A. What You Should Know
Define:
Deontology:___________________________________________________________________, Kantianism_____________________________________________________________________, virtue ethics____________________________________________________________________, compassion____________________________________________________________________, discernment____________________________________________________________________, trustworthiness_________________________________________________________________, integrity_______________________________________________________________________, and particularism________________________________________________________________.
1. What are focal virtues?___________________________________________________________
2. What are values?________________________________________________________________ How are they acquired and clarified?________________________________________________
3. Why is self-awareness important in professional nursing?________________________________
4. What is the difference between overt and covert values?_______________________________
5. Define these terms as they relate to nursing: autonomy_________________________________, informed consent_______________________________________________________________, paternalism_____________________________________________________________________ beneficence____________________________________________________________________ prevent harm___________________________________________________________________, remove evil or harm_____________________________________________________________, Nonmaleficence_________________________________________________________________, veracity, _______________________________________________________________________
confidentiality,_________________________________________________________________
justice_________________________________________________________________________
distributive justice_______________________________________________________________,
use of material rules_____________________________________________________________,
fidelity________________________________________________________________________.
6. How can moral distress impact nursing practice?_______________________________________
___________________________________________________
B. What You Should Know
*Instructions: Complete this document either in Word or manually (and scanned) and place in the appropriate drop-box before the start of class (ex. If your class begins at 12:00 pm, submit no later than 11:59). This must be completed in its entirety to receive the allotted participation points. All of this information is found in the Power Point presentations and assigned readings. You must be prepared to discuss this information during the synchronous class session. Format your submission: LastnameFirstinitial_Class2_WYSK.doc or .pdf
Week 1, Class 2: What you should know…
1. Where are values learned__________________________________________________?
2. How many levels are in Kohlberg’s Theory of Moral Development?________. Name and define them______________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3. How many stages are in the theory?_______ What are they called? _________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. What is an androgenic study? What is the significance of this topic to us?____________
________________________________________________________________________
5. What is the underlying premise for Gilligan’s study of the Psychological Development of Women?________________________________________________________________
6. How many phases are in Gilligan’s theory? _____What are they called?______________
________________________________________________________________________
7. What is Fowler’s definition of faith? __________________________________________
________________________________________________________________________
8. What are the stages of Fowler’s Theory of Faith Development?_____________________
________________________________________________________________________
9. Why should nurses be spiritually & culturally sensitive in their practice?______________
________________________________________________________________________
10. Define wholistic health care_________________________________________________
11. Define spiritual care_______________________________________________________
12. Define American individualism_______________________________________________
13. How can a nurse’s faith & spiritual health impact their practice?____________________
________________________________________________________________________
14. What is complementary medicine?___________________________________________
15. Name some cultural healthcare treatments____________________________________
_________________________________________
Ethics in Nursing
NUR 4242
Notes # 1
Social, Philosophical, and Other Historical Forces Influencing the Development of Nursing
Introduction
Moral action is the historical basis for the creation, evolution, and practice of nursing.
Moral beliefs produce rules of action, or ethics.
Throughout history, spiritual beliefs, religious practice, philosophy, cultural norms, and political factors influenced changes in nursing.
Introduction
In the United States, Western tradition and philosophy is the predominate context for nursing.
In an increasingly multicultural environment, it is important to fully appreciate the beliefs and traditions of others.
We can only understand each aspect of a social phenomenon in relation to the history and structure in which it is found.
To understand the meaning of ideas and behaviors, we must objectively view them in the context of historical and social practices and entanglements of power and interest.
Social need is the criterion for the existence of all professions.
Helping professions find their origin, purpose, and meaning within the context of culturally accepted moral norms, individual values, and perceived social need.
ANA Social Policy Statement
Related to the thoughtful examination of right and wrong, good and bad.
Begins as individuals’ or groups’ desire to meet the needs of others.
Empathy is a motive for moral reasoning and action.
Moral Thought and Nursing
The practice of nursing is focused on meeting the health care needs of others; therefore, the practice of nursing originates in moral thinking.
Nursing as Part of Society
Professions exist to meet the needs of society.
Nursing must serve the interest of the “larger whole of which it is a part.”
Society grants professionals the exclusive right to practice within defined limits.
Professionals have a reciprocal duty to society to practice competently.
Spiritual/Religious Influences
Contribute to the moral foundation of nursing
Influence the gender and activities of healers
Influence beliefs about the value of individuals, life, death, and health
Spiritual/Religious and Nursing
Nursing in some form has existed in every culture and been influenced by spiritual beliefs, religious practices, and related cultural values.
In every culture, women have been healers.
Women’s status in society is central to determining the extent of freedom and respect granted to nurses.
Philosophical Influences
Philosophers ask important questions and propose theories that shape culture and influence society.
Questions about truth and reality
Theories about morality and the good life
Theories that impact the scientific method
Cosmology describes how people of the culture view the structure, origin, and processes of the universe.
Early culture linked healers with the sacred.
There is early and diverse cultural evidence of women as healers and priestesses.
Women were leaders in the healing arts when the reigning deity was feminine, bisexual, or androgenous.
As deities became more masculine the woman’s role as an independent, primary healer was taken away.
Asclepius was the mythical god of medicine and healing. His followers established temples of healing or asclepieions.
Some of his mythological children included:
Hygieia—goddess of health—“hygiene”
Panaceia—goddess of healing—“panacea”
Iaso—goddess of medicine
Ancient Romans
Also worshipped Asclepius. Hippocrates may have studied at an asclepion.
Hippocratic oath begins, “I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea…”
The “Staff of Asclepius” is a snake ascending a staff. It is the official symbol of the AMA and AOA.
