Professional Nursing Practice:
Ethics Ethics
Ethics TheoriesEthics Theories
-- Deontological TheoriesDeontological Theories--from the Greek from the Greek word
word ““dutyduty””, derived rules and norms for , derived rules and norms for the duties that human beings owe one
the duties that human beings owe one another by virtue of commitments made another by virtue of commitments made
and roles assumed; has sometimes and roles assumed; has sometimes
been subdivided into situational ethical been subdivided into situational ethical
theory.
theory.
Professional Nursing Practice:
Professional Nursing Practice:
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Ethics Theories continuedEthics Theories continued
-- Teleological theoriesTeleological theories--from the Greek word from the Greek word
““endend””, derived norms and rules for conduct, derived norms and rules for conduct from the consequences of actions.
from the consequences of actions.
-- PrinciplismPrinciplism-- emerging theory of ethics that emerging theory of ethics that incorporates existing ethical principles and incorporates existing ethical principles and
attempts to resolve conflicts by applying one attempts to resolve conflicts by applying one
or more of the ethical principles.
or more of the ethical principles.
Professional Nursing Practice:
Professional Nursing Practice:
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Ethical PrinciplesEthical Principles
-- AutonomyAutonomy--personal freedom and the rightpersonal freedom and the right to choose what will happen to one
to choose what will happen to one’’s owns own person.
person.
-- BeneficenceBeneficence--principle that states that theprinciple that states that the action one takes should promote good.
action one takes should promote good.
-- Nonmaleficence Nonmaleficence –– states that one should dostates that one should do no harm
no harm
Professional Nursing Practice:
Professional Nursing Practice:
Ethics Ethics
Ethical principles continuedEthical principles continued
-- VeracityVeracity-- principle that compels the truth is principle that compels the truth is told completely.
told completely.
-- JusticeJustice-- principle that all persons should beprinciple that all persons should be treated equally and fairly.
treated equally and fairly.
-- Paternalism Paternalism –– principle that allows one to principle that allows one to make decisions for another.
make decisions for another.
Professional Nursing Practice:
Professional Nursing Practice:
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Ethical principles continuedEthical principles continued
-- Fidelity Fidelity –– keeping onekeeping one’’s promises or s promises or commitments.
commitments.
-- Respect for others Respect for others –– the highest ethical the highest ethical principle, respect for others acknowledges principle, respect for others acknowledges
the right of individuals to make decisions and the right of individuals to make decisions and
live by those choices.
live by those choices.
Professional Nursing Practice:
Professional Nursing Practice:
Ethics Ethics
Ethical decisionEthical decision--making involves reflectionmaking involves reflection on the following:
on the following:
-- who should make the choicewho should make the choice
-- possible options or courses of actionpossible options or courses of action -- available optionsavailable options
-- consequences, both good and badconsequences, both good and bad
-- rules, obligations, and values that shouldrules, obligations, and values that should direct choices
direct choices
--desired goals or outcomesdesired goals or outcomes
Professional Nursing Practice:
Professional Nursing Practice:
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Ethical DecisionEthical Decision--making contmaking cont’’d.d.
Nurses need to combine all of these elements Nurses need to combine all of these elements
using an orderly, systematic and objective using an orderly, systematic and objective
method. Ethical decision
method. Ethical decision--making models making models assist in accomplishing this goal.
assist in accomplishing this goal.
Professional Nursing Practice:
Professional Nursing Practice:
Ethics Ethics
MORAL Model for Ethical Decision MakingMORAL Model for Ethical Decision Making
M M –– Massage the dilemma. Identify and defineMassage the dilemma. Identify and define the issues in the dilemma. Consider the the issues in the dilemma. Consider the options of all the major players in the
options of all the major players in the dilemma and their value systems. This dilemma and their value systems. This
includes patients, family members, nurses, includes patients, family members, nurses,
physicians, clergy, and any other inter physicians, clergy, and any other inter-
-disciplinary healthcare members.
disciplinary healthcare members.
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MORAL Model contMORAL Model cont’’dd
O O –– Outline the options. Examine all the Outline the options. Examine all the options, including those that are less options, including those that are less
realistic and conflicting. This stage is realistic and conflicting. This stage is designed only for considering options designed only for considering options
and not for making a final decision.
and not for making a final decision.
Professional Nursing Practice:
Professional Nursing Practice:
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MORAL Model contMORAL Model cont’’dd
R R –– Resolve the dilemma. Review the issuesResolve the dilemma. Review the issues and options, applying basic principles of and options, applying basic principles of
ethics to each option. Decide the best ethics to each option. Decide the best
option based on the views of al those option based on the views of al those
concerned in the dilemma.
concerned in the dilemma.
Professional Nursing Practice:
Professional Nursing Practice:
Ethics Ethics
MORAL Model contMORAL Model cont’’dd
A A –– Act by applying the chosen option. ThisAct by applying the chosen option. This step is usually the most difficult because step is usually the most difficult because
it requires actual implementation, whereas it requires actual implementation, whereas the previous steps allow only for dialogue the previous steps allow only for dialogue
and discussion.
and discussion.
Professional Nursing Practice:
Professional Nursing Practice:
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MORAL Model contMORAL Model cont’’dd
L L –– Look back and evaluate the entire process,Look back and evaluate the entire process, including the implementation. No process including the implementation. No process is complete without a thorough evaluation.
is complete without a thorough evaluation.
Ensure that those involved are able to Ensure that those involved are able to
follow through on the final option. If not, follow through on the final option. If not, a second decision may be required and the a second decision may be required and the
process must start again at the initial step.
process must start again at the initial step.
Professional Nursing Practice:
Professional Nursing Practice:
Ethics Ethics
Ethics committeesEthics committees
Provide structure and guidelines for potential Provide structure and guidelines for potential problems and can provide short term and long problems and can provide short term and long
term assistance. They also serve as open forums term assistance. They also serve as open forums
for discussion and function as true patient for discussion and function as true patient
advocates by placing the patient at the core of advocates by placing the patient at the core of
the committee discussions.
the committee discussions.