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Professional, Legal

and Moral
Accountability and
Responsibility
LAW
• Etymology : lex
• A set of rules established by a
governing power to guide actions,
regulate conduct of the people and
impose sanctions for violation or non-
compliance thereof.
• Obligatory upon the people because it
commands the people to do right and
prohibits them to do wrong.
Branches of Law
• Divine Law : promulgated by our
Creator.
• Human Law
* General / Public Law : includes
international law and religious law
* Individual or private law : consists of
civil law, mercantile and procedural
law.
Jurisprudence
• Etymology : juris (oral legal tradition
and to functional applications of Law,
to and in particular sets of facts ans
circumstances); prudentia (one who
behaves prudently or wisely because
he has knowledge of the possible
consequences of a particular action).
Jurisprudence (cont)
• Denotes or pertains to the judicial
precedent or the course or
established decisions of the Supreme
Court.
Ethics
• Etymology : ethos (custom or
particular behavior)
• Practical science dealing with morality
of the human acts or conduct.
ETHICS DEFINED
• Ethics is a study of good conduct,
character, & motives & is
concerned with determining what
is good or valuable for all people.
It goes beyond personal
preferences to establish norms &
standards upon which individuals,
professions & societies agree.
NURSING ETHICS
• Within nursing, specific values &
moral requirements are
necessary to maintain the
integrity of the profession. An
ethical nurse will act & treat
others in specific ways that are
consistent with nursing norms &
will be guided by more than
personal preferences or values.
NURSING ETHICS (cont’d)
• To become mature professionals who
are able to participate effectively in
the ethical dimensions of their
practice, nurses must continue to
develop a strong sense of their moral
identity, seek support from
professional resources & expand their
knowledge and skill in the area of
ethics.
NURSING ETHICS (cont’d)
• A nurse assumes responsibility
and accountability for nursing
care provided.
RESPONSIBILITY
• Refers to the execution of duties
associated with the nurse’s particular
role. A nurse who acts in a
responsible manner gains the trust of
clients & other professionals. A
responsible nurse remains competent
in knowledge & skills & demonstrates
a willingness to perform within the
ethical guidelines of the profession.
RESPONSIBILITY
(example)
• When administering medications,
the nurse is responsible for
assessing clients’ need for the
drugs, giving them safely &
correctly, and evaluating the
responses.
ACCOUNTABILITY
• Being answerable for one’s own
actions. A nurse is accountable
to self, the client, the profession,
the employer, and society
ACCOUNTABILITY
(example)
• If a wrong dose of medication is
given, the nurse is accountable to
the client who received it, the
physician who ordered it, the
nursing service that set standards
of expected performance, &
society which demands
professional excellence.
ACCOUNTABILITY
(example cont’d)
• Thus, when an error is made, the
nurse reports it and initiates care
to prevent further injury.
Accountability calls for an
evaluation of a nurse’s
effectiveness in practice.
ACCOUNTABILITY
PURPOSE
• 1. To evaluate new professional
practices & reassess existing ones.
• 2. To maintain standards of health
care.
• 3. To facilitate personal reflection,
ethical thought, & personal growth on
the part of health care professionals.
• 4. To provide a basis for ethical
decision making.
VARIABLES AFFECTING
ETHICAL DECISIONS
• Because ethical problems occur
in situations involving people who
have different approaches to
“moral reasoning”, it is helpful if
the nurse can sort through the
various factors that influence a
persons’ thinking.
VARIABLES (cont’d)
• Emotions
• Legal considerations
• Cultural diversity
• Religious/Spiritual convictions
• Education level
• Past life experiences
• Developmental level
VARIABLES (cont’d)
• Societal changes
• Race
• Gender
• Class
• Economic level
• Sexuality orientation
• Current state of “health”
ETHICAL DECISION
MAKING METHODS
• Each ethical situation or dilemma
will be different, but the nurse in
any setting can use the following
guidelines for ethical processing
and decision making.
METHODOLOGY (cont’d)
• Presume good will
• Identify all important persons
• Gather relevant information
• Identify important ethical
principles
• Propose alternative courses of
action
• Take action
SENSITIVE ETHICAL SITUATIONS
• Bio-technology
• Surrogate Pregnancy Contracts
• Adoption
• Abortion
• Substance Abuse
• AIDS/HIV
• Death & Dying
• Living Wills/Health Care Surrogates
• Organ Donations
Ethico-Moral
Aspects of
Nursing
THE CODE OF ETHICS FOR
FILIPINO NURSES
• First approved in 1982, 5 decades
after it was formed in 1922.
• March 21, 1984: PRC adopted the
ICN Code of Ethics and subsequentle
was approved by the Board on March
21, 1984 pursuant to RA No. 877 and
PD No. 223.
THE CODE OF ETHICS FOR
FILIPINO NURSES (cont)
• Unanimously approved through BON
Resolution No. 633 on March 21,
1984.
THE ICN CODE OF ETHICS
FOR NURSES
An international code of ethics
for nurses was first adopted by
the International Council of
Nurses (ICN) in 1953. It has
been revised and reaffirmed at
various times since, most
recently with this review and
revision completed in 2005.
