principles of ethics-lecture
TRANSCRIPT
8/6/2019 Principles of Ethics-Lecture
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Principles of Ethics
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� Objectives:
� At the end of the end of the lecture the student should be able to:
� Define ethics
� Discuss the ethical reasoning
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Definitions
� Ethical principles
� Autonomy
� Non ±maleficence� Justice
� Beneficence
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Descriptions
� Patients¶ rights
� Nurses rights
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At the end of the lecture you should
be able to :
� Understand and relate ethical principals toyour nursing practices.
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REFERENCES
� Thomson, Ian, E., Melia,Kath, M., Boyd,Kenneth,M (2003) Nursing Ethics,4th edition,Elsevier, Science Limited,Philadelphia , US A.
� Crisp &Taylor (2005) Potter & Perry¶sFundamentals of Nursing 2nd ed., Elsevier, Australia.
� Presenter: Sr., Uma Lal 22/03/11
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ETHICS
� Ethics is concerned with the studies and
practice of what is good and right for
human beings. In ethics we seek todetermine what conditions will promote
what is good or bad for the betterment of
individuals,communities,businesses and
organizations.
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ETHICS TO NURSES
� Values and means to ensure the wellbeing
,health ,prosperity and happiness of
people with identifying the kind of things
that are likely to prevent this happening.
This was recognized in the ICN code for
nurses: Ethical concepts applied to
nursing (ICN 1973).
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FOUR FUNDAMENTAL
RESPONSIBILITY OF A NU
RSE
� A) To promote health
� B)To prevent illness
� C) To restore health� D) To alleviate suffering
� The need for nursing is universal
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CORE COMPONENT OF
NUR
SING CAR
E� A) Respect for life
� B) Dignity and rights of human being
� C) Unrestricted by considerations of Nationality,race,creed,color,
age,sex,politics or social status.
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Core component of nursing care
� Nurses render health services to the
individual, the family,and the community.
They coordinate their services with those
of related groups.
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ETHICS IS CONCERNED WITH
� Formation of rules defining what is right or
wrong, eg to state what regulations are
necessary to monitor (oversee) individual
and community wellbeing and what is
required to protect the safety /integrity of
individuals ,communities and
organizations.
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Ethics is concerned with
� Fundamental responsibility of nurses is to hold
in confidence personal information and use
judgment in sharing this information.
� To maintain the highest standards of nursingcare possible within the reality of a specific
situation.
� Maintain personal and professional conduct atall times to uphold nursing profession (ICN
1973).
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Nurses role in safeguarding Human
R
ights (ICN 1983) asserts that:� Health care is a right of all individuals.
� Everyone should have access to health
care regardless of financial ,political,geographic, racial or religious
backgrounds.
� Nurses must make sure that they deliver
impartial and adequate treatment within
available resources.
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SUMM ARY-what ethic is?
� Commitment to positive values to ensurethe wellbeing and flourishing of individualsand society.
� Communal activity of applying rationalprinciples and universal standards tosocial life.
� Our active participation in a moralcommunity and ownership of the policies itdevelops.
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Summary of what ethic is
� Problem solving activity based on
knowledge of ethical principles and their
skilled application to life.
� Educational process in which by
experience we learn what it means to be
responsible moral agents.
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Autonomy
� Principles of self rule, of clients makingdecisions about their own lives.
� An individual who is able to exercise somedegree of self determination in terms of understanding the requirement of membershipof the moral community to he/she belongs.
� A person who is free and able to act ,to exercisehis or her rights and to recognize his or her
duties to others.� Respect for persons also requires that we also
respect his independence for self determination.
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NON M ALEFICIENCE
� Not to do harm-the duty to do good and to avoidharm to others.
� The duty of care ,to protect the weak and the
vulnerable.� The duty of advocacy, depending on the rights of
those incompetent or temporarily unable todefend their own.
� The golden rule says:� DO UNTO OTHERS AS YOU WOULD HAVE
THEM DO UNTO YOU.
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BENEFICENCE
� To do good, it is the protective duty of care
the strong owe to the weak. Patient
advocacy, defending the rights of the
vulnerable patient or acting on behalf of
those unable to assert their rights.
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Beneficence
� Principle of beneficence is indispensible in
cases of dependent ,severely disabled or
helpless people in need of support or
urgent care and attention.
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Beneficence
� This duty of care towards one another
should make us realize that we all need
others to speak for us ,to do things for us,
or to defend our rights when we are too
weak to do so for ourselves.
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Beneficence
� But if knowledge is power ,the power of
the true carer is aimed at sharing
knowledge and skills with vulnerable
individuals so as to empower them to
reassert control over their own lives, if this
is humanly possible (May,
1983,Campbell,1984,&1985).
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JUSTICE
� The demand for universal fairness in terms of respect for the rights of individual persons ,theexercise of individual rights such as freedom of
movement, or association.� Equal opportunity to benefit from ,or have
access to, preventative medicine and treatmenthealth services and the outcome of research.
� Equality of outcomes for different ethnic groupsin terms of fair distribution and access to healthresources by sound research and policydevelopment.
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The right to know
� The normal expectation of clients is that
carers will discuss their problem with them
and give an opinion as to its nature ; that
they will discuss the proposed course of
treatment or management of the problem
;and they will discuss the possible options
and outcomes.
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The right to privacy
� The right to respect for the dignity of the person in terms of physicalprivacy
� Respect for the persons secret in terms of maintaining strictconfidentiality of the information disclosed.
