School of Nursing
Course Information
NURS 2513 M 3.00 Ethics and Health Equity in Interprofessional Practice
Prerequisite/Co-requisite(s): Prerequisites for 4-year Direct Entry BScN students: HH/NURS 1511 3.00.
Prerequisites for 2nd Entry BScN students: HH/NURS 1512 3.00. Course Credit Exclusion(s): HH/NURS 3400
3.00. Open to: Students in the BScN programs, and by permission to Faculty of Health students. Note: A
minimum grade of 5.00 (C+) is required for this course for in the BScN program.
Brief Description
Focuses on bioethical theories, health equity, and related concepts and current issues relevant to nursing
and other health professionals’ practice. Reflection on self-beliefs and the meaning of collaboration with
various clients and other practitioners occurs in the context of ethical decision making and the application
of various ethical frameworks. The impact on client health and autonomy are explored.
Course Learning Outcomes
Upon completion of this course, students will be able to:
1. Describe the role of the ethical practitioner in the context of issues of equity, diversity and justice in
healthcare.
2. Apply ethical frameworks, theoretical principles and concepts to diverse health care situations that
support client-centred outcomes.
3. Identify ways to advocate and work collaboratively with clients, family and intra/interprofessional
healthcare when responding to ethical issues.
4. Examine, from a theoretical and philosophical ethical perspective, current issues in health care in
terms of health equity and Indigenous health disparities, culture, law, health resources and societal
expectations.
5. Differentiate between ethical obligations, professional boundaries and legal requirements according to
professional standards and legislation.
6. Critically reflect on own values and beliefs, including professional position and perceived power, in
relation to the provision of ethical health care.
Effective Term (and Session): Winter 2023
Introduction
Time and Location: Include all face-to-face and synchronous meetings. Blended and remote courses need
to also identify dates for in-person and zoom meetings.
Example:
Lecture
Mondays 830-1130
CLH – J
Instructor Information
(/Clinical) Course Director
Mina Singh RN, PhD
Contact Information
minsingh@yorkuca
HNES 345
416-736-2100 xt 66439
Office Hours
By appointment [Office/Zoom]
Teaching & Learning Approaches
This is an interactive course, where we will learn the ethical theories, then apply to case studies
Course Website
The eClass course management system will be used as an extension of this course outline, and for course
content, extra learning materials (i.e., assignment rubrics), and communication. Students are required to
check the course eClass site on a very regular basis. Students should use their York U email for course
communication. For more information, see How do I access my eClass Course?.
Links to CNO Entry-to-Practice (ETP) Competencies (2020)
Roles
Clinician
Professional
Communicator
Collaborator
Coordinator
Leader 6.10
Advocate
Educator
Scholar 9.3
ETP Competencies
1.1
2.7, 2.8
7.3 -7.4, 7.6 7.7, 7.8, 7.9, 7.10, 7.11, 7.12, 7.13, 7.14
Links to NCLEX-RN Categories and Sub-Categories
Course Text/Readings.
The following text is required for this course (available at the York University Bookstore, or online).
Required Texts
Yeo, Michael, Moorhouse., A., Khan, P., & Rodney, P (2020). Concepts and Cases in
Nursing Ethics (4th Ed). ON, Broadview Press.
Supplemental Readings:
Required texts/articles & professional web-based sources (20 references).
NB: These materials will be used extensively in class and/or for student evaluation - if you do not obtain and use them
then you will be setting yourself up for earning poor grades.
American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.).
Washington, DC: Author.
Burkhardt, M. A., Nathaniel, A. K., & Walton, N. (2018). Ethics and issues in contemporary nursing (3rd Canadian ed.).
Toronto, ON: Nelson Education.
Canadian Nurses Association. (2009). Ethics in practice for registered nurses. Social justice in practice. Ottawa, ON:
NURS 2513 3.00 Ethics and Health Equity in Interprofessional Practice
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Author. Retrieved from cna-aiic.ca/~/media/cna/page-content/pdfen/ethics_in_practice_april_2009_e.pdf?la=en
Canadian Nurses Association. (2011). Position statement: Global health partnerships (PS-115). Ottawa, ON: Author.
