Comm. Health - Ethics in Community Health Nursing Practice
Terms
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- Morals
- shared and generational societal norms about what constitutes right or wrong conduct
- Values
- Beliefs about the shared worth or importance of what is desired or esteemed within a society
- Florence Nightingale
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- saw nursing as a call to service
- thought nurses should be people of good character
- gave enduring morals and values to the profession of nursing - Nursing Code of Ethics
- a framework that nurses use to guide their ethical obligations and actions within the profession
- The Nightingale Pledge
- nursing's first code of ethics
- Ethical decision making
- that component of ethics focusing on the PROCESS of how ethical decisions are made
- Ethical Issues
- Moral challenges facing the nursing profession
- Ethical Dilemmas
- puzzling moral problems in which morally justified reasons for both taking and not taking a certain course of action are envisioned
- In what year was the (CNA) Code of Ethics developed?
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1980
**it was adopted in 1985 as the Code of Ethics for Nursing - Ethical decision-making frameworks
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- use problem solving processes
- serve as guides for making ethically sound decisions that can be morally justified - 7 Steps to ethical decision making
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1. Identify
2. Meaningful context
3. Relevant facts
4. Reformulate issues and dilemmas, if needed
5. Consider approaches (utilitarianism, denontology, principlism, virtue, ethics, ethic of care, feminist ethics)
6. Make decisions & take action
7. Evaluate - Veracity
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telling the truth
*veractiy promotes trust in the nurse-client relationship - Ethics
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- a branch of philosophy
- includes a body of knowledge about the MORAL LIFE and a PROCESS OF REFLECTION for determing what persons ought to do or be - Some general ethical obligations
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1. not to HARM others
2. to RESPECT others
3. to tell the TRUTH
4. to keep PROMISES - Consequentialism
- the right action is the one that produces the GREATEST amount of GOOD or the LEAST amount of HARM in a given situation
- Utilitarianism
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- a CONSEQUENTIALIST theory
- appeals exclusively to OUTCOMES or consequences in determining which choice to make
- "the moral of an action is determined by its overall benefit" - Denontology
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- persons should be treated as ends in themselves, and never as mere means to the ends of others
- always do what is right - Autonomy
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- independence or free-will
- respecting individuals right to make their own decisions - What ethics prinicple is normally emphasized in ACUTE CARE settings?
- Autonomy
- Beneficence
- performing acts of kindness and charity
- What ethical principles are emphasized more in COMMUNITY HEALTH?
- Beneficence & distributive justice
- Distributive (or social) justice
- the allocation of benefits (ex. basic needs) and burdens to members of society
- Principlism
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Health care professionals have specific obligations that exist because of the practices and goals of the profession:
- autonomy - ability to make choices for yourself
- nonmaleficence - do no harm
- beneficence - do good
- distributive justice - fairness with regards to distribution of benefits within society - Communitarianism
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- abstract, universal principles are not an adequate basis for moral decision making
- history, tradition, and concrete moral communities should be the basis of moral thinking and action - What are 3 theories with a communitarian focus?
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1. Virtue ethics
2. The ethics of care
3. Feminist ethics - Virtue Ethics
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- virtues are acquired, excellent traits of character that dispose humans to act in accord with their natural good
- one of the oldest types of ethical thinking - Examples of virtues
- benevolence (an inclination to perform kind, charitable acts), compassion, discernment, trustworthiness, integrity, and conscientiousness
- Feminist ethics
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- supports critical thinking and focus on issues such as gender, power, and socioeconomic status
- entails knowledge about and critique of classical ethical theories developed by men and women, and knowledge about the social, cultural, political, economic, evironmental, and professional contexts that insidiously and overtly oppress women as individuals or within a family, group, or society - The ethic of care
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- based on feminist theory
- a response to the technological advances in health care science, to the desire of nurses to differentiate nursing practice from medical practice
- emphasizes a belief in the morality of responsibility in relationships that emphasize connection and caring
- a core value of community health nursing - Which communitarian theory is based on feminist theory?
- The ethic of care
- CNA Code of Ethics for Registered Nurses
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- provides guidance for decision making concerning ethical matters
- serves as means of self-evaluation and self-reflection regarding ethical nursing practice
- provides a basis for peer feedback and review
- serves as a basis for which nurses can advocate for quality work environments that support delivery of safe, compassionate, competent, and ethical care -
Code of Ethics for Registered Nurses (CNA)
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- provides guidance for decision making concerning ethical matters
- serves as means of self-evaluation and self-reflection regarding ethical nursing practice
- provides a basis for peer feedback and review
- serves as a basis for which nurses can advocate for quality work environments that support delivery of safe, compassionate, competent, and ethical care
- informs other health care professionals and members of the public about the ethical commitments of nurses
- upholds the responsibilities of being a self-regulating profession
- concerns the social responsibility of the professionals who are accountable to society and to communities and implies an understanding of these foundations
- What are 2 important ethical obligations that CHNs face?
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1. Confidentiality
2. Accountability - What are the 7 primary values of the CNA Code of Ethics?
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1. Providing safe, compassionate, competent and ethical care
2. Promoting health & well-being
3. Promoting and respecting informed decision-making
4. Preserving dignity
5. Maintaining privacy & confidentiality
6. Promoting justice
7. Being accountable - What does advocacy mean for community health nursing & for public health nursing?
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COMMUNITY health nursing:
- the application of information & resources to effect systemic changes that shape the way people in a community live
PUBLIC health nursing:
- intended to benefit aggregates (sub-population) (ex. to reduce death or disability in groups of people) and uses information & resources to reduce the occurence or severity of public health problems - What are some ethical principles for effective advocacy?
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1. act in the client's (group's, community's) best interest
2. act in accordance with the client's wishes & instructions
3. keep the client properly informed
4. carry out instructions with diligence & competence
5. act impartially & offer frank, independent advice
6. maintain client confidentiality