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The end!!

One thing to take away from today is

DO NO HARM!!!

Drawing blood on patient

how to tell non-maleficence apart:

Giving a patient a

shot/vaccination

She is discharged but afraid to go home. What would you do?

Hospital calls Department of Child and Family Services.

You are a nurse caring for 16 year old girl. She has broken arm, black eye and bruises from physically abusive father.

Scenario 2

Patient with brain tumor no chance of surviving. Wants to avoid pain from dying and requests euthanasia.

Physicians in ethical problem: to respect patient's wish to have a peaceful death or follow non-maleficence?

Non-Maleficence VS Autonomy

Non-Maleficence- Do no harm!!!

Conflict when patients disagree with health recommendations of doctors

Moral situation- Should defeat cancer but can make her really sick in the process.

Dilemma- Chemotherapy will destroy her bad and good cells. Lower immune system.

You are a nurse caring for a 7 year old cancer patient. Order to give chemotherapy.

What would you do?

Autonomy-Respect for

patients' right to make own healthcare decisions

Scanario 1

Religious or cultural views as barriers. Jehovah's witness

want no blood transfusions

Citation sources:

Burkhardt, M., & Nathaniel, A. (2014). Social Issues. Ethics & issues: in contemporary nursing (4) p. 439. Stamford, CT: Cengage Learning

Edelstein, L. (1943). The Hippocratic oath, text, translation and interpretation.

Gillon, R. (1994). Medical ethics: four principles plus attention to scope. BMJ: British Medical Journal, 309(6948), 184.

McCarthy, J. (2003). Principlism or narrative ethics: must we choose between them?. Medical Humanities, 29(2), 65-71.

Andersson, G. B., Chapman, J. R., Dekutoski, M. B., Dettori, J., Fehlings, M. G., Fourney, D. R., ... & Weinstein, J. N. (2010). Do no harm: the balance of “beneficence” and “non-maleficence”. Spine, 35(9S), S2-S8.

Van der Maas, P. J., Van Delden, J. J., Pijnenborg, L., Looman, C. W., of Statistics, C. B., & Hague, T. (1991). Euthanasia and other medical decisions concerning the end of life. The Lancet, 338(8768), 669-674.

Rosenbluth, M., Kleinman, I., & Lowy, F. (1995). Suicide: the interaction of clinical and ethical issues. Psychiatric services.

Beauchamp, T. L., & Childress, J. F. (1994). Nonmaleficence. In Principles of biomedical ethics (pp. 179-258). Oxford New York, NY.

Non-maleficence

First, do no harm!

GOAL!

Thank you!

By Tony Hsu, Portia Obeng, Kristen Burton

Ethical problem: Non-maleficence vs Beneficence

Cancer patient: Undergo chemotherapy or risk is not worth it?

Physician provide all the information of risks and benefits.

Ultimately up to cancer patient to make the final decision

Physicians must do their best in treating patients. Beneficence

Physicians must do their best in not harming patient. Non-maleficence

Many medications and

procedures cause harm

BUT also benefit patient

Pillar of Ethics

Non-maleficence is one of 4 principles of ethics

Example: Giving patient IV injection. Short pain suffering of patient from being pricked but medicine in IV outweigh pain of needle.

Under utilitarian theory-Benefit of procedure should outweigh the harm done.

Benefit should outweigh patient suffering

Do no harm!! But sometimes harmful action is necessary to get the job done

Nonmaleficence in

healthcare setting

Comes from Latin primum nil nocere, first, before anything is to be done, do no harm!!

part of the larger Hippocratic Oath physicians swear by

Principlism

Principlism- four moral principles for patients:

Autonomy- Patient has right to do whatever they want in their treatment

Beneficence-Promote patient well being

Non-maleficence- Must not do harm

Justice- Equal treatment of patients regardless of background, race, gender, occupation, etc.

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