Retrieved from cna-aiic.ca/~/media/cna/page-content/pdfen/ps115_global_health_partnerships_2011_e.pdf?la=en
Canadian Nurses Association. (2012). Ethics in practice for registered nurses. When private becomes public: The ethical
challenges and opportunities of social media. Ottawa, ON: Author. Retrieved from cnaaiic.ca/~/media/cna/page-content/pdf-en/ethics_in_practice_feb_2012_e.pdf?la=en
Canadian Nurses Association. (2017a). Code of ethics for registered nurses. Ottawa, ON: Author. Retrieved from cnaaiic.ca/~/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-secure-interactive.pdf?la=en
Canadian Nurses Association. (2017b). National nursing framework on medical assistance in dying in Canada. Ottawa,
ON: Author. Retrieved from cna-aiic.ca/~/media/cna/page-content/pdf-en/cna-national-nursing-frameworkon-maid.pdf?la=en
Canadian Nurses Association. (2018). Position statement: Promoting cultural competence in nursing. Ottawa, ON:
Author. Retrieved from cna-aiic.ca/-/media/cna/page-content/pdfen/position_statement_promoting_cultural_competence_in_nursing.pdf?la=en&hash=4B394DAE5C2138E7
F6134D59E505DCB059754BA9
College of Nurses of Ontario. (2017a). Practice guideline: Consent. Toronto, ON: Author. Retrieved from
cno.org/globalassets/docs/policy/41020_consent.pdf
College of Nurses of Ontario. (2017b). Practice guideline: Refusing assignments and discontinuing nursing services.
Toronto, ON: Author. Retrieved from cno.org/globalassets/docs/prac/41070_refusing.pdf
College of Nurses of Ontario. (2017c). Practice standard: Confidentiality and privacy - Personal health information.
Toronto, ON: Author. Retrieved from cno.org/globalassets/docs/prac/41069_privacy.pdf
College of Nurses of Ontario. (2017d). Practice standard: Documentation, Revised 2008. Toronto, ON: Author.
Retrieved from cno.org/globalassets/docs/prac/41001_documentation.pdf
College of Nurses of Ontario. (2018b). Guidance on nurses’ roles in medical assistance in dying. Toronto, ON: Author.
Retrieved from cno.org/globalassets/docs/prac/41056-guidance-on-nurses-roles-in-maid.pdf
College of Nurses of Ontario. (2018c). Practice standard: Ethics. Toronto, ON: Author. Retrieved from
cno.org/globalassets/docs/prac/41034_ethics.pdf
College of Nurses of Ontario. (2019b). Practice standard: Code of conduct. Toronto, ON: Author. Retrieved from
cno.org/globalassets/docs/prac/49040_code-of-conduct.pdf
Davies, B., Steele, R., Krueger, G., Albersheim, S., Baird, J., Bifirie, M., … Zhou, Y. (2017). Best practices in
provider/parent interaction. Qualitative Health Research, 27(3), 406-420. doi:10.1177/1049732316664712
De Lima, L., Woodruff, R., Pettus, K., Downing, J., Buitrago, R., Munyoro, E., ... Radbruch, L. (2017). International
Association for Hospice and Palliative Care position statement: Euthanasia and physician-assisted suicide.
Journal of Palliative Medicine, 20(1), 8-14. Retrieved from
online.liebertpub.com/doi/pdfplus/10.1089/jpm.2016.0290
NURS 2513 3.00 Ethics and Health Equity in Interprofessional Practice
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Gottlieb, L. N. (2014). CE: Strengths-based nursing: A holistic approach to care, grounded in eight core values.
American Journal of Nursing, 114(8), 24-32 (+ CE exam: 33, 36). doi:10.1097/01.NAJ.0000453039.70629.e2
International Nurse Regulator Collaborative (INRC). (2016). Position statement: Social media use: Common
expectations for nurses. Chicago, IL: Author. Retrieved from cno.org/globalassets/docs/prac/incr-socialmedia-use-common-expectations-for-nurses.pdf
Pollard, C. L. (2015). What is the right thing to do: Use of a relational ethic framework to guide clinical decisionmaking. International Journal of Caring Sciences, 8(2), 362-368. Retrieved from
internationaljournalofcaringsciences.org/docs/13_pollard.pdf
Evaluation/Evidence of Learning
The learning evidences for this course are designed to evaluate your knowledge and application of
essential concepts that support safe, competent nursing practice.
