The Ethical Component of Nursing Education: Integrating Ethics into Clinical Experiences

The Ethical Component of Nursing Education: Integrating Ethics into Clinical Experience......Page 1
Title Page......Page 3
Copyright......Page 4
Dedication......Page 5
Contributors......Page 6
Reviewers......Page 7
Preface......Page 9
Acknowledgments......Page 12
Contents......Page 13
UNIT 1: Components of Clinical Ethics......Page 21
KEY WORDS......Page 23
ETHICAL THEORIES......Page 24
SUMMARY......Page 33
ETHICAL PRINCIPLES......Page 34
SUMMARY......Page 48
KEY WORDS......Page 51
HISTORY OF ETHICS......Page 52
THE FIRST CLINICAL ETHICS EDUCATION PROGRAM......Page 54
THE CONSUMER MOVEMENT AND THE WOMEN’S MOVEMENT......Page 56
DIFFERENCE BETWEEN MEDICAL ETHICS AND NURSING ETHICS......Page 57
TEACHING ETHICS IN NURSING......Page 58
PROLIFERATION OF ETHICS COMMITTEES......Page 60
NURSING ETHICS NOW AND IN THE FUTURE......Page 61
SUMMARY......Page 62
KEY WORDS......Page 65
CODE OF ETHICS......Page 66
STANDARDS AND SCOPE OF PRACTICE......Page 71
POLICY AND POSITION STATEMENTS
......Page 73
CODES OF ETHICS......Page 76
THE 2001 ANA CODE OF ETHICS FOR NURSES: ASPIRATIONS AND CHALLENGES
......Page 77
SUMMARY......Page 83
KEY WORDS......Page 87
ACADEMIC DISHONESTY......Page 88
ERRORS......Page 94
PROFESSIONAL RELATIONSHIPS AND BOUNDARIES
......Page 97
SUMMARY......Page 100
KEY WORDS......Page 105
ETHICAL DECISION-MAKING......Page 106
ETHICAL DECISION-MAKING GOALS
......Page 107
REALITIES IN DECISION-MAKING......Page 108
ETHICAL DECISION-MAKING USING THE NURSING PROCESS......Page 109
DECISION ANALYSIS MODEL......Page 112
RESOURCES FOR FACILITATING ETHICAL DECISION-MAKING......Page 113
SUMMARY......Page 117
UNIT 2: Ethical Themes and Research Ethics......Page 121
KEY WORDS......Page 123
RATIONALE FOR KEEPING INFORMATION CONFIDENTIAL......Page 124
WHAT INFORMATION IS CONFIDENTIAL?......Page 126
WHO CAN ACCESS CONFIDENTIAL INFORMATION?
......Page 127
SUMMARY......Page 130
KEY WORDS......Page 133
THE IMPORTANCE OF TRUTH-TELLING......Page 134
DISCRIMINATING BETWEEN TRUTH AND NONTRUTH......Page 135
SUMMARY
......Page 142
KEY WORDS......Page 145
WHAT IS ADVOCACY?......Page 146
THE STRENGTH TO ADVOCATE
......Page 147
RELATIONSHIPS BETWEEN HEALTH CARE PROFESSIONALS
......Page 149
UNCERTAINTY, DILEMMA, AND DISTRESS......Page 151
ADVOCACY FOR THE PROFESSION......Page 153
SUMMARY......Page 155
KEY WORDS......Page 159
THE U.S. HEALTH CARE SYSTEM......Page 160
MANAGED CARE......Page 163
WHAT TO DO?......Page 166
NURSES’ ROLE IN MACRO ALLOCATION
......Page 167
NURSES’ ROLE IN MICRO ALLOCATION
......Page 168
SUMMARY......Page 173
Special Topic: Using Research in Resource Allocation......Page 174
KEY WORDS......Page 179
ETHICAL THEMES......Page 180
HISTORY OF RESEARCH ETHICS
......Page 182
INSTITUTIONAL REVIEW BOARDS
......Page 185
INFORMED CONSENT......Page 187
SUMMARY
......Page 197
UNIT 3: Clinical Ethics Issues......Page 201
KEY WORDS......Page 203
TRUTH-TELLING......Page 204
CONFIDENTIALITY
......Page 205
ADVOCACY
......Page 208
ALLOCATION OF RESOURCES
......Page 214
SUMMARY
......Page 222
SURROGATE DECISION-MAKING
......Page 223
SUMMARY
......Page 227
SECTION 3: The Moral Status of Children......Page 228
PERSONHOOD......Page 229
SUMMARY......Page 234
EUGENICS......Page 235
GENETIC TESTING......Page 236
IMPLICATIONS FOR THE FAMILY
......Page 238
SUMMARY......Page 239
Objectives......Page 245
CONFIDENTIALITY......Page 246
TRUTH-TELLING......Page 248
ADVOCACY......Page 251
ALLOCATION OF RESOURCES......Page 252
SUMMARY
......Page 254
AUTONOMY......Page 255
BEFORE THE ADVENT OF ADVANCE DIRECTIVES......Page 257
OTHER LIFE-SAVING INTERVENTIONS
......Page 258
THE PATIENT SELF-DETERMINATION ACT OF 1990
......Page 260
ADVANCE DIRECTIVES......Page 261
VALUES CLARIFICATION
