Health Ethics (Bioethics) PDF

HEALTH ETHICS (BIOETHICS)  THEORIES and PRINCIPLES of HEALTH ETHICS  Deals with the application of ethico – moral concepts and principles, affecting care of the individuals, families, population group and community. It involves discussions of issues and concerns i...

HEALTH ETHICS (BIOETHICS)  THEORIES and PRINCIPLES of HEALTH ETHICS  Deals with the application of ethico – moral concepts and principles, affecting care of the individuals, families, population group and community. It involves discussions of issues and concerns in varied health care situations. ETHICAL THEORIES  ETHICAL THEORIES A. Deontology B. Teleology C. Utilitarianism Hedonistic Utilitarianism. Pleasure and the absence of pain are good. Pleasure is any sensation you would rather have than no sensation at all; pain is any sensation you’d rather not have than no sensation at all Rule Utilitarianism. Always act according to the rule that would produce the most utility in the world (vs. “act” utilitarianism) Preference Utilitarianism. Always act so as to maximize satisfaction of people’s preferences (vs. “Hedonistic” Utilitarianism)  VIRTUE ETHICS A. Virtue Ethics in Nursing B. Core Values of a Professional Nurse  Virtue ethics is a broad term for theories that  Caring is best demonstrated b y a emphasize the role of character and virtue in nurse's ability to embody the five core moral philosophy rather than either doing values of professional nursing. Core one's duty or acting in order to bring about nursing values essential to good consequences. baccalaureate education include human dignity, integrity, autonomy, altruism, and social justice.  Virtue ethics are normative ethical theories which emphasize virtues of mind, character and sense of honesty. Virtue ethicists discuss  The caring professional nurse integrates the nature and definition of virtues and other these values in clinical practice. related problems that focus on the consequences of action.  ETHICAL PRINCIPLES A. Autonomy - defined as “self-rule with no control, undue influence or interference from other. It is about respecting other people’s wishes and supporting them in their decisions. Patient’s Rights 1948,Universal Declaration of Human Rights recognizes “the inherent dignity” and the “equal and unalienable rights of all members of the human family”. what is owed to the patient as a human being, by physicians and by the state, (World Health Organization, 2020).  Patient’s Bill of Rights  The patient has the right to considerate and respectful care.  The patient has the right to obtain from his physician complete and current information concerning his diagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand.  The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment.  The patient has the right to refuse treatment and to be informed of the medical consequences of his action.  The patient has the right to every consideration of his privacy concerning his own medical care program.  The patient has the right to expect that all communications and records pertaining to his care should be treated as confidential.  The patient has the right to expect within its capacity, a hospital must make a reasonable response to the request of a patient for services.  The patient has the right to obtain information as to any relationship his hospital has to other health care and educational institutions as far as his care is concerned.  The patient has the right to be advised if the hospital proposes to engage of inform human experimentation affecting his care or treatment.  The patient has the right to examine and receive an explanation of his bill.  The patient has the right to know what hospital rules and regulations apply to his conduct as a patient.  Informed Consent. Relates to the patients right to accept or reject treatment by a nurse or any other health care provider. A right of all legally competent adults or emancipated minors. The Doctrine of Informed Consent. A fundamentally accepted principle governing the relationship between professional nurses and all other health care providers and patients. The Role of the Physician. In the majority of circumstances, informed consent is obtained for medical or surgical procedures to be performed by physicians. to inform the patient of alternative treatments, the nature of the procedure, and benefits and potential  The Role of the Nurse - Oftentimes, especially when the patient is hospitalized, the nurse is required to witness the patient’s signature before the procedure. It is prudent for the nurse to note witness to signature directly next to the patient’s signature. The Duty of the Nurse. Advise the patient of available alternatives. This enables the patient to make an intelligent and informed decision and choice about whether to undergo treatment. NURSING ALERT: With the increasing cultural diversity of our patient population, it is prudent to obtain an interpreter for the patient if there is a reasonable chance that the patient will not understand explanations in the English language. Proxy Consent/Legally Acceptable Representative Parents can give informed consent for treatment for their minor children. A mentally disabled person has an appointed guardian authorized to make medical decisions, Medical providers need to make sure that when they obtain informed consent for incompetent individuals, they have obtained it from the correct person or persons. B. Confidentiality It is the right of an individual to have personal, identifiable medical information kept out of reach of others. The only times this principle may be violated are If clients indicate harm to themselves or others If the clients give permission for the information to be shared C. Veracity Truth telling and right to information – Principle implies truthfulness. Nurses need to be truthful to their clients. Veracity is an important component of building trusting relationships. D. Fidelity it is faithfulness to a person, cause, or belief, demonstrated by continuing loyalty and support. It is the quality or state of being faithful where there are strict observance of promises and duties. - Loyalty -The promise to fulfill all commitments - The basis of accountability E. Justice - rendering of what is one’s due. A person who is justly doing an act to another person gives the latter what is his due. It could be described as the moral obligation to act on the basis of fair adjudication (court0 between parties. As such, it is linked to fairness, entitlement and equality. F. Beneficence It provides that good must be done either to oneself or to others. It is to do what is good, performing for good as a moral obligation and mandating the right of every human person to the preservation of life. G. Non-Maleficence It provides that evil or harm should not be inflicted either on oneself or on others. This binds and urges everyone to avoid inflicting harm as a moral obligation.  OTHER RELEVANT ETHICAL PRINCIPLES A. Principle of Double effect The doctrine of double effect. This doctrine says that if doing something morally good has a morally bad side-effect it is ethically okay to do it providing the bad side-effect is not intended. This is true even if you foresaw that the bad effect would probably happen. B. Principle of Legitimate Cooperation It is applied whenever an act we are considering would assist someone else in committing a morally evil act. C. Principle of common good and subsidiary The term the “common good” has been used in various contexts to identify actions or outcomes that have some definable benefit that extends beyond individual gain. The c o m m o n go o d ha s be e n a ddre sse d in p r o f e s s i o n a l literature pertaining to ethics, political action, the environment, nursing,  PRINCIPLE OF BIOETHICS A. Principle of Stewardship and Role of Nurses as Stewards Stewardship in nursing involves valuing and respecting patients' priorities and self-determination. Nurses become stewards or teachers to patients who may not have the expertise or experience in the disease process, but who understand the consequences of their illness. Personal Social Ecological Biomedical B. Principle of Totality and its Integrity Ethico-moral Responsibility of Nurses in Surgery Sterilization/Mutilation Preservation of Bodily Functional Integrity Issues of Organ Donation C. Principle of Ordinary and Extraordinary Means - the good of saving life is morally obligatory. only if its pursuit is not excessively burdensome or disproportionate. in relation to the expected benefits. D. Principle of Personalized Sexuality - As one of the basic traits of the human person and must be developed in ways consistent with enhancing human dignity - this element of human character often leads to a loss of human dignity and an inability to pursue the truly fulfilling goals of human life.