Description of Course Evaluation
1. Analysis Paper of an Experienced Ethical Issues (10%): Reflect upon an ethical dilemma you
have participated in and how you solved it, what you learned, how you applied ethical principles.
Please also use CNA Guidelines to support your answer. Submit to Turnitin. Due at the beginning
of class 5, February 6th, bring a hard copy.
2. Midterm Exam (35%): multiple choice, short answer, on class 9.
3. Group Presentation (20%): Based upon class readings, your group will create a presentation on an
ethical issue. During classes 10-12.
4. Final Paper (35%): Please check our Moodle site for details about this written paper (individual, not a
group project) - see the folder labelled “Final Paper”. In general, you will use the Oberle and Raffin model
(CNA, 2017a) to demonstrate your ability to use an ethical framework to guide your thinking about an ethical
problem or concern. As with the first paper, appropriate use of relevant literature is important for earning a
high grade and critical analysis is essential. Again, how you write is as important as what you write.
Submission Process: Please submit a stapled, hard copy of this paper (no binders/folders) at the beginning
of week 12’s class on April 3rd. There will be NO extensions allowed for this paper.
In addition, you must submit an electronic version of the exact same document on the course Moodle
site by 11.59pm on Monday April 3rd. The electronic version may be checked for potential academic
honesty issues, but will not be submitted through Turnitin. Please name your electronic document as
follows: “Surname First Name Initial Final Paper 2513L”. For example, I would name my document as
“Singh M Final Paper 2513L”. As with the first paper, the electronic version of your paper must be
submitted in a Word format - either ‘.doc’ or more likely ‘.docx’. Do NOT submit in any other format,
including as a pdf. Failure to submit the electronic version on time and/or in the correct format will
result in penalties as described above. The day count is for business days only.
NOTE: Unofficial letter grades for the final paper will be posted on the Moodle website; students can
view only their own grades.
NURS 2513 3.00 Ethics and Health Equity in Interprofessional Practice
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1. If you want the graded hard copy returned to you then you will either need to make an
appointment to pick it up from my office or you may include a stamped, self-addressed
envelope with your paper - but there must be sufficient postage on the envelope as neither I nor
the School of Nursing will pay to mail a paper.
The final grade for the course* will be based on the following items, weighted as indicated:
Week
Week 4-5
Week 9
Week 1012
Week 12
Assignment Name
Analysis Paper of an Experienced Ethical Issues
(Relates to Course Learning Outcomes #1-6
Midterm Test
(Relates to Course Learning Outcomes # 1, 2, 3, 5, 6)
Group Presentation
(Relates to Course Learning Outcomes # 1-6)
Percentage of
Course Grade
10%
Final Paper
(Relates to Course Learning Outcomes # 1-6)
35%
20%
35%
* As per Faculty of Health and School of Nursing program policies, a student’s final course grade is not
necessarily confined to a compilation of marks earned on individual course components. Final course grades
may be adjusted to conform to Program or Faculty grades distribution profiles.
** The last date to drop a course without receiving a grade is Month XX, 20XX. Note that the late drop option
of the Withdrawn from Course (W) Policy does not apply to: Practica learning placements/courses. Students
must contact the undergraduate program coordinator or director in advance of any deadlines, in order
to exercise any course removal or withdrawal options.
Grading, Assignment Submission, Lateness Penalties and Missed Tests
Grading : The grading scheme for the course conforms to the 9-point grading system used in
undergraduate programs at York (e.g., A+ = 9, A = 8, B+ - 7, B = 6, C+ = 5, etc.). Assignments and tests*
will bear either a letter grade designation or a corresponding number grade (e.g. A+
= 90 to 100, A = 80 to 90, B+ = 75 to 79, etc.) For a full description of York grading system see the York
University Undergraduate Calendar.
For a full description of York grading system see the York University Undergraduate Calendar.
