Recently, Sellman (2011) used the concept of vulnerability as central to understanding nursing goals. Many chapters in this book refer directly to the findings and analyzes of these reports.
Contents
Contributors
Janet Holt Janet Holt is a Senior Lecturer at the School of Healthcare at the University of Leeds. As a member of the Ethics Committee of the Royal College of Nursing (RCN), she was appointed chair of this committee in 2013.
Nursing and the Ethical Dimension of Practice
Anne Scott
Nurse-patient interaction and involvement, as manifested through the nurse-patient relationship, is at the heart of the moral domain of nursing practice. The nurse-patient and patient-nurse relationship is a negotiated and evolving reality for the duration of the patient-nurse contact.
A Duty-Based Approach for Nursing Ethics & Practice
The good will is the person's ability to recognize the moral law and act on it. For Kant, actions performed out of duty and moral law demonstrate the autonomy of the person.
Utilitarianism as an Approach to Ethical Decision Making in Health Care
For example, in the case of the CF drug, it is not sufficient that it has a substantial benefit, but the benefit must be high enough to be in proportion to the money spent. Resource allocation: Utilitarians argued that applying the principle of utility means that resources in the health care system should be allocated on the basis of obtaining the most utility for the cost expended.
Virtue Ethics and Nursing Practice
If this is true, then the implications for nursing and for the idea of virtue ethics are profound. In my view, this does not diminish the value of virtue ethics for nursing.
Care Ethics and Nursing Practice
In this chapter, I will give an overview of the development of care ethics and an explanation of the 'core' elements of care ethics. Ethics of care in the context of care practices always requires agents to have caring attitudes that focus on a positive response to the interests of others. The strengths of care ethics in relation to care practice seem obvious as it addresses fundamental ethical aspects of care.
Ethics of care or ethics of care is an approach to the ethics of care that continues to evolve with the contributions of philosophers and social scientists. The six critiques of care ethics discussed by Sander-Staudt (undated) should be kept under review as the approach evolves. The beginning of the "ethics of care" - also known as the "ethics of care" - is attributed to the work of Carol Gilligan and Nel Noddings in the early 1980s.
The Concept of Person
The purpose of the initial discussions4 about the concept of the person was considered essential and. This chapter is primarily intended to provide a survey of some of the main views on the concept of the person. 4 A very good historical overview of the evolution of the concept of the person can be found in Clark (1992).
The concept of the person can be used when considering some of the ethical issues in nursing practice and health care. The concept of the person is sometimes used in ethical debates about the beginning and end of life. Engelhardt: The two senses of person - the strict sense (the possession of consciousness, rationality and moral freedom) and the social sense (the category that can be applied to those who are not strictly persons).
Patient Autonomy in Nursing and Healthcare Contexts
Health care professionals outlined the significant roles they played as partners in the decision-making process. For the most part, the law internationally respects an individual's right to autonomy in the context of health care decisions. This is related to the fact that capacity legislation in the UK predates the UNCRPD (2006).4.
Contemporary health care practice is developing a growing awareness of the complexities involved in respecting autonomy in the care setting. This is partly due to the increasing importance of personal autonomy in the law, as described above. Interdependence is evident in participants' accounts of living with diabetes and in the self-testing process.
The Nurse as Patient Advocate?
In considering this particular argument in relation to the nurse's advocacy role, the following can be said: (a). This highlights the differences between nursing in the acute care context and community care with regard to the nurse's advocacy role. Nevertheless, the coordinating role of the nurse remains an important part of patient care.
This lack of freedom of choice for patients means that nurses cannot be patient advocates in the legal sense of the word. The role of the nurse as a patient advocate is very well accepted, both in the international nursing practice context and in the nursing literature. An analysis of nursing practice and the role of the nurse supports an advocacy role for nurses – but such a role, in the context of health care, is not exclusive to nurses.
Ethical Issues at the Beginning of Life
At the very least, infertility is a malfunction of a part of the body, just like diabetes. In the UK, surrogacy is legal if, using IVF, an embryo is created using the intended parents' eggs and sperm. While Ruth can be a surrogate for her sister, she must consider that not the entire process is legally enforceable.
