SEMIS ETHICS TRANSES

 You should examine the situation for evidence of

BIOETHICS AND RESEARCH conflicting obligations, principles, duties, rights,
- loyalties, values or beliefs.
 The data provide an understanding of the ethical
-most cited violations of human rights in research components, principle of concern, and the various
are those that were perpetrated by the Nazis during World perceptions of issues and principles by those involved
War II in the situation.
Nuremberg Code - introduced in August 1947,  You must pay attention to societal, religious and
after the Nuremberg trials. In these trials, Nazi doctors cultural values and beliefs.
were convicted of the crimes committed during human  A situation you initially think constitutes an ethical
experiments on concentration camp prisoners. dilemma will actually turn out to be a practical
-developed as a set of principles for the dilemma. This recognition allows the participants to
ethical conduct of research appropriately weigh choices and expedite decision
making.
Belmont Report- principles set forth in these codes
serve as the basis for policies
Declaration of Helsinki- issued by the World Medical IDENTIFY KEY PARTICIPANTS
Assembly in 1964 and revised in 1975 and in 2001 to  Identify the key person involved in the decision-
guide clinical research. making process and delineate each person’s role.
 Determining rights, duties, authority, context and
Principles of beneficence,respect for human capabilities of decision makers is critical component
dignity,and justice underlie the ethical conduct of of the process.
research.  Identification of the principal decision maker is
sometimes all that is needed to facilitate the process.
The principle of beneficence implies the right to  Recognition that one has the legitimate authority to
protection from harm and discomfort,including a balance make an important decision is an empowering event.
between the benefits and risk of a study.  Once the principal decision maker is identified, the
roles of the participants can be explicitly outlined.
The principle of respect for human dignity implies the
rights to full disclosure and self determination or DETERMINE MORAL PERSPECTIVE
autonomy.

The principle of justice implies the rights of fair treatment Determine Moral Perspective and Phase of Moral
and privacy, including anonymity and confidentiality. Development of Key Participants

Coercion- Includes threat of harm or penalty for not  Knowledge of moral development and ethical theory
participating in the research,or offering excessive rewards may provide a helpful framework
for participation.  It is also crucial to identify participatns’ ethical
Full disclosure- The potential participant should be fully perspectives.
informed of the nature of the study,the anticipated risks
and benefits, time commitment DETERMINE DESIRED OUTCOMES

ETHICAL DECISION MAKING  Identifying the desired outcomes and their potential
consequences is a substantial step in the decision-
Many models of decision making describe step-by – step making process. At this point, participants will exclude
processes that are linear in nature, not reflecting the those outcomes that are totally unacceptable
potential for an evolving perspective.  As with the nursing process, implementation of a
plan of action cannot logically occur without explicit
The decision making process is spiral in nature knowledge of the desired outcome. Likewise,
evaluation of the success or failure of the plan is
GATHER DATA IDENTITY measured by the degree to which the outcome is met.
 Clarifying the outcomes and their anticipated
Gather Data Identity Conflicting Moral Claims consequences enhances the understanding of
options and alternatives.
 When an ethical problem occurs, gather information
or facts in order to clarify issues.
 Identification of the conflicting moral that constitute
the ethical dilemma is part of the process.

IDENTIFY OPTIONS
  H
a
vi
n
g

determined the desired outcomes, participants should

identify possible options for action.
 Various options begin to emerge through the
assessment process
 Participants must consider legal and other
consequences.
 They must also determine which alternatives best
meet the identified outcomes and fit their basic
beliefs, lifestyles and values.

 The process helps to narrow the list of acceptable

alternatives
FORMAL AND MATERIAL JUSTICE
 It is critical to eliminate all unacceptable alternatives MEANING AND SERVICE VALUE
and begin the process of listing, weighing, ranking,
and prioritizing those that are found to be acceptable.