Assignment Submission: Proper academic performance depends on students doing their work not only
well, but on time. Accordingly, assignments for this course must be received on the due date specified for
the assignment. Assignments are to be handed in (specify how, where and when if this information was
not provided in the Description of Assignments above). All assignments will adhere to APA guidelines (7th
edition) in formatting and referencing.
NURS 2513 3.00 Ethics and Health Equity in Interprofessional Practice
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Lateness Penalty: Assignments received later than the due date, without negotiated extensions, will be
penalized. Any assignment that is not submitted by the date and time specified, OR any assignment for
which an extension is granted that is not handed in by the negotiated date and time, to the location
specified, is subject to the following penalty(s):
For 1 day late (any time up to 24 hours after date/time due), the penalty is 5% deducted from the
grade for the assignment (e.g., mark of 75% would be reduced to 70%)
For each subsequent day late (each 24-hour period), the reduction increases daily:
 for 2 days late, deduct 15% (e.g., mark of 75% would be reduced to 60%)
 for 3 days late, deduct 30%
 for 4 days late, deduct 50%
 for 5 or more days late, deduct 100% (assignment is given zero [0])
Exceptions to the lateness penalty for valid reasons such as illness, compassionate grounds, etc., may be
entertained by the Course Director but will require supporting documentation (e.g., a doctor’s
letter/attending physician’s statement). Generally, 24-hour notice for extension requests is required.
Assignments submitted later than five calendar days without negotiation will not be accepted.
Missed Tests: Students with a documented reason for missing a course test, such as illness,
compassionate grounds, etc., which may be confirmed by supporting documentation (e.g., doctor’s
letter/attending physician’s statement) may request accommodation from the Course Director. (State
accommodation arrangement: e.g., allowed to write a make-up test on xx date, or as arranged at the
discretion of the Course Director). Further extensions or accommodation will require students to submit
a formal petition to the faculty.
Additional Information
Important Course Information for Students
All students are expected to familiarize themselves with the academic policies, procedures and guidelines
available on the Senate Committee on Academic Standards, Curriculum & Pedagogy webpage including
the Senate Policy on Academic Honesty and the Academic Integrity and Student Professional Behaviour
Policy (BScN).
Accessibility Services: Student Accessibility Services provides academic accommodations and supports
for students with temporary and permanent disability including physical, sensory, medial, learning, and
mental health disabilities. Students who had an Individualized Education Plan (IEP) in high school are
eligible for support. Please note that registering with disabilities services and discussing your needs with
your professors is necessary to avoid any impediment to receiving the necessary academic
accommodations to meet your needs.
Ethics Review Process: York students are subject to the York University Policy for the Ethics Review
Process for Research Involving Human Participants. Ethics approval must be obtained prior to the starting
any research activities involving human participants, including research conducted by students in a
graduate or undergraduate course, for an undergraduate thesis or project, or for a Major Research Paper,
NURS 2513 3.00 Ethics and Health Equity in Interprofessional Practice
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Thesis or Dissertation. If you are in doubt as to whether this requirement applies to you, contact your
Course Director immediately.
Religious Accommodation: York University is committed to respecting the religious beliefs and practices
of all members of the community and making accommodations for observances of special significance to
adherents. Should any of the dates specified in your course syllabus pose such a conflict for you, contact
the Course Director within 14 days of the date for which accommodation is sought. Other procedures are
outlined in the York University policy, guidelines and procedures on Academic Accommodation for
Students’ Religious Observances. Please note that to arrange an alternative date or time for an examination
scheduled in the formal examination periods (December and April/May), students must complete an
Religious Accommodation Agreement.
Academic Skills Support: York University Libraries and the Learning Commons provide students with
academic support for their course assignments and research requirements. The Libraries offer an array of
supports, services, workshops, resources and people available to help ensure continued success during a
student’s academic career.
Centre for Human Rights, Equity, and Inclusion: The Centre for Human Rights, Equity and Inclusion
facilitates confidential processes to discuss allegations of discrimination and harassment by York
Community members. There are also robust training opportunities and workshops available to the
community year-round.
