Nursing Ethics

NUR403
 Professor Susan Kagan
Office GH1190
susan.kagan@senecacollege.ca
416-491-5050 ext 55208
Course overview tour course blackboard site
Required texts
Evaluation
Course structure
Group ground rules Class norms

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 Respect Confidentiality
Food- no strong smelling food in the classroom
please
Tidy up after class
Try to eat, phone home, use the washroom
etcduring the break
Classroom A NO TEXT ZONE
No tolerance for Discrimination in the
classroom - we will discuss issues such as
race, culture, religion openly
Listen when others are talking or sharing
stories
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 If you must leave class please do it
quietly
During debates and presentations.?
Prepare for class by doing readings and
other required work
Read assigned material and come to
class prepared to discuss it

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 Do you want to add any norms?

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 Human Rights Electronic devices
Academic Honesty Academic
Appeals Accommodation
Promotion policies Late assignments
Program attendance Deferred Tests
Evaluation
Guidelines
Progression policy

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 Introduction to course
History of Bioethics and Nursing Ethics
Values and values clarification
Foundational Knowledge: Ethical Theory
Part 1

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 An unexamined
life is not worth
living
Entrance into a
moral life: Know
thyself

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 The values and attitudes we live by affect how
we relate to other people and to all our
activities in the environment, and so are a
major influence on our prospects for achieving
a sustainable future
Affective or emotional dimension of human
behaviour

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 At the heart of ethics
Influence behaviour on the basis of the
conviction that a certain action is correct in a
certain situation

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 A personal belief about the worth of an idea, attitude,
custom, object.
Values come from culture, social relationships,
personal needs.
Values differ among individuals.
Values can change over time.
Values must be freely chosen
Personal values of a nurse influence her/his care.
Has a positive quality for us
Results from meaningful thoughtful consideration of
choices
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 Shows up in every aspect of our living
Actions speak louder than words
Have persistence and assume a pattern in our
lives
Not one time occurrences
Values can change
From experience

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 In Canada we value -
Freedom
Health
Fairness
Honesty
Integrity
Charter of Rights and Freedoms
Canada Health Act

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 Becoming aware of values that have
been inculcated in us through various
influences this enables us to decide in
a self conscious way what values we
ought to prize or promote and to assess
how various practices stand in relation to
these values.

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 Process through which individuals come
to understand the values they hold and
the relative importance of each of these
values:
Open discussion
Listening
Mutual respect

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 List alternatives
Are you considering other courses of action?
Examine possible consequences of choices
What do you think you will gain from doing that?
Choose freely
Did you have a say in that decision?
Feel good about the choice
How do you feel about the decision?

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 Affirm the choice
How will you discuss this with others?
Act on the choice
Will it be difficult to tell your partner about this?
Act with a pattern (consistency)
How many times have you done that before?

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 The Alligator River Story

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 Moral beliefs are developed after
examination of ones values!!

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 Define ethics

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 Systematic study and analysis about
what is right and wrong
Body of knowledge concerned with what
ought to be done
Applied ethics
Application of theoretical thinking about
ethics to fields of study

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 Do what you say you will do
Never divulge information given to you in
confidence
Accept responsibility for your mistakes
Never become involved in a lie
Avoid accepting gifts that compromise
your ability to perform in the best
interests of the organization
(Manske, 1987)
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 Why is it important to use ethical
behavior?

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 Ethics
Morality

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 Develops sensitivity to ethical dimensions of nursing
Develops ability to become more conversant in the
moral values and principles that are at issue or at
stake in the scope of nursing practice
Recognize, identify and articulate ethical issues
when they arise
Analyze ethical issues more thoroughly
Helps us to reach a morally principles and rationally defensible
decision
Deepens our understanding of moral ideals and
principles
Helps us to understand the basis of moral conflict

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 Bioethics may be defined as reasoned inquiry
about the ethical dimension of interventions in
the lives of human beings directed to or
bearing on their healthindividually or
collectively..pg 13

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 Study of ethical issues and how they are
applied to thinking about issues and
problems in health care
Conduct doing the right thing for the
patient
Problems studied from the daily lives of
patients, health care professionals,
administrators, researchers and politicians
involved in health care
Origin: Ancient world - Hippocrates
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 Developed alongside broader
phenomenon of bioethics
Study of ethical issues in nursing
practice, education, research,
administration
Branch of applied ethics: apply ethics to
situations that arise in daily practice,
bedside to national and international
levels
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 Examples:
Not only dilemmas: More often
problems, issues, setting priorities
Did that patient really understand what
they agreed to?
Everyday to infrequent issues
Use of restraints vs who will get the last
ICU bed

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 Are there distinctions between nursing
ethics, medical ethics and more generally
bioethics?
The relationship between nursing ethics,
medical ethics and more generally
bioethics is a matter of some controversy
(pg. 15)

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 Technological developments
Research and experimentation
Authority, consumerism and patient rights

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 Technological Developments
Respirator
DNA analysis
Reproductive technology
Transplantation
Computerized health information

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 Research and
Experimentation
Tuskegee Study
Nuremberg Code
1947
Declaration of
Geneva - 1948
Declaration of
Helsinki - 1964
Belmont Report -
1974

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 Research and experimentation
Voluntary informed consent
No coercion
Risks weighed against harms

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 http://www.pre.ethics.gc.ca/eng/policy-
politique/initiatives/tcps2-eptc2/Default/

Interagency
CIHR
NSERC
SSHRC

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 Contractual
Negotiate moral parameters
Advocacy
Consumerism
Paternalism

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 Moral beliefs and values
Relevant codes, policies and laws
Fundamental concepts of moral
philosophy
Ethical decision making

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