ACT ON CHOICE
formal justice,as attributed byAristotle, are that in
distribution, equals must be treated equally,and
 Taking action is a major goal of the process, but can unequals must be treated unequally.Formal justice does
be one of the most difficult parts. not attempt to provide any criteria for the determination of
equality
 It can stir numerous emotions laced with both
certainty and doubt about the rightness of the material justice- specify relevant characteristics or
decision. morally relevant criteria

 Participants must be empowered to make a difficult MACRO ALLOCATION- Deals with the larger societal
decision, setting aside less acceptable alternatives. issues
MICRO-ALLOCATION- Deals with the personal
EVALUATE OUTCOMES OF ACTION determination of who will receive scarce resources.
•Triage system that evaluate medical utility
 After acting upon the decision, participants begin a issues
process of response and evaluation. EGALITARIAN THEORIES- Emphasize equal access to
goods and services.
 As in all decision making, reflective evaluation sheds UTILITARIAN THEORIES- These theories emphasize a
light on the effectiveness and validity of the process. mixture of criteria so that public utility is maximized.
• Public utility is defined in the phrase“the greatest
 Evaluate the action in terms of the effects upon those good for the greatest number.”
involved. Ask “ has the original problem been LIBERTARIAN THEORIES- Libertarians emphasize
resolved?” and “have other problems emerged personal rights to social and economic liberty.
related to the action?”
Date and Time - Document the date and time of each Admissible in court as a legal document, the clinical
recording. This is essential not only for legal reasons but record provides proof of the quality of care given to a
also for client safety. client. Documentation is usually viewed by juries and
attorneys as the best evidence of what really happened to
Timing- Follow the agency’s policy about the frequency of the client.
documenting, and adjust the frequency as a client’s
condition indicates

Legibility- All entries must be legible and easy to read to

prevent interpretation errors. Hand printing or easily WELL-FORMED CONSCIENCE
understood handwriting is usually permissible. Follow the
agency’s policies about handwritten recording. -Human person recognizes the moral quality of a concrete
act
Permanence- All entries on the client’s record are made  Pray
in dark ink so that the record is permanent and changes  Learn
can be identified. Dark ink reproduces well on microfilm  Reflect
and in duplication processes.  Nurture Friendship

Accepted Terminology- Use only commonly accepted Types of Conscience

abbreviations, symbols, and terms that are specified by Correct or True conscience- corresponds to moral
the agency. Many abbreviations are standard and used values and percept
universally; others are used only in certain geographic False or Erroneous conscience- mistakenly judges as
areas. morally good
TWO BASIC ELEMENTS
Correct Spelling- Correct spelling is essential for Moral Judgement- discerns what is right or wrong
accuracy in recording. If unsure how to spell a word, look Moral Obligation or command- to do good or avoid evil
it up in a dictionary or other resource book. Two decidedly
different medications may have similar spellings. MOMENTS OF CONSCIENCE

Signature- Each recording on the nursing notes is signed Antecedent- which discerns (before)
by the nurse making it. The signature includes name and Concomitant- in action (during)
title. Consequent- which review (after)

Accuracy- The client’s name andidentifying information LEVELS OF CONSCIENCE

shouldbestampedor writtenoneach page of the clinical
record. Before making any entry, check that it is the Instinctive level- dominated by fear or punishment
correct chart. Moral/Philosophical- operates on ethical level
Christian Level- christian faith
Accurate notations consist of facts or observations
rather than opinions or interpretations.

Sequence- Document events in order in which they occur;

for example, record assessments, then the nursing
interventions, and then the client’s responses.

Appropriateness- Record only information that pertains

to the client’s health problems and care. Any other
personal information that the client conveys is
inappropriate for the record.

Completeness- Not all data that the nurse obtains about

a client can be recorded. However, the information that is
recorded needs to be complete and helpful to the client
and health care professionals.

Conciseness- Recordings need to be brief as well as

complete to save time in communication. The client’s
name and the word client are omitted.

Legal Prudence- Accurate, complete documentation

should give legal protection to the nurse, the client’s other
caregivers, the health care facility and the client.