Ethics Assignment Basic Ethical Concepts of Nursing

Written by : Nor Amali Hidayatni 011024

BANJARMASIN MUHAMMADIYAH HEALTH COLLEGE INTERNATIONAL CLASS OF NURSING DIPLOMA ACADEMIC YEAR 2011/ 2012

Basic Ethical Concepts of Nursing

1. Right
The concept of rights in health care is overused and difficult to define, but needs clarification. Beginning in the 1960s and 1970s, American society became accustomed to talking about the rights of comparatively disadvantaged groups, such as ethnic and racial minorities, women, and patients. More recently, physicians and other health care

professionals have pointed out that they have rights too (paralleling the development of victims rights to complement the rights of persons accused and convicted of crimes). As the uses of the term rights have become more extensive, its meaning has faded. There are many different types of legal rights, for example, so that the mere assertion of a right tells us little about its scope or effect. Much specificity is necessary in order to make a claim of right clear and meaningful. The best way to think about rights (moral or legal) is that they are correlative to duties. Thus, if I have a right to do X, someone else -- an individual or perhaps the state - has a duty to me, either not to interfere with my doing X or, in some instances, to assist me in doing X. I may also have a duty to exercise my right responsibly, so as not to interfere with the rights of others. One common problem with rights language is the perception that everyone has rights and no one has responsibilities. Another is that rights belong only to individuals, so that the rights of individuals are pitted against the interests of communities. Rights language should be used judiciously to avoid these pitfalls.

2. Autonomy
The principle of respect for autonomy, and the right of self-determination, are important concepts in health care ethics. Autonomy means the ability to govern oneself and the freedom to do so. Self-determination is often used to mean autonomy, especially in health care settings. A person acts autonomously if that person acts intentionally, with understanding, and without being controlled by others. Both persons and their actions can be

autonomous; autonomous people do not always act autonomously, and sometimes people who are not autonomous are able to make autonomous decisions or act autonomously in some instances. It is important to remember that no one is fully autonomous; we judge autonomy by the expectations we have of common human behavior, and set a minimal standard of substantial autonomy by which to judge people and their actions. Autonomy is not the same as freedom, and usually we view autonomy as including some responsibility for the consequences of ones actions. Now that society has become especially concerned about the interests or rights of communities, there is much disagreement about the boundaries between an individuals autonomy and the legitimate rights or interests of others.Competence and decisional capacity, concepts related to autonomy, are defined below.

3. Beneficence and non-malefince

The term beneficence refers to actions that promote the well being of others. In the medical context, this means taking actions that serve the best interests of patients. However, uncertainty surrounds the precise definition of which practices do in fact help patients.

James Childress and Tom Beauchamp in Principle of Biomedical Ethics (1978) identify beneficence as one of the core values of health care ethics. Some scholars, such as Edmund Pellegrino, argue that beneficence is the only fundamental principle of medical ethics. They argue that healing should be the sole purpose of medicine, and that endeavors like cosmetic surgery, contraception and euthanasia fall beyond its purview The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the Latin, primum non nocere. Many consider that should be the main or primary consideration (hence primum): that it is more important not to harm your patient, than to do them good. This is partly because enthusiastic practitioners are prone to using treatments that they believe will do good, without first having evaluated them adequately to ensure they do no (or only acceptable levels of) harm. Much harm has been done to patients as a result, as in the saying, "The treatment was a success, but the patient died." It is not only more important to do no harm than to do good; it is also important to know how likely it is that your treatment will harm a patient. So a physician should go further than not prescribing medications they know to be harmful - he or she should not prescribe medications (or otherwise treat the patient) unless s/he knows that the treatment is unlikely to be harmful; or at the very least, that patient understands the risks and benefits, and that the likely benefits outweigh the likely risks. In practice, however, many treatments carry some risk of harm. In some circumstances, e.g. in desperate situations where the outcome without treatment will be grave, risky treatments that stand a high chance of harming the patient will be justified, as the risk of not treating is also very likely to do harm. So the principle of non-maleficence is not absolute, and balances against the principle of beneficence (doing good), as the effects of the two principles together often give rise to a double effect .

Depending on the cultural consensus conditioning (expressed by its religious, political and legal social system) the legal definition of non-maleficence differs. Violation of non-maleficence is the subject of medical malpractice litigation. Regulations therefore differ over time, per nation.

4. Justice
Justice is a significant ethical principle that has many different aspects. Generally speaking, we worry about justice on a larger scale than the individual -- for example, for communities, special groups (women, minorities, disabled persons, etc.), and societies. Justice is roughly synonymous with fairness, but what is just or fair depends on the circumstances. Is treating everyone equally just? Or is affirmative action more just because it redresses past wrongs? Distributive justice addresses how social goods (like food, shelter, and health care) should be distributed. Once again, we might ask whether equality is a just principle of distribution, or whether from each according to his ability, to each according to his needs is more just. Fair procedures and fair hearings are also components of justice. The word justice is closely tied with the legal system. However, the word refers to the obligation to be fair to all people. In 2001, healthcare economics have hospitals and other providers stretching their resources to their limits. Economic decisions about healthcare resources have to be made based on the number of patients who would benefit. The potential of rationing care to the frail elderly, poor, and disabled creates an ethical dilemma that is sure to become even more complicated in the future.

5. Fidelity
Fidelity refers to the concept of keeping a commitment. Although the word is more closely used to describe a marital relationship, fidelity is the concept of accountability. What is the nurse's responsibility to his or her patient, employer, society, or government? Privacy and confidentiality are concepts that could be challenged under the concept of fidelity.

6. Veracity
Is the principle of truthfulness - requires the health care provider to tell the truth and not to decieve or mislead clients intentionally . in this situation as a nurse we should tell the truth when it is known that doing so will cause harm to the patient .

7. The standard of best interest

Applied when a decision must be made about a patients health care and the patient is unable to make an informed decision .

References

http://www.med.uottawa.ca/sim/data/Ethics_e.htm

http://www.enotes.com/code-ethics-nurses-reference/code-ethics-nurses

http://en.wikipedia.org/wiki/Medical_ethics