CONCEPT IN NURSING ETHICS

Nelia B. Perez RN MSN Northeastern College Santiago City Philippines

NURSING ETHICS: Its Purposes

The changing philosophy of health care with its increasing emphasis on the principle of personal autonomy; The changing philosophy of nursing with its emphasis on patient-oriented care; and The evolution of nursing as profession distinct from medicine.

Related Divisions of Ethics

Bioethics : The Division of ethics that relates to human life or the ethics of the life sciences and health care , both delivery and research. Health Ethics : The division of ethics that focuses on human health. It is more limited in scope compared to bioethics because it confines itself only to the moral behavior in relation to health.

 Nursing Ethics : The division of ethics that deals with the ethicomoral behavior in the nursing practice. --- Nursing Professional Ethics is the division of ethics which treats of the moral principles, duties or behavior of the members of the nursing profession toward their co-nurses, to their profession, to other health care workers, to the patients and to the public in general.

 Professional Ethics : a division of ethics that relates to professional behavior. - it includes the moral duty or obligations, which a member of the profession owes to the public, to his profession, to his colleagues, and to his clients. - 3 Main functions: 1. to reassure the public; 2. to provide guidelines for the profession to discipline and regulate its members; and 3. to provide a framework on which individual members can formulate their decisions.

Nursing Professional Ethics

Autonomy Informed consent confidentiality

Nursing professional ethics VS Medical ethics

End-justifies-the-means Ethics
Considerations : 1. human happiness 2. nursing goals 3. rights and beliefs of the patient 4. duties of the nurse

 Code of Ethics consists of declarations of faith, beliefs and ideals which the profession upholds and the members conform to and follow. Code of Conduct is a statement about how the profession considers its members should behave toward clients, the society as a whole and each other.

Four Fundamental Responsibilities of the two codes

To promote health To prevent illness To restore health To alleviate suffering

CHRISTIAN HEALTH ETHICS

Five Main Principles

Stewardship A person, as a child of God, must use the sacred gift of life as a faithful steward. Thus, a persons duty to protect the body is a duty to protect the soul.

 Inviolability of Human life Considering that life is a gift from God, it is sacred and inviolable.

 Totality
The principle of totality upholds the unity of the whole because the whole is greater than its parts. Each part only exists for the good of the whole.

 Principle of Double Effect Applies in case an act is foreseen to have both good and bad effects.

Four Criteria: a. The act itself must be morally good, or at least neutral. b. The purpose must be to achieve the good consequence, the bad consequence being only a side effect. c. The good effect must be achieve by way of the bad, but both must result from the same act. d. The bad result must not be serious as to outweigh the advantage of a good result.

 Sexuality and procreation This principle is all about pleasure, love, reproduction, and the sacramental meaning of sex. 5 Principles A. Sex is search for sensual pleasure and satisfaction, releasing physical and psychic tensions; b. Sex is a search for the completion of the human person through an intimate personal union of love expressed by bodily union for the achievement of a more complete humanity

5 Principles
c. Sex is a social necessity for procreation of children and their education in the family so as to expand the human community and guarantee its future beyond death; and d. Sex is a symbolic (sacramental) mystery, somehow revealing the cosmic order.

Christian Health Maxims

Principle of Ordinary Means refers to the basic right and duty of a person in case of serious illness to take the necessary means for the preservation of life and health. Principle of Subsidiary affirms the principle of human dignity by requiring or making the highest authority respect and protect the common good.

Christian Health Maxims (cont) Principle of Epikia (epikeia) is a moral principle applicable to nursing because it is actually used by taking or treating some acts as exceptions to the rule; hence they are allowed to be done or their performance is justified under this principle. Principle of Preservation. Regardless of ideological persuasion and religious belief, the direct taking of human life is morally wrong, inhuman and unethical.

ETHICO-LEGAL RIGHTS AND DUTIES

Nightingale Pledge Oath of a professional Autonomy, informed consent and confidentiality Right to appeal to conscience Right to end suffering

LEGAL BASES OF NURSING EDUCATORS, NURSING REGULATION AND NURSING PRACTICE

 Nursing Education and nursing practice are constantly interacting while in the process of rapid change to adopt to the existing demands and condition of the health care delivery system. They are complimenting each other. The success of nursing practice rest upon a sound educational foundation of the nurse. The goal of nursing education is to prepare the nursing student for nursing practice.

