Ethical Issues in the Workplace

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Ethical Issues in the Workplace

• By Dr David Lee
• VUT
• 2001

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What is ethics?

• Ethics is concerned with how correct an
  individual or group perceives an action to be,
  and why they think that action is correct
• The basis is that we have different value systems
  resulting from our diverse social, cultural
  and/or religious upbringing

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What is ethics?

• Ethics involve judgements that help you to
  distinguish between what you perceive to be right
  or wrong, or what ought or ought not to be done
  in a situation

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Codes of ethics for nurses

• As a professional group, nurses have developed 2
  codes that are designed to guide the ethical
  practice of nurses, they are
• 1. The Code of Ethics for Nurses in Australia
• 2. The Code of Professional Conduct for Nurses in
  Australia

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The Code of Ethics for Nurses in Australia

• It is a formal statement of the standards and
  principles of ethical behaviour that govern a
  group of people.
• In other words, it is a set of guidelines on how
  to behave properly and appropriately as you go
  about your professional duties

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The Code of Ethics for Nurses in Australia

• Unlike the Code of Conduct outlines the
  responsibilities of the nurse in terms of legal
  obligation,
• Code of Ethics identifies a set of moral
  standards that nurses are encouraged to adopt

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Codes of ethics for nurses

• Over the last 40 years, the focus in codes of
  ethics for nurses has moved from
• an emphasis on loyalty tot he physician
  (Internaltional Council of Nurses, 1953) to
• developing confidence and trust in the
  relationship between nurses and the persons for
  whom they care (Australian Nursing Council, 1993)

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The ANC Codes of ethics

• The Australian Nursing Council (ANC) Code of
  Ethics contains 6 broad value statements.
• The purpose of the ANC Code of Ethics is to
• identify the basic moral commitments of the
  profession
• provide nurses with a basis for professional and
  self reflection and a guide for ethical practice
• indicate to the community the values which nurses
  hold

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The ANC Codes of ethics -the 6 value statements

• Value statement I
• Nurses respect persons individual needs, values
  and culture in the provision of nursing care

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The ANC Codes of ethics -the 6 value statements

• this statement means that nursing care is to be
  given to any person in the same competent and
  respectful manner, no matter what their gender,
  race, ability, age, values, beliefs or social or
  health status

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The ANC Codes of ethics -the 6 value statements

• Each person must be recognized as part of his/her
  own family, social and community unit. Therefore,
  you must realize and accept that he/she may want
  others apart from the health carers involved in
  his/her care or rehabilitation

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The ANC Codes of ethics -the 6 value statements

• Each person should be provided with as much
  comfort, dignity, privacy and pain- and
  anxiety-relief as possible

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The ANC Codes of ethics -the 6 value statements

• Value Statement II
• Nurses respect the rights of persons to make
  informed choices in relation to their care

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The ANC Codes of ethics -the 6 value statements

• This value statement recognizes the right of
  patients, or their nominated representatives, to
  make informed decisions about the health care
  provided

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The ANC Codes of ethics -the 6 value statements

• A scenario
• A mother with a child who has contracted a
  notifiable, highly contagious eye infection
  refuses to have the child treated.

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The ANC Codes of ethics -the 6 value statements

• Value statement III
• Nurses promote and uphold the provision of
  quality nursing care for all people

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The ANC Codes of ethics -the 6 value statements

• Provision of quality nursing care there is a
  expectation that you will keep yourself up to
  date with practice through continuing education
  by taking advantage of formal and informal
  opportunities for education

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The ANC Codes of ethics -the 6 value statements

• Value Statement IV
• Nurses hold in confidence any information
  obtained in a professional capacity, and use
  professional judgement in sharing such information

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The ANC Codes of ethics -the 6 value statements

• As a nurse, your responsibility is to respect the
  person's fight to say who will be provided with
  him or her personal information, and in what
  detail. The only exceptions will be in cases
  where the life of that person or others is in
  danger, and in these situations you should always
  be guided by the advice of the senior staff
  member on duty at the time.

