Chapter 5, 6, 7 (Taylor)

Beauchamp & Childress Principle-Based Approach to Bioethics

Autonomy: respect rights of patient to make health care decisions Nonmaleficence: avoiding causing harm Beneficence: benefit the patient Justice: give each his or her due and act fairly Fidelity: keep promise Veracity, accountability, privacy, confidentiality

Cultural imposition

Belief that everyone should conform to the majority belief system

intentional and unintentional torts

Intentional: Assault and battery Defamation of character Invasion of privacy False imprisonment Fraud Unintentional: Negligence Malpractice

Common Modes of Value Transmission

Modeling Moralizing Laissez-faire Rewarding and punishing Responsible choice

deontologic

an action is right or wrong independent of its consequences

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances?

The nurse is legally held to the same standards of care as when staffing levels are normal.

utalitarianism

The rightness or wrongness of the action depends on the consequences of the action

Patient's rights by HIPPA

To see and copy their health records To update their health records To request correction of any mistakes To get a list of the disclosures a health care institution has made independent or disclosure made for purposes of treatment, payment, and health care operations To request a restriction on certain uses of disclosures To choose how to receive health information

A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?

battery

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?

certification

A nurse is caring for a client with bacterial pneumonia and a temperature of 104°F (40.0°C). Yesterday, the client's temperature was 102°F (38.9°C). The health care provider on call prescribes cool compresses for the client to help lower the fever. The client insists that the nurse bring warm blankets because they will help the client to recover more quickly. The nurse recognizes that the client's request is an example of:

cultural ritual

Healthcare facilities that sponsor health promotion activities only in affluent areas are considered:

culturally blind

While caring for an infant, the nurse hears another child screaming in the next room and rushes there, forgetting to put the side rails up on the infant's crib. The nurse returns to the room to find that the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for?

malpractice

ethical distress

occurs when the nurse knows that right thing to do but either personal or institutional factors make it difficult to follow the correct course of action

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

paternalism

litigation

process of bringing and trying a lawsuit

Three Main Activities of the Valuing Process

• *Choosing* - Choosing freely from alternatives after careful consideration of the consequences of each alternative • *Prizing* (treasuring) - Involves pride, happiness, and public affirmation •*Acting* - Combining choice into one's behavior with consistency and regularity on the value

A nurse is asked to serve on an ethics committee. Which roles would the nurse be required to fill on the committee? Select all that apply.

Serving as a liaison between the family and the committee members Presenting explanations about technical terminology Advocating for the client's wishes

law

Standard or rule of conduct established and enforced by government Designed to protect the rights of the public

A legal document that states a client's health-related wishes — such as a preference for pain management if the client becomes terminally ill — and also allows the client's adult child to direct the client's care, is:

an advance directive

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

autonomy

A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case?

the agency's risk manager

function of ethical committees

Education Policy making Case review Consultation Occasionally research

ethical dilemma

two or more clear moral principles apply but support mutually inconsistent courses of action

An older female client has just informed her family that she does not want to have surgery if the biopsy on a lung mass shows malignancy. Which statement(s), made by family members, violate the concept of feminist ethics? Select all that apply.

"Of course you would have the surgery." "Daddy will want you to have the surgery." "You need to do what the doctor thinks is best for you." "If it was me who was sick, you would want me to have the surgery."

professional values

Altruism: concern for welfare and well-being of others Autonomy: right to self-determination Human dignity: respect for inherent worth and uniqueness of individuals and populations Integrity: acting according to code of ethics and standards of practice Social justice: upholding moral, legal, and human rights

sources of law

Constitutions: serves as guides to legislative bodies Statutory law: enacts by a legislative body Administrative law: empowered by executive officers Common law: judiciary system reconciles controversies, creates body of common law

criminal law: crime vs. tort

Crime: wrong against a person or the person's property as well as the public Misdemeanor: punishable by fines or less than 1-year imprisonment Felony: punishable by imprisonment for more than 1-year Tort: a wrong committed by a person against another person or that person's property; tried in civil court Intentional Unintentional

Which example most accurately depicts the ethical principle of autonomy?

Describing a surgery to a client before the consent is signed

informed consent elements

Disclosure Comprehension Competence voluntariness

elements of liability

Duty Breach of duty Causation Damages

Examples of ethical problems

Paternalism Deception Privacy Confidentiality Allocation of scarce nursing resources Valid consent or refusal Conflicts concerning new technologies Unprofessional, incompetent, unethical, or illegal physician practice Unprofessional, incompetent, unethical, or illegal nurse practice Short staffing and whistle-blowing Beginning-of-life issues End-of-life issues

types of law

Public law- government is directly involved Regulates relationships between individuals and government Private law- Civil law Regulates relationships among people Criminal law- concerns state and federal criminal statutes Defines criminal actions (e.g., murder, theft)

risk management programs

Safety program Products safety program Quality assurance programs