Culturally competent Care for patients and ethical dilemmas
Presented by
Agenda
Introduction
Ethical Decision-Making Model
Ethical Dilemma 1
Ethical Dilemma 2
Ethical Dilemma 3
Conclusion
References
Ethical Decision Making
1) Articulate the Problem
2) Collect information and perspectives on differing moral claims
3) Explore options
4) Choose and implement an option
5) Evaluate outcomes
Ethical Dilemma 1
Problem statement what is the dilemma?
What are the perspectives on it?
Who are keystakeholders/decision makers?
What is the goal outcome for/of the patient?
Ethical Dilemma 1
Ethical Dilemma 1
General discussion slide if necessary; point out specific conflicts and options
Ethical Dilemma 1
Identify solutions and ways to evaluate outcomes
Ethical Dilemma 2
Problem statement what is the dilemma?
What are the perspectives on it?
Who are keystakeholders/decision makers?
What is the goal outcome for/of the patient?
Ethical Dilemma 2
Ethical Dilemma 2
General discussion slide if necessary; point out specific conflicts and options
Ethical Dilemma 2
Identify solutions and ways to evaluate outcomes
Ethical Dilemma 3
Problem statement what is the dilemma?
What are the perspectives on it?
Who are keystakeholders/decision makers?
What is the goal outcome for/of the patient?
Ethical Dilemma 3
Ethical Dilemma 3
General discussion slide if necessary; point out specific conflicts and options
Ethical Dilemma 3
Identify solutions and ways to evaluate outcomes
Conclusion
Restate Ethical Decision making framework 30seconds
Restate examples given
Final closeout leave audience with final question or thought?
References
Nathaniel, A. 2012. Chapter 7: Ethical decision making. [PowerPoint slides]. Retrieved from Resurrection University Brightspace, 10DEC2020.
References as Embedded Attachments
Powerpoint Ethics
Decision Model
CHAPTER 7
Ethical Decision Making
*
Moral Problems
Moral problems are complex.
They may:
Include intricate relationships among people with opposing views
Incorporate a mix of values, risks, benefits, and harms
Include solutions that are obscure until the situation unfolds
*
Problem Analysis
A problem is
A discrepancy between the current situation and a desired state
Usually unplanned and often unexpected
Simple or complex, routine or moral
*
Think About It
Articulate the current situation and a practical desired state.
A terminally ill patient with intractable pain
A critically ill person with no health insurance
An Alzheimers patient who wants to go home
A narcotic drug abuser who has severe, chronic pain
*
Types of Moral Problems
Moral uncertainty
Moral dilemma
Moral distress
Moral outrage
Moral reckoning
*
Moral Uncertainty
Occurs when one senses that there is a moral problem, but
Is not sure of the morally correct action,
Is unsure which moral principles or values apply, or
Cannot define the moral problem (Jameton, 1984).
*
Dilemma
A dilemma is a problem
That requires a choice between two equally unfavorable and mutually exclusive options
That seems to defy a satisfactory solution
*
Moral Dilemma
A moral dilemma occurs when solutions to a problem include conflicting moral claims.
*
Moral Dilemma Presentation
Two ways moral dilemmas may present:
Evidence indicates that an act is morally right, and other evidence indicates that the act is morally wrong, but no evidence is conclusive.
One moral rule supports one course of action and another moral rule supports another course of action, yet the two actions are mutually exclusive.
(Beauchamp & Childress, 2001)
*
Think About It
What are the conflicting moral claims in these situations?
A terminally ill patient experiences severe intractable pain.
A patient seeks an experimental treatment that is likely to cause harm.
An alert elderly patient falls often, so the physician orders physical restraints.
