Rank Each Profession by Level of Trust
 Teacher
 Clergy
 Doctor
 Nurse
 Attorney
Presented by
Marlene Meador RN, MSN, CNE
Ethics vs. Morals
Ethics- by definition is the study of
philosophy that deals with the distinction
between right and wrong, and the moral
consequences of human action.
Morals- pertaining to the rightness or
wrongness of an act.
Stedman’s Medical Dictionary for the Health Professions and
Nursing, 2005
Code of Ethics
 ANA - Code of Ethics for Nurses
 The Code of Ethics for Nurses was developed as a guide
for carrying out nursing responsibilities in a manner
consistent with quality in nursing care and the ethical
obligations of the profession.
 ANA web page
http://nursingworld.org/MainMenuCategories/ThePra
cticeofProfessionalNursing/EthicsStandards/CodeofEt
hics.aspx
ANA Code of Ethics for Nurses
1.
2.
3.
4.
5.
Practices with compassion and respect for inherent
dignity
Commitment is to the patient.
Promotes, advocates for and strives to protect the
health, safety and rights of the patient.
Responsible and accountable for nursing practice &
delegation of tasks to provide optimum care.
Owns the same duties to self as to others; preserve
integrity, maintain competence & professional
growth.
ANA Code of Ethics for Nurses
6.
7.
8.
9.
Participates in establishing, maintaining, and improving
health care environment.
Contributes to advancements of the profession through
contributions in practice, education, administration &
knowledge
Collaborates with other health professionals and the public in
promoting community, and national efforts to meet health
needs.
The profession of nursing is responsible for articulating
nursing values, for maintaining the integrity of the profession
and its practice and for shaping social policy.
Ethical Principles and Nursing Practice
(p.11 Box 1-3)
 Beneficence- a nurse is required to
promote good for others
 Nonmaleficence- “do no harm” a nurse
must avoid risk or causing harm to others
 Autonomy- respect of self-determination
(patient’s right to respect, privacy, and information
necessary for decisions)
 Justice- duty to treat others fairly
 Fidelity- obligations to the client
Developmental Stages
of Value Formation
Kohlberg Theory
 Preconventional: 4-7yrs
 Imprinting: 0-7 years
 Conventional: 7-12 yrs
 Modeling: 8-13 years
 Post Conventional: 12+
 Socialization: 14-20 yrs
Page 136 McKinney
 Value Development:
20+ years
Kohlberg Theory
Derived from Piaget’s cognitive theory
Preconventional- 4-7 yrs: decisions based on desire to
please others and “avoid punishment”
Conventional- 7-12 yrs: conscience or internal
standards important- follow rules and be good
“fairness” comes into play
Post Conventional- >12 yrs: internalized ethical
standards to base decisions on different moral
approaches “social responsibility”
Social & Cultural influences on
value/ethical development:
 Family
 Friends
 Religion
 Geography
 School
 Family Income
 Nursing
Ethical Dilemma
 No absolute right or wrong answer
 Both sides have merit
 Outside the scope of written law
Role of Ethics Committee:
Act as representative for the clients
who cannot speak for themselves
Render judgment when an ethical
dilemma exists
Members of the Ethics Committee:
What members of the healthcare team does
the ethics committee need?
Who should not serve on an ethics
committee?
Ethics Committee at Work
Review previous ethical decisions and adapt
to current standards of care and culture
If an dilemma occurs the committee must
render a judgment in writing based on the
evidence presented and values of the
facility.
Professional Obligations
Nurses have no obligation to
support a position with which they
disagree.
Must relinquish care using appropriate means:
 Notify immediate supervisor prior to providing any care
 Make certain that the patient is cared for by a
qualified member of the nursing staff (cannot
delegate to lesser healthcare provider)
Current Issues Related to
Childbearing and Childrearing
 Definition of family
 Gestational vs. genetic parental rights
 Maternal vs. fetal rights
Nursing Process
and the Ethical Dilemma
Assessment
Analysis
Planning
Implementation
Evaluation
Note from another professor
(aka: something to think about)
“Many health care providers claim to
utilize the problem solving model when in
fact they often determine their course
of action and then use ethical principles
to rationalize their response.”
Marita Peppard RN, DN
Use the nursing process to reach a
decision on the following: What
would you do?
 A woman serves as a surrogate
(gestational mother= egg + sperm of
biologic couple). During the labor and
delivery process she decides she wants to
keep the newborn.
 Does your response change if the egg
belongs to the surrogate?
 A couple undergoes in vitro
fertilization with successful
implantation of 5 embryos. The
obstetrician suggests selective
reduction of 3 embryos as a measure
to increase viability of the pregnancy
What is the nurses’ role?
 A fetus is delivered at 37 weeks gestation.
Anencephaly is discovered at delivery. The parents
decline medical intervention and request that no
extraordinary measures prolong the newborn’s life.
In the current situation the newborn is unable to suck
and swallow, has no brain waves and no cry. The
parents, physician and hospital agree on the plan of
treatment. An outside source learns of the situation
and notifies the press and other groups who actively
seek legal action for life support for this infant.
What is the role of the nurse
as client advocate?
 A young child sustains a brain injury and prognosis is
dire. The physicians place the child on life support
and attempt to correct the injury. As time passes the
prognosis worsens and the physicians seek worldwide assistance to locate additional treatment to
benefit the child or transfer to another facility. The
physicians/hospital order removal from life support
and the mother refuses to remove the child from life
support equipment.
Let’s do some math:
1
One Nurse
5 patients/day
X 5 days/week
25 patients/week
25 patients/week
x 50 weeks/year
1250 patients/year
1250 patients/year
x 25 years
31,250 patients/career
31250 pts/career
X 20 people who love them
625,000 people you will impact
in the course of your nursing
career
610,000
Population of
Austin, Texas
for 2000 census
Thank you for choosing to become a
nurse. We need highly trained, ethical
individuals to carry the lamp.
It has been my pleasure to share the art of
nursing with you this semester.
Please contact me if you have any questions or concerns
regarding this lecture
Marlene Meador RN, MSN, CNE
mmeador@austincc.edu