Ethical Principles in Pediatric Nursing & Rights of the Egyptian Child (Final 2024-2025) PDF

Ethical Principles in Pediatric Nursing & Rights of the Egyptian Child Prepared by: Dr. Amira Sobhy El–Sayed Pediatric Nursing  Learning objectives At the end of this lecture each student should be able to:  Define terms of...

Ethical Principles in Pediatric Nursing & Rights of the Egyptian Child Prepared by: Dr. Amira Sobhy El–Sayed Pediatric Nursing  Learning objectives At the end of this lecture each student should be able to:  Define terms of ethics, ethical principles and ethical dilemma.  Classify the basic pediatric ethical principles.  Recognize ethics in pediatrics  Identify ethical issues  Apply basic ethical principles and their applications.  Discuss the basic and general child’s rights.  Outlines:  Definition of ethics  Principles of ethics  Child’s right  Introduction  Ethics have always been an integral part of nursing  Nurses at all levels/areas of practices experience a range of ethical issue during the course of their day–to-day.  Pediatric nurses are in a unique position with their responsibility to their patients since children do not have the maturity, competency, or the legal right to consent for their own care.  The ethical issues pediatric nurses face can be quite challenging at times, as they must often professionally solve conflicts involving a family’s personal values. What is ethics means ?  Definition  Ethics is about making “right” or “good” choices and the reasons that we give for our choices and actions. Ethics addresses the question “What should we do and why?” Ethics is about: Deciding What we should do – what decisions are morally right or acceptable; Explaining Why we should do it – justifying our decision using language of values and principles Describing How we should do it – outlining an appropriate process for enacting the decision.  Definitions Bioethics refers to ethical conduct in health care providers, including those caring for children and families (Butts & Rich, 2008). Pediatric ethics is a branch of bioethics that analyzes moral aspects of decisions made relating to the healthcare of children.  Ethical behavior for nurses is discussed in codes such as the American Nurses Association Code for Nurses (www.nursingworld.org/ethics).  Primary Ethical Principles Ethical principles are the basis of all nursing practice and provide a framework to help the nurse in ethical decision making. The primary ethical principles include:  Autonomy ‫المريض سيد قرار‬  Respect the individual’s right to self-determination and decision-making.  Involves the right of self-determination or choice, independence, and freed on  This includes the right to respect, privacy, and information necessary to make decisions based on their personal values and beliefs.  Respect another's right to determine a course of action.  Application of Autonomy  Enable the child and family to make a free, informed decision which depends on:  The provided knowledge , information, communication skills on the part of the nurse  The level of understanding on the part of the child\family.  Generally, parents have the autonomy to make health care decisions for their child.  In special situations, adolescents are decided the autonomy to consent to health care procedure without the parents’ knowledge.  Giving children the opportunities to make age appropriate decisions (clothes, food)  Engaging a family in a multi-disciplinary patient care conference about their child’s case  Application of Autonomy  Children were not involved in major decisions (treatment decisions) as refusal was not an option.  They were generally involved in minor decisions (choices about care delivery) with the purpose of gaining their cooperation, giving back a sense of control and building trusting relationships.  Some adolescents were aware that choices were not ‘real’ decisions since they were not allowed to refuse and expressed feelings of frustration.  Engaging a family in a multi-disciplinary patient care conference about their child’s case  ‘Informed Consent’ is an important outcome of this principle.  Beneficence = do good  Beneficence is commonly defined as “the doing of good” (without errors).  Our actions must aim to ‘benefit’ people – health  Act beneficently toward others (contribute to the welfare of others, which may include preventing harm, removing harm, promoting well-being, or maximizing good).  Beneficence refers to taking positive actions to help other.  The nurse and other team members must protect life, health, privacy and dignity of the child Application: Applying a topical analgesic to the site prior to inserting a peripheral IV in a toddler  Non- maleficence ‫ال ضرر وال ضرار‬  Non-maleficence: is defined as the duty to do no harm (physical and/ or psychological).  Doing No harm, reducing risk, and reducing pain or discomfort. Application  Using appropriate pain management strategies for a child in pain Related values: Safety  Justice ‫العدالة‬  Justice refers to fairness:  The concept fairness for all, equity and equality of care.  Justices : There are three aspects as legal justice, respect for right, and fair distribution of resources even the nurses time and attention.  This principle is based on providing care and health care resources to all patients equally and without any discrimination. Regardless of disease, educational level or socio–economic status. Application: Advocating for children without health care coverage to receive immunizations.  