NUR..2349..Exam..2..Concept..Guide:..Professiona
l..Nursing..I../..PN1
Ethics:..The..study..or..examination..of..moralitythrough..a..variety..of..different..approaches..
HIPPA..and..nursing..research..in..2003
The..law..that..protects..the..basic..rights..and..privacy..of..the..patient..to..control..the..disclosureof..that..pa
tient’s..personal..health..care..information.
Information..can..only..be..shared..with..worksdirectly..involved..with..the..patient’s..care...Et
hical..responsibility..shown..by..nurse
Intermediary:..Nurses..have..more..direct..contactwith..patients..than..any..other..health..care..member...Th
ey..interact..more..and..receive..moreinformation.
Moral..distress:..Nurse..is..aware..of..the..right..and..moral..action..to..take..in..any..given..situation..but..the
y..are..unable..to..carry..out..the..action..becauseof..external..constraints..(E.g...Heavy..workload,..lack..of..
nurses,..financial..constraints..in..a..facility,conflicts..with..co-workers/managers)
Patient..advocacy:..Speaking..for..the..patient..to..the..fullest..extent...It’s..up..to..nurses..to..plead..theirsense
..in..a..legal..manner.
Moral..principles
Veracity:..Truth..(Obligated..to..tell..the..truth..to..the..patient,..even..if..the..family..doesn’twant..you
to)
Nonmaleficence:..Do..no..harm..Autonomy:..Requires..that..the..patient
have..autonomy..of..thought,..intention,..and..action..when..making..decisions..regarding..healthcare..proc
edures...Therefore,..the..decision-
..making..process..must..be..free..of..coercion..or..coaxing...In..order..for..a..patient..to..make..a..fully..inform
ed..decision,..she/he..must..understand..allrisks..and..benefits..of..the..procedure..and..the..likelihood..of..s
uccess.
Beneficence:..Requires..that..the..procedure..be..provided..with..the..intent..of..doing..good..for..th
e..patient..involved...Demand..that..health..care..providers..develop..and..maintain..skills..and..knowledge
,..continually..update..training,..consider..individual..circumstances..of..allpatients,..and..strive..for..the..ne
t..benefit.
Fidelity:..Strict..observance..of..promises,duties,..etc.
Justice:..Must..be..distributed..equally..among..all..groups..in..society...Requires..that..procedures..uphold..t
he..spirit..of..existing..laws..and..are..fair..toall..players..involved
Living..will..and..DPAHC:
Living..will:..Allows..a..person..to..show..specific..documentation..of..what..medical..treatment..theywant..or
..do..not..want..if..they..become..terminally..ill.
DPAHC:..Allows..a..person..to..appoint..an..agent..orproxy..decision..maker..to..make..health..care..decisions..
,in..the..case..the..patients..capacity..is..lost.
, **The..living..will..goes..into..effect..when..a..personhas..a..terminal..illness..and..lacks..capaci
ty...DPAHC..is..not..constrained..by..a..terminal..state..ofhealth.
Lack..of..decision..capacity..may..be..temporary.Palliative..vs..hospice
Palliative:..The..process..that..is..focused..on..relieving..pain..and..physical..symptoms,..enhancing..psychos
ocial..support,..and..enhancingthe..families..to..feel..meaningful..to..resolve..the..patient’s..pain..as..they..ar
e..passing...This..is..comfort..care..that..is..NOT..federally..funded.
Hospice:..A..program..that..is..sponsored..by..Medicare..to..provide..comfort..care..for..the..terminally..ill..an
d..the..families...An..individual..has..to..meet..specific..guidelines...These..people..have..6months..or..less..to
..live.
Moral..distress..vs..burnout
Moral..distress:..Inability..to..carry..out..a..moraldecision...Percei
ved..constraints:
Physicians:..nurse..administrators;..other
nurses
The..law;..threat..of..lawsuit
Advanced..directives..and..information..to..makeinformed.. consent
Advanced..directives:..Allows..a..person..to..makefuture..decisions..about..his/her..health..car
e...These..documents..are..typically..written..but..canalso..be..verbal.
Informed..consent:..For..a..patient..to..give..informed..consent..they..must..have..the..autonomyto..do..so...
They..must..have:..cognitive..ability..to..understand,..deliberate..reasoning..skills,..be..able..to..come..to..a..c
onclusion,..must..not..be..coerced,..information..about..what..will..happen..if..they..do..not..give..consent,..a
nd..must..be..able..to..freely..consent..based..on..values..an..wishes.
Confusion..with..informed..consent
Adults..who..do..not..have..autonomy..and..need..a..decision..maker..or..individuals..under..18..cannot..give.
.consent...If..someone..does..have..the..right..toinformed..consent..but..this..becomes..questionable,..the..ab
ility..is..taken..away...A..nursecan..question..ability..of..an..adult..even..if..the..health..care..provider..doesn’t
.
Right..of..terminally..ill..patient
Right..to..die:..Formal..advanced..directives..can..assist..in..the..making..of..end..of..life..decisions..evenif..the..patie
nt..does..not..have..mental..capacity..(can..be..used..when..a..patient..is..in..a..coma)
Active..euthanasia:..Someone..other..than..the..patient..performs..an..action..to..end..the..patientslife...(E.g.
