Ethico Moral in Nursing
Content
E T H I C O - M O R A L
A S P E C T S
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N U R S I N G
Ethics Ethos - comes from Greek work w/c means character/culture - Branch of Philosophy w/c determines or study morality (right and wrong) - Systematic inquiry into principles of right, from good & evil as they relate to conduct Moral - personal/private interpretation from what is good and bad. TYPES OF ETHICS Those of particular concern to the nurse are: 1. BIOETHICS- branch of ethics that studies moral values in the biomedical sciences 2. CLINICAL ETHICS– concerned with ethical problems “at the bedside” that arise within the context of caring for actual patients Ex.: Informed consent & how one ought to respond to requests for assisted suicide 3. NURSING ETHICS– study of ethical issues that arise in the daily practice of nursing & of the analysis used by nurses to make ethical judgment Ex.: cost-containment, breaches of patient’s confidentiality, illegal practices of colleagues Ethical Principles: 1. Autonomy – the right/freedom to decide (the patient has the right to refuse despite the explanation of the nurse) Example: surgery, or any procedure 2. Nonmaleficence – the duty not to harm/cause harm or inflict harm to others (harm maybe physical, financial or social) 3. Beneficence- for the goodness and welfare of the clients 4. Justice– equality/fairness in terms of resources/personnel 5. Veracity- the act of truthfulness 6. Fidelity– faithfulness/loyalty to clients Moral Principles: 1 . G o l d e n R u l e
A. B. C
Three Service Rules by: Bryan K. Williams, June 2007 Golden Rule, which basically states that you should treat others the way YOU want to be treated. is all about what you want. Platinum Rule, which focuses on treating people the way THEY want to be treated. . Double Platinum Rule “treat others the way they don’t even know they want to be treated”. To boil it down…anticipate, anticipate, anticipate. Don’t just meet your customer’s expectations, EXCEED them.
2. The principle of Totality – The whole is greater than its parts 3. Epikia – There is always an exemption to the rule
4. 5. 6. 7. 8. 9. 10.
One who acts through as agent is herself responsible – (instrument to the crime) No one is obliged to betray herself – You cannot betray yourself The end does not justify the means Defects of nature maybe corrected If one is willing to cooperate in the act, no justice is done to him A little more or a little less does not change the substance of an act. No one is held to impossible
Law - rule of conduct commanding what is right and what is wrong. Derived from an Anglo-Saxon term that means “ that which is laid down or fixed ” Court-body/agency in government wherein the administration of justice is delegated. Plaintiff – complainant or person who files the case (accuser) Defendant – accused/respondent or person who is the subject of complaint Witness – individual held upon to testify in reference to a case either for the accused or against the accused. Written orders of court Writ – legal notes from the court Subpoena - A writ requiring appearance in court to give testimony 1. Subpoena Testificandum – a writ/notice to an individual/ordering him to appear in court at a specific time and date as witness. 2. Subpoena Duces Tecum - notice given to a witness to appear in court to testify including all Important documents Summon – notice to a defendant/accused ordering him to appear in court to answer the complaint against him Warrant of Arrest- court order to arrest or detain a person Search warrant - court order to search for properties. Private/Civil Law - body of law that deals with relationships among private individuals Public law - body of law that deals with relationship between individuals and the State/government and government agencies. Laws for the welfare of the general public. Private/Civil Law can be : Contract law – involves the enforcement of agreements among private individuals or the payment of compensation for failure to fulfill the agreements Ex. Nurse and client nurse and insurance Nurse and employer client and health agency
- An agreement between 2 or more competent person to do or not to do some lawful act. - It maybe written or oral = both equally binding (2) Types of Contract: 1.Expressed – when 2 parties discuss and agree orally or in writing the terms and conditions during the creation of the contract. Example : Nurse will work at a hospital for only a stated length of time (6 months), understated conditions (as volunteer, straight AM shift, with food/transportation allowance) 2. Implied – one that has not been explicitly agreed to by the parties, but that the law considers to exist. Example: Nurse newly employed in a hospital is expected to be competent and to follow hospital policies and procedures even though these expectations were not written or discussed. Likewise: the hospital is expected to provide the necessary supplies, equipment needed to provide competent, quality nursing care. Feature/Characteristics/Elements of a lawful contract: 1.Promise or agreement between 2 or more persons for the performance of an action or restraint from certain actions. 