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The ANC Codes of ethics -the 6 value statements

• It is because of the intent of this value
  statement, that the consent of the
  patient/resident is always obtained before he/she
  is used as the subject of teaching or research.

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The ANC Codes of ethics -the 6 value statements

• In order to maintain this privacy, any
  communication that you and others have about the
  patient will be held in an appropriate place on
  the ward or in the care environment usually in a
  private office. It is not appropriate to discuss
  patients where others will hear.

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The ANC Codes of ethics -the 6 value statements

• Further, all patient records are kept in a safe
  and secure place to ensure that the patient /
  resident's confidentiality is maintained.

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The ANC Codes of ethics -the 6 value statements

• What do you do with this?
• You are in a social environment with members of
  staff from the hospital where you work. You
  overhear another nurse who is senior to you
  discussing one of your current patients,
  describing his medical details and treatment. The
  audience have nothing to do with the patient or
  the health facility and seem to be enjoying the
  story

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The ANC Codes of ethics -the 6 value statements

• Value statement V
• Nurses respect the accountability and
  responsibility inherent in their roles

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The ANC Codes of ethics -the 6 value statements

• This statement is acknowledging that you may have
  different values and beliefs to those held by
  your collegues. There is no problem with this,
  but you should remember that they are just as
  entitled to hold their beliefs as you are.
• The most important thing to remember is that the
  team must work to present a professional and
  caring attitude

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The ANC Codes of ethics -the 6 value statements

• You do have a moral obligation to provide nursing
  care to your patients, but you also have the
  moral right to refuse to participate in
  procedures which would violate your reasonable
  moral conscience
• e.g. abortion

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The ANC Codes of ethics -the 6 value statements

• Scenario
• you have been unemployed for 6 months and longing
  for a steady / permanent employment. You are
  offered a position in a nursing home . The
  nursing home has had a high turnover of staff and
  one of your friends who has recently left ahs
  told you that the staff there are expected to use
  physical restraints on the patients to keep them
  from wandering

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The ANC Codes of ethics -the 6 value statements

• Value Statement VI
• Nurses value the promotion of an ecological,
  social and economic environment which supports
  and sustains health and well being

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The ANC Codes of ethics -the 6 value statements

• This means that you will be always on the look
  out for practices that have the potential to harm
  patients/residents or staff or visitors.
• You will also be careful of the use of resources
  such as disposable products that are not only
  expensive but contribute to waste in our health
  facilities, and ultimately in our community

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Ethics in everyday practice

• Child abuse
• artificially prolonging life
• voluntary euthanasia
• not for resuscitation order
• informed consent

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Ethics in everyday practice

• withholding information
• refusal of treatment
• Quality Vs quantity of life
• ding with dignity
• conflict of values and beliefs between members of
  the health team

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Four factors in making ethical decisions

• 1. The ethical delemma must be recognised and
  defined
• 2. All the facts relevant to the issue and to the
  individuals involved must be obtained

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Four factors in making ethical decisions

• 3. The people involved in making a decision must
  understand the relevant moral rules and
  principles involved, and be able to apply them in
  an appropriate manner
• 4. Proper evaluation must be made of possible
  solutions to the problem and of the strategies to
  be implemented

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The case of the heavy smoker

• A 65 year old lady, who is a' heavy smoker, has
  been admitted to the medical ward of the local
  hospital have revealed that the lady has advanced
  Cancer of the lungs, and her relatives have been
  advised that she is likely to only have a few
  months to live. The relatives have asked the
  staff not to tell their mother of he as they
  would like her to spend her remaining time as
  happily as possible. when you are showering the
  lady the next morning she says to you that she
  knows that something is wrong, and wants to be
  told the truth

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The case of the heavy smoker

• Using the 4 factors in making ethical decisions,
• define the dilemma
• examine the facts
• identify the relevant moral principles involved
• evaluate possible solutions
• write down the results of this process, then
  decide what you would do