� The right to privacy does not mean the right to have a private wardor the right to private medicine although in some case it may includethat eg an elderly lady who has never shared a room with another person may be emotionally distressed at having to be nursed in apublic ward . She might prefer to pay extra health insurance toensure that she can get privacy that is very important to her.
� Most people might expect some general loss of privacy which oftencomes as a shock to realize how little privacy they have.
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Right to privacy
� Hospital staff often show very little consideration
for people¶s sensitivities or need for privacy, the
needs of those who are dying.
� Generally people are prepared to expose their secrets ,expose their bodies and reveal their
vulnerabilities when they need help and when
they feel that they can TRUST the person from
whom they are seeking help.
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Right to privacy
� Sensitive carers will respect the patient¶s
confidences and privacy.
� The carers will also recognize that theinformation is to be used ONLY for the
benefit of the patient, and that they acquire
duties of advocacy, to protect the rights
and interests of their patients in the light of what they have learnt about them .
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The right to care and treatment
� Every person who has been taken on by a
doctor or nurse as a patient has a right to
expect proper care and treatment. The
doctor or nurse is employed to provide a
service, or offers a service on a fee- for
service basis ,and patients are entitled to
treatment in fulfillment of the deal madewith the carer to whom they have
entrusted themselves.
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Right to care and treatment
� Malpractice and negligence are not
confined to being incompetent but also for failure to provide due in fulfillment of the
contract to-care.
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Nurses Rights
� Nurses have the right to practice in
accordance with the Nursing legislation
of the country in which they work.
� They adopt the ICN code for nurses or
their own national ethical code-
� Nurses &Midwives Board Fi ji ±Code of
ethics &Code of conduct for Fi ji Nurses
1999.
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Nurses rights
� Right to practice in an environment that provides
personal safety ,freedom from abuse and
violence, threats or intimidation.
� National nurses associations need to ensure aneffective mechanism through which nurses can
seek confidential advice , counsel, support and
assistance in dealing with difficult human rights
situations.`
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Relating Ethical Principle To
Nursing Practices
� Nurses have an obligation to safeguard
people¶s health rights at all times and in all
places. This includes assuring that
adequate care is provided within the
resources available and in accordance
with nursing ethics.
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Relating ethical principle to nursing
practices
� The nurse is obliged to ensure that
patients receive appropriate information
prior to consenting to treatment or
procedures, including participation in
research if you do one in future.
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Relating ethical principle to nursing
practices
� As professionals, nurses are accountablefor their own action in safeguarding their
patients rights in every sense of their care.
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Limitations
� In all aspects of their professional role
nurses deal with human rights issues
everyday .Nurses may be pressured to
apply their knowledge and skills in ways
that are detriment to patients and others.
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Limitations
� There is a need for increased vigilance ,
and a requirement to well informed ,abouthow new technology and experimentation
can violate these human rights.
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Limitations
� Furthermore nurses are increasinglyfacing complex human rights issues,arising from conflict situations within
jurisdictions, political upheaval and wars.The application of human rights protectionshould emphasize vulnerable groups suchas women,children,elderly people,
refugees and stigmatized groups.
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Limitations
� ICN has developed a Health and Human
rights fact sheet ,addressing the ma jor areas where human rights impact on the
health of populations, including public
health, health care reform, access to care
and gender perspectives
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Home work
� Read ICN publications on their website:
� http://www.icn.org>
� (ICN endorsed the Universal Declarationof Human Rights ,adopted by the United
Nations General assembly in 1984).
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Discussion activity
Get into groups of five and discuss how you
are going to relate the above ethical
principles to your daily nursing practices.
� What are some of the limitations that you
are going to come across in applying
these ethical principles ?
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Bill of rights ±( American Hospital
Association 1973,revised 1992)
� 1.The patient has the right to considerate
and respectful care.
� 2. The patient has the right to obtainunderstandable information concerning
diagnosis,treatment and prognosis.
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Bill of Rights
� 3.The patient has the right to makedecisions about the plan of care prior toand during the course of treatment.
� 4.The patient has the right to have anadvance directive such as a living will,health care proxy ,or durable power of attorney for health care.
� 5.The patient has the right to everyconsideration of privacy.
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Bill of rights
� 6.The patient has the right to
confidentiality.
� 7.The patient has the right to review his/her records pertaining to his health care.
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Bill of rights
� 8.The patient has the right to expect that
,within its capacity and policies a hospital
will make reasonable response to his /her
request.
� 9.The patient has the right to ask and be
informed of the people and other health
care agencies which influences his healthcare.
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Bill of rights
� 10.The patient has the right to consent or
refuse in any kind of research studies or
human experimentation affecting his care
and treatment.
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Bill of rights
� 11.The patient has the right to expect
reasonable continuity of care when
appropriate and to be informed by the
physicians and other care givers of
available and realistic patient care options
when hospital care is no longer
appropriate.
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Bill of rights
� 12.The patient has the right to be informed
of hospital policies and practices thatrelate to his /her care ,treatment and
responsibilities.
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IMPORTANT NOTE:
� Remember your primary role as a nurse is
to provide competent nursing care
promoting an environment in which the
values ,customs,and spiritual beliefs of the
individuals are respected. Maintain
confidentiality in holding personal
information and use your judgment insharing this information .
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Important Note
� ³DO UNTO OTHERS WHAT YOU W ANT OTHERS TO DO TO YOU´.