Morals: private personal standards of what is right and wrong in conduct character, and attitude Ethics: rules or procedures that determine what is right or wrong and implies a high standard of moral quality. Ethics may involve personal decisions or professional practice. Values: personal belief about the worth of a given idea, attitude, custom, or object that sets standards and influences behavior
Development is learned thru observation and experience, heavily influenced by environment – takes shape early in life Personal internalize values from society and personalize these
Specific knowledge and skills – foundation of nursing science Person-centered Autonomy and accountability – adheres to standards of practice and is responsible for care given Nursing practice validates standards to adhere to with care given Ethical standards: respect for human dignity – give respectful service regardless of client’s personal characteristics confidentiality – does not discuss condition with anyone not involved with care advocacy – protects client from incompetent or unethical practice promotion of public health – committed to local and global goals for health of community
Protected relationship: RN or client cannot be forced to reveal communication between them unless the person who would benefit from relationship agrees to reveal it
Right to be left alone without unwarranted publicity Right to make personal choices without interference contraception, abortion, refusal of tx Who authorized personnel What data, photos, videos, research When anytime Where pt permission even with family Violated when info revealed to unauthorized or observed without permission
Requirements capacity – age (adult) competence-(can make choices and understand consequences) voluntary-freedom of choice without force, fraud, deceit, duress, coercion Info must be in lay terms No consent if intoxicated or premedicated Minors who can consent married minors over certain age (12) for STD tx, HIV testing and tx, drug/alcohol tx seeking birth control psych services pregnant minor-for themselves and fetus after delivery (mom retains rights over baby)
Requirements capacity – age (adult) competence-(can make choices and understand consequences) voluntary-freedom of choice without force, fraud, deceit, duress, coercion Info must be in lay terms No consent if intoxicated or premedicated Minors who can consent married minors over certain age (12) for STD tx, HIV testing and tx, drug/alcohol tx seeking birth control psych services pregnant minor-for themselves and fetus after delivery (mom retains rights over baby)
Requirements capacity – age (adult) competence-(can make choices and understand consequences) voluntary-freedom of choice without force, fraud, deceit, duress, coercion Info must be in lay terms No consent if intoxicated or premedicated Minors who can consent married minors over certain age (12) for STD tx, HIV testing and tx, drug/alcohol tx seeking birth control psych services pregnant minor-for themselves and fetus after delivery (mom retains rights over baby)
Requirements capacity – age (adult) competence-(can make choices and understand consequences) voluntary-freedom of choice without force, fraud, deceit, duress, coercion Info must be in lay terms No consent if intoxicated or premedicated Minors who can consent married minors over certain age (12) for STD tx, HIV testing and tx, drug/alcohol tx seeking birth control psych services pregnant minor-for themselves and fetus after delivery (mom retains rights over baby)
Self-Determination Act federal law requiring healthcare facilities to provide written info to adults about rights to make hc decisions Aggressive tx extraordinary support measures used to maintain individuals physiologic processes may be withheld to avoid prolonging life without dignity supportive care to promote comfort and reduce suffering Advanced Directives Wills legal document signed by competent individual that indicates tx or life-saving measures (surgery, CPR, respirator) to be used if individual’s ability to make decisions is lost due to terminal illness or permanently unconscious state indicates who is authorized to make hc decisions if individual becomes incapacitated DPA permits competent adult to appoint surrogate or proxy in event adult becomes incompetent HC provider must follow decisions stated in document
Self-Determination Act federal law requiring healthcare facilities to provide written info to adults about rights to make hc decisions Aggressive tx extraordinary support measures used to maintain individuals physiologic processes may be withheld to avoid prolonging life without dignity supportive care to promote comfort and reduce suffering Advanced Directives Wills legal document signed by competent individual that indicates tx or life-saving measures (surgery, CPR, respirator) to be used if individual’s ability to make decisions is lost due to terminal illness or permanently unconscious state indicates who is authorized to make hc decisions if individual becomes incapacitated DPA permits competent adult to appoint surrogate or proxy in event adult becomes incompetent HC provider must follow decisions stated in document
Self-Determination Act federal law requiring healthcare facilities to provide written info to adults about rights to make hc decisions Aggressive tx extraordinary support measures used to maintain individuals physiologic processes may be withheld to avoid prolonging life without dignity supportive care to promote comfort and reduce suffering Advanced Directives Wills legal document signed by competent individual that indicates tx or life-saving measures (surgery, CPR, respirator) to be used if individual’s ability to make decisions is lost due to terminal illness or permanently unconscious state indicates who is authorized to make hc decisions if individual becomes incapacitated DPA permits competent adult to appoint surrogate or proxy in event adult becomes incompetent HC provider must follow decisions stated in document
OBRA: provides pt with right to be free from physical and chemical restraints imposed for purposes of discipline or convenience and not required to tx medical sx Chemical psych drugs not used to control behavior can be used only for diagnoses-related conditions inappropriate use causes deep sedation, agitation, combativeness Consent: needed for use of restraints if client unable to consent then OK for proxy with full disclosure of risks/benefit without consent is FALSE IMPRISONMENT
OBRA: provides pt with right to be free from physical and chemical restraints imposed for purposes of discipline or convenience and not required to tx medical sx Chemical psych drugs not used to control behavior can be used only for diagnoses-related conditions inappropriate use causes deep sedation, agitation, combativeness Consent: needed for use of restraints if client unable to consent then OK for proxy with full disclosure of risks/benefit without consent is FALSE IMPRISONMENT
OBRA: provides pt with right to be free from physical and chemical restraints imposed for purposes of discipline or convenience and not required to tx medical sx Chemical psych drugs not used to control behavior can be used only for diagnoses-related conditions inappropriate use causes deep sedation, agitation, combativeness Consent: needed for use of restraints if client unable to consent then OK for proxy with full disclosure of risks/benefit without consent is FALSE IMPRISONMENT
Assess and document need Document alternative measures MD order must specify duration and circumstances Cannot order PRN Monitor pt closely and periodically reassess for continued need and document
Defend client participation in decision affecting them Communicate client needs to other hc members Safeguard client autonomy and independence Provide client info about needs Provide client options so client can make informed decisions about care
Negligence unintentional failure of individual to perform act that reasonable person would or would not perform in similar circumstance can be omission or comission Malpractice professional negligence involving misconduct or lack of skill in carrying out professional responsibilities required elements : duty, breach of duty, causation, injury Invasion of privacy: release of info to unauthorized person without consent Assault intentional threat to cause harm or offensive contact Battery intentional touching without consent
Negligence unintentional failure of individual to perform act that reasonable person would or would not perform in similar circumstance can be omission or comission Malpractice professional negligence involving misconduct or lack of skill in carrying out professional responsibilities required elements : duty, breach of duty, causation, injury Invasion of privacy: release of info to unauthorized person without consent Assault intentional threat to cause harm or offensive contact Battery intentional touching without consent
Nursing Practice Act defines reasonable care in each state, scope of nursing practice, roles, rules, educational requirements Licensure req. differs slightly among states Good Samaritan Law limits the liability of professionals in emergency situations Tarasoff Act duty to warn of threatened suicide or harm to others