Ethical Issues in Nursing

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1 Ethical Issues in Nursing

2 Ethical Aspects of Nursing Advance directives Two types Living wills Durable power of attorney Patient Self-Determination Act (PSDA) of 1991 requires all health care institutions to provide written information to patients regarding their right to make decisions about their health care See Figure 2-5 and Box 2-7 2

3 Ethical Aspects of Nursing Advance directives Two types Living wills Durable power of attorney Patient Self-Determination Act (PSDA) of 1991 requires all health care institutions to provide written information to patients regarding their right to make decisions about their health care See Figure 2-5 and Box 2-7

4 Ethical Aspects of Nursing cont d Development of ethical principles Define values Define value clarification Define ethical dilemma (refer to Box 2-8) 4

5 Ethical Aspects of Nursing cont d Ethical principles in nursing practice Most fundamental principle is respect for people Autonomy freedom of personal choice Beneficence acting for someone s good Nonmaleficence means to do no harm Justice concept of what is fair 5

6 Ethical Aspects of Nursing cont d Ethical issues Change as society changes Practitioner-assisted suicide (PAS) 6

7 Ethical Aspects of Nursing cont d Refusal to treat The nurse cannot refuse to care for a patient because he/she disagrees with the decisions the patient makes Nurse does not have to participate in the procedure, but cannot refuse to provide care after the procedure Do not abandon the patient; ask for another assignment 7

8 Ethical Aspects of Nursing cont d Refusal to treat The nurse DOES NOT have the legal right to refuse to care for a patient with an infectious disease Standard Precautions should be applied to every patient; therefore, the nurse is at no greater risk The patient has the right to receive care and the nurse has the responsibility to provide care 8

9 Ethical Aspects of Nursing cont d Do not resuscitate (DNR) orders The patient is usually incapacitated with little hope of recovery Health care provider will consult with the family before writing a DNR order Nurse has the duty to follow the order 9

10 Conclusion No easy answers to legal or ethical issues Nursing profession will continue to be responsible for adjusting to changes as the future of health care changes Important to work together to maintain the ethical and legal rights of our patients 10

11 Question 1 A nurse notes that her neighbor has been admitted to her unit. At dinner with her family she states, Ms. Long has been admitted to my unit with pneumonia. I m so concerned for her. Which violation has the nurse committed? 1. The nurse has not violated any rights because she is acting in good faith when she tells her immediate family how she feels. 2. The nurse is violating the patient s right to privacy or HIPAA. 3. The nurse is violating the Patient s Bill of Rights. 4. The nurse is violating the standards of practice. 11

12 Question 2 Which would be considered a breach of the standard of care in nursing? (Select all that apply.) 1. Failure to properly assess 2. Failure to provide a safe environment 3. Failure to go through hierarchy to get the care needed 4. Failure to detect the patient has an allergy 5. Failure to use proper judgment 12

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