2M: ETHICS AND VALUES SYSTEM

Ethics

"ethos" a method of inquiry that helps people to understand the morality of human behavior (i.e., it is the study of morality), ´Practices or beliefs of a certain group ´ ´Expected standards of behavior of a group

Outward Autonomy

- Choices are not limited or imposed by others.

Inward Autonomy

- People have the ability to make choices.

Veracity

- Refers to telling the truth. Nurses must also have professional accountability and responsibility. According to the Code of Ethics for Nurses (Fowler, 2010)

Nonmaleficence

- The duty to "do no harm".

Deontology

- looks to the presence of principles regardless of outcome Examines a situation for the existence of essential right or wrong

CODE OF ETHICS FOR NURSES: FOUR PRINCIPAL ELEMENTS

1. Nurses and People 2. Nurses and Practice 3. Nurses and Profession 4. Nurses and Co-workers

1.Choosing (Cognitive) 1.Prizing (Affective) 1.Acting (Behavioral)

3 value clarification process

Altruism

A concern for the welfare and well-being of others. In professional practice, altruism is reflected by the nurse's concern for the welfare of patients, other nurses, and other health care providers.

VALUES CLARIFICATION

A process by which people identify (choosing), examine (prizing), and develop (acting) their own individual values. Promotes personal growth by fostering awareness, empathy, and insight.

Value Clarification

Analyzing one's own values to better understand these things that are truly important in life.

Accountability

Answerable to oneself and others for one's own actions.

Values

Are enduring beliefs or attitudes about the worth of a person, object, idea, or action. Can be learned through observation and experience. influence decisions and actions, including nurses' ethical decision making. Set of personal beliefs, attitudes about truth and beauty ´ Worth of any thought, object, or behavior Freely chosen Comes from the Latin word "Valere"

Attitudes

Are mental positions of feeling toward a person, object, or ideas (e.g. acceptance, compassion, openness) Are often judged as bad or good, positive or negative, whereas beliefs are judged as correct or incorrect.

MORAL PRINCIPLES

Are statements about broad, general, philosophical concepts such as autonomy and justice. They provide the foundation for moral rules, which are specific prescriptions for actions. Principles are useful in ethical discussions because even if people disagree about which action is right in a situation, they may be able to agree on the principles that apply. Such agreement can serve as the basis for a solution that is acceptable to all parties.

Accountability ✓ Confidentiality ✓ Veracity ✓ Fidelity ✓ Autonomy ✓ Beneficence ✓ Nonmaleficence ✓ Altruism ✓ Integrity ✓ Responsibility ✓ Respect for Person

BASIC VALUES FROM CODE OF ETHICS

altruism, autonomy, human dignity, integrity, social justice

CORE VALUES OF A NURSE

1. Individual's right to make decision for self. 2. Abortion 3. Passive and Active Euthanasia 4. Blood Transfusion 5. AIDS 6. Cultural Differences 7. Spiritual and Religious Differences

ETHICAL ISSUES IN THE FAMILY AND COMMUNITY

Uprightness

Ethically responsible

Bioethics

Ethics as applied to human life or health.

Feminist of Ethics

Focused on differences between genders, especially women's point of view, developed a critique of ethical philosophies called feminist ethics.

Justice

Frequently referred to as fairness. Nurses often face decisions in which a sense of justice should prevail.

Compassion and Courtesy

Holistic caring care Good manners

Culture - Society - Institutions - Personality

How Are Values Transmitted:

´Serves as "guiding star" which navigates our lives ´ ´Gives definite directions to one's life ´ ´It reflects a person's identity ´ ´Motivates behavior ´Gives meaning to life in fulfilling self-esteem and promotes self-actualization ´ ´Basis for individual's position on personal, professional, social, and philosophical issues ´ ´Shapes and determines an individual or group decision to like or dislike, favor, or disfavor, change or not change.

Importance of Values

GENERAL VALUES

Intrinsic and Extrinsic

Principles-based (deontological) theories

Involve logical and formal processes and emphasize individual rights, duties, and obligations. The morality of an action is determined not by its consequences but by whether it is done according to an impartial, objective principle.

Advocate

Is one who expresses and defends the cause of another.

Dedication and Discipline

Lifelong learner Social involvement Research productive

Beneficence

Means "doing good". Nurses are obligated to do good, that is, to implement actions that benefit clients and their support persons.

. Fidelity

Means to be faithful to agreements and promises.

MORAL FRAMEWORKS

Moral theories provide different frameworks through which nurses can view and clarify disturbing client care situations. Nurses can use moral theories in developing explanations for their ethical decisions and actions and in discussing problem situations with others.

Utilitarianism

One form of consequentialist theory, views a good act as one that is most useful - that is, one that brings the most good and the least harm to the greatest number of people.

´Value - Belief Pattern

Pattern of values, beliefs and goals that guides the client's choices or decisions

Value System

People organize their values internally along a continuum from most important to least important. Organization of a person's values along a continuum of relative importance.