Counselling, Health and Well Being: Student Counselling, Health & Well Being supports students in
realizing and developing their personal potential in order to maximally benefit from their university
experience and manage the challenges of university life. Services include peer-led workshops, certificate
training programs, support groups, same-day and appointment-based counselling, short-term therapy,
and more.
For other information, please see the current Supplemental Calendar.
These course materials are designed for use as part of the (enter course code) course at York University and are the
property of the instructor unless otherwise stated. Third party copyrighted materials (such as book chapters, journal
articles, music, videos, etc.) have either been licensed for use in this course or fall under an exception or limitation in
Canadian Copyright law. Copying this material for distribution (e.g., uploading material to a commercial third-party
website) may lead to a violation of Copyright law.
NURS 2513 3.00 Ethics and Health Equity in Interprofessional Practice
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Week
1.
2.
Weekly Topics and Learning objectives
Assignments
Reqiuired Preparation/Readings
Introduction to Ethical Decision Making
-Course outline review
 Discuss the purpose of moral reasoning and the
origin of nursing
 Describe the effect of culture’s prevailing belief
system on the practice of nursing
 Discuss the relationship between moral reasoning
and the origin of nursing
 Identify historic, spiritual and religious practices
that influenced evolutionary changes in nursing
 Discuss importance or ethical theory
Yeo, Michael, Moorhouse., A., Khan, P., &
Rodney, P ( 2020) Concepts and Cases in Nursing
Ethics (4th Ed). ON, Broadview Press.
Ethical Principles Part 1
 Describe deontological ethics
Define the terms: moral philosophy and ethics;
utilitarianism, virtue, and virtue ethics
 Discuss the principles of respect for autonomy
 Discuss the principle of beneficence as it relates to
nursing practice
Yeo, Michael, Moorhouse., A., Khan, P., &
Rodney, P (2020) Concepts and Cases in Nursing
Ethics (4th Ed). ON, Broadview Press.
Chapter: 2
Chapter – Introduction
Reminder to bring to every class: CNA (2017a);
CNO (2018c, 2019b)
Canadian Nurses Association. (2017) Code of
ethics for registered nurses. ON: Author. Canaiic.ca/~/mdica/can/page-content/pdf-en/codeof-ethics-2017-edition-secureinteractive.pdf?la=en
College of Nurses of Ontario. (2019). Practice
standard: Ethics. Toronto, ON: Author.
Other: CNA (2012); CNO (2017c); INRC (2016)
Cno.org/globalassests/doc/prac/41034_ethics.pd
f
NURS 2513 3.0 Ethics and Health Equity in Interprofessional Practice
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3.
Ethical Principles Part 2
 Define non-maleficence
 Define veracity
 Briefly discuss the importance of confidentiality
4
Values Clarification
 Discuss the difference between personal
values, societal values, professional and
organizational values
 Identify how values are acquired
 Describe how self-awareness is used as an
element of ethical practice
 Describe what some values conflict and their
implication for nursing care
 Discuss the difference between institutional
values and personal values
 Discuss how the nurse can attend to both
personal and patient values
 Identify and discuss how culture influences
values development
 Discuss moral development from theoretical
perspectives
 Discuss gender bias and cultural bias in
relations to theories of moral development
NURS 2513 3.0 Ethics and Health Equity in Interprofessional Practice
Yeo, Michael, Moorhouse., A., Khan, P., &
Rodney, P (2020) Concepts and Cases in Nursing
Ethics (4th Ed). ON, Broadview Press.
Chapter: 2
Analysis Paper
Due week 4-5
on Turnitin
Burkhardt, M. A, & Nathaniel, A. K., &
Walton, N. A. (2020). Ethics and issues
in Contemporary Nursing. St. Louis:
Elsevier (pdf will be available on
eClass) Chapters 4 and 5
Other: CNO (2017b); Davies et al. (2017)
9
5
Ethical Decision Making and Integrity
Define and describe the following terms:
1. Ethical dilemma
2. Moral uncertainty
3. Practical dilemmas
4. Moral distress
Describe and distinguish between the following concepts:
1. Moral outrage
2. Moral residue
3. Moral disengagement
4. Moral courage
Discuss ethical decision-making process to clinical
situation
Discuss the role of emotions in ethical decisions
6
Legal and Professional Relationships Issues






Distinguish the difference between ethics and the
law and discuss the relationships of each to the
other
Distinguish between constitutional law, statutory
law, administrative law and common law.
