ETHICAL ISSUES IN HEALTH CARE

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ETHICAL ISSUES IN HEALTH CARE

• VOCATIONAL NURSING CONCEPTS Chapter 10

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Ethics

• By becoming a nurse you agree to provide services
  to human beings who by virtue of being human have
  certain rights
• What rights do human beings have by virtue of
  being human what responsibilities are
  associated with these rights?

• Ethical comes from the Greek word amethikos and
  means knowledge of right wrong related to human
  conduct
• Personal value system - Decisions based on what
  you personally believe to be right wrong

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Ethics

• Healthy individuals change their value system
  over a lifetime
• Life experience teaches you lessons that make you
  grow as an individual
• Society is constantly redefining right and wrong.
  Examples are the abolition of slavery, the right
  to vote, womens rights, the rights of the
  disabled and the right to die with dignity

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Nursing Ethics

• Nurses, by virtue of their education, have the
  ability, the responsibility, and the obligation
  to help patients
• Nurses are often put in the situation where there
  is no right or wrong answer. You will be able to
  see the viewpoints of both the patient and the
  doctor. Or you will understand intellectually
  about cost-cutting measures, but feel concerned
  because the quality of care is suffering.

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Nursing Ethics

• A nurse is someone who has internalized the
  concept of what it means to be a human being and
  accepts personal responsibility for relationships
  with other human beings
• A strong belief in the rights of people to be
  treated with dignity and respect must be the
  foundation of your relationships and interactions
  with your patients, with your fellow nurses, and
  with members of the health care team

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Personal Accountability

• CODE OF ETHICS A list of rules of good conduct
  for members of a particular group.
• With responsibility comes accountability
• Being responsible means to accept being the cause
  of an action
• Being accountable means to accept the
  consequences of the action

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Unethical Behavior

• You will be faced with health care workers who do
  not behave ethically
• dont wash their hands
• show disrespect to patients families
• chart procedures that they did not do
• How will you react? What will you do?
• You will be faced with ethical dilemmas
  situations where there is no absolute right or
  wrong
• Box 10-1

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ETHICAL DILEMMAS

• A situation in which there is conflict or
  opposition between personal values, moral
  principles, laws, personal and professional
  obligations, and the rights of the individual and
  society
• No absolute right or wrong, black or white
  answers
• Before taking any action you need to decide
  whether the situation is a legal one or an
  ethical one

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ETHICAL DILEMMAS

• First collect the facts- did you witness the
  situation firsthand or did you get the
  information from someone else?
• Second- ask yourself what would happen if
  everyone acted or behaved in the same manner?
• Third- Talk to someone in authority- someone who
  can help you separate the facts from the
  emotional components of ethical dilemmas

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Ethical Dilemmas

• If you decide to pursue your concerns, talk to
  your immediate supervisor. If you feel after a
  reasonable amount of time your concerns have not
  been dealt with- go higher up the chain of
  command
• Most organizations have committees you can take
  your concerns to
• Bioethics Committees deal with any ethical
  decision that needs to be made within the
  facility related to employees or patients.

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ETHICAL DILEMMAS

• When you make a decision to pursue an ethical
  dilemma, you have to be prepared to accept the
  consequences of your actions. Realize that others
  may not support your decision.
• Be sure of your facts and avoid making personal
  judgments about other peoples behavior
• Your motivation should always be to protect your
  patients human rights and their right to
  adequate and safe nursing care

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Ethical Issues in Nursing

• Cost Containment Measures
• reducing sometimes quality of nursing staff
• using UAP
• providers have less time for patients
• depersonalizing care by using protocols, etc
• creating conflicts between needs of pt needs
  of the employer

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Ethical Issues in Nursing

• Managed Care Measures
• shortening length of stay
• outpt care instead of inpt
• requiring preapproval for services
• denying approval for treatments diagnostic
  services
• putting limits on spending for each illness
• expecting families to care for very ill pts at
  home

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Contemporary Bioethical Dilemmas

• Birth Control age limits, married vs unmarried,
  mandatory sterilization for mentally ill or for
  abusive parents? Abortion?
• Alternative Fertilization surrogates, in
  vitro, who is legal parent?, maternal and
  paternal rights, adultery? Why not require
  infertile couples to adopt orphans?

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Contemporary Bioethical Dilemmas

• Genetic Issues box 10-3
• human genome project able to see what gene
  controls what
• genetic screening confirm diagnosis, predict
  possible future illness, detect carrier state
• Organ Transplants who should get limited of
  organs, age limit, cost, require organ donation?

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Contemporary Bioethical Dilemmas

• Death who determines when it has occurred?
• Euthanasia deliberate causing of someones
  death by active or passive means
• Living Wills a document that tells what a pt
  wants or does not want when death is likely