Summary Advanced Practice Nursing

Values and Ethics Interactive Notebook

Use this notebook to keep track of the Challenge answers and your own notes. Reflecting by writing will
help you increase your competency for this course.
To use the Table of Contents, click on the hyperlink, and then click on the corresponding URL that
appears in a popup window. Alternatively, you can switch from Editing to Viewing in the upper right hand
corner.


Table of Contents

Topic 1: Ethical Theories, Principles, and Standards
CHALLENGE 1: Responding to the Tuskegee Syphilis Study
CHALLENGE 2: Justice in Context
Topic 2: Legal Principles, Standards, and Law
CHALLENGE 1: Changing Laws
CHALLENGE 2: A Negligent Doctor
CHALLENGE 3: Conflicting Contracts
CHALLENGE 4: Privacy Laws
CHALLENGE 5: Patient Protection Laws
CHALLENGE 6: Ethical Actions of Leaders
Engage and Summary
Topic 3: Patient Rights
CHALLENGE 1: Patient Rights
CHALLENGE 2: The Elements of Autonomy
CHALLENGE 3: Navigating Informed Consent
CHALLENGE 4: Patient Assurance
Engage and Summary
Topic 4: Contemporary Ethical Dilemmas
CHALLENGE 1: Sarah’s Pregnancy
CHALLENGE 2: Physician-Assisted Suicide
CHALLENGE 3: Organ Transplants
CHALLENGE 4: Ethical Considerations For Healthcare Personnel
Engage and Summary
Topic 5: Professional Responsibilities and Corporate Ethics

, CHALLENGE 1: Corporate Ethics
CHALLENGE 2: Employee Beliefs
CHALLENGE 3: Organizational Values
CHALLENGE 4: Ethics in Communication
CHALLENGE 5: Code of Ethics and Accreditation
CHALLENGE 6: Conflicts of Interest
Engage and Summary




Topic 1: Ethical Theories, Principles, and Standards
Competency: Describe ethical theories, ethical and legal principles and standards, and laws as applied in
a healthcare setting
CHALLENGE 1: Responding to the Tuskegee Syphilis Study
Imagine that the Tuskegee study occurred today at the organization for which you work. How would a
manager react, and what tools are available to address the situation?
Objectives:
 Evaluate ethical theories
 Define key principles in healthcare ethics
o Beneficence
o Nonmaleficence
o Autonomy
o Justice
EXAMINE THINK ABOUT NOTES
Chapter 1 How might Who is it effecting? Is the greater good benefitted with the
(pp. 6–9) healthcare managers sacrifice of these people?
view the Tuskegee
case differently
based on different
ethical theories?
Chapter 1 How were the four Four Basic Principles of Ethics
(pp. 9–23) principles violated in  Beneficence
the Tuskegee case?
o Principle of doing good
How might these o Demonstrating kindness
principles come into o Showing compassion
conflict with one o Helping others
another? o Paternalism
 Making decisions for others;
 The family physician does not
fully inform Mr. Smith as to
the seriousness of his illness
and how the consequences of

, the various alternative
treatments might affect his
life style.
 Ethical and Legal Issues
 Legal issues
 Informed consent
 Ethical issues
 Autonomy
 Paternalism
 Non-maleficence
o Duty to Care
o Avoid causing harm
o Not concerned with
improving others’
well-being but with
avoiding the infliction
of harm
 Autonomy
o Right to make one’s
own decisions
 Justice
o Obligation to be fair in
distribution of
benefits and risks
o Distributive Justice
 Requires all individuals be treated
equally
o Justice and
government spending
 Change is coming
Chapter 4 What types of Committee Composition
(pp. 163– healthcare  Ethicist/s
175) professionals sit on  Educator/s
an ethics committee?  Caregiver/s
How can managers  Legal advisor/s
ensure the  Political leader/s
organization is aware  Religious leader/s
of the function of the  Corporate leader/s
ethics committee?
Education
 Ethics committee members
 Community
 Patients and family

,  Staff
o Ambulatory care facilities
o Home health agencies
o Long term care facilities
o Physician office practices
 Recognize time commitment.
 Include training in philosophy, religion, medicine, and
law.
 Include formal training and experience in clinical
ethics.
 Develop and distribute appropriate materials for
committee members, caregivers , patients and family.
 Promote Patient Rights
o Right to self-determination (autonomy)
 Accept or reject care and treatment
 Right to ethics committee consultation
Ethics in Which questions in MEDICAL INDICATIONS
Medicine the following The Principles of Beneficence and Nonmaleficence
Framework quadrants are 1. What is the patient’s medical problem? Is the problem
relevant to the acute? Chronic? Critical? Reversible? Emergent?
Tuskegee study? Terminal?
• MEDICAL 2. What are the goals of treatment?
INDICATIONS 3. In what circumstances are medical treatments not
•PATIENT indicated?
PREFERENCES 4. What are the probabilities of success of various
treatment options?
•QUALITY OF LIFE
5. In sum, how can this patient be benefited by medical
•CONTEXTUAL and nursing care, and how can harm be avoided?
FEATURES
How would an ethics PATIENT PREFERENCES
committee answer The Principle of Respect for Autonomy
the identified
1. Has the patient been informed of benefits and risks,
questions?
understood this information, and given consent?
Based on the 2. Is the patient mentally capable and legally competent,
answers to the and is there evidence of incapacity?
relevant questions in
the framework, how
were each of the four 1. If mentally capable, what preferences about
ethical principles treatment is the patient stating?
violated? 2. If incapacitated, has the patient expressed prior
preferences?
3. Who is the appropriate surrogate to make decisions
for the incapacitated patient?
4. Is the patient unwilling or unable to cooperate with
medical treatment? If so, why?