Ethics of Double Effect

Double Effect

• An action intended for good may have a harmful side effect.
• The action is ethically permissible if the harm is not intended, even if it is foreseen.
• Example: Chemotherapy intended to kill cancer cells can cause nausea and vomiting.

Advantages of Double Effect

• Improves patient's chance of recovery and prolongs life
• Provides a compassionate option for suffering patients

Disadvantages of Double Effect

• Can be cumbersome in low-risk situations
• May cause discomfort to patients
• Time-consuming, potentially delaying treatment, especially in emergencies
• Side effects can be severe and negatively impact patient quality of life

Virtues

• Courage: doing the right thing for people you care about, facing difficult decisions and advocating for patient care.
• Justice: ensuring fairness and equality in patient treatment and access to care

Vices

• Substance abuse & drug addiction: Can impair judgment and patient care. Misuse of drugs can endanger patients’ well-being.
• Theft: Stealing things, medical supplies, funds, time, resources.
• Fraud: Falsifying medical records, insurance claims, receiving illegal claims.
• Plagiarism: Citing someone else's work or documentation without giving proper credit.
• Pride: Undermining trust and professional credibility. Failure to seek help; damaging someone else's work or career.

Responsibilities of a Nurse

• Providing basic bedside care.
• Operating medical equipment.
• Conducting physical examinations.
• Providing support and advice to patients.
• Advocating for patient well-being.
• Maintaining inventory.
• Educating patients about managing illness.
• Monitoring patient health.
• Collaborating with a team for patient care.
• Performing diagnostic procedures.
• Recording patient history and symptoms.
• Training and educating staff.
• Administering medications and treatment.

Additional Notes on Responsibilities

• Greed can lead to unnecessary procedures.
• Slander damages the reputation of colleagues by making false statements.
• Greed can lead to unethical practices, such as overcharging.

Ethical Principles in Healthcare

• Beneficence: acting in the best interest of the patient, promoting well-being, and preventing harm.
• Example: encouraging patients to receive necessary vaccinations.

Advantages of Beneficence

• Reduces disease incidence
• Contributes to public health and community well-being

Disadvantages of Beneficence

• Patient concerns or fears about vaccines might lead to conflicts concerning informed consent.

Nonmaleficence

• The duty to do no harm. Emphasizes providing safe, effective, high-quality care.
• Example: Following strict hygiene protocols (handwashing, wearing gloves) when treating patients to prevent infection.

Advantages of Nonmaleficence

• Reduces the risk of hospital-acquired infections
• Protects vulnerable patients.

Qualities that Promote Ethical and Effective Care

• Fidelity (Loyalty): loyalty to patient, colleagues, institutions, schools, community; commitment to providing care.
• Integrity (Honesty): upholding honesty and ethical standards; transparency.
• Humility: accurate self-assessment; recognizing one's limitations; It is important because it fosters learning and growth.
• Respect: valuing patient's dignity, rights, values, and cultural diversity; intentional acts of showing considerations to other people and well-being.
• Compassion: recognition and understanding of emotional resonance with others' concerns, pain, and suffering; showing empathy.
• Prudence: wise decision-making; ability to govern and discipline oneself by practical wisdom.
• Empathy: understanding and sharing the feelings of patients; better address their needs; putting yourself in someone's shoes; providing validation.

Ethical Considerations In Healthcare

Justice

• Advantages: Reduces health disparities and promotes equal access to essential health services
• Disadvantages: Limited resources might affect the quality of care during screenings
• Example: A hospital offering free health services to low-income communities to ensure everyone has access to preventive care

Fairness in Distribution of Resources

• Advantages: Reduces financial barriers to care and encourages people to seek necessary health services.
• Disadvantages: Cost of providing comprehensive care may lead to higher premiums for all insured individuals.
• Example: Health insurance policy covering essential services like preventive care and chronic disease management for all members

Patient Autonomy

• Definition: Refers to the patient's right to make their own healthcare decision and willingly undertaking a given behavior.
• Example: A patient choosing to refuse a specific medication due to personal beliefs or side effects.

Advantages and Disadvantages of Patient Treatment

Respecting Patient Choice

• Advantages: The patient has the right to make informed decisions about their treatment.
• Disadvantages: Refining treatment options may lead to adverse health outcomes. The patient may feel overwhelmed or pressured.

Patient-Centred Decision Making

• Advantages: Empowers patients to choose treatment after discussing potential risks and benefits. Facilitates informed consent.
• Disadvantages: Patients might feel pressured or anxious due to fear of missing opportunities.

Veracity (Honesty)

• Advantages: Honesty with patients about their condition, treatment, and prognosis allows families to prepare emotionally and make necessary arrangements.
• Disadvantages: Family members might experience grief and feel overwhelmed with information.

Transparency

• Advantages: Open communication builds trust and confidence. Corrective actions to avoid future mistakes can be taken.
• Disadvantages: Lack of transparency may lead to loss of confidence and anxiety from the patient.

Respect for Others

• Acknowledging the dignity, rights, and values of all individuals (patients, families, and colleagues) is crucial
• Example: A nurse respects a patient's decision to refuse a particular treatment, even if the nurse believes it beneficial.

Advantages of Respecting Others:

• Supporting patient autonomy
• Respecting patient values and beliefs

Disadvantages of Respecting Others:

• Potential for negative health outcomes due to patient choices
• Ethical dilemmas for the healthcare team

Stewardship

• Responsible management of resources, including time, supplies, and finances, to provide the best care without waste.
• Example: A nurse monitors medication expiration dates and ensures medications are used before they expire.

Advantages of Stewardship

• Reduces medication waste and ensures patients receive effective treatments.

Disadvantages of Stewardship

• May pressure nurses to use medications quickly, potentially compromising careful patient assessment.

Cooperation

• Working with other professionals and clients to achieve the best outcomes.
• Example: Nurses must collaborate with other healthcare team members to provide integrated care. Nurses collaborate with incoming shift nurses during handoff reports to ensure continuity of care.

Advantages of Cooperation

• Reduce the risk of errors
• Enhances patient safety by sharing critical information.

Disadvantages of Cooperation

• Information overload if too much detail is provided, leading to confusion.