*
Moral Distress
arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. (Jameton, 1984, p. 6)
nurses participate in the action that they have judged to be morally wrong. (Jameton, 1993)
*
Moral Distress
More likely to occur in highly stressful situations or when dealing with more vulnerable patients. Factors:
Ethical and working climate in the facility
Relationshipsespecially with physicians and role expectations
Stressors resulting from nursing shortage
Results in psychosocial, physical, and emotional consequences for nurses
When it occurs it is unfavorable for nurses and patients and can have a long-term impact
Moral Outrage
occurs when someone else performs an act the nurse believes to be immoral
Nurses
Do not participate in the act
Do not believe they are responsible for wrong
Believe they are powerless to prevent the act
(Wilkinson, 19871988)
*
Moral Reckoning
Encompasses moral distress, moral outrage, and more
May last a lifetime
Is a three-stage process
Stage of ease
Stage of resolution
Stage of reflection
*
Intervening Factors
Intervening factors appear in ways that interfere with, alter, or obstruct action, and add to the complexity of ethical problems.
Uncertainty
Context
Stakeholders
Power imbalance
Extraneous variables
Other relevant cases
Urgency
*
Ethical Decision Making
Basic features constitute every type of decision
A problem
Alternative solutions
Uncertainty
Outcome
*
Effective Decision Maker Attributes
Moral integrity
Sensitivity, compassion, and caring
Sense of responsibility
Empowerment
Patience and willingness to deliberate
Knowledgeable about societal rules, ethical principles, and professional standards
*
Decisions at the Bedside
Ethics and ethical decision making are part of every aspect of nursing.
Make decisions of moral importance daily
Conscious of the moral nuances in each situation
Ethic: personal consciousness of the moral importance that guides personal actions in particular situations.
Various ethics such as ethic of responsiveness which includes respect for persons and a desire to do good
Ethical Decision-Making Model
Articulate the problem
Gather data and identify conflicting moral claims
Explore strategies
Implement the chosen strategy
Evaluate outcomes
*
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Culturally competent Care for patients and ethical dilemmas
Presented by
Agenda
Introduction
Ethical Decision-Making Model
Ethical Dilemma 1
Ethical Dilemma 2
Ethical Dilemma 3
Conclusion
References
Ethical Decision Making
1) Articulate the Problem
2) Collect information and perspectives on differing moral claims
3) Explore options
4) Choose and implement an option
5) Evaluate outcomes
Ethical Dilemma 1
Problem statement what is the dilemma?
What are the perspectives on it?
Who are keystakeholders/decision makers?
What is the goal outcome for/of the patient?
Ethical Dilemma 1
Ethical Dilemma 1
General discussion slide if necessary; point out specific conflicts and options
Ethical Dilemma 1
Identify solutions and ways to evaluate outcomes
Ethical Dilemma 2
Problem statement what is the dilemma?
What are the perspectives on it?
Who are keystakeholders/decision makers?
What is the goal outcome for/of the patient?
Ethical Dilemma 2
Ethical Dilemma 2
General discussion slide if necessary; point out specific conflicts and options
Ethical Dilemma 2
Identify solutions and ways to evaluate outcomes
Ethical Dilemma 3
Problem statement what is the dilemma?
What are the perspectives on it?
Who are keystakeholders/decision makers?
What is the goal outcome for/of the patient?
Ethical Dilemma 3
Ethical Dilemma 3
General discussion slide if necessary; point out specific conflicts and options
Ethical Dilemma 3
Identify solutions and ways to evaluate outcomes
Conclusion
Restate Ethical Decision making framework 30seconds
Restate examples given
Final closeout leave audience with final question or thought?
References
Nathaniel, A. 2012. Chapter 7: Ethical decision making. [PowerPoint slides]. Retrieved from Resurrection University Brightspace, 10DEC2020.
References as Embedded Attachments
Powerpoint Ethics
Decision Model
CHAPTER 7
Ethical Decision Making
*
Moral Problems
Moral problems are complex.
They may:
Include intricate relationships among people with opposing views
Incorporate a mix of values, risks, benefits, and harms
Include solutions that are obscure until the situation unfolds
*
Problem Analysis
A problem is
A discrepancy between the current situation and a desired state
Usually unplanned and often unexpected
Simple or complex, routine or moral
*
Think About It
Articulate the current situation and a practical desired state.
