ethical decision making

Topics: Ethics, Health care, Virtue Pages: 68 (15994 words) Published: March 12, 2014
CHAPTER 11

Ethics and Health
Pat Kurtz and Ronald L. Burr
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Authors Go Here
Authors Go Here

Visit http://nursing.jbpub.com/communityhealth for
Visit http://nursing.jbpub.com/communityhealth
interactive exercises, review questions, WebLinks
for interactive exercises, review questions,
and more.

Web links, and more.

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REFLECTIONS

It has become appallingly obvious that our technology has exceeded our humanity. —Albert Einstein
A state legislature allotted its state health department $750,000 to match Ryan White federal funding for medication sufficient to treat 20 patients with acquired immune deficiency syndrome (AIDS). However, there were 100 patients who needed the help. Public health nurses in each district were asked to select patients for the medication program. A terminally ill cancer patient who is in great pain begs the nurse for more medication than the physician has ordered. What should the nurse do?

A man was diagnosed and treated for a venereal infection by his family nurse practitioner. He agreed that his wife should also be treated but he did not want her to know that he acquired the disease from a prostitute and infected her. He asked the nurse practitioner if there was any way to avoid sharing this information. When faced with situations like these, it sometimes feels like there are no “right” answers. What are your reactions to the three ethical dilemmas? What other information would be helpful to know about these situations to make a decision?

CHAPTER FOCUS

Virtue or Character Ethics
Principle-Based Ethics: Developing Moral Rules
Utilitarian Theories: Doing the Most Good for the Most People Deontological Theories: Balancing Rights and Obligations
Justice in Health Care
Values and Health Policy

Ethics of Care
Ethical Problems Faced by Community Nurses: The Research
Ethical Decision Making
Service Learning: Discovering the Self and Developing Community Values

QUESTIONS TO CONSIDER

After reading this chapter, you will know the answers to the following questions:
1. What is bioethics, and how is it important to the community nurse?
2. What is the ethics of virtue, and what part do virtues play in the practice of nursing?
3. What is meant by principle-based ethics?
4. How does Kant’s deontological approach differ from Mill’s utilitarian approach?

5. What role does each of the four major ethical concepts— beneficence, nonmaleficence, autonomy, and justice—play in community nursing practice?
6. How can health care resources be distributed in a fair manner? 7. How does the ethical theory of care differ or agree with other theories?
8. What information does the nurse need to make ethically based decisions?
9. What is service learning, and how does it apply to community health?

KEY TERMS
Autonomy
Benevolence
Bioethics
Casuistry
Compassion

Consequentialism
Deontological
Discernment
Ethic of caring
Ethical decision making

Ethical dilemma
Ethics
Integrity
Justice
Nonmaleficence

Service learning
Trustworthiness
Utilitarianism
Virtue ethics

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COMMUNITY-FOCUSED NURSING

UNIT 2 Influences on a Community’s Health

“One of the dilemmas of today’s health care debate is that medical ethics, as currently structured and interpreted, is bad public policy and actually counterproductive to the total wellbeing of society.



—Richard Lamm, Executive Director, Center for Public Policy and Contemporary Issues, and former governor of Colorado

The situations we encounter as health care professionals
may be complex and puzzling dealing with serious issues of
well-being, life, and death. Our early experiences are usually of little help in guiding our actions in such complex...


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