1
Q
why do we study law & ethics?
A
- help us identify what we ought to do
- just because we can, doesnt mean we should
- to understand the expectations & limits of nursing practise
- to navigate and resolve competing interests & values
2
Q
define ethics
A
- what we ought to do in a particular situation
- answer reflects values & beliefs
3
Q
define laws
A
- established rules for behavior
- rules that govern actions & decisions
- encompasses rights, privileges, and obligations (things people must do or are expected to do in order to maintain a lvl of order in society)
4
Q
what are some examples of actions & decisions governed by laws (4)
A
- nurses’ duty to pts, family, and community
- provides framework for resolving conflicts between people
- specifies how harms or injuries committed by one person against another should be remedied
- consequences for breaching law
5
Q
describe the relationship between ethics and laws
A
- what is legal is not always ethical
6
Q
what are 3 sources of law
A
- statutory law
- common law
- civil law
7
Q
what is statutory law (aka acts) (3)
A
- public law (applies to every member of society)
- federal, provincial, or city laws
- formal written set or rules passed by a parliament or other legislative body to regulate a particular area
8
Q
who makes statutes
A
- parliament & provincial legislatures
9
Q
what is a federal example of statute law? provincial?
A
- federal: Canada Health Act (describes the responsibilities of the provinces in the delivery of health care)
- provincial: Personal Health Info Act, Protections for Persons in Care Act, Regulated Health Professions Act, Mental Health Act
10
Q
what is a regulation (3)
A
- laws (details) that are passed to update or amend existing statutes (it is very complicated to change a law, so this is an easier process to clarify or update laws)
- delegated (they delegate the power or authority to set and enforce laws)or subordinate legislation
- legally binding –> subordinate to statutes but are as enforceable
11
Q
who makes regulations
A
- persons to whom Parliament/Legislature has delegated the authority
ex. medical officer of health
12
Q
describe regulation that affects nurses
A
- Regulated Health Professions Act Registered Nurse Regulation
- specifies how registered nursing practice is governed, and delegates the College of Registered Nurses of Manitoba the power to set requirements for registration, and the specific actions that nurses are able to perform in the course of their work
13
Q
describe how public health orders are an example of a regulation
A
- they delegate authority under the Public Health Act to a Medical Officer of Health who can use the power of the Public Health Act to establish restrictions during a pandemic or require reporting of certain communiable diseases
14
Q
what is common law
A
- court interpretation of a statute
- body of unwritten laws based on legal precedents established by the courts
- aka case law
15
Q
how is common law established
A
- thru prosecutions of people found to be in violation of an Act, and thru civil lawsuits that adjudicate disputes & harms that have been committed by one individual against another
16
Q
what is a precedent
A
- the first case that is brought where a judge makes a determination of how a particular law or conflict should be interpreted
- that precedent (judge’s previous decision) then serves as a guide or model for deciding future similar cases should be treated
17
Q
what is an example of common law
A
Nancy B case:
- pt was dependent on a ventilator & requested the ventilator be removed and she be allowed to die
- court decided that the pt had the right to decline medical treatment if she was fully informed about the implications of the decision, even if it meant she would die
- this is an important precedent to informed consent –> means we need to have consent to provide treatments, and that the pt has the right to withdraw consent at any time
18
Q
what is civil law
A
- aka tort law
- system of law concerned with private relations between members of a community rather than criminal, military, or religious affairs
- relates a wrong committed by one person against another
- a body of rules & legal principles that govern relations, respective rights, and obligations among individuals, corporations, or other institutions
- also part of common law
19
Q
who are civil laws established by
A
- courts –> seperate from governments
20
Q
what is an example of civil law
A
ex. negligence
- if a pt is harmed because a nurse failed to fulfill a duty of care, the pt or their family can sue the nurse & the nurse may be found liable for the tort of negligence
21
Q
what is the hierarchy of law in Canada
A
from most to least powerful:
- acts/statutory law
- regulations
- court decisions (including common law interpretations of statutes & decisions in civil cases)
- administrative tribunals (regulatory)
22
Q
what are administrative tribunals?