 Goal of nursing practice is to provide quality nursing service and improve nursing care. This is when nursing regulation comes into play. Everyone has a right to nursing education as a constitutionally guaranteed right.

Art. XIV, Sec. 1 of the 1987 Constitution

To protect and promote the right of all citizen to quality education at all level and to take all appropriate steps to make such education accessible to all.

R.A. No. 9173 Nursing Law

Aims to provide a sound general and professional foundation for the practice of nursing through quality nursing education. The first policy encourages nursing schools and colleges to implement some standards for admission, qualifying exams for 3rd year level promotion and quality part indices for the continuance of nursing student in their respective nursing degree programs to ensure the quality of their nursing graduates.

R.A. No, 9173 Nursing Law (cont)

The 2nd policy total quality education can only be achieved when the government makes it accessible to all who are fit and prepared for it. Uplift standard of nursing education for this country to produce quality nursing graduates and ultimately globally competitive Filipino Nurses. Not to discriminate against student where spirits are willing but in intellectual, they are wanting. Every Filipino has the right to education however; every Filipino has the responsibility to know his limitation and to change the course for which he is suited.

A. NURSING EDUCATION
R.A. 7164 Required a certification by the school that the applicant belong to the upper 40% of the graduating class, as a general requirement to the nursing degree course. R.A. 9173 > deletion of said admission requirement > one high school performance is not an accurate basis for college admission and students mental competence and psychological preparedness for college education. > More nursing students because more graduating students will be eligible to enroll in nursing degree program and more nursing schools will be opened and offer the degree of BSN.

NURSING EDUCATION (Cont) R.A. 7722 CHED Provide standard or minimum requirement for the operation and regulation of educational institution offering tertiary courses such as BSN.

Duly authorized government agency that approves the opening and regulates the operation of nursing schools all over the country. Created through R.A. 7722, May 18, 1994 CHED Memo Circular No. 30, s. 2001
Updated policies and standards for nursing education. New policy directing the CHED to regulate the establishment and operation of review center.

CHED Policy on Nursing schools and colleges

Nurses are needed in every part of the world, with the tremendous global demand, nursing schools and colleges are sprouting everywhere like mushrooms. Authority to open and close nursing schools / colleges

CMO No. 30
The authorization to open a nursing school shall be based upon: 1. written recommendation of BON, PRC and NSA (National Student Affiliation), DOH 2. approval of CHED The power of BON as to authorization of opening or closing nursing schools is recommendatory pursuant to COM No. 30 and RA 9173.

B. ADMINISTRATION AND FACULTY

Fulltime Dean and Faculty
Qualification of Dean Perform vital role and function in nursing school, required to work fulltime because she is in charge to administer and manage the nursing school, faculty and staff, the nursing student and degree program. Filipino Citizen Currently registered nurse in the Philippines Holder of Masters Degree in Nursing 5 years of competent teaching and supervisory experience in college or institute of nursing. Member of good standing (ADPCN) and accredited national nursing organization (PNA)

Qualification and Rank of Faculty Members A Filipino Citizen Currently RN in the Philippines Holder of Masters degree At least 3 years of Clinical experience Member of good standing accredited national nursing organization.

C. NURSING REGULATION
Professional Regulatory Board of Nursing * created under new nursing law (RA 9173) * Primary agency responsible for the regulation of the admission, registration and practice of nursing profession in the Philippines. * Composition of BON * one Chairperson * Six Members * Appointed by the President of the Philippines

Qualification of Chairperson and Members of BON

Representative of 3 areas of nursing (education, service and community health nursing) Natural born citizen and resident of the Philippines. Member of good standing accredited professional organization of nurses. Registered nurses and holder of Masters Degree 10 years of continuous practice of the profession prior to appointment No conviction of any offense involving sound turpitude.

Powers, Duties and Responsibilities of the BON

Conduct licensure examination for nurses (R.A. 8981)

Prepare adopt and issue the syllabi or tables of specification of the subject for examination in consultation with the academe. Determine and prepare the questions for the licensure examinations which shall strictly be within the scope of syllabi or table of specification of the subject for examination.

Conduct licensure examination for nurses (R.A. 8981)-Cont

To score and rate the examination papers with the name and signature of the board members concerned appearing thereon and sublit the result in all subjects duly signed by the members of the board to the commission within 10 days from the last day of examination unless extended by the commission for justifiable cause and subject to the approval of the commission. Determine the appropriate passing general average rating in an examination if not provided for in the law regulatory thru profession.

To be Continued