Nursing Values and Ethics
A) The nursing profession, today, has built for its members a high level of academic excellence leading them to a state where they have an ability to provide specific service and complete professional autonomy to make decisions. Professional autonomy means that a nurse is independent reasonably and self-governing in making decisions in practice. There are independent measures a nurse can initiate without medical orders.
B) The nurse is a client advocate. She has to protect the human and legal rights of the patient under her care, based on his cultural and religious affiliations. The nurse is a "Caregiver" helping the patient regain health through the process of healing. The nurse is also the pivot (中心) of all communications in the health care delivery system. Thus, it is important that this professional autonomy is always governed by a code of ethics and values.
C) Patient care should be based on the universal principles of beneficence, justice and autonomy. Beneficence is the concept where human participants are treated in an ethical
manner by maximizing benefits and minimizing possible harm. Justice is all about the ethical considerations or risks versus benefits leading to the question of law. Respect for autonomy is all about respecting the individual decisions. But there seems to be a gap and significant perception differences among nurses between a learning environment and actual professional situations. Hence, teaching ethics and nursing values is important to bridge this gap.
D) There is no doubt that ethics, as a field of study, has its own theories of moral development. Teaching ethics that is exclusively for the nurses requires unique theories and curriculum models. Ethics learning is a personal process that always goes with everyday nursing work. Hence, there is also a need for development of a pedagogy (教学法) that integrates this self learning experience along with professional training where they see ethics as a natural component of their being instead of a rule that they should follow as professionals.
E) The nursing profession constantly involves the ethical and moral conflict. There are so
me core situations in nursing practice that demands ethical decision-making with regards to the patient's right to life, right to choose, right and ability to give consent to treatment, end-of-life treatment options and the right to end life.
F) Dorothea Orem defined nursing with emphasis on client's self-care needs which is a learned, goal-oriented activity directed toward the self in the interest of maintaining life, health, development and well-being. The right to life is the corner stone of any human rights law and hence, a nurse, by duty, has to strive to safeguard the life of every patient.
G) As per US laws, a patient or his health attorney should give a well-documented, informed consent before any treatment procedures are carried out. Informed consent refers to legal rules that prescribe (法律规定) behaviors for medical professionals in their interactions with patients based on the ethical doctrine rooted in the value of autonomy that facilitates patients' right to self-determination. It is an interpersonal process whereby professionals interact with patients to select an appropriate course of action. Informed consent means that tests, treatments and medications have been explained to the person,
as well as outcomes, possible complications (并发症) and alternative procedures before the treatment and his consent is documented.
H) Problems related to "End-of-life" are on the rise especially when concepts of euthanasia (安乐死) and physician-assisted deaths are trying to find legitimate positions in the society. The state of Oregon in the US already has a legal backing and the bill introduced by Lord Joffe in UK Parliament recently has stirred a chain of debates on the ethical aspects of assisted death of the terminally ill.
I) Research studies have confirmed that patients want information about their illness and end-of-life choices. According to Cardozo, the decision to limit care for critically ill patients is not uncommon, which is regarded by some as a way to make death more humane and respect patient autonomy.
J) Rosalia Hamilton advocates simple instead of complex approaches for teaching ethics to nursing students. She recommends a nursing pedagogy that will help students in learning basic principles involved in ethical decision-making and train them in applying th
ose principles in the analysis and interpretation of clinical events. She describes specific "teachable moments" in clinical practice that allows the integration of the clinical application of ethics and values in the curriculum. She views ethics as a continuing and recurring curricular theme that will permit the teaching of core principles and values, such as, critical thinking, analysis of management principles, power and practice issues and analysis of client educational needs. She also stresses the need for reviewing the curriculum on a regular basis to ensure that nurse education reflects current health care practices. Thus, it is important to teach core nursing values and ethics with regards to various complex nurse situations discussed that demand ethical decision-making.
(1)
It is common to limit care for dying patients to respect their dignity and self-determination.
(2)
In terms of patient care, instructions should be given on ethics and nursing values to shorten the distance between the taught knowledge and actual work experience.
(3)
Regarding the fact that nurses are exposed to situations about ethics, core moral principles should be taught in the curriculum.
(4)
Nowadays nurses' academic excellence enables them to offer required service and independently decide on medical issues.
(5)
As people attempt to make doctor-aided death legal, more relevant questions come along.
(6)
An approach to nursing teaching is recommended to help students learn basic rules for making ethical decisions and analyzing medical cases.today
(7)
Ethical or moral situations always confront nurses because of the choices to be made on medical treatments directly related to the issue of life and death.

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