A
- form of law that interpret or apply law in the real world
23
Q
what is an example of an administrative tribunals
A
- the College of Registered Nurses of Manitoba may convene an administrative tribunal in a situation where a complaint has been made against a nurse
- the administrative tribunal may conduct an investigation into the complaint & the nurse’s conduct & makes a determination about whether the conduct was acceptable or unacceptable
- a determination that the nurse failed to meet standards of acceptable nursing practice can result in punishment of the nurse such as fines, suspension, or cancellation of their certificate to practice nursing
24
Q
what is the difference between public & private law
A
- public = involves issues between the state or society & individuals
- private = involves only individuals
25
what are some examples of statutes that govern nursing practise? (6)
- canada health act
- regulated health professions act
- PHIA
- protection of persons in care act
- mental health act
- public health regulations
26
what are examples of case/common law that govern nursing practice (4)
- nancy B
- Melette v Shulman
- Rassouli
- carter v canada
27
describe the Carter v Canada case
- case brought before the courts that challenged the Criminal Code of Canada, which stated that helping someone die was prohibited
- a number of people argued that this was unconstitutional, and the Supreme Court of Canada decided that they were right & rules that in certain circumstances, people should have the right to medically assisted death
- this was case law, but the federal gvmt later passed a statute to amend the Criminal Code to permit assisted dying in certain situations.
28
what plays a role in deciding what is the right thing to do (3)
- legal systems provides foundational rules to guide nursing practice
- sometimes legal clarity is not enough to provide a definitive answer
= ethics refines the choice further
29
ethics is all about?
- values --> what is important/valued to the people involved in a situation, which is often different from person-to-person
30
what are values influenced by? (9)
- family
- peers
- religions
- culture
- society
- profession
- personal experiences (positive and negative)
- trauma
- education
31
describe the consistency of values
- not always consistent
- may change between work & home --> ex. as nurses we ought to help someone who needs it, but there is no expectation that anyone with training or proper equipment will go into a burning building to rescue another person
32
what is moral conflict
- situation in which a person has two moral obligations, which cannot be met both at once
- can be internal (dilemma) or external (interpersonal)
33
what does moral conflict come from
- disagreement about what is important
34
what is required to resolve or manage moral conflict (3)
- requires examining it systematically
- consider all important factors before acting
- discussing it w someone else is also helpful
35
what is an internal moral conflict ? provide an example
- dilemma
- a situation where two person values are in conflict so that any choice will result in a compromise
ex. the duty to care prevents a nurse from abandoning a pt, but there may be situations when it is not safe to provide care, and the nurse needs to decide whether or not to provide essential care
36
what is interpersonal moral conflict
- conflict between two people
ex. one person may feel strongly that respect for a pt's autonomy extends to helping them obtain an assisted death, whereas another person may feel that helping someone to die is unethical
37
define ethics
- the study or examination of morality thru a variety of different approaches
- the work of looking at a moral conflict from numerous perspectives and coming to a decision about what is the best thing to do
38
define morality
- an accepted set of social standards (or morals) that guide behaviors
- set of standards or norms that act as a framework for the process of considering all the relevant factors
39
what determines how you respond to an ethical situation
- a reflection of the core values, beliefs, and character that make you the person you are, and ultimately, the professional you will become
40
what is societal ethics (4)
- what we value as a society
- norms accepted as reasonable in daily life
- standards for how to behave in public
- expectations of everyone in society
41
what are examples of societal ethics (3)
- wearing masks
- non-discrimination or racism
- protection of human rights
42
what are organizational ethics (3)
- formal and informal principles & values that guide the behavior, decisions, and actions taken by members of an organization
- what policies & philophies guide the employees of an organization (ex. hospital, care home, etc.)
- reflect the values of an institution
43
what are examples of organizational ethics (3)
- for U of M: TRC Calls to action
- St. B --> catholic values (no MAID)
- Klinic --> prochoice
44
what is professional ethics
- ethical standards for a particular profession
- sets highest ideals for practice
- values that underpin the profession
45
describe professional ethics for nurses (2)
- critical to nursing practice
| - nurses are held to higher standards because they have a privileged role in society
46
what sets of professional ethics for nurses
Canadian nurses association code of ethics for RNs
47
what are examples of professional ethics for nurses (7)
- provide safe, compassionate, competent, and ethical care
- promote health and well-being
- promote & respect informed decision making
- honour dignity
- maintain privacy & confidentiality
- promote justice
- being accountable
48
what are clinical ethics (3)
- reflected in the principle of biomedical ethics
- the duties and obligations of people working in health & human services professions
- what values and principles apply to health and human services
- includes clinical & research ethics
49
what are examples of clinical ethics (3)
- respect for autonomy
- "first, do no harm"
- equality & equity
50
what are personal ethics (2)
- personal values
| - what is important to you personally, based on your beliefs, life experience, background, etc.
51
what is important to consider w personal ethics (2)
- continuously evolving
- can conflict w other values
ex. may believe in animal rights but support the practice of research involving animals
52
what are examples of personal ethics (4)
- equality
- sanctity of life (ex. abortion)
- environmentalism
- animal rights
53
what are some difference between law & ethics
- law: basic expectations, formal set of rules, minimum standards
- ethics: complex, principled reasoning, personal, often less formal