Secondary Ethical Principles The secondary ethical principles that can be incorporated with the primary principles when interpreting ethical issues and making clinical decisions are , 1. Veracity and fidelity: ‫صدق واالخالص‬ Veracity (Telling the truth) Fidelity (duty to keep promises) 1. Confidentiality ‫— خصوصية‬Keep information private. Children are owed the same duty of confidentiality as adults 2. Accountability ‫— مسئولية‬Accept responsibility for actions as a health care professional. 3. Integrity ‫ سالمة‬: Acting consistently with honesty and basing actions of moral standards.  Ethical Dilemma  Situations necessitating choice between two equal (usually undesirable) alternatives.  Sometimes the values are equally strong on both sides of the issue.  A Situation in which there is conflict or opposition between:  Personal values,  Moral principles,  Laws, personal and professional obligations,  The rights of the individual and society.  Ethical dilemmas An ethical dilemma is a situation in which NO solution is completely satisfactory. Opposing courses of action may seem equally desirable, or all possible solutions may seem undesirable. e.g. the parents may refuse treatment for the child, or the child’s desires may conflict with the parents' decisions, resulting in a powerful ethical dilemma. Child’s Rights  Child’s Rights Children (anyone under the age of 18 as defined by the Convention on the Rights of the Child), like adults, have rights to ensure their well-being and safety are maintained at all times. Children's 4 Core Basic Rights. Right of Survival Right of Development Right of Protection Right of Participation  Basically and generally every child has the right for Survival The child’s right to life and to the most basic needs for existence (food and Nutrition, Shelter, Clean Water, Medical Services)  To live  Get good food regularly  Get good health care  Have a name and identity  To have a nationality belong to a country that will care for him\her Basically and generally every child has the right for Development To achieve their full potential  Right to Education,  Access to information & Freedom of thoughts  Cultural Activities & Religion  Recreation, play and Leisure Those with disabilities to receive special services.  Basically and generally every child has the right for Protection  To have a family that will protect him\her  To become safe from every harm- physical or mental  To have their own privacy  Protection from all forms of abuse, neglect & exploitation and discrimination.  Protection children in criminals & employment,  Special Care for Refugee Children,  Basically and generally every child has the right for Participation To take an active role in their communities and nations.  Children’s Freedom to express opinion & be heard,  Right to participate in social activities,  Become a member of associations  United Nations Declaration of the Rights of the Child  To be free from discrimination  To develop physically and mentally in freedom and dignity  To have a name and nationality  To have adequate nutrition, housing, recreation, and medical services  To receive special treatment if handicapped  To receive love  To receive an education and develop his/her abilities  To be protected from neglect, cruelty, and exploitation  To be the first to receive protection in disaster  Conventions of Child’s Rights in Egypt  Egypt is a signatory to a number of major human rights conventions. More notably as it relates specifically to children.  On a national level, Egypt passed landmark legislation when it enacted a comprehensive Childhood Law in 1996, which has resulted in important gains for Egyptian children.  The Egyptian Parliament strengthened its position on child rights when it passed significant modifications to the Law in 2008. ‫وثيقة حقوق الطفل حسب قانون الطفل‬ ‫المصري رقم ‪ 126‬لسنة ‪2008‬‬  Sick Child’s Rights Application for 3 levels of prevention  Primary prevention  Secondary prevention  Tertiary prevention  Primary Prevention 1- Assessment - Condition of health (if handicapped) - Nutrition (malnutrition- right to eat well) - Housing 2- Health teaching - School (teachers & curriculum) - How to enhance the child behavior about hygiene, nutrition and good behavior. - Media  Secondary Prevention  Respectful and Considerable Care  Right to be informed  Right to Decision-making  Rights related to informed consent  Privacy and Confidentiality  Rights of Refuse treatment  Tertiary Prevention Right in referral and participation in research  Right to receive complete 'information and explanation concerning the need for risks, benefits and alternatives to the referral.  Right to be informed about all the procedures required for medical follow up after their discharge from the hospital.  Right to know of medical treatment is for purposes of experimental research (fully explained ,researcher identity, nature of the study, risks and benefits)  Child's Rights in the Hospital:  Children should be admitted to hospital only if they require care  Children in hospital shall have the right to have their parents or parent substitute with them at all times.  Accommodation should be offered to all parents, and they should be helped and encouraged to stay.  Children and parents shall have the right to be informed in a manner appropriate to age and understanding. Bill of rights for children and teens In this hospital, you and your family have the right to : Respect and personal dignity Care that supports you and your family Information you can understand Quality health care Emotional support Care that respects your need to grow, play, and learn Make choices and decisions  Thank You All Any Question?????