Module 2.01 ETHICAL DECISION MAKING PROCESS

Nursing Process

1. Assessment 2. Diagnosis 3. Planning 4. Interventions 5. Evaluation

Decision Making Process

1. Identify and clarify ethical problem 2. Gather factual data 3. Identify and evaluate options 4. Make a decision 5. Act and assess

Ethical decision making is influenced by what three perspectives?

Care, contextualism, and principlism Traditionally, three perspectives provide a foundation for and influence ethical thinking: principlism, care, and contextualism.

Three approaches:

Deontological: Duty-focused normative approach centered on rules from which all action is derived Teleological: Outcome-focused approach that places emphasis on results and protects the interest of the majority Situational: No prescribed rules, norms, or majority-focused results that must be followed

Which is not part of the ethical decision-making process in nursing?

Diagnose The ethical decision-making process involves resolving moral and ethical problems to create a workable environment. Diagnosis is a part of the nursing process and not a part of the ethical decision-making process.

The nurse knows that clients are receiving substandard care due to reductions in staffing. She reads current literature, looking for serious gaps in the accepted standards of practice, and examines the effects of the new staffing practice on ethical principles. Which step in the process for ethical decision making is the nurse using?

Evaluating the ethical problem Evaluating the ethical involves examining ethical norms by reviewing the literature, code of ethics for nursing, and moral traditions in the profession. Additionally, nurses identify guides for moral actions that are appropriate for the situation, examine the dilemma using ethical principles, and consider aspects that are unique to the dilemma.

Which actions represent steps in the ethical decision-making process for nurses? Select all that apply.

Evaluating the ethical problem Choosing and acting The steps in the ethical decision-making process include identifying the problem, identifying the morally relevant facts, evaluating the ethical problem, identifying and analyzing action alternatives, choosing and acting, and evaluating and modifying the plan.

Which ethical framework is based on the idea of analyzing situations using general norms derived from common morality?

Principlism The ethical framework of principlism is based on the idea of analyzing situations using general norms derived from common morality.

How many steps are there in the ethical decision-making process?

Six The steps in the ethical decision-making process include identifying the problem, identifying the morally relevant facts, evaluating the ethical problem, identifying and analyzing action alternatives, choosing and acting, and evaluating and modifying the plan.

Ethical Frameworks

Utilitarian: Provide the greatest good for the greatest number of people Rights based: Individuals have basic inherent rights that should not be interfered with Duty based: A duty to do something or to refrain from doing something Intuitionist: Each situation weighed on a case-by-case basis to determine relative goals, duties, and rights.

A nurse's ethical decision-making process has many pitfalls. An example of one of the pitfalls includes

arguing that because everybody does something, that something must be good. The pitfalls—or 'fallacies'—that nurses may encounter when using an ethical decision-making process include arguing that because everybody does something, that something must be good.

A 95-year-old client has been informed he has terminal brain cancer. The client states he wants to do everything possible to prolong his life because he owes it to his family. This is an example of:

deontology. Nurses engage in ethical decision making using the concepts of deontology (acting on the basis of moral duty and obligations), utilitarianism (acting to bring about the greatest good), or principlism (using duties, rights, and rules based on truth, laws, or doctrine) to navigate ethical challenges encountered in daily practice.

In ethical issues, the primary responsibility of the nurse in caring for the client is:

to always respect the person as a unified being. In dealing with each of these ethical issues, the primary responsibility of the nurse in caring for the client is always to respect the person as a unified being.