decide whether she wants an abortion or not. The nurse who values accountability documents nursing care accurately and honestly. The nurse who adapts the environment so that it is pleasing to the client values esthetics.

A client with five children suspects that she is pregnant again. She is also going through a financial crisis and asks the nurse for a medicine to cause abortion. The nurse is under obligation to promote family planning but feels the need to save the unborn fetus. What value is the nurse considering more important? a) Respect for life b) Accountability c) Choice d) Esthetics

a) Refuse to administer pain medication as ordered. Explanation: The duty not to inflict harm, as well as prevent and remove harm, is termed nonmaleficence. Providing comfort measures for a terminally ill patient, assisting a patient with ADLs and providing information related to procedures would not be considered a contradiction to the nurse's duty of nonmaleficence.

A nurse has a duty of nonmaleficence. Which of the following would be considered a contradiction to that duty? a) Refuse to administer pain medication as ordered. b) Assist the patient with ADLs. c) Provide all information related to procedures. d) Provide comfort measures for a terminally ill patient.

b) Personal values Explanation: Personal values are ideas or beliefs a person considers important and feels strongly about.

A nurse is of the Catholic faith and votes pro-life. He is considered to have a) Personal morality b) Personal values c) Legal obligations d) Ethics

b) The nurse needs to be creative in integrating the technical and relational aspects of care Explanation: The nurse needs to be creative in integrating the technical and relational aspects of care. The current reimbursement system does not recognize the family's nontechnical value priorities. Nurses are expected to educate the family caregivers to conduct the skilled task where possible. In this case, the nurse can teach the family caregivers to inject insulin. Family caregivers can be perceived to be nonsupportive of good care if the families do not follow through.

A nurse is providing home-care to a client with a diabetic foot ulcer who needs daily insulin injections. The family caregivers do not possess the technical skill to inject insulin. Which of the following should the nurse keep in mind? a) Family caregivers are always perceived to be supportive of good care b) The nurse needs to be creative in integrating the technical and relational aspects of care c) Nurses should avoid asking the family caregivers to conduct the skilled task d) The current reimbursement system recognizes the family's nontechnical value priorities

nursing ethics

a subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgement

utilitarian

action-guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action

principle-based approach

an approach to bioethics that offers specific action guides

care-based approach

approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative

clinical ethics

branch of bioethics concerned with ethical problems that arise within the context of caring for patients

value system

organization of values ranked along a continuum of importance

code of ethics

principles that reflect the primary goals, values, and obligations of the profession

autonomy

self-determination; being independent and self-governing

value

set of beliefs that are meaningful in life and that influence relationships with others

ethical dilemma

situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action

ethics

system dealing with standards of character and behavior related to what is right and wrong