Lecture 1 Introduction to Ethics and Nursing - Revision

Dr EnasMohamed Lofty Associated Professor In Nursing Administration College Of Nursing, PNU Lecture -1 Ethical Aspects Of Nursing 1  Midwifery Legal And Ethical Principles  Learning objectives On completion of this lecture the studen...

Dr EnasMohamed Lofty Associated Professor In Nursing Administration College Of Nursing, PNU Lecture -1 Ethical Aspects Of Nursing 1  Midwifery Legal And Ethical Principles  Learning objectives On completion of this lecture the student will be able to: Define the terms: ethics, nursing ethics and value, belief,morals, Define Ethics and its importance in nursing Discuss the ICN Code of Ethics Explain the ethical principles in nursing Ethics: A system of valued behaviors and beliefs for determining right or wrong and for making judgments about what should be done to or for other human beings. Ethics ‫االداب‬and Moral ‫واالخالق‬ Are regarded as identical concepts, but actually they are not. The term ethics is derived from the Greek word ήθος (ethos) meaning moral character. Ethics refers to the practices or beliefs of a certain group (i.e. Nursing ethics, Physicians' ethics). It also Refers to the expected standards as described in the group's code of professional conduct. The term morality comes from the Latin word mos meaning custom or manner ‫تعني العرف أو‬ ‫األسلوب‬ Moral: is principles and rules of right conduct. It is private or personal. Commitment to principles and values are usually defended in daily life  Types of Ethics 2- Health care ethics: Deals with conduct of moral issues that arise in the practice of health care professionals. 3- Nursing ethics: It is known as nursing etiquette, concerned with moral principles governing the right conduct of nurses in her relationship patients, physicians, colleagues, nursing profession and the public.  Need to study Ethics in Nursing Enables to make correct judgement of different types of situations.  Need to study Ethics in Nursing Guides to choose the right course of action towards attainment of goals.  Need to study Ethics in Nursing Outlines professional responsibilities, values, standards, and rules of behavior.  Need to study Ethics in Nursing Protects patient’s right and dignity. Ethical Principles  1. Autonomy Comes from the G reek word ––’autos’ meaning self and “nomos” meaning self governance. Autonomy is the promotion of independent choice, self determination and freedom of action. To govern one’s self, they need: -Understand the issue -Reason out and give one’s own decision -Weigh the pros and cons of the issue -Make an independent choice. Infants, young children, mentally handicapped or incapacitated people, or comatose patient do not have the capacity to participate in decision making about their health care.. If the client becomes unable to make decisions for himself/ herself, this “surrogate decision maker” would act on the client's behalf.‫"ليدبالرارقالعناص‬  Ethical Principles2 Beneficence ‫االحسان‬ Latin word –“bene” = good “fiche” = to act or to do The generic definition of beneficence is an act of charity, mercy,and kindness. Beneficence Beneficence is doing or promoting good. Principle of beneficence: it refers to moral obligation to act for the benefit of others. Ethical Principles3 Non maleficience It means to avoid doing harm. When working with clients, health care workers must not cause injury or suffering to clients.  Non- maleficence The principle of non maleficence supports the following rules: Do not kill. Do not cause pain or suffering. Do not incapacitate. Do not cause offense. Nonmaleficience Even verbal abuse at work is treated as maleficence. The non-maleficence principle was developed to protect health care workers and patients. Ethical Principles4 The justice principle States that there should be fairness in all medical decisions.  The justice principle Equal and fair treatment. It means: -Fairness -Equitable -Deserved -Appropriate Injustice : Involves a wrongful act or omission that denies people benefits to which they have right. Veracity Veracity means telling the truth, which is essential to the integrity of the client-provider relationship Health care providers obliged to be honest with clients Veracity Veracity is necessary in professional patient relationship for 3 reasons it is based on respect owed to others. it has close connection to obligations of fidelity and promise keeping relationship of trust between persons are necessary for fruitful intervention and cooperation.  EXAMPLES OF VERACITY IN NURSING? 1 Admitting mistakes veracity in nursing means being willing to admit our shortcomings and face the consequences of mistakes. Most mistakes are not intentional. -2Maintaining accurate charts Honesty in documentation is another example of veracity in nursing. -3Asking for help when you need it -4Demonstrating accuracy in patient care nurses strive to do jobs completely and as accurately as possible. -5Informed Consent True informed consent only occurs when patients are presented with accurate, and honest information necessary to make knowledgeable decisions. Confidentiality It is a moral and legal obligation of health care providers. Any information gathered by the nurse during the course of their treatment will be treated confidential until death of the patient.  Fidelity Fidelity means being faithful to one's commitments and promises. The main principle supports the concept of “accountability”. Abandonment ‫–التخلي عن‬is a breach of fidelity and infidelity amounting to disloyalty.  Fidelity For example, 1-A nurse who told their patient they were coming back in 30 minutes to check on their pain,would either come back, or delegate somebody else to come back if they got tied up. 2- if a patient asks how long they’ll be in the hospital and you tell them,“just one more day,” they should be able to trust that answer as accurate.An exception would be if an unforeseen circumstance or emergency occurs.  Ethical responsibilities of Nurses Promotion of health Prevention of illness Prolongation of life Restoration of health  ICN Code of Ethics It has been revised in 2021. The ICN Code of Ethics for Nurses is a statement of the ethical values, responsibilities and professional standards of nurses. Principle elements of ICN code of Ethics There are four elements: - Nurses and patients or people requiring care - Nurses and practice - Nurses and the profession - Nurses and global health  Nursing Codes of Ethics Provision 1 The nurse practices with compassion and respect for the inherent dignity, worth, and personal attributes of every person, without prejudice. Page 33 ‫ممارسة مهنة التمريض برأفة واحترام للكرامة المتأصلة‬ ‫ دون تحيز‬، ‫والقيمة والسمات الشخصية المنفردة لكل شخص‬ Provision 2. The nurse‟s primary commitment is to the patient, whether an individual, family, group, community, or population. The patient should always be a first and primary concern. INTRODUCTION TO PROFESSIONAL ETHICS Provision 3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. It is important for the nurse to understand all privacy guidelines concerning patient care and patient identifiers. Provision 4. The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care. Use of authority must be professional and about all aspects of individualism and patient, ethical concerns. ‫اوقات الزيارة والسماح بها‬ Nursing decisions must be well thought, planned, and purposefully implemented responsibly. ‫مثال نقل مريض من غرفة لغرفة بدون سبب او تاجيل اي اجراء‬ ‫خاص به‬ Any delegation of nursing activities or functions must be done with respect for INTRODUCTION TO PROFESSIONAL ETHICS the action and the ultimate results to occur. Page 02  Provision 5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth. An ideal nurse uphold safe practice within the care setting and at home. Nurses should be concerned about personal growth Provision 6. The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care. It's important to understand safety, quality and environmental considerations that are conducive to best patient care outcomes. Provision 7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy. Nurse education should include principles of research, Provision 8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities. INTRODUCTION TO PROFESSIONAL ETHICS Page 02 Provision 9. The profession of nursing, collectively through its professional organization, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.  1. World Health Organization (2020). Social determinants of health. Retrieved from: https://www.who.int/social_determinants/sd h_definition/en/