Chapter 4 Ethical Theories in Nursing Practice Discussion Question I have attached a powerpoint necessary to complete this discussion.Each question must have at least 3 paragraphs and you must use at 3 least references included in your post..Discussion board questions:1. Think about the ethical theories and approaches in chapter 4 and the moral conflicts you have experienced in the past. Have you used one of these approaches to resolving conflict? Which theory or approach have you used?2. Has there ever been a time when you have experienced the dilemma of having to make a choice that you know will affect the well-being of another individual? Have you ever experienced moral suffering? Chapter 4
Ethics versus morals
Values in Nursing
Values emphasized in the Code of Ethics with
Interpretive Statements (ANA, 2001)
Wholeness of character
Ethical Theories and Approaches
Natural law theory
Ethics of care
Professional Ethics and Codes
The Nightingale Pledge (1893)
Nursing Ethics: For Hospital and Private
ICNs Code of Ethics for Nurses (1953)
ANAs Code of Ethics for Nurses (1950)
ANAs Code of Ethics for Nurses
Nine provisions with interpretive statements
containing specific guidelines for clinical
practice, education, research, and
The code is considered to be nonnegotiable in
regard to nursing practice
Examples of Themes in the Code of
Ethics with Interpretive Statements
Respect for autonomy
Environment and moral
Contributions to the
professional codes by
The ICN Code of Ethics for Nurses
Nurses have 4 fundamental responsibilities:
To promote health
To prevent illness
To restore health
To alleviate suffering
Common Themes of ANA & ICN Codes
Focus on the importance of nurses delivering
compassionate patient care aimed at alleviating
suffering; patient is the central focus of nurses work
Applies to all nurses in all settings and roles;
nonnegotiable ethical nursing standards with a focus
on social values, people, relationships, and
Share values of respect, privacy, equality, and
Both codes illustrate idea of nurses moral selfrespect
Ethical Analysis and Decision Making
Ethical dilemmas and conflicts
Case-based approach using 4 topics method
Quality of life
What is the patients medical problem? History?
Is the problem acute? Chronic? Critical?
What are the goals of treatment?
What are the probabilities of success?
What are the plans in case of therapeutic failure?
In sum, how can this patient be benefited by
medical and nursing care, and how can harm be
Is the patient mentally capable and legally competent? Is
there evidence of incapacity?
If competent, what is the patient stating about preferences
Has the patient been informed of benefits and risks,
understood this information, and given consent?
If incapacitated, who is the appropriate surrogate? Is the
surrogate using appropriate standards for decision making?
Has the patient expressed prior preferences?
Is the patient unwilling or unable to cooperate with medical
treatment? If so, why?
Quality of Life
What are the prospects, with or without treatment, for a
return to normal life?
What physical, mental, and social deficits is the patient
likely to experience if treatment succeeds?
Are there biases that might prejudice the providers
evaluation of the patients quality of life?
Is the patients present or future condition such that his
or her continued life might be judged undesirable?
Is there any plan and rationale to forgo treatment?
Are there plans for comfort and palliative care?
Contextual Features (1 of 2)
Are there family issues that might influence
Are there provider (physicians and nurses)
issues that might influence treatment
Are there financial and economic factors?
Are there religious and cultural factors?
Contextual Features (2 of 2)
Are there limits on confidentiality?
Are there problems of allocations or resources?
How does the law affect treatment decisions?
Is clinical research or teaching involved?
Is there any conflict of interest on the part of
the providers or the institution?
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