Ethical issues: When organizations and their leaders become fixated on the bottom line and ignore values,

an environment conductive to ethics failure is nurtured - J.G Bruhn Ethics is a systematic study of what a persons conduct and actions should be with regard to self, other humans, and the environment. Nurses are often placed in a situations where they are expected to be agents for patients, physicians and the organization simultaneously , all of which may have conflicting needs, wants and goals. To make an appropriate ethical decisions , the manager must have knowledge of ethical principles and framework use as a professional approach that eliminates trial and error .

Organizational process includes : Institutional review boards Ethics committees Professional codes of ethics

LEADERSHIP ROLES: 1. Is self- awareness own values and basic beliefs about the rights, duties and goals of human beings 2. Accepts that some ambiguity and uncertainly must be a part of all ethical decision making 3. Accepts that negative outcomes occur in ethical decision making despite high quality problem solving and decision making 4. Demonstrate risk taking in ethical decision making 5. Role models ethical decision making, with congruent with the American nurses association code of ethics and interpretive statements and professional standards 6. Clearly communicates expected ethical standard if behavior. Management Functions: 1, uses systematic approach to the problem solving and decision making

2, identifies outcomes in ethical decision making that should always be avoided 3, uses established ethical framework to clarify values and beliefs 4, applies principles of ethical reasoning to define what beliefs or values from the basis 5, aware of legal precedents that ethical decision making ans is accountable for possible liabilities against the legal precedents 6, continually to reevaluates the quality of own ethical decision making, based on the process of decision making or problem solving 7, recognizes and rewards ethical conduct of subordinates 8, takes appropriate action when subordinates use unethical conduct

TYPES OF ETHICAL ISSUES: Moral uncertainty , occurs when an individual is unsure with moral principles or values. Moral conflicts, when the duties and obligations of health care providers or general guiding ethical principles are unclear. Moral distress, result of the individual knowing the right thing to do but organizational constraints make it difficult to take the right course of action. Moral outrage, when an individual witnesses the immoral act of another but feels powerless to stop it. Moral or ethical dilemma , occurs when tow or more are clear moral principles apply but they support inconsistent course of action.

Individual values beliefs, and personal philosophy play a major role in the moral or ethical decision making that is part of the daily routine of all managers.

No rules , guidelines or theories exist that cover all aspect og the ethical problem that managers faces. It is the managers responsibility to understand the ethical problem solving codes.

ETHICAL PRINCIPLES:

Autonomy ( self determination)- promotes self determination and freedom of choice Beneficence (doing good)- actions are taken in an effort to promote good Paternaliste rightm one individual assumes the rige many outht to make decisions for another Utility- the good of the many outweighs the wants or needs of the individuals Justice- seek fairness treat equals equally and treat unequals according to their differences Veracity- obligation to tell the truth Fidelity- need to keep promises Confidentiality- keep privileged information private.

AMERICAN NURSES ASSOCIATION CODE OF ETHICS AND PROFESSIONAL STANDARDS

A code of ethics is a set of principles, established by a profession , the first code of ethics for Nurses was adopted by the ANA in 1950 and has been revised five times since then.

Professionals codes of ethics function as a guide to the highest standards of ethical practice for nurses.

The scope of standards for nurses administrators, revised in 2004 specifically delineates professional standards in management ethics. The nurse administrators decision and actions are based on ethical principles. MEASUREMENT CRITERIA: 1 advocayes on behalf of the recipients of the services and personnel 2. maintains privacy and confidentiality security of patiehents/clients/staff/residents 3. adheres to codes of ethics for nurses with interpretive statements 4. assures compliance with regulatory and professional standards as well as integrity in business 5. fosters a nondiscriminatory climate in which care is delivered in a manner sensitive to sociocultural diversity 6. assures a process to identify and address ethical issues within nursing and the organization. THE MORAL DECISION MAKING MODEL Massage the dilemma collect data about the ethical problem and who should be involved in the decision making process. Outline option- identify alternatives and analyze the causes and consequences of each. Review criteria and resolve- weigh the option against the values of those involved in the decision Affirm position and act- develop the implementation strategy. Look back- evaluate the decision making