UNIVERSAL PRINCIPLES

Marion Katrina L. Raguini, RN


UNIVERSAL PRINCIPLES
1.

Help nursing professionals determine right and wrong

when making decisions about health care


1.Autonomy
2.Beneficence
3.Non-maleficence
4.Confidentiality
5.Fidelity
6.Justice
7.Veracity

1. AUTONOMY
 autos “self”
nomos “governance”
freedom to choose one’s own decisions, free
from deceit, constraint or coercion.
self-determination
 THREE ELEMENTS :



AUTONOMY 1. Ability to decide



2. Power to act upon decision

 Personal 3.

liberty 4. Respect for individual autonomy

of others
  INFORMED CONSENT
X Rational

AUTONOMY X Client has position to refuse

or grant


 Elements :
1. Disclosure
2. Understanding
3. Voluntary
4. Competence
5. Consent
  INFORMED CONSENT


 Types :
AUTONOMY 1. Oral
2. Implied
3. Written
4. General – routine services
5. Special – high-risk

procedures
 Therapeutic Privilege –
incompetence, emergency,
depression



 

DEATH AND DYING
X Right of informed
AUTONOMY refusal
X DNR order
X Death certificate
X Care of the body
X Organ transplant
X Organ donation
X Autopsy

 

PATERNALISM
 belief that one should limit
AUTONOMY the patient’s autonomy on
the basis of doing good for
patient


1. Lie prevents more evil than it

causes
2. Describe possible good that
occurs


 “Benevolent deception”

2. BENEFICENCE
 to do good
duty to do what is beneficial for the patient


 3 COMPONENTS
1. Do good.
2. Prevent evil or harm in all instances and
always advocate client’s best interest.
3. Remove evil or harm.

 

GOOD SAMARITAN LAW
 Emergency situations
BENEFICENCE
 CLIENT ADVOCATE  Provides protection to
health care providers
3. NON-MALEFICENCE
1.

2.Do no harm
3.

4.Remove harm
5.

6.Prevent harm



4. JUSTICE
Fair, equitable and appropriate treatment
Proper allocation of resources
Triage


 To each person an equal share

 To each person according to need
 To each person according to merit
 To each person according to distribution
 To each person according to effort
 To each person according to social worth



5. CONFIDENTIALITY
 “The patient has a right to every consideration
of privacy concerning his own medical care

program.”
observing the seal of secrecy
personal privacy is a basic right!

 1.

2. Records
 Property
CONFIDENTIALITY  Access
3. Teaching
4. Research
5.
Breach of Confidentiality:

1. Danger to self
2. Danger to others
3. Required by law
 A man was diagnosed of HIV and he
requests that his condition be kept a secret.
Would you disclose the information to the ff.
persons and why?

a.Community
b.Parents
c.Wife
 A patient frequently having psychiatric
therapy confides to the practitioner that he plans
to kill a certain young woman. Through exploring,
the practitioner learned of the identity of the
woman.
The psychiatric institution did not inform the
woman and she ended up getting killed as
planned.
What is your stand on the issue?
6. FIDELITY
 Loyalty/faithfulness
Keeping promises


 ROLE FIDELITY
 remaining within the legitimate scope of
practice
 

GATEKEEPING
One looks out for the
ROLE interests of the profession
FIDELITY Strong sense of collegiality


 WHISTLE – BLOWING
reporting misconduct of
colleagues or institution
failure to report –
“accessory to the crime”
7. VERACITY
 practice of telling the truth
honest disclosure of
information
true and accurate and complete



  PATERNALISM
 belief that one should limit
VERACITY the patient’s autonomy on

the basis of doing good for
X Trust patient


X Open 1. Lie prevents more evil than it

communication
X Respect causes
X Shared 2. Describe possible good that
responsibility occurs


 “Benevolent deception”
 
Fraud – deliberate deception
VERACITY intended to produce unlawful

gain
Defamation – character

assassination
Libel – written


Slander – verbal/oral