2.Mutual understanding of the terms and meaning of the contract by all. 3.A lawful purpose – activity must be legal 4.Compensation in the form of something of value -monetary Persons who may not enter into a contract: minor, insane, deaf, mute and ignorant TORTLAW – is a civil wrong committed against a person or a person’s property. - Person/person’s responsible for the tort are sued for DAMAGES - Is based on: ACT OF COMMISSION–something that was done incorrectly or ACT OF OMMISION– something that should have been done but was not. Classification of Tort 1. Unintentional a. Negligence – misconduct or practice that is below the standard expected of ordinary, reasonable and prudent person - Failure to do something due to lack of foresight or prudence - Failure of an individual to provide care that a reasonable person would ordinarily use in a similar circumstance. - An act of omission or commission wherein a nurse fails to act in accordance with the standard of care. Doctrines of Negligence: 1.Res ipsa loquitor – the thing speaks for itself – the injury is enough proof of negligence 2.Respondeat Superior – let the master answer command responsibility
3.Force majuere – unforeseen event, irresistible force b. Malpractice – stepping beyond one’s authority ( 6) elements of nursing malpractice: 1. Duty– the nurse must have a relationship with the client that involves providing care and following an acceptable standard of care. 2.Breach of duty– the standard of care expected in a situation was not observed by the nurse-is the failure to act as a reasonable, prudent nurse under the circumstances-something was done that should not have been done or nothing was done when it should have been done 3. Foreseeability – a link must exist between the nurse’s act and the injury suffered 4.Causation– it must be proved that the harm occurred as a direct result of the nurse’s failure to follow the standard of care and the nurse should or could have known that the failure to follow the standard of care could result in such harm. 5. Harm/injury– physical, financial, emotional as a result of the breach of duty to the client Example: physical injury, medical cost/expenses, loss of wages, pain and suffering 7. Damages– amount of money in payment of damage/harm/injury 2. Intentional Tort Unintentional tort – do not require intent bur do require the element of HARM I n t e n t i o n a l t o r t – t h e a c t w a s P U R P O S E o r w i t h I N T E N T - No harm/injury/damage is needed to be liable- No expert witnesses are needed 1.Assault – an attempt or threat to touch another person unjustifiably Example: (1) A person who threatens someone with a club or closed fist. (2) Nurse threatens a client with an injection after refusing to take the meds orally.
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2.Battery – willful touching of a person, person’s clothes or something the person is carrying that may or may not cause harm but the touching was done without permission, without consent, is embarrassing or causes injury. Example: (1) a nurse threatens the patient with injection if the patient refuses his meds orally. (2) If the nurse gave the injection without client’s consent, the nurse would be committing battery even if the client benefits from the nurse’s action. 3.False Imprisonment – unjustifiable detention of a person without legal warrant to confine the person – Occurs when clients are made to wrongful believe that they cannot leave the place Example: (1) Telling a client no to leave the hospital until bill is paid (2) Use of physical or chemical restraints (3) False Imprisonment Forceful Restraint=Battery 4.Invasion Of Privacy – intrusion into the client’s private domain
Types of Invasion the client must be protected from: a. use of client’s name for profit without consent – using one’s name, photograph for advertisements of HC agency or provider without client’s permission b. Unreasonable intrusion – observation or taking of photograph of the client for whatever purpose without client’s consent. c. Public disclosure of private facts – private information is given to others who have no legitimate need for that. d. Putting a person in a false/bad light – publishing information that is normally considered offensive but which is not true. 5.Defamation – communication that is false or made with a careless disregard for the truth and results in injury to the reputation of a person (2) Types: Libel >defamation by means of print, writing or picture Example: 1. writing in the chart/nurse’s notes that doctor A is incompetent because he didn’t respond immediately to a call >defamation by the spoken word stating unprivileged (not legally protected) or false word by which a reputation is damaged Example: 1. Nurse a telling a client that nurse B is incompetent 2. Person defamed may bring the lawsuit 3.The material (nurse’s notes) must be communicated to a 3rd party in order that the person’s reputation maybe harmed
Slander
Public Law: Criminal Law – deals with actions or offences against the safety and welfare of the public. Homicide K i l l i n g p e r s o n c r i m i n a l o f a n y w i t h o u t i n t e n t
Arson Theft Sexual Harassment Active euthanasia Illegal possession of controlled drugs
m a y b e d o n e s e l f - d e f e n s e Burning of property Stealing
a s
Prepared by: CONTESSA M. GABRIEL,RM,RN,MAN Professor, College of Nursing Ramon Magsaysay Technological University