..lethal..injection)
l..Nursing..I../..PN1
Ethics:..The..study..or..examination..of..moralitythrough..a..variety..of..different..approaches..
HIPPA..and..nursing..research..in..2003
The..law..that..protects..the..basic..rights..and..privacy..of..the..patient..to..control..the..disclosureof..that..pa
tient’s..personal..health..care..information.
Information..can..only..be..shared..with..worksdirectly..involved..with..the..patient’s..care...Et
hical..responsibility..shown..by..nurse
Intermediary:..Nurses..have..more..direct..contactwith..patients..than..any..other..health..care..member...Th
ey..interact..more..and..receive..moreinformation.
Moral..distress:..Nurse..is..aware..of..the..right..and..moral..action..to..take..in..any..given..situation..but..the
y..are..unable..to..carry..out..the..action..becauseof..external..constraints..(E.g...Heavy..workload,..lack..of..
nurses,..financial..constraints..in..a..facility,conflicts..with..co-workers/managers)
Patient..advocacy:..Speaking..for..the..patient..to..the..fullest..extent...It’s..up..to..nurses..to..plead..theirsense
..in..a..legal..manner.
Moral..principles
Veracity:..Truth..(Obligated..to..tell..the..truth..to..the..patient,..even..if..the..family..doesn’twant..you
to)
Nonmaleficence:..Do..no..harm..Autonomy:..Requires..that..the..patient
have..autonomy..of..thought,..intention,..and..action..when..making..decisions..regarding..healthcare..proc
edures...Therefore,..the..decision-
..making..process..must..be..free..of..coercion..or..coaxing...In..order..for..a..patient..to..make..a..fully..inform
ed..decision,..she/he..must..understand..allrisks..and..benefits..of..the..procedure..and..the..likelihood..of..s
uccess.
Beneficence:..Requires..that..the..procedure..be..provided..with..the..intent..of..doing..good..for..th
e..patient..involved...Demand..that..health..care..providers..develop..and..maintain..skills..and..knowledge
,..continually..update..training,..consider..individual..circumstances..of..allpatients,..and..strive..for..the..ne
t..benefit.
Fidelity:..Strict..observance..of..promises,duties,..etc.
Justice:..Must..be..distributed..equally..among..all..groups..in..society...Requires..that..procedures..uphold..t
he..spirit..of..existing..laws..and..are..fair..toall..players..involved
Living..will..and..DPAHC:
Living..will:..Allows..a..person..to..show..specific..documentation..of..what..medical..treatment..theywant..or
..do..not..want..if..they..become..terminally..ill.
DPAHC:..Allows..a..person..to..appoint..an..agent..orproxy..decision..maker..to..make..health..care..decisions..
,in..the..case..the..patients..capacity..is..lost.
, **The..living..will..goes..into..effect..when..a..personhas..a..terminal..illness..and..lacks..capaci
ty...DPAHC..is..not..constrained..by..a..terminal..state..ofhealth.
Lack..of..decision..capacity..may..be..temporary.Palliative..vs..hospice
Palliative:..The..process..that..is..focused..on..relieving..pain..and..physical..symptoms,..enhancing..psychos
ocial..support,..and..enhancingthe..families..to..feel..meaningful..to..resolve..the..patient’s..pain..as..they..ar
e..passing...This..is..comfort..care..that..is..NOT..federally..funded.
Hospice:..A..program..that..is..sponsored..by..Medicare..to..provide..comfort..care..for..the..terminally..ill..an
d..the..families...An..individual..has..to..meet..specific..guidelines...These..people..have..6months..or..less..to
..live.
Moral..distress..vs..burnout
Moral..distress:..Inability..to..carry..out..a..moraldecision...Percei
ved..constraints:
Physicians:..nurse..administrators;..other
nurses
The..law;..threat..of..lawsuit
Advanced..directives..and..information..to..makeinformed.. consent
Advanced..directives:..Allows..a..person..to..makefuture..decisions..about..his/her..health..car
e...These..documents..are..typically..written..but..canalso..be..verbal.
Informed..consent:..For..a..patient..to..give..informed..consent..they..must..have..the..autonomyto..do..so...
They..must..have:..cognitive..ability..to..understand,..deliberate..reasoning..skills,..be..able..to..come..to..a..c
onclusion,..must..not..be..coerced,..information..about..what..will..happen..if..they..do..not..give..consent,..a
nd..must..be..able..to..freely..consent..based..on..values..an..wishes.
Confusion..with..informed..consent
Adults..who..do..not..have..autonomy..and..need..a..decision..maker..or..individuals..under..18..cannot..give.
.consent...If..someone..does..have..the..right..toinformed..consent..but..this..becomes..questionable,..the..ab
ility..is..taken..away...A..nursecan..question..ability..of..an..adult..even..if..the..health..care..provider..doesn’t
.
Right..of..terminally..ill..patient
Right..to..die:..Formal..advanced..directives..can..assist..in..the..making..of..end..of..life..decisions..evenif..the..patie
nt..does..not..have..mental..capacity..(can..be..used..when..a..patient..is..in..a..coma)
Active..euthanasia:..Someone..other..than..the..patient..performs..an..action..to..end..the..patientslife...(E.g.
..lethal..injection)
