Ethical Dilemmas in Nursing Class 2

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Questions and Answers

Which action is essential for nurses to address moral distress?

Support and restore moral integrity (correct)

Limit communication with colleagues

Ignore personal feelings

Focus only on clinical skills

What does moral resilience refer to?

Sustaining integrity in complex moral situations (correct)

Taking no action in response to moral confusion

Focusing solely on personal well-being

The ability to avoid ethical dilemmas

What contributes to creating a moral community in the workplace?

Sharing no common values

Accepting all ethical viewpoints equally

Encouraging silence about ethical issues

Clear, shared values directing ethical action (correct)

How can nurses demonstrate moral courage?

By taking principled actions that align with their values Signup and view all the answers

Which of the following is NOT a method for nurses to develop ethical competence?

Avoiding discussions on ethical concerns Signup and view all the answers

What is a significant consequence of conflict between moral values in healthcare settings?

Compromised well-being Signup and view all the answers

Which ethical decision-making tool focuses on the steps to resolve an ethical dilemma?

IDEA Framework Signup and view all the answers

Which element is part of the IDEA ethical decision-making framework?

Explore alternatives Signup and view all the answers

What does the presence of communication difficulties in healthcare indicate?

Complexity of ethical issues Signup and view all the answers

What is a primary focus of aligning healthcare with ethical values?

Ensuring fairness in access to care Signup and view all the answers

What is one of the major challenges for health care teams in ethical dilemmas?

Difficulty managing ethical principles Signup and view all the answers

Which of the following is NOT a step in the IDEA Framework?

Decide on a team leader Signup and view all the answers

Which factor can complicate ethical decision-making processes in healthcare?

Social inequities Signup and view all the answers

What characterizes an ethical dilemma?

It requires a choice with multiple potential consequences. Signup and view all the answers

Which ethical approach emphasizes the best outcome for the majority?

Utilitarianism Signup and view all the answers

What is a common component of ethical decision-making processes?

Considering the ethical norms and moral values of a community Signup and view all the answers

Which of the following is NOT a paradigm of normative ethics mentioned?

Pragmatism Signup and view all the answers

What is a potential result of an ethical dilemma?

Complexity due to interpersonal factors Signup and view all the answers

What does moral distress refer to in an ethical context?

The awareness of the right course of action but feeling unable to act on it Signup and view all the answers

Which ethical framework focuses on the character and virtues of individuals?

Virtue Ethics Signup and view all the answers

Which statement about ethical decisions is accurate?

Ethical decisions often involve weighing multiple alternatives. Signup and view all the answers

What is moral distress primarily characterized by?

Knowledge of the correct response but inability to act due to constraints Signup and view all the answers

How does moral distress differ from moral uncertainty?

Moral distress involves knowledge of right action without the ability to act. Signup and view all the answers

Which statement reflects a common misconception about moral distress?

It is a sign of emotional weakness in clinicians. Signup and view all the answers

What does moral agency enable a person to do?

Act in a deliberate manner regarding moral choices Signup and view all the answers

According to the content, moral distress can be a result of which of the following?

The limitations posed by hierarchical structures Signup and view all the answers

What is NOT a characteristic of moral distress?

A state of confusion about ethical decisions Signup and view all the answers

All nurses are regarded as having what capacity?

The capacity to act as moral agents Signup and view all the answers

In which scenario would moral distress most likely occur?

When a known solution is available but restricted from being acted upon Signup and view all the answers

What is the first step in the Storch Model for Ethical Decision-Making?

Information & Identification Signup and view all the answers

Which of the following statements best describes the importance of articulating different perspectives in ethical situations?

All perspectives, regardless of agreement, must be considered for informed decision-making. Signup and view all the answers

What type of question should be formulated when addressing ethical dilemmas?

Open questions with broad implications Signup and view all the answers

Which of the following factors is NOT essential to consider when evaluating an ethical decision?

Personal beliefs of the healthcare provider. Signup and view all the answers

Which ethical principle involves respecting a patient's right to make their own decisions?

Autonomy Signup and view all the answers

What is the role of professional codes of ethics in the Storch Model?

They provide a framework for actions and consequences. Signup and view all the answers

What does the range of actions/anticipated consequences step involve?

Identifying all potential outcomes of different actions. Signup and view all the answers

What is indicated by moral distress in nursing practice?

Inadequate support for staff. Signup and view all the answers

Why is it important to understand the possible implications of ethical decisions?

To promote comprehensive and responsible decision-making. Signup and view all the answers

What key aspect should be emphasized when discussing ethical scenarios?

All possible choices, including detrimental ones, should be analyzed. Signup and view all the answers

Study Notes

Ethical Dilemmas and Decision-Making Process

The class focuses on ethical dilemmas and tools for decision-making in nursing.
Marianne Sofronas, RN, PhD, a faculty lecturer at the Ingram School of Nursing, McGill University, teaches this course.