A S P E C T S
I N
N U R S I N G
Ethics Ethos - comes from Greek work w/c means character/culture - Branch of Philosophy w/c determines or study morality (right and wrong) - Systematic inquiry into principles of right, from good & evil as they relate to conduct Moral - personal/private interpretation from what is good and bad. TYPES OF ETHICS Those of particular concern to the nurse are: 1. BIOETHICS- branch of ethics that studies moral values in the biomedical sciences 2. CLINICAL ETHICS– concerned with ethical problems “at the bedside” that arise within the context of caring for actual patients Ex.: Informed consent & how one ought to respond to requests for assisted suicide 3. NURSING ETHICS– study of ethical issues that arise in the daily practice of nursing & of the analysis used by nurses to make ethical judgment Ex.: cost-containment, breaches of patient’s confidentiality, illegal practices of colleagues Ethical Principles: 1. Autonomy – the right/freedom to decide (the patient has the right to refuse despite the explanation of the nurse) Example: surgery, or any procedure 2. Nonmaleficence – the duty not to harm/cause harm or inflict harm to others (harm maybe physical, financial or social) 3. Beneficence- for the goodness and welfare of the clients 4. Justice– equality/fairness in terms of resources/personnel 5. Veracity- the act of truthfulness 6. Fidelity– faithfulness/loyalty to clients Moral Principles: 1 . G o l d e n R u l e
A. B. C
Three Service Rules by: Bryan K. Williams, June 2007 Golden Rule, which basically states that you should treat others the way YOU want to be treated. is all about what you want. Platinum Rule, which focuses on treating people the way THEY want to be treated. . Double Platinum Rule “treat others the way they don’t even know they want to be treated”. To boil it down…anticipate, anticipate, anticipate. Don’t just meet your customer’s expectations, EXCEED them.
2. The principle of Totality – The whole is greater than its parts 3. Epikia – There is always an exemption to the rule
4. 5. 6. 7. 8. 9. 10.
One who acts through as agent is herself responsible – (instrument to the crime) No one is obliged to betray herself – You cannot betray yourself The end does not justify the means Defects of nature maybe corrected If one is willing to cooperate in the act, no justice is done to him A little more or a little less does not change the substance of an act. No one is held to impossible
Law - rule of conduct commanding what is right and what is wrong. Derived from an Anglo-Saxon term that means “ that which is laid down or fixed ” Court-body/agency in government wherein the administration of justice is delegated. Plaintiff – complainant or person who files the case (accuser) Defendant – accused/respondent or person who is the subject of complaint Witness – individual held upon to testify in reference to a case either for the accused or against the accused. Written orders of court Writ – legal notes from the court Subpoena - A writ requiring appearance in court to give testimony 1. Subpoena Testificandum – a writ/notice to an individual/ordering him to appear in court at a specific time and date as witness. 2. Subpoena Duces Tecum - notice given to a witness to appear in court to testify including all Important documents Summon – notice to a defendant/accused ordering him to appear in court to answer the complaint against him Warrant of Arrest- court order to arrest or detain a person Search warrant - court order to search for properties. Private/Civil Law - body of law that deals with relationships among private individuals Public law - body of law that deals with relationship between individuals and the State/government and government agencies. Laws for the welfare of the general public. Private/Civil Law can be : Contract law – involves the enforcement of agreements among private individuals or the payment of compensation for failure to fulfill the agreements Ex. Nurse and client nurse and insurance Nurse and employer client and health agency
- An agreement between 2 or more competent person to do or not to do some lawful act. - It maybe written or oral = both equally binding (2) Types of Contract: 1.Expressed – when 2 parties discuss and agree orally or in writing the terms and conditions during the creation of the contract. Example : Nurse will work at a hospital for only a stated length of time (6 months), understated conditions (as volunteer, straight AM shift, with food/transportation allowance) 2. Implied – one that has not been explicitly agreed to by the parties, but that the law considers to exist. Example: Nurse newly employed in a hospital is expected to be competent and to follow hospital policies and procedures even though these expectations were not written or discussed. Likewise: the hospital is expected to provide the necessary supplies, equipment needed to provide competent, quality nursing care. Feature/Characteristics/Elements of a lawful contract: 1.Promise or agreement between 2 or more persons for the performance of an action or restraint from certain actions. 