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key ideas as you begin your exploration of clinical ethics

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by

Patti Zuzelo

on 9 January 2018

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Transcript of key ideas as you begin your exploration of clinical ethics

points to consider
ethical dilemmas are inherent in clinical practice. Expect them. Every clinical encounter takes place within the context of the code of nursing ethics.
clinicians of all types need to be able to collaboratively reason through ethical dilemmas.
No provider is permitted to do harm. All are required to do good. The patient's wishes should be known and respected and care should be fair.
Why is there conflict?
Scarce resources
Captain of the ship
Power differentials
Knowledge deficits
Fear of reprisal
Individual morality
Compassion fatigue, stress, other non-case related influences
biomedical ethics is more complex than it seemingly should be
Maximize use of available resources
Share
Value the group
READ! LISTEN!
Four topics chart
Medical Indications
Patient Preferences
Quality of Life
Contextual Features
medical indications
facts and interpretations of such; forms reasonable basis for clinical decision making. Physician focused on prevention, cure, and care of illness and injury.
facts inform the plan.
benefit-risk ratio
therapeutic relationship and professionalism.

KEY IDEA: Always patient first.
4 ethical principles
beneficence: do good
nonmaleficence: do not harm
autonomy: self-determination
justice: fairness

Others:
fidelity, veracity
key ideas as you begin your exploration of clinical ethics
Keep in mind that Jonsen et al.
write as physicians. Their
medico-centric views can be
barriers to interprofessional
collaboration; however,
like SBAR, there are
opportunities over
time
Treatment goals must be considered
Cure
Symptom relief
Health promotion
Acute intervention to prevent death
education
dying process
Futility
Statistical probability
Who should decide?
Institutional futility policies--
valid science; option to recuse
DNR
Often a concern related to
surgical consent
Errors
Full disclosure
Full transcript