Ethics, values and Legal Ethics, values and Legal Aspects of NursingAspects of Nursing

Ethics and values Ethics and values are part of nursing are part of nursing and nursing practice. Legal aspects of and nursing practice. Legal aspects of nursing focuses on the relationshipnursing focuses on the relationship between nursing practice and the lawbetween nursing practice and the law..AA s system of valued ystem of valued behaviors/beliefs that direct behaviors/beliefs that direct individual manner or behaviors individual manner or behaviors to protect individual rightsto protect individual rights . .

Ethics, values and Legal Aspects Ethics, values and Legal Aspects of Nursingof Nursing

Recent changesRecent changes in the provision of health in the provision of health care have made knowledge of this care have made knowledge of this relationship more important than before relationship more important than before and many topics are involved. and many topics are involved. These These topics include; topics include; nursing legislation, nursing legislation, standards of care, patient rights,informed standards of care, patient rights,informed consent, malpractice liability, patient consent, malpractice liability, patient safety, and documentation and safety, and documentation and confidentiality.  Every nurse should have confidentiality.  Every nurse should have a basic understanding of the lawa basic understanding of the law..

Definition of terminologyDefinition of terminologyValuesValues::

Personal belief about the worth of a Personal belief about the worth of a given idea, attitude, or objectgiven idea, attitude, or object

Personal valuesPersonal values:: Beliefs and ideas that form basis Beliefs and ideas that form basis

for behavior; moral & non-moral for behavior; moral & non-moral beliefsbeliefs

MoralsMorals :: Standards of right or wrong, how Standards of right or wrong, how

things get donthings get donee

Ethical Principles and Importance Ethical Principles and Importance to nursing practiceto nursing practice

AutonomyAutonomy –– individuals have the right to individuals have the right to determine own actions, make own decisionsdetermine own actions, make own decisions

BeneficenceBeneficence –– ““the doing of goodthe doing of good””, inflict , inflict no harmno harm

VeracityVeracity –– telling the truth. No deception telling the truth. No deception (trick)(trick)

FidelityFidelity –– faithfulness, Faithful to address faithfulness, Faithful to address ethical issues, practicing within scope of ethical issues, practicing within scope of nursing, Code of Ethics, keeping nursing, Code of Ethics, keeping commitments. Basis of nurse-patient commitments. Basis of nurse-patient

relationshiprelationship

LawsLaws:: Rules of social conduct devised to protect Rules of social conduct devised to protect

societysociety . .Nursing ethicsNursing ethics : :

Philosophical analysis of moral Philosophical analysis of moral phenomena in the practice of nursingphenomena in the practice of nursing

Code of EthicsCode of EthicsA written list of a professionA written list of a profession ’’s values and s values and

standards of conduct, it is also a standards of conduct, it is also a framework for decision making and framework for decision making and orientation towards day to day decision orientation towards day to day decision makingmaking

Purpose of the Code of Purpose of the Code of ethicsethics

Purpose of the Code of Purpose of the Code of ethics ethics 1-It gives guidance for decision- 1-It gives guidance for decision-making concerning ethical making concerning ethical matters, 3-serves as a means for matters, 3-serves as a means for self-evaluation and self-self-evaluation and self-reflection regarding ethical reflection regarding ethical nursing practice 4- and nursing practice 4- and provides a basis for feedback provides a basis for feedback andand

Foundation for ethical Foundation for ethical decision making in nursingdecision making in nursing

11--AdvocacyAdvocacy Active support of an Active support of an important causeimportant cause

Nurse as advocacy: defender Nurse as advocacy: defender patientpatient’’s rightss rights

Assistant to patient to make Assistant to patient to make decisions based on his/her values decisions based on his/her values and lifestyleand lifestyle

Accountability Accountability

AccountabilityAccountability health, prevent health, prevent illness and to alleviate suffering. illness and to alleviate suffering. CooperationCooperation Active participation with others Active participation with others

to obtain quality care for to obtain quality care for patientspatients

CaringCaring Kind nurse/patient relationshipKind nurse/patient relationship

EthicalEthical decision making decision making processprocess

11--CollectCollect, analyze, and interpret , analyze, and interpret data data (( (State the dilemma (State the dilemma

22 - -ConsiderConsider choices of action choices of action

33--AnalyzeAnalyze pros/cons of each pros/cons of each choice (what is for and what is choice (what is for and what is against)against)

44 - -MakeMake a decision about how a decision about how to resolve the dilemmato resolve the dilemma

Nursing Values and Nursing Values and Responsibility StatementsResponsibility Statements

Safe, Competent and Ethical Safe, Competent and Ethical CareCare

Nurses must strive for the highest quality in determining and expressing their own

moral choices

Safe, Competent and Ethical Safe, Competent and Ethical CareCare

- -Nurses should be Nurses should be sufficiently clear sufficiently clear and reflective about their personal and reflective about their personal values to recognize potential value values to recognize potential value

conflictsconflicts - -Nurses must Nurses must maintain an acceptable maintain an acceptable

level of health and well-beinglevel of health and well-being - - Nurses must base their practice on Nurses must base their practice on

relevant research findings and relevant research findings and acquire new skills and knowledge in acquire new skills and knowledge in their area of practice their careertheir area of practice their career . .