Clare thinks of the fetus she already carries in terms of being a baby, with the same moral status and right to protection as herself. The technique allows healthy mitochondria from a female donor to be combined with the DNA of the parents. All of this adds to the dilemma and complexity of the ethical problems women face, such as those in the scenario above.
Ethical Issues at the End of Life
One of the key issues in discussions about assisted dying is confusion in the way the terms are used. Under the provisions of the Suicide Act 1961 in England and Wales, a legal right to suicide is recognized. The defeat of the Assisted Dying Bills in England and Scotland means that it is unlikely that further attempts will be made to bring about changes to the law in the near future.
Despite the defeat of the Assisted Dying Act, there is still a debate about the morality of assisted dying. Administering lethal drugs with the intent to kill someone is considered murder in Britain, regardless of the motive or whether it is done at the person's request. This is especially noticeable in the assisted dying debate, where public attitudes appear to be at odds with those of both healthcare professionals and legislative bodies.
Ethical Issues in Mental Health Nursing
A mental health nurse has the power to supervise an individual with a diagnosed mental condition (Roberts 2005). Determining whether a user of mental health services is non-autonomous is an ethically complex matter. This, however, depends on whether these strategies are used in a way that is sensitive to the needs of the mental health service user.
If used in accordance with mental health law, it can be considered justified. To be expert, the mental health nurse must be skilled in both top-down and bottom-up ethical reasoning. The ethical dimension of clinical decision-making within mental health nursing practice can sometimes be hidden.
Resource Allocation and Rationing in Nursing Care
All of the above would seem to suggest that it is time to explore issues of resource allocation and rationalization and their relevance to nursing and nursing delivery. Considering the different viewpoints presented in the above definitions seems important for several reasons. The potential impact of enhanced teamwork, levels of nurse education, and nursing leadership on the efficient use of nursing resources appear to be important issues to investigate in improving patient care and avoiding what may be an unrecognized, uncontrolled, implicit allocation of nursing care.
Covert rationing of nursing care in this way is potentially detrimental to the care and experience of patients who do not receive adequate nursing care. HIQA (2015) Report of an inquiry into the safety, quality and standards of services provided by the Health Services Executive to patients at the Midland Regional Hospital, Portlaoise. Schubert M, Glass T, Clarke SP, Aiken LH, Schaffert-Witvlet B, Sloane DM, De Geest S (2008) Nursing care rationing and its relationship to patient outcomes: a Swiss extension of an international hospital study.
Values-Based Nursing and Fitness to Practice Issues
It could be argued that this is achieved through the regulation of regulators by a professional standards body. Guidance on character and health decision-making' (NMC 2016) and 'Code - professional standards of practice and conduct for nurses and midwives'. These guidelines have since been replaced by the NMC (2015a) 'Code - Professional Standards of Practice and Conduct for Nurses and Midwives', which is a set of standards for all nurses - both registered and student.
Thus, even if systems of accountability and transparency aims (eg the NMC, 2015c, Duty of Candor guidance) are in place, if patients mistrust these systems, trust itself may be difficult to establish. The NMC will consider that every registered practitioner has a fully formed understanding of the concept of professional conduct and the code of conduct outlines the requirements in practice. The increase in misconduct cases correlates with the publication of the NMC (2014) 'Raising concerns- guidance for nurses and midwives'.
Ethical Principles in Healthcare Research
Based on the work of the philosopher Immanuel Kant1, such values are expressed in the principle of respect for persons, sometimes translated as respect for autonomy. In terms of protecting the participant's right not to be harmed or harmed, it is usually the duty of the research team not to expose the research participant to severe, unreasonable, known or foreseeable risk. However, in cases where substantial burden or foreseeable material risk is unavoidable, it is the duty of the research team to provide adequate information on the potential burden and/or risk involved so that the participant can determine whether they fully understand and accept such burden or risk.
Such measures help to provide insight into the potential effects of the particular drug or device—at least in non-human subjects. Such considerations are directly related to the discussion of principles of beneficence and non-maleficence below. Respect for the individual's right to make decisions about themselves and their lives (respect for autonomy) requires that research participants be adequately and properly informed about the nature of the research project.