Neatness

Personal cleanliness

Competence and Commitment

Professional competence Global mindset Technically experienced Team collaborator Effective communicator Critical thinker

Nursing Ethics

Refers to ethical issues that occur in nursing practice.

Autonomy

Refers to the right to make one's own decisions.

Responsibility

Refers to the specific accountability or liability associated with the performance of duties of a particular role.

Autonomy

Right to self-determination Being "assertive" nurse respects patients' rights to make decisions about their health care

Confidentiality

Safeguarding the clients right to privacy by protecting one's information.

Relationships-based (caring) theories

Stress courage, generosity, commitment, and the need to nurture and maintain relationships. Caring theories promote the common good or the welfare of the group. A moral framework guides moral decisions, but it does not determine the outcome.

Ethics of Care

Strives to address issues beyond individual caring occurs-structures such as hospitals or universities - Closely related to feminist ethics, both promote a philosophy that focuses on understanding relationships, especially personal narratives.

Utilitarianism

System of ethics proposes that the value of something is determined by its usefulness Measure the effect that action will have

The Surrogate Mother The Nurse as an Advocate

THE ROLE OF THE NURSE IN VALUES FORMATION AND ETHICAL ISSUES IN THE FAMILY AND COMMUNITY

Principle of Utility

The approach is often used in making decisions about the funding and delivery of health care.

Social Networking

The online presence of social networks presents ethical challenges for nurses. On one hand social networks can be a supportive source of information about patient care or professional nursing activities.

MORAL DEVELOPMENT

The process of learning to tell the difference between right and wrong and of learning what ought and ought not to be done. Complex process that begins in childhood and continues throughout life.

Casuistry (case-based reasoning)

Turns away from conventional principles of ethics as a way to determine best actions and focuses instead on an "intimate understanding of a particular situation" - This approach to ethical discourses depends on finding consensus more than an appeal to philosophical principle

Morals

Usually refers to private, personal standards of what is right and wrong in conduct, character, and attitude. What individuals would do to live together in society

1. List Alternatives 2. Examine possible consequences of choices 3. Choose freely 4. Feel good about the choice 5. Affirm the choice 6. Act on the choice 7. Act with a pattern

Ways on How to Help Clients Identify Values:

Ethical problems

are created as a result of changes in society, advances in technology, conflicts within nursing itself, and nurses' conflicting loyalties and obligations (e.g., to clients, families, employers, primary care providers, and other nurses).

Federal legislation

known as the Health Insurance Protocol and Accountability Act of 1996 (HIPAA) mandates confidentiality about the protection of patients' personal health information. - This legislation defines the rights and privileges of patients for protection and privacy.

Consequence-based (teleological) theories

look to the outcomes (consequences) of an action in judging whether that action is right or wrong

Latin word "Valere"

measure the worth of something.

1. Consequences 2. Principles and Duties 3. Relationships

moral theories

nurse-client relationship

nurses are the ones who are there to support and advocate for clients and families who are facing difficult choices, and for those who are living the results of choices that others make for and about them.

´Religion

´A person obtains strength from religious belief.

. Integrity

´Acting in accordance with an appropriate code of ethics and accepted standards of practice nurse is honest and provides care based on an ethical framework that is accepted within the profession.

´Purposive Behavior

´Actions that are performed on purpose with the intention of reaching a goal or to bring an important result.

Choosing (Cognitive)

´Beliefs are chosen freely among alternatives without pressure after reflecting and considering consequences

.Prizing (Affective)

´Chosen beliefs are cherished and prized

Acting (Behavioral)

´Chosen beliefs of a person are affirmed to others and incorporated, demonstrated consistently in one's life

Value Set

´Group of values a person holds

Theoretical

´Holds the truth, rationality, and empiricism in high esteem.

Personal Values

´Internalization and perception of values acquired ´Family Unity ´Self-Worth ´Religion ´Honesty ´Fairness ´Love

´Extrinsic

´It originates outside the individual (e.g. Health and Humanism)

´Value Transmission

´Process of acquiring values which usually occur in an unconscious level.

intrinsic

´Relates to the maintenance of life (e.g. Food and Water)

Human Dignity

´Respect for the inherent worth and uniqueness of individuals and population. ´Belief in the dignity and worth of each person nurse values and respects all patients and colleagues.

beliefs (or opinions)

´Something accepted as true by a judgment of probability rather than actuality. Interpretation or conclusion that people accept as true. Based on faith.

Value Formation

´The ability to identify strong feelings and act on them.

Social Justice

´Upholding moral, legal, and humanistic principles Is acting in accordance with fair treatment regardless of economic status, race, ethnicity, age, citizenship, disability, or sexual orientation.

Aesthetic

´Values on beauty, harmony, and form.

´Social

´Values on human interactions, kindness, sympathy, and unselfishness

Professional Values

´Values that are acquired during socialization in their respective professions

´Political

´Values that are placed in power

´Economic

´Values that focus on usefulness and practicality.