Explain torts and their significance
Describe difference between public and private
law
Describe the significance of right of privacy in
Canada
Discuss consent and important elements of
consent process
NURS 2513 3.0 Ethics and Health Equity in Interprofessional Practice
Yeo, Michael, Moorhouse., A.,
Khan, P., & Rodney, P (2020)
Concepts and Cases in Nursing
Ethics (4th Ed). ON, Broadview
Press.
Chapter 1 and Chapter 7
Kraaijeveld, M. & Schilderman,
V.K. (2021). Moral sensitivity
revisited. Nursing Ethics. 28(2).
https://doi.org/10.1177/096973302093
0407
Other: CNO (2017b); Davies et al. (2017); Pollard (2015)
Burkhardt, M. A., Nathaniel, A. K., &
Walton, N. A. (2017). Ethics and issues
in contemporary nursing (3rd Canadian
ed.). Toronto, ON: Nelson Education.Chapter7 ( Pdf will available on eClass)
Other: CNO (2017a, 2017d)
10
7
READING WEEK
Practice Issues related to Patient Self Determination
READING WEEK
Yeo, Michael, Moorhouse., A., Khan, P., &
Rodney, P (2020) Concepts and Cases in Nursing
Ethics (4th Ed). ON, Broadview Press
Chapter 3

8
Distinguish the difference between autonomy and
self determination
 Discuss what factors may threaten autonomy for
the client
 Discuss justice and autonomy and the interaction
between the two
 Discuss how informed consent relates to patient
self determination
 Describe what the nurse’s role is in informed
consent
 Describe advance directives and how they relate to
health care decisions
Practice Issues related to end-of-life care
 Discuss the impact of technology on nursing and
health care at the end of life
 Discuss issues and concerns related to current
technology and to life-sustaining interventions
 Describe legal issues associated with end-of-life
care
 Discuss the economics of medical futility and
health technology
Other: CNO (2017a); Davies et al. (2017)
Yeo, Michael, Moorhouse., A.,
Khan, P., & Rodney, P (2020)
Concepts and Cases in Nursing
Ethics (4th Ed). ON, Broadview
Press
Chapter 8
CNO 2018 Guidance of nurses’
roles in medical assistance in
dying, Toronto, ON
Other: CNA (2017b); CNO (2018b); De Lima et al. (2017);
MAiD folder on e-Class
9
Midterm 35%
NURS 2513 3.0 Ethics and Health Equity in Interprofessional Practice
2-hour test
11
10
Student Presentations begin- no lecture
11
Diversity and Equity/Gender/Culture/ Spirituality and
religion:
 Discuss the different health problems and
challenges facing urban and rural areas
 Discuss the health of indigenous Peoples in
Canada
 Describe historical foundations of gender issues in
nursing
 Discuss issues of sexual harassment within a
nursing context
 Describe issues related to cultural humility within
nursing
 Discuss and identify the type of influences of
culture on health and health care decision making
12
Topics of Justice
 Describe how economics play a role in health care
 Identify how distributive justice is conceived in
terms of economics
Time 9-11
March 13th, in
class
Student
presentations
Student
presentations
Hunter, K., & Cook, C. (2020). Indigenous
nurses' practice realities of cultural safety
and socioethical nursing. Nursing ethics,
27(6), 1472–1483.
https://doi.org/10.1177/0969733020940376
Case studies
Other: CNA (2018); CNO webpage re culturally
sensitive care (see Moodle)
Student
presentations
Final Paper due
before start of
class and on
Turnitin 35%
Yeo, Michael, Moorhouse., A., Khan,
P., & Rodney, P (2020) Concepts and
Cases in Nursing Ethics (4th Ed). ON,
Broadview Press
Chapter 6
Other: CNA (2009, 2011)
NURS 2513 3.0 Ethics and Health Equity in Interprofessional Practice
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