What Keeps Nurses Awake at Night

This summarizes a video about the factors that concern nurses.
Key elements include Integrity, Truth, and Commitment.

Content for Class 2

Normative Ethics: Includes Virtue Ethics, Utilitarianism, Deontology, Principlism, and other paradigms--Narrative Ethics, Relational Ethics, Casuistry, Interpretivism, Feminist Ethics, and Ethics of Care. Relevant screencasts are available on MyCourses.
Ethical Dilemmas and Decision-Making Process: Includes defining ethical dilemmas, ethical decision-making tools and frameworks, ethical questions, moral distress, moral resilience, moral courage, and moral communities.

What is an ethical dilemma?

Ethical dilemmas involve choosing a course of action with multiple alternatives and consequences.
Uncertainty regarding the best alternative often arises due to complex interpersonal and contextual aspects.

Decision-making process

A commonly considered best alternative aligns with ethical norms and community values.
Multiple right and wrong alternatives exist.

Other components of ethical dilemmas

Conflict or opposition between two or more moral values/principles frequently occurs.
Compromises on well-being and communication difficulties are often present.
Ethical dilemmas may be difficult for healthcare teams and patients/families to resolve. This was authored by Olsen (2017).

Aligning Values to Practice: Example

Aligning care with values is important.
Recognizing and addressing social inequalities in access to healthcare is crucial. This example was presented by Colleen Varcoe.

Ethical Decision-Making Tools & Frameworks

IDEA Framework
Canadian Nurses Association (CNA)
Storch Model
Community Ethics Toolkit

IDEA: Ethical Decision-Making Framework

This framework outlines the four main steps in ethical decision-making.
The cycle of this framework involves: Identifying the facts, Determining the relevant ethical principles, Exploring the options, and Acting.

Canadian Nurses Association (CNA)

This model for decision-making has ten steps:
1. Determine who is involved
2. Describe the issue
3. Assess the situation
4. Clarify values
5. Explore the story and note reactions
6. Identify ethical principles
7. Clarify legal rules
8. Explore options and alternatives
9. Decide the course of action
10. Develop an action plan
11. Evaluate the plan

Storch Model

This model has three steps: Information and identification, clarification and evaluation, and action and review.
Key components include Professional codes of ethics, Ethical principles, Social expectations, Legal requirements, Range of actions, and anticipated consequences.

Identifying the ethical question

Understanding different viewpoints, stakes, and the perspectives of all involved is crucial.
Important to formulate a good ethical question to avoid broad, yes/no type questions, and be focused on the unique case.

The Ethical Question

Articulating different values at stake is essential.
Clarifying perspectives, even those not agreed upon, is needed.
A well-framed ethical question is open-ended and broadens the analysis. Specific examples include asking what is at stake when, what are the implications?

Case Study (Example)

Case study: woman stopping life-sustaining therapy.
Factors to consider, along with ethical issues, include autonomy, benefits, consequences, mental health, and education of the patient.

Encounters with Moral Distress

Moral Distress includes inadequate nursing staff, patient suffering, patient death with dignity, and the challenges of being a nursing student.

Moral Distress

Feelings arise when the correct response is known but cannot be acted upon due to institutional or hierarchical constraints, as defined by Jameton (1984).
It is not moral uncertainty (Jameton 1984) or emotional distress (McCarthy & Deady 2008), but knowing what to do but being able to act differently.

From Moral Distress to Moral Agency

Nurses have the capacity to engage in deliberate action, understand the moral dimension of practice, and engage in morally relevant actions.

What Nurses Can Do to Address Moral Distress

Recognizing, reflecting, and reconnecting to their purpose are crucial.
Supporting personal well-being, restoring integrity, developing ethical competence, speaking up, taking principled actions, and contributing to an ethical practice culture are recommended.

Moral Courage, Resilience, and Communities

These elements relate to the individual journey of becoming a nurse.

Moral Courage

Moral courage is an expression of moral agency.

Moral Resilience

Moral resilience is the ability to maintain integrity and respond to moral complexity, confusion, or setbacks.

Moral Resilience Going Beyond the Individual

Focuses on resistance and system improvement, moving beyond individual resilience.

Moral Community

A moral community encompasses a workplace where values are clear, shared, and respected.
Coherence between professed values and lived reality is necessary.

Class 3 Nursing & the Law

This class covers professional obligations, civil liability, patient rights, and consent and confidentiality.
Topics include sources and key concepts of Canadian and Quebec law, patient's rights, nursing legal obligations, legal recourses for patients, malpractice cases, informed consent, capacity, and delegated consent.

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Description

This quiz explores ethical dilemmas and the decision-making processes specific to nursing. It covers various ethical theories and paradigms such as Virtue Ethics and Utilitarianism, along with ethical questions and frameworks. Perfect for understanding the complexities nurses face in their profession.