Nursing values and Health Nursing values and Health and Well-beingand Well-being

- - Nurses should respect and value the Nurses should respect and value the knowledge, skills and perspectives of knowledge, skills and perspectives of

the persons in theirthe persons in their - - Nurses must foster comfort and Nurses must foster comfort and

well-being when persons are well-being when persons are terminally ill and dyingterminally ill and dying

- - Nurses should recognize the need to Nurses should recognize the need to address organizational, social, address organizational, social, economic and political factors economic and political factors influencing healthinfluencing health

ChoiceChoice

Nurses respect Nurses respect and promote the and promote the autonomy of persons and help them autonomy of persons and help them to express their health needs and to express their health needs and values andvalues and

obtain desired obtain desired information and information and services so that they can make services so that they can make

informed decisionsinformed decisions . . Nurses must be Nurses must be committed to committed to

building trusting relationsbuilding trusting relations

ChoiceChoice

Nurses should Nurses should provide the desired provide the desired information and support required so information and support required so people are enabled to act on their people are enabled to act on their own behalf in meeting their healthown behalf in meeting their health

Nurses must Nurses must continue to provide continue to provide opportunities for people to make opportunities for people to make choices and maintain their capacity choices and maintain their capacity to make decisions, even when illness to make decisions, even when illness or other factorsor other factors

DignityDignity 11 - -Nurses recognize Nurses recognize and respect the and respect the

inherent worth of each person and advocate inherent worth of each person and advocate for respectful treatment of all personsfor respectful treatment of all persons

22--Nurses must be Nurses must be sensitive to an sensitive to an individual's needs, values and choicesindividual's needs, values and choices . .

33--Nurses must recognize the vulnerability of Nurses must recognize the vulnerability of personspersons

44--Nurses must respect Nurses must respect the physical privacy the physical privacy of persons when care is given, by providing of persons when care is given, by providing care in a discreet manner and by minimizingcare in a discreet manner and by minimizing

ConfidentialityConfidentiality

11 - -Nurses must respect Nurses must respect the right of the right of each person to informational privacyeach person to informational privacy

22 - -Nurses must protect the Nurses must protect the confidentiality of all information confidentiality of all information

gainedgained 33--Nurses must intervene Nurses must intervene if other if other

participants in the health care participants in the health care delivery system fail to maintain their delivery system fail to maintain their duty of confidentialityduty of confidentiality

ConfidentialityConfidentiality

44 - -Nurses should Nurses should inform the persons inform the persons in their care that their health in their care that their health information will be shared (informed information will be shared (informed consent)consent) . .

55--Nurses must Nurses must advocate for and advocate for and respect policies andrespect policies and

JusticeJustice NursesNurses uphold principles of equity uphold principles of equity

and fairness to assist persons in and fairness to assist persons in receiving a share of health services receiving a share of health services and resources proportionate to their and resources proportionate to their needs and promoting social justiceneeds and promoting social justice..

Nurses must Nurses must not discriminate in the not discriminate in the provision of nursing care based on a provision of nursing care based on a person's race, ethnicity, culture, person's race, ethnicity, culture, spiritual beliefs, social or marital spiritual beliefs, social or marital status, sex, sexual orientation, age, status, sex, sexual orientation, age, health status, lifestylehealth status, lifestyle , ,

JusticeJustice

Nurses should Nurses should be aware of be aware of broader health concerns such broader health concerns such

asas-: -: environmental pollutionenvironmental pollution,,

violations of human rightsviolations of human rights , , world hungerworld hunger

AccountabilityAccountability

11 - -Nurses are answerable for their Nurses are answerable for their practice, and they act in a manner practice, and they act in a manner consistent with their professional consistent with their professional responsibilities and standards of responsibilities and standards of

practicepractice 22 - -Nurses must respect and practice Nurses must respect and practice

according to the values and according to the values and responsibilities in this Code of Ethics responsibilities in this Code of Ethics for Registered Nursesfor Registered Nurses

AccountabilityAccountability33 - -Nurses, in clinicalNurses, in clinical, administrative, , administrative,

research or educational practice, research or educational practice, have professional responsibilities and have professional responsibilities and accountabilitiesaccountabilities

44 - -Nurse educatorsNurse educators, to the extent , to the extent possible, must ensure that students possible, must ensure that students will possess the required knowledge, will possess the required knowledge,

skills and competenciesskills and competencies

AccountabilityAccountability 55 - -Nurses should Nurses should advocate foradvocate for

discussion of ethical issues among discussion of ethical issues among healthhealth

team members, patients and team members, patients and familiesfamilies..