2.Mutual understanding of the terms and meaning of the contract by all. 3.A lawful purpose – activity must be legal 4.Compensation in the form of something of value -monetary Persons who may not enter into a contract: minor, insane, deaf, mute and ignorant TORTLAW – is a civil wrong committed against a person or a person’s property. - Person/person’s responsible for the tort are sued for DAMAGES - Is based on: ACT OF COMMISSION–something that was done incorrectly or ACT OF OMMISION– something that should have been done but was not. Classification of Tort 1. Unintentional a. Negligence – misconduct or practice that is below the standard expected of ordinary, reasonable and prudent person - Failure to do something due to lack of foresight or prudence - Failure of an individual to provide care that a reasonable person would ordinarily use in a similar circumstance. - An act of omission or commission wherein a nurse fails to act in accordance with the standard of care. Doctrines of Negligence: 1.Res ipsa loquitor – the thing speaks for itself – the injury is enough proof of negligence 2.Respondeat Superior – let the master answer command responsibility
3.Force majuere – unforeseen event, irresistible force b. Malpractice – stepping beyond one’s authority ( 6) elements of nursing malpractice: 1. Duty– the nurse must have a relationship with the client that involves providing care and following an acceptable standard of care. 2.Breach of duty– the standard of care expected in a situation was not observed by the nurse-is the failure to act as a reasonable, prudent nurse under the circumstances-something was done that should not have been done or nothing was done when it should have been done 3. Foreseeability – a link must exist between the nurse’s act and the injury suffered 4.Causation– it must be proved that the harm occurred as a direct result of the nurse’s failure to follow the standard of care and the nurse should or could have known that the failure to follow the standard of care could result in such harm. 5. Harm/injury– physical, financial, emotional as a result of the breach of duty to the client Example: physical injury, medical cost/expenses, loss of wages, pain and suffering 7. Damages– amount of money in payment of damage/harm/injury 2. Intentional Tort Unintentional tort – do not require intent bur do require the element of HARM I n t e n t i o n a l t o r t – t h e a c t w a s P U R P O S E o r w i t h I N T E N T - No harm/injury/damage is needed to be liable- No expert witnesses are needed 1.Assault – an attempt or threat to touch another person unjustifiably Example: (1) A person who threatens someone with a club or closed fist. (2) Nurse threatens a client with an injection after refusing to take the meds orally.
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2.Battery – willful touching of a person, person’s clothes or something the person is carrying that may or may not cause harm but the touching was done without permission, without consent, is embarrassing or causes injury. Example: (1) a nurse threatens the patient with injection if the patient refuses his meds orally. (2) If the nurse gave the injection without client’s consent, the nurse would be committing battery even if the client benefits from the nurse’s action. 3.False Imprisonment – unjustifiable detention of a person without legal warrant to confine the person – Occurs when clients are made to wrongful believe that they cannot leave the place Example: (1) Telling a client no to leave the hospital until bill is paid (2) Use of physical or chemical restraints (3) False Imprisonment Forceful Restraint=Battery 4.Invasion Of Privacy – intrusion into the client’s private domain
Types of Invasion the client must be protected from: a. use of client’s name for profit without consent – using one’s name, photograph for advertisements of HC agency or provider without client’s permission b. Unreasonable intrusion – observation or taking of photograph of the client for whatever purpose without client’s consent. c. Public disclosure of private facts – private information is given to others who have no legitimate need for that. d. Putting a person in a false/bad light – publishing information that is normally considered offensive but which is not true. 5.Defamation – communication that is false or made with a careless disregard for the truth and results in injury to the reputation of a person (2) Types: Libel >defamation by means of print, writing or picture Example: 1. writing in the chart/nurse’s notes that doctor A is incompetent because he didn’t respond immediately to a call >defamation by the spoken word stating unprivileged (not legally protected) or false word by which a reputation is damaged Example: 1. Nurse a telling a client that nurse B is incompetent 2. Person defamed may bring the lawsuit 3.The material (nurse’s notes) must be communicated to a 3rd party in order that the person’s reputation maybe harmed
Slander
Public Law: Criminal Law – deals with actions or offences against the safety and welfare of the public. Homicide K i l l i n g p e r s o n c r i m i n a l o f a n y w i t h o u t i n t e n t
Arson Theft Sexual Harassment Active euthanasia Illegal possession of controlled drugs
m a y b e d o n e s e l f - d e f e n s e Burning of property Stealing
a s
Prepared by: CONTESSA M. GABRIEL,RM,RN,MAN Professor, College of Nursing Ramon Magsaysay Technological University
