_____: The systematic study of what a person’s CONDUCT AND ACTIONS OUGHT TO BE with regard to self, others, and the environment.
1.) It is the JUSTIFICATION OF WHAT IS RIGHT OR GOOD
2.) It is the study of what a person’s life and relationships OUGHT TO BE, not necessarily what they are.
ETHICS
_____: Requires the APPLICATION of NORMATIVE ETHICAL THEORY to everyday problems.
For NURSING PROFESSION: The foundation for ethical decisions comes from the profession’s values and norms.
For NURSE MANAGER: Has a different ethical responsibility and lacks a clearly defined professional foundation (because management is a discipline, not a profession).
Applied Ethics
For the Nursing Profession:
Nurses make ethical (right or wrong) decisions based on the core values and standards of nursing — like caring, compassion, respect, and doing what’s best for the patient. These values serve as the foundation or guide whenever a nurse faces moral choices in practice.
For the Nurse Manager:
A nurse manager also faces ethical situations, but their role is more about managing people, resources, and systems. Management itself doesn’t have a single set of professional values like nursing does — it’s more of a discipline or skill area. So, nurse managers have to balance both nursing ethics and organizational ethics (like fairness, efficiency, and leadership decisions).
NUSE MANAGER’S ETHICAL OBLIGATION:
1.) Tied to the ORGANIZATION’S PURPOSE.
2.) Influenced by the NORMS AND VALUES reflected by the organization.
3.) Emerge from a COMPLEX SET OF INTERACTIONS with society and the specific institution’s values.
CIC
• It is connected to what the organization stands for
• It is influenced by the organization’s culture
• It comes from many interactions
The potential for conflict is high due to differences in:
- Personal responsibilities
- Organizational responsibilities
- Subordinate responsibilities
- Consumer responsibilities
POSC
There’s a high chance of conflict because a nurse manager has to deal with many different responsibilities — and sometimes, they don’t match or go against each other.
• Personal responsibilities: What the nurse manager personally believes is right or moral.
• Organizational responsibilities: What the hospital or institution expects them to do (like following policies or saving resources).
• Subordinate responsibilities: Duties toward the nurses they supervise — being fair, supportive, and protective of their team.
• Consumer responsibilities: Duties toward patients and their families — giving safe, quality, and compassionate care.
_____: Occurs when one is UNSURE WHAT PRINCIPLES OR VALUE APPLY in an ethical conflict, or even if an ethical problem exists (Marquis & Huston, 2006).
_____: Occurs when one KNOWS THE RIGHT THING TO DO, but institutional or other constraints make it difficult to pursue the desired course of action (Marquis & Huston, 2006).
_____: Nurse managers frequently face these due to MULTIPLE ADVOCACY ROLES (for patients, physicians, and the organization simultaneously), which may have conflicting needs, wants, and goals.
Moral Uncertainty
Moral Distress
Ethical Dilemmas
• Moral Uncertainty: → Happens when you’re unsure if a situation is really an ethical problem, or you don’t know which moral rule or value applies. (Example: You’re not sure if a certain action is right or wrong.) • Moral Dilemma: → Happens when you know what the right thing to do is, but something (like hospital rules or authority) stops you from doing it. (Example: You want to speak up for a patient, but your supervisor tells you not to.) • Ethical Dilemmas: → Common among nurse managers, because they have to balance the needs of patients, doctors, and the organization — and these often conflict with each other. (Example: Choosing between what’s best for the patient and what the hospital policy requires.)
_____: A COMBINATION of being a MORAL PERSON and being a MORAL MANAGER.
Ethical Leadership
Being a _____ (Traits & Behaviors):
- Key Traits: _____, _____, _____
- Behaviors: Doing the RIGHT THING, concern for people, being open, and maintaining personal integrity standards.
Being a _____ (Role):
- Serves as a ROLE MODEL for others in all duties.
- Provides REWARDS AND DISCIPLINE around the ethical and unethical decisions made by others to send a clear message.
Moral Person
- INTEGRITY, HONESTY, AND TRUSTWORTHINESS
Moral Manager
A. The Qualities of an Ethical Leader
_____:
- Ability to be THOROUGH, careful, and vigilant.
- Dedication to get the job done, empower others, and ensure success.
- Showcases a STRONG MORAL IDENTITY (wants to be seen and think of him- or herself as a good person).
_____:
- OPEN to other opinions and encourages voicing different ideas.
- Works with people from DIVERSE BACKGROUNDS (ethnicities, races, cultures) and understands the benefits of a diverse work environment.
_____:
- Treats the responsibility of leadership seriously and with respect.
- Builds trust by DOING WHAT YOU ARE SAYING (showing true ethical leadership).
- Must be RESPONSIBLE for actions and decisions.
_____: (In two separate senses)
- Must CONSIDER all actions to MINIMIZE HARM.
- Requires the PROPER TREATMENT OF SUBORDINATES and other stakeholders.
_____:
- Ethical leadership framework must be PRESENT AT ALL TIMES.
- Must showcase consistency in approach and in the WAY SUBORDINATES AND STAKEHOLDERS ARE TREATED.
- Can inspire the workforce by STAYING TRUE to his or her ethical standards.
_____:
- Must learn to be authoritative and to use his or her power.
- Emphasizes COLLABORATION in the decision-making process (unlike purely authoritarian models).
- Uses authority as a MEAN TO EMPOWER OTHERS; sharing responsibilities and power is a means to increase success.
CIACCA
Conscientious
Inclusive
Accountable
Considerate
Consistent
Authoritative
A. Principles for Decision Making
- _____:
- People are obligated to INFORM THEMSELVES about ethical norms.