......Page 262
DO NOT RESUSCITATE ORDERS
......Page 275
THE NURSE’S ROLE......Page 277
SUMMARY......Page 279
SECTION 3: Nursing of the Adult: End-of-Life Choices......Page 280
AUTONOMY AND END-OF-LIFE CHOICES
......Page 281
SUMMARY......Page 287
ETHICAL ISSUES OF PRESYMPTOMATIC DIAGNOSIS
......Page 289
ACTIONS THAT PROMOTE INFORMED CONSENT
......Page 291
SUMMARY......Page 292
Special Topic: Medical Directive Project......Page 293
Special Topic: It’s Over, Debbie......Page 294
KEY WORDS......Page 301
CONFIDENTIALITY
......Page 302
TRUTH-TELLING......Page 303
ADVOCACY......Page 305
ALLOCATION OF RESOURCES......Page 306
SUMMARY......Page 309
BALANCING MATERNAL AND FETAL INTERESTS......Page 310
PREGNANCY AND HIV
......Page 311
PREGNANCY AND DELIVERY......Page 312
CONTRACEPTION
......Page 313
ABORTION......Page 314
STERILIZATION......Page 315
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)......Page 316
CAREGIVER BURDEN......Page 317
SUMMARY
......Page 318
ASSISTED REPRODUCTION......Page 319
SUMMARY......Page 323
GENETICS......Page 324
PRENATAL TESTING
......Page 325
SUMMARY......Page 327
KEY WORDS......Page 331
CONFIDENTIALITY......Page 332
TRUTH-TELLING
......Page 334
ADVOCACY......Page 335
RESOURCE ALLOCATION......Page 337
SUMMARY......Page 339
SECTION 2: Autonomy Versus Paternalism......Page 340
PROVIDING TREATMENT AGAINST THE PATIENT’S WILL
......Page 342
USE OF RESTRAINTS......Page 343
NURSING OBLIGATIONS......Page 349
SUMMARY......Page 350
SECTION 3: Caring for the Challenging Patient......Page 351
INADEQUATE RESOURCES FOR DEALING WITH A CHALLENGING PATIENT
......Page 352
UNMET EXPECTATIONS
......Page 353
APPLICATION OF ETHICAL PRINCIPLES TO FACILITATE WORKING WITH CHALLENGING PATIENTS
......Page 355
SUMMARY......Page 357
TARASOFF V. REGENTS OF THE UNIVERSITY OF CALIFORNIA......Page 358
PRIVILEGE......Page 359
DUTY TO PROTECT......Page 360
STRATEGIES
......Page 361
SUMMARY
......Page 362
KEY WORDS......Page 367
ADVOCACY......Page 368
CONFIDENTIALITY......Page 371
ALLOCATION OF RESOURCES......Page 373
SUMMARY......Page 374
SECTION 2: Autonomy Versus Paternalism......Page 376
PARENTAL AUTONOMY......Page 377
FAMILY PATERNALISM......Page 378
SUMMARY......Page 379
SECTION 3: Cultural Competency......Page 380
CULTURAL/RELIGIOUS PRACTICES......Page 382
SUMMARY......Page 384
HEALTH PROMOTION AND DISEASE PREVENTION......Page 385
SUMMARY......Page 388
UNIT 4: Ethical Issues Impacting the Professional Nurse’s Values......Page 391
Objectives......Page 393
CONFIDENTIALITY......Page 394
TRUTH-TELLING......Page 396
ADVOCACY......Page 402
ALLOCATION OF RESOURCES......Page 404
SUMMARY......Page 407
SECTION 2: Professional Nurse Issue: Conscientious Objection......Page 408
APPEAL TO CONSCIENCE......Page 409
APPEAL TO NONMALEFICENCE......Page 410
SUMMARY......Page 411
SECTION 3: Professional Nurse Issue: Whistle-Blowing......Page 413
FALLOUT FROM ACTS OF WHISTLE-BLOWING......Page 416
SUMMARY......Page 417
SECTION 4: Professional Nursing Issue: Professional Misconduct—Incompetent and Impaired Practice......Page 418
INCOMPETENT PRACTICE
......Page 419
IMPAIRED PRACTICE......Page 422
REPORTING PROFESSIONAL MISCONDUCT
......Page 425
STRATEGIES......Page 426
SUMMARY......Page 427
KEY WORDS......Page 433
CONFIDENTIALITY......Page 434
TRUTH-TELLING
......Page 437
ADVOCACY
......Page 440
SUMMARY......Page 441
SECTION 2: Professional Nursing Issues: Staffing......Page 442
STAFFING ISSUES......Page 443
MANDATORY OVERTIME
......Page 445
SUMMARY......Page 447
SECTION 3: Professional Nursing Issue: Management Issues......Page 448
MANAGEMENT RESPONSIBILITIES......Page 449
SUMMARY
......Page 454
SHARED GOVERNANCE......Page 455
SUMMARY
......Page 458
Appendix: Reports of Presidential Commissions......Page 461
Glossary......Page 465
Index......Page 474