Elsevier Inc. items and derived items 2006 by Elsevier Inc. Slide 1 Ethics in Healthcare.

Elsevier Inc. items and derived items © 2006 by Elsevier Inc. Slide 1

Ethics in HealthcareEthics in Healthcare


Learning Objectives

• List four current ethical issues of concern in twenty-first century health care.

• Explain the differences among ethics, morals and values.(Cont'd…)


Learning Objectives(…Cont’d)

• Discuss how nonmaleficence is more complex than the definition of “do no harm.”


Ethical Issues in 21st Century Health Care

• in vitro fertilization• artificial insemination• surrogate motherhood• cloning• organ donation§ Including cadaver, child, and aborted fetus

donations• stem cell research/procedures

(Cont'd…)


Ethical Issues in 21st Century Health Care

(…Cont’d)

• abortion• euthanasia• assisted suicide• advance directives§ living wills, power of attorney

• right to die


Ethics, Morals, and Values

• Ethics—a system of standards or moral principles that directs actions as being right or wrong

• Morals—system dealing with right or wrong behavior (conduct) and character (will vary from person to person)

• Values—the worth a person assigns to an idea or action (will change as one moves through life)


Nursing Ethical and Legal Responsibilities

• Ethics: the values and principles governing practice, conduct, and relationships§ Responsibilities: focused on ideal behavior, morality,

and higher standards

• Legal aspects: state laws that apply to licensed persons and the situations in patient care that could result in legal action§ Responsibilities: focused on rules, regulations, and

obligations mandated by law


• See the patient as more than just a disease• Western Secular Belief System§ Individual autonomy: patient’s freedom to

choose§ Individual rights: patients rights are limited if

they clash with the health professional’s§ Belief systems and decision making will vary

from culture to culture and person to person


Principles of Ethics

• Nonmaleficence (Do No Harm): the principle of doing the least amount of harm possible to a patient

• Most beneficial treatments involve harming the patient to some extent

• Examples:§ skin puncture (you need the IV fluids, or the antibiotic

shot!)§ drug side effects (cost vs. benefit)§ physical manipulation (you have to reposition people

frequently… even if it causes pain while doing it)


Beneficence

• Two major duties associated with beneficence:§ Put patient interests first§ Place the good of patients before one’s own

needs• includes organizational and other work-related

needs


Autonomy (Free to Choose)

• Four steps of autonomous decisions:§ Thinking through all the facts § Deciding on the basis on an independent

thought process § Acting based on a personal decision§ Undertaking a decision voluntarily, without

pressure from anyone else

(Cont'd…)


Autonomy (Free to Choose)(…Cont’d)

• Patient’s right to privacy§ choose care based on personal beliefs§ accept or reject treatment§ avoid needless exposure

• Personal values may be contrary to medical ethics§ patient can refuse care for religious, cultural, or

personal reasons


Fidelity (Be True)

• Fidelity: Acting in patients’ best interests when they are unable to make free choices§ does not include resuscitation or paternalistic

decisions§ must differentiate between your own feelings

and those of the patient


Justice (Fair to All)

• Justice: give patients their due and treat each patient fairly and equally (i.e., with dignity and respect)

• avoid letting personal ethics and values interfere with patient justice


Beneficent Paternalism

• a disrespectful attitude toward the patient and his or her contribution to personal care and recovery§ “I know what’s best for you”§ discounts the patient’s self-knowledge§ often occurs with female patients in response to

female-specific health issues• Examples:§ deciding in advance that a patient fits into a certain

category§ developing a care plan without patient input§ influencing a patient’s choice

As You Read ....

• Pay attention to the following legal terms:• Tort, Assault and Battery, Negligence,

Malpractice, Defamation, False Imprisonment, Implicit Contract, Implied Contract, Expressed Contract, Durable Power of Attorney, Patient Self Determination Act

And the following Ethical Qualities:

• Freedom, Reliability, Equality, Respect, Truthfulness, Caring,

• And the following responsibilities:• Attitude, Authorization, Dependability,

Method, Qualification, Safety,

Elsevier Inc. items and derived items 2006 by Elsevier Inc. Slide 1 Ethics in Healthcare.

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