A terminally ill patient with intractable pain
A critically ill person with no health insurance
An Alzheimers patient who wants to go home
A narcotic drug abuser who has severe, chronic pain
*
Types of Moral Problems
Moral uncertainty
Moral dilemma
Moral distress
Moral outrage
Moral reckoning
*
Moral Uncertainty
Occurs when one senses that there is a moral problem, but
Is not sure of the morally correct action,
Is unsure which moral principles or values apply, or
Cannot define the moral problem (Jameton, 1984).
*
Dilemma
A dilemma is a problem
That requires a choice between two equally unfavorable and mutually exclusive options
That seems to defy a satisfactory solution
*
Moral Dilemma
A moral dilemma occurs when solutions to a problem include conflicting moral claims.
*
Moral Dilemma Presentation
Two ways moral dilemmas may present:
Evidence indicates that an act is morally right, and other evidence indicates that the act is morally wrong, but no evidence is conclusive.
One moral rule supports one course of action and another moral rule supports another course of action, yet the two actions are mutually exclusive.
(Beauchamp & Childress, 2001)
*
Think About It
What are the conflicting moral claims in these situations?
A terminally ill patient experiences severe intractable pain.
A patient seeks an experimental treatment that is likely to cause harm.
An alert elderly patient falls often, so the physician orders physical restraints.
*
Moral Distress
arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. (Jameton, 1984, p. 6)
nurses participate in the action that they have judged to be morally wrong. (Jameton, 1993)
*
Moral Distress
More likely to occur in highly stressful situations or when dealing with more vulnerable patients. Factors:
Ethical and working climate in the facility
Relationshipsespecially with physicians and role expectations
Stressors resulting from nursing shortage
Results in psychosocial, physical, and emotional consequences for nurses
When it occurs it is unfavorable for nurses and patients and can have a long-term impact
Moral Outrage
occurs when someone else performs an act the nurse believes to be immoral
Nurses
Do not participate in the act
Do not believe they are responsible for wrong
Believe they are powerless to prevent the act
(Wilkinson, 19871988)
*
Moral Reckoning
Encompasses moral distress, moral outrage, and more
May last a lifetime
Is a three-stage process
Stage of ease
Stage of resolution
Stage of reflection
*
Intervening Factors
Intervening factors appear in ways that interfere with, alter, or obstruct action, and add to the complexity of ethical problems.
Uncertainty
Context
Stakeholders
Power imbalance
Extraneous variables
Other relevant cases
Urgency
*
Ethical Decision Making
Basic features constitute every type of decision
A problem
Alternative solutions
Uncertainty
Outcome
*
Effective Decision Maker Attributes
Moral integrity
Sensitivity, compassion, and caring
Sense of responsibility
Empowerment
Patience and willingness to deliberate
Knowledgeable about societal rules, ethical principles, and professional standards
*
Decisions at the Bedside
Ethics and ethical decision making are part of every aspect of nursing.
Make decisions of moral importance daily
Conscious of the moral nuances in each situation
Ethic: personal consciousness of the moral importance that guides personal actions in particular situations.
Various ethics such as ethic of responsiveness which includes respect for persons and a desire to do good
Ethical Decision-Making Model
Articulate the problem
Gather data and identify conflicting moral claims
Explore strategies
Implement the chosen strategy
Evaluate outcomes
*
Applied Sciences
Architecture and Design
Biology
Business & Finance
Chemistry
Computer Science
Geography
Geology
Education
Engineering
English
Environmental science
Spanish
Government
History
Human Resource Management
Information Systems
Law
Literature
Mathematics
Nursing
Physics
Political Science
Psychology
Reading
Science
Social Science
Home
Homework Answers
Blog
Archive
Tags
Reviews
Contact
twitterfacebook
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