Beruflich Dokumente
Kultur Dokumente
Of CSUN?
Values Ethical code Center for ethics & values Business Dept
What is Ethics ?
The explicit, philosophical reflection on moral beliefs and practices. The difference between ethics and morality is similar to the difference between musicology and music. Ethics is a conscious stepping back and reflecting on morality, just as musicology is a conscious reflection on music.
http://ethics.sandiego.edu/LMH/E2/Glossary.asp
Ethics is NOT
Feelings Religion Following the law Following cultural norms Science (is is not an ought)
What is Morality?
Morality is behaviors & beliefs about human decency, right/wrong, good/evil, proper/improper
(Butts & Rich; http://ethics.sandiego.edu/LMH/E2/Glossary.asp)
Practices and beliefs about good and evil by means of which we guide our behavior.
Hinman,
http://ethics.sandiego.edu/Glossary.html
What is law?
Minimum ethic Rules made by human beings to guide society & regulate human interactions. (Aiken, p. 98). They written down and enforced by the state to promote peaceful & productive interactions (Aiken; Hall).
Types of Law
1.
Classification of Law
Criminal law wronged the public Civil law wronged another individual
2.
3.
LEGAL Yes
No
Yes No No No
Legal rights are defined by law Ethical rights are grounded in ethical principles, rules, values (not law)
Nursing Codes
Nightingale pledge 1853 International Council of Nurses Code 1953/2005 ANA Code (1950/2005) Think about what each has to do with Relationships in nursing Who we should be and how we should
act
Nightingale Pledge
1893 - Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician, in his work, and devote myself to the welfare of those committed to my care.
Professional codes reflect professional values. They do not necessarily reflect all the values of the individual professional.
Case #1
ANA Guide to Code of Ethics for
Nurses*
Ethical Dilemma
However, sometimes instead of Right action good outcome. We end up with a choice between: Right action bad outcome.
OR
Wrong action outcome. good (or less bad)
3.
4. 5. 6.
Similar to Nursing Process Your own values (Hall, pp. 48-50) Collect information (Jonsen 4 quadrant model) State dilemma (in ethical terms, not clinical ones) List choices (include do nothing) Analyze pros & cons of each choice Decide!
(cont.)
Quality of life Context (loyalty & (beneficence, fairness) Nonmaleficence & respect for autonomy)
If not a clinical ethical dilemma, you should still seek to list all the facts of the case. e.g., p. 107, Box 3.6 from Butts & Rich for nonclinical case.
4. List choices
Do nothing _________ _________
Option 2
Pros Cons
5. Decide!
Not to decide, is to decide. You dont get a choice This will be affected by law, values, your moral orientation, professional duties, and so on. Along with these ethical decisionmaking steps we use ethical reasoning to make decision
How do we choose?
In the WEST perhaps more Autonomy (self-determination) Individualism Self-understanding e.g.," You deserve a break today In the EAST perhaps more Relationships/ community Connections with others & cosmos e.g., do this for your family/ community
(Butts & Rich, 2008; Hall 2002)
Ethical reasoning
Deontologists Duty & reason. If I act this way, is it an action that could be a universal law for everyone to act in the same way? (categorical imperative. Consequentialists the greatest happiness or pleasure and least pain/suffering to the most people (utilitarianism) Virtue ethicists An excellent person will make excellent decisions (Aristotle) Natural law based in the rational order of nature & persons
(Butts & Rich, 2008; Hall 2002)
Causistry individual cases decided based on similar, model cases. Narrative context bound stories tell us how we should be; people are moral agents who make choices Critical theory ethics as liberation from dominant groups (e.g., feminist/care ethic) Principlism ethics is done based on ethical principles (e.g., Belmost report: respect, beneficence & justice)
(Butts & Rich, 2008; Hall 2002
How do we reason?
In the WEST perhaps more Autonomy (self-determination) Individualism Self-understanding You deserve a break today
In the EAST perhaps more Relationships/ community Connections with others & cosmos
(Butts & Rich, 2008; Hall 2002)
Ethical reasoning
Hinduism: ethic of unity with the cosmos Buddhism: ethic of suffering
Avoid attachment
Taoism (& native American traditions): ethic of harmony Confucianism: ethic of what is good for society
(Butts & Rich, 2008)
3.
4. 5. 6.
Similar to Nursing Process Your own values (Hall, pp. 48-50) Collect information (Jonsen 4 quadrant model) State dilemma (in ethical terms, not clinical ones) List choices (include do nothing) Analyze pros & cons of each choice Decide!
Summary
Relationships! Law reflects a minimum standard of ethics, but it is not ethics One persons right is another persons duty. Ethical decision-making in nursing includes
Law Values Moral orientation Professional codes Ethical reasoning