66 - -Nurses should Nurses should advocate for advocate for

changes to policy, legislation orchanges to policy, legislation or

Legal aspects of careLegal aspects of care Standards of CareStandards of Care

A standard of care tells us what a A standard of care tells us what a person should do. One standard of person should do. One standard of care can describe what you should docare can describe what you should do

Scope of PracticeScope of Practicethe the scope of practicescope of practice for nurses, for nurses,

doctors, nursing assistants and others. doctors, nursing assistants and others. They list what a person can and cannot They list what a person can and cannot do in the jobdo in the job egeg;;

a registered nurse's scope of practice a registered nurse's scope of practice may list that the nurse can give may list that the nurse can give medicinesmedicines..

MalpracticeMalpractice

A person who does not give care with A person who does not give care with same level of skill that they learned same level of skill that they learned e g:- e g:- when a nursing assistant when a nursing assistant does NOT wash their hands does NOT wash their hands between patients and some of between patients and some of the patients get a serious the patients get a serious infection, this nursing assistant infection, this nursing assistant can be found guilty of can be found guilty of malpracticemalpractice..

NegligenceNegligenceNegligenceNegligence is when a person does not is when a person does not

act the way they should. act the way they should. For exampleFor example, , a nursing assistant is negligent when a nursing assistant is negligent when they do not take vital signs when they they do not take vital signs when they should have . should have . For exampleFor example, , a nursing a nursing assistant can be found guilty of assistant can be found guilty of criminal negligence if their falls risk criminal negligence if their falls risk patient falls and dies after they were patient falls and dies after they were left alone for hours in a bath tubleft alone for hours in a bath tub..

Ethical careEthical careAll patients and residents have a right toAll patients and residents have a right to::

- - Respect and dignityRespect and dignity - - PrivacyPrivacy

- - ConfidentialityConfidentiality- - Freedom from abuse and Freedom from abuse and

neglect neglect- - Control over their own moneyControl over their own money - - Have their personal propertyHave their personal property

- - Know about their medical Know about their medical condition & treatments condition & treatments

- - Choose their own doctor'sChoose their own doctor's ) ) - - Make decisions about their Make decisions about their

medical care medical care - -

American Nurses Association American Nurses Association Code of EthicsCode of Ethics   

  The nurse The nurse provides services with provides services with respect for human dignity and the respect for human dignity and the uniqueness of the clientuniqueness of the client , ,

The nurse safeguards the client's The nurse safeguards the client's right to privacyright to privacy

The nurse The nurse assumes responsibility assumes responsibility and accountability for individual and accountability for individual nursing judgments and actionsnursing judgments and actions

Code of Ethics American Nurses Code of Ethics American Nurses AssociationAssociation

The nurse The nurse exercises informed exercises informed judgment and uses individual judgment and uses individual competence and qualifications as competence and qualifications as criteria in seeking consultation, criteria in seeking consultation, accepting responsibilities, and accepting responsibilities, and delegating nursing activities to thersdelegating nursing activities to thers..

The nurse The nurse participates in activities participates in activities that contribute to the ongoing that contribute to the ongoing development of the profession's body development of the profession's body of knowledgeof knowledge..

Code of Ethics American Nurses Code of Ethics American Nurses AssociationAssociation

The nurse The nurse participates in activities participates in activities that contribute to the on going that contribute to the on going development of the profession's body development of the profession's body

of knowledgeof knowledge . .The nurse The nurse participates in the participates in the

profession's effort profession's effort toto -: -: - -implement and improve standards of implement and improve standards of

nursingnursing . . - -establish and maintain conducive to establish and maintain conducive to

high quality nursing carehigh quality nursing care

Code of Ethics American Nurses Code of Ethics American Nurses AssociationAssociation

-- The nurse The nurse protectprotect the public from the public from misinformation and misinformation and misrepresentation and to maintain misrepresentation and to maintain the integrity of nursingthe integrity of nursing..

- - The nurse The nurse collaborates with collaborates with members of the health professions members of the health professions and other citizens in promoting and other citizens in promoting community and national efforts to community and national efforts to meet the health needs of the publicmeet the health needs of the public