PREAMBLE
Nurses have four fundamental responsibilities: to
promote health, to prevent illness, to restore
health and to alleviate suffering. The need for
nursing is universal. Inherent in nursing is
respect for human rights, including cultural
rights, the right to life and choice, to dignity and
to be treated with respect. Nursing care is
respectful of and unrestricted by considerations
of age, color, creed, culture, disability or illness,
gender, sexual orientation, nationality, politics,
race or social status. Nurses render health
services to the individual, the family and the
community and co-ordinate their services with
those of related groups.
1. NURSES AND PEOPLE
The nurse’s primary professional responsibility is to people
requiring nursing care.
• In providing care, the nurse promotes an environment in
which the human rights, values, customs and spiritual
beliefs of the individual, family and community are
respected.
• The nurse ensures that the individual receives sufficient
information on which to base consent for care and related
treatment.
• The nurse holds in confidence personal information and
uses judgement in sharing this information.
• The nurse shares with society the responsibility for initiating
and supporting action to meet the health and social needs of
the public, in particular those of vulnerable populations.
• The nurse also shares responsibility to sustain and protect
the natural environment from depletion, pollution,
degradation and destruction.
2. NURSES AND PRACTICE
• The nurse carries personal responsibility and
accountability for nursing practice, and for
maintaining competence by continual learning.
• The nurse maintains a standard of personal
health such that the ability to provide care is
not compromised.
• The nurse uses judgement regarding
individual competence when accepting and
delegating responsibility.
• The nurse at all times maintains standards of
personal conduct which reflect well on the
profession and enhance public confidence.
• The nurse, in providing care, ensures that use
of technology and scientific advances are
compatible with the safety, dignity and rights of
people.
3. NURSES AND THE PROFESSION
• The nurse assumes the major role in
determining and implementing acceptable
standards of clinical nursing practice,
management, research and education.
• The nurse is active in developing a core of
research-based professional knowledge.
• The nurse, acting through the professional
organization, participates in creating and
maintaining safe, equitable social and
economic working conditions in nursing.
4. NURSES AND CO-
WORKERS
• The nurse sustains a co-operative
relationship with co-workers in
nursing and other fields.
• The nurse takes appropriate action to
safeguard individuals, families and
communities when their health is
endangered by a coworker or any
other person.
Morals
• Closely associated with the
concept of ethics is that of
morals.
Morals
• The word morals is derived from the
Latin mores, which means custom
or habit.
• Morals are the basic standards for
what we consider right and wrong.
• Morals or standards are often based
on religious beliefs and, to some
extent, social influence and group
norms.
Ethics & Morals
• Together, the two words ethics and
morals form constructs related to
conduct, character, and motives for
action.
Ethics & Morality
• “Ethics seems to pertain to an
individual’s character, whereas
morality speaks to relationships
between human beings.” - Thiroux,
1998
Good (Ethical)
• In either case, we typically describe
the behavior we observe as good,
right, desirable, honorable, fitting, or
proper.
• Bad (Unethical) or, we might
describe the behavior as bad,
wrong, improper, irresponsible, or
evil.
Good / Ethical = Values
• Quickly you will realize that such
perceptions are based on values,
and that each of us (and each
society) has a differing set of values.
Values
• “ . . . values are abstract standards
that give a person a sense of what is
right and wrong and establish a
code of conduct for living.” -
Videbeck, 2001
What are Values?
Examples of Values
• hard work
• honesty
• sincerity
• genuineness and
• being clean.
Values
• Values are most commonly derived
from societal norms, religion, and
family orientation
• Our Values Provide the framework
for making decisions about the
actions we take every day.
Values Conflict
• This occurs when we must choose
between two things, both of which
are important to us.
Values Conflict
• For example, if you are a new
mother, you probably would like to
spend all of your time with your
child; however, if you also must help
provide support for the family, and
that requires leaving the child to go
to work, you have a values conflict.
Values Conflict
• Most of the time we don’t think
about our values—we just accept
them.
• We are most likely to think about
them when we have a difficult
decision to make, when something
goes wrong, or when we find
ourselves in a conflict because of
differing values.
Values & Nursing
• In nursing we work with a diverse
patient population and therefore are
exposed to a variety of values and
ethical standards.
• The need to give conscientious care
to all patients often forces us to
examine our own values.
Values Clarification
• The process of becoming more
conscious of and naming what one
values or considers worthy is known
as values clarification
• We examine what we believe is
good, bad, beautiful, worthy,
meaningful, and so forth, and
explore the process of determining
our personal values.
Values Clarification (cont)
• This increases our self-awareness
or understanding of ourselves and
assists us in making choices.
• Clarification It facilitates decision-
making, because we have a better
grasp of our own value systems.
Ethical Dilemna
• Having a good understanding of
yourself will be helpful when you are
faced with an ethical dilemma.
Ethical Dilemma
• An ethical dilemma occurs when an
individual must choose between two
unfavorable alternatives.
Ethical Dilemma
• Ethical dilemmas usually have no
perfect solution, and those making
decisions may find themselves in
the position of having to defend their
decisions.
Ethical Dilemma
• Although there are times when a
difference in values and decisions
can be accepted, at other times
differences put people into direct
conflict.
CRITICAL THINKING
ACTIVITY
• Identify situations you might confront in nursing
in which your personal religious or philosophic
values would be involved.
• What would be the consequences of following
the dictates of your value system?
• Do conflicts exist between your value system
and actions required by the situation? If so, how
will you recognize the differences and how will
you deal with them?
• Are there any other alternatives? What might
they be?