Ch. 44 Ethics & Values

The ability of nurses to base their practice on professional standards of ethical conduct and to participate in ethical decision making is known as which of the following? 1) Ethical agency 2) Attitudes 3) Belief 4) Value neutrality

1) Ethical agency

A pregnant adolescent is in hypertensive crisis, and will likely die unless the obstetrician performs surgery to deliver the baby immediately. However, the baby is not mature enough to survive outside the uterus. The obstetrician believes that there is no good choice: either he risks harm to the mother or harm to the baby. This situation describes which of the following? 1) Ethical dilemma 2) Moral distress 3) Whistleblowing 4) Values conflict

1) Ethical dilemma

Which of the following terms refers to the ethical questions that arise out of nursing practice? 1) Nursing ethics 2) Bioethics 3) Ethical dilemma 4) Moral distress

1) Nursing ethics

A physician has requested privileges to admit and monitor patients at the community hospital. A license check by the hospital administrator reveals that there have been four successful lawsuits against the physician for unsafe medical practice. The hospital ethics committee will meet to discuss granting privileges to him. Which of the following models will the ethics committee most likely follow as they review the physician's case? 1) Social justice 2) Patient benefit 3) Autonomy 4) Privilege to practice

1) Social justice

A 45-year-old patient is ventilator dependent after a high cervical neck injury. He is alert and oriented and, after giving it much thought, has decided that he wants to be removed from the ventilator. The nurse believes the patient intends suicide, but supports his final decision. When the ventilator is removed, the nurse remains with the patient to support him. The nurse's action demonstrates respect for what moral principle? 1) Nonmaleficence 2) Autonomy 3) Beneficence 4) Fidelity

2) Autonomy

The healthcare team meets with the family of a man with documented brain death. They discuss discontinuing advanced life support, including mechanical ventilation. For several days, the wife of the patient has been agonizing over this decision. She says, "I don't know what to do. I know there is no hope for him, and it would be kind to let him go; but I just don't see how I can say goodbye forever." Which of the following nursing diagnoses should be used? 1) Moral Distress 2) Decisional Conflict 3) Death Anxiety 4) Spiritual Distress

2) Decisional Conflict

There has been an accident involving two busloads of school children. The accident victims have been transported to the local emergency department (ED). The ED nurse is triaging the children to determine who will receive treatment first. Which ethical framework does this process illustrate? 1) Teleology 2) Utilitarianism 3) Deontology 4) Categorical imperative

2) Utilitarianism

Which of the following consequentialist theories takes the position that the value of an action is determined by its usefulness? 1) Ethics of care 2) Utilitarianism 3) Deontology 4) Categorical imperative

2) Utilitarianism

Based on Gilligan's theory of moral development, compared with men, which of the following statements would a woman be more likely to use in ethical reasoning? "We shouldn't lie to the patient because 1) it is against agency policy." 2) the patient might lose trust in us." 3) lying disrespects the principle of veracity." 4) we might be sued by the patient."

2) the patient might lose trust in us

A 45-year-old patient is ventilator dependent after a high cervical neck injury. He is conscious and competent and has decided that he wants to be removed from the ventilator. His family and the multidisciplinary team agree. The nurse believes the patient intends suicide, and would prefer he choose differently, but says nothing. The nurse remains at the bedside holding the patient's hand. In this instance, the nurse is displaying which of the following? 1) Value set 2) Value system 3) Value neutrality 4) Value awareness

3) Value neutrality

A 77-year-old woman with an inoperable brain tumor has been hospitalized for the past 5 days. Her daughter comes to visit her. The patient has asked that her daughter not be told her diagnosis. After visiting with her mother, the daughter asks to speak to the nurse. She says, "My mother claims she has pneumonia, but I know she is not telling me the truth." The daughter asks the nurse to tell her what is truly wrong with her mother. The nurse should tell her that: 1) her mother has an inoperable brain tumor, but does not wish anyone to know. 2) she needs to speak to the physician in charge of her mother's care. 3) her mother has requested that her case not be discussed with anyone, not even family. 4) her mother is very sick with a serious case of pneumonia that could lead to death.