- Must incorporate that knowledge, ACT ACCORDING to it, and take responsibility for those actions. - _____:
- Engages spirituality, intellect, imagination, intuition, and beliefs.
- A structured process helps:
1.) Discipline decision making.
2.) Ensure relevant dimensions are considered.
3.) Elicit a multiplicity of perspectives.
4.) Align moral sensibilities with deliberative intellect.
5.) Foster the ability to articulate the rationale for organizational decisions.
- REQUIRES STRUCTURED TIME FOR REFLECTION AND PAPER.
The Principle of Well-Formed Conscience
Ethical Discernment
The Principle of Well-Formed Conscience:
→ This means making decisions based on a clear, informed, and moral conscience — knowing what’s right and wrong, and choosing to do what’s right even when it’s hard.
In nursing, it means thinking carefully before acting and letting your moral values guide your choices for your patients.
Ethical Discernment:
→ This means the ability to recognize and understand what is right or wrong in a given situation. It’s like having a good moral sense — being able to see the ethical side of a situation and make the best possible decision based on both reason and compassion.
B. Framework of Ethical Discernment
STAGES
OBSERVE
DELIBERATE
ACT
B. Framework of Ethical Discernment
STEPS
IAGCEEAI
- Identify the Problem
- Acknowledge Feelings
- Gather the Facts
- Consider Alternatives
- Examine Values
- Evaluate Alternatives
- Articulate the Decision
- Implement the Plan
C. Strategies of Moral Decision Making
- The Nursing Process (as a problem-solving process)
- Identify the problem.
- Gather data to analyze the causes and consequences.
- Explore alternative solutions.
- Evaluate the alternatives.
- Select the appropriate solution.
- Implement the solution.
- Evaluate the results.
C. Strategies of Moral Decision Making
- The _____ (Crisham, 1985)
A MNEMONIC MODEL that incorporates the nursing process and biomedical ethics principles, useful for CLARIFYING ETHICAL PROBLEMS from CONFLICTING OBLIGATIONS. (The mnemonic is given, but the text does not define the letters.)
MORAL Decision-Making Model
C. Strategies of Moral Decision Making
D. Ethical Frameworks for Decision Making
_____:
- Focuses on MAXIMIZING THE WELFARE (happiness) of the subordinates.
- Concern is on the PROPER ENDS OF THE ACTION (results).
- Associated with John Stuart Mill and ethical cost-benefit analysis.
_____:
- The leader’s main concern is to PROTECT THE FREEDOM OF INDIVIDUALS
- Would not proceed with an action that would restrain a subordinate’s freedom.
- Concern is on the INTENT OF INDIVIDUALS.
Follows Aristotle’s idea of virtue ethics (eudaimonism).
_____:
- Focuses on DOING THE RIGHT THINGS (duty).
- Approach looks at the PROPER MEANS.
- Moral actions come from understanding and FOLLOWING THE RULES AND CUSTOMS of the organization (common, agreed values).
Utilitarianism Theory
Libertarianism Theory
Immanuel Kant’s Ethical Theory
_____: EFFECTIVE AND EFFICIENT DELIVERY OF SERVICES while generating needed revenues for continued organizational productivity.
Importance: Scarce resources and soaring healthcare costs strain delivery systems, making the ability to use fiscal resources wisely critical for the viability of healthcare organizations.
Responsibility: Cost containment is the responsibility of every healthcare provider.
Cost Containment
Cost containment means providing good and efficient care while also controlling expenses so the hospital or organization can continue to operate effectively.
Allocation of Resources
_____(General): Refers to the ALLOCATION OF RESOURCES to a service, department, or project. Ethically, it is a neutral concept regarding the moral implications of the allocation decision.
_____:
- A way of ENSURING LIMITED RESOURCES are used in a way which provides the GREATEST VALUE TO THE PATIENT.
- Puts what patients value at the center of healthcare.
- Focuses resources on high-value interventions that provide outcomes patients value.
Resource Allocation
Value-Based Healthcare (VBHC)
Three Types of Values:
1. _____
2. _____
3. _____
Four Attributes of Value-Based Healthcare:
4. _____
5. _____
6. _____
7. _____
_____: Defined as all materials, personnel, facilities, funds, and anything else that CAN BE USED FOR PROVIDING HEALTH CARE SERVICES.
ATP
Allocative value
Technical value
Personalized value
ASEC
Accessibility
Service
Effectiveness
Costs
Health Care Resources
C. Guiding Principles for Allocating Health Care Resources
IMPROVES PEOPLE’S HEALTH Resources should be used to treat disease, relieve pain, promote public health, and/or support research.
INFORM PATIENTS AND MEMBERS: Individuals should be informed about how resources are allocated and the rationale for the allocation (justified by the principle of autonomy and the concept of publicity).
PROVIDE OPPORTUNITY TO CONSENT TO OR DENY : Patients/members should have the opportunity to consent to or deny the organization’s allocation based on the information provided (promotes individuals as autonomous agents and stakeholders).
MINIMIZE CONFLICTS OF INTEREST: The allocation process may benefit or penalize individuals. Financial incentives for decreased usage or penalties for excessive usage should be minimized to protect the patient’s best interests.
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Chapter 126
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Chapter 2: Lesson 1 (ETHICAL THEORIES, OTHER RELATED THEORIES AND VIRTUE ETHICS)18
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Chapter 2: Lesson 2 ( BASIC ETHICAL PRINCIPLES AND OTHER RELEVANT ETHICAL PRINCIPLES)16
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Chapter 2: Lessons 2.213
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Chapter 2: Lesson 313
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Chapter 417
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Chapter 518
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Chapter 6 (Lesson 1)15
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Chapter 6 (Lesson 2)6
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Chapter 6 (Lesson 3)3
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Chapter 728