Was applied to every aspect of individual, family, and community life, including rest, sleep, cleanliness, hygiene, hand washing, care of food, and childbearing
Required inspection of food, detection and reporting of disease, methods of disposal of excreta, feminine hygiene, and isolation of those with communicable illness
Hippocrates: Father of Western Medicine
Revolutionized healing arts in Greece, established medicine as a profession, believed the care of the sick included observation, symptoms, rational conclusions, and a predictable prognosis.
Proposed the role of healing was to reinstate the healthy balance of four bodily humors.
The Hippocratic oath is attributed to him.
Philosophy in Ancient Times
Philosophers began questioning beliefs, mythologies, and folklore.
Used abstract thinking and asked questions about nature, religion, the origins and nature of things, and the nature of reality and truth
Socrates, Plato, and Aristotle proposed new ideas about truth, reality, relationships, ethics, and the right way to live.
Philosophy in Ancient Times
Socrates developed the Socratic method of teaching, which provides a systemic and objective approach to problem solving.
Aristotle proposed that the aim of the good life is eudaimonia (happiness, flourishing), which is achieved through a virtuous life of excellence.
Exerted profound influences on healing beliefs and practices.
With religious belief in a single male god, women’s healing role changed from that of a sacred healer to subservient caregiver.
Women’s place in the healing art was minimal when Jesus lived, but he challenged traditions by associating freely with women.
New Testament
The New Testament message regarding the care for others:
Caring for others represents caring for Jesus.
A spiritual reward is gained by caring for others.
Even in an evil world, one should love God and one’s neighbor.
Every person is an important member of God’s Kingdom.
Every person has worth and dignity.
Philosophy: Early Christian Era
St. Paul was a highly influential philosopher who held that there is a natural law of conscience in each person.
St. Augustine believed true reality was spiritual and Being comes from God. He emphasized the inner life and contemplation of God and examined the passions of the soul.
Middle/Dark Ages saw social disruption and cultural deterioration. Most philosophy was theological at this time.
Thomas Aquinas synthesized Greek rationalism and Christian doctrine, which became the cornerstone of Catholic philosophy.
Retranslation of Plato and Aristotle (later Middle Ages).
Nursing in the Middle Ages
Based on imitating Jesus, who spent his life ministering to those in need.
Service was viewed as a means of securing salvation.
Religious orders were the way respectable women and men could serve as nurses.
Influences of Middle Ages Church
Credentialed health professionals.
Deeply anti-empirical beliefs.
Believed only God and the devil had the power to cause illness or promote healing.
Religious fervor saw treatment not approved by the Church as the work of the devil.
Women healers persecuted.
Deplorable sanitary conditions, fatigue, poor nutrition, diarrhea, and the spread of communicable diseases
Military nursing orders formed as a response, which drew a large number of men into the field of nursing
Some patients were treated as welcome guests; others were treated inhumanely.
Nurses who believed their duty was to God/the spiritual may have paid less attention to physical, emotional, and comfort needs.
Mental illness was seen as possession by the devil or punishment for sins.
Patients chained, starved, and sometimes tortured to try to drive out madness.
“Women was created to be man’s [helper] but her unique role is conception…since for all other purposes men would be better assisted by other men.” Thomas Aquinas
“Woman is the gate of the devil, the path of wickedness, the sting of the serpent, in a world a perilous object.” St. Jerome
Women healers represented a political, religious, and sexual threat to both Church and state, which added to the beginning of the witch hunts.
Religious- and Church-sanctioned secular nursing orders were the only avenues for women as nurses.
During the Crusades, nursing orders provided care in infirmaries and clinics.
Nursing orders were subordinate in the Church, but these women did exercise a degree of autonomy and independence.
Led to laws and customs that discouraged the humane care of the poor and vulnerable
“Dark period of nursing”
Nursing orders expelled from hospitals
Hospital care provided by convalescent patients, prostitutes, prisoners, and drunkards
Also allowed for new types of thinking and opened the door for the Renaissance
Birth of scientific revolution and a new era in the healing arts.
Philosophical humanism emerged with humans rather than God as the focus.
Empiric phenomena and subjective reasoning became the focus of knowledge.
Brought relief from witch hunts but didn’t really change the lives of women.
Brought tremendous advances in science, politics, and philosophy.
Modern philosophers’ ideas directly influenced nursing.
Cartesian philosophy resulted in a separation between the acts of caring and curing.
Nurse’s role restricted to the caring realm.
Florence Nightingale
Florence Nightingale worked to free nursing from the bonds of the church.
Became a model for all nurses.
Addressed moral and social issues.
Was a nurse, statistician, sanitarian, social reformer, and a scholar.
Think About It and Discuss
Nursing is primarily a profession of women. How has the social status of women affected the status of the profession in the past and present?
Does the status of the nursing profession change its members’ ability to practice? Explain your answer.
It is through the intimacy and trust of the nurse-patient relationship that nurses become critical participants in the process of ethical decision making.
By developing a working knowledge of ethical theory, nurses can make clear and consistent decisions.
The intense and critical examination of beliefs and assumptions.
It gives coherence to the whole realm of thought and experience and offers principles for deciding what actions and qualities are most worthwhile.
It gives shape to what would otherwise be a chaos of thoughts, beliefs, assumptions, values, contradictions, and superstitions.
Provides a framework for cohesive and consistent ethical reasoning and decision making.
The best moral theories are part of larger integrated philosophies.
Two moral theories having the greatest influence on contemporary bioethics and nursing: utilitarianism and deontology.
Moral philosophy is the philosophical discussion of what is considered good or bad, right or wrong, in terms of moral issues.
Moral issues are those which are essential, basic, or important and deal with important moral issues.
Ethics is a formal process making logical and consistent decisions, based upon moral philosophy.