3) her mother has requested that her case not be discussed with anyone, not even family

What is the correct term for a belief about the worth of something that serves as a principle or a standard that influences decision making? 1) Morals 2) Attitudes 3) Beliefs 4) Values

4) Values

personal value system

A set of values that you have reflected on and chosen that will help you to lead a good life

ethical dilemma

A situation in which a choice must be made between two equally undesirable actions

Integrity

Acting in accordance with an appropriate code of ethics and accepted standards of practice. Includes honesty

Altruism

Concern for the welfare and well-being of others. Altruism is reflected by the nurse's concern for the welfare of patients, other nurses, and other healthcare providers. Includes patient advocacy

Ethics of Care

Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives

social justice model

Focuses more on broad social issues involving the entire institution, rather than on a single patient issue.

Human Dignity

Respect for the inherent worth and uniqueness of individuals and populations

Autonomy

The right to self-determination - to choose and act on that choice. Every competent person has the right to decide on his own course of action

Consequentialism

The rightness or wrongness of an action depends on the consequences of the act rather than on the act itself.

Social Justice

Upholding moral, legal, and humanistic principles. Treating others fairly regardless of race, age, citizenship, economic status, disability, or sexual orientation. This value is reflected in professional practice when the nurse works to ensure equal treatment under the law and equal access to quality healthcare

value neutrality

We attempt to understand our own values regarding an issue and to know when to put them aside, if necessary, to become nonjudgmental when providing care to clients.

Value

a belief about the worth or importance of something that acts as a standard to guide one's behavior

whistleblower

a person who reveals information about the practices of others that he reasonably believes is corruption; mismanagement; fraud; abuse; illegal; or harmful to the health, safety, and welfare of the general public

Moral agency/ethical agency

ability of nurses to base their practice on professional standards of ethical conduct and to participate in ethical decision making

deontology

based on rules and principles and uses the language of rights and duties

professional values

caring, autonomy, veracity, competence, justice

Moral behavior

consistent with customs or traditions based on external influence

Nonmaleficence

do no harm and to prevent harm

fidelity

duty to keep promises

veracity

duty to tell the truth

compensatory justice

focuses on making amends for wrongs that have been done to individuals or groups (i.e: malpractice lawsuits)

professional code of ethics

formal statements of a group's expectations and standards for professional behavior generally accepted by members of the profession

procedural justice

important in processes that require ranking or ordering

patient benefit model

is used for the incompetent patient by using substituted judgment (what the patient would want for himself if he were capable of making these issues known

autonomy model

is used when a patient is competent to decide and emphasizes patient autonomy and choice as the highest value

value set

list of values. gives direction for your life and forms a basis for behavior

attitudes

mental dispositions or feelings toward a person, object, or idea

justice

obligation to be fair

moral outrage

occurs when an individual witnesses the immoral act of another but feels powerless to stop it

impaired nursing practice

occurs when the nurse's ability to perform the essential functions of nursing is diminished by chemical dependence on drugs or alcohol or by mental illness

good compromise

one that preserves the integrity of all parties

Morals

private, personal, or group standards that consider in a broad, general manner what is good or bad, right or wrong

values clarification

process of becoming conscious of and naming one's values

Respect for dignity

refers to the nurse's respect for the intrinsic worth of each person, without respect to age, race, religion, medical condition, or any other factors

distributive justice

requires fair distribution of both benefits and burdens

belief

something that one accepts as true

Ethics

study of a system of moral principles and standards, or the process of using them to decide your conduct and actions

ethical framework

systems of thought that are the basis for the differing perspectives people have in ethical situations

moral distress

the anguish experienced when a person feels unable to act according to closely held core values

Beneficence

the duty to do or promote good

Utilitarianism

the value of an action is determined by its usefulness

Paternalism

treating others like children

value system

your value set ranked from most important value to least important value