Case Studies in Nursing Ethics

by Fry, Sara T.; Veatch, Robert M.

• ISBN13: 9780763730376
• ISBN10: 0763730378
• Edition: 3rd
• Format: Paperback
• Copyright: 2005-08-15
• Publisher: Jones & Bartlett

Summary

Case Studies in Nursing Ethics presents basic ethical principles and specific guidance for applying these principles in nursing practice through analysis of over 150 actual ethical case study conflicts that have occurred in the practice of nursing. Each case study allows readers to develop their own approaches to the resolution of ethical conflict and to reflect on how the traditions of ethical thought and professional guidelines apply to the situation.

Table of Contents

Preface	vii
List of Cases	ix
Introduction	xiii
Four Questions of Ethics	xiii
What Makes Right Acts Right?	xiv
Distinguishing between Evaluative Statements and Statements Presenting Nonevaluative Facts	xiv
Distinguishing between Moral and Nonmoral Evaluations	xv
Determining Who Ought to Decide	xvi
What Kinds of Acts Are Right?	xviii
Consequentialism	xix
Nonconsequentialism	xx
How Do Rules Apply to Specific Situations?	xxii
What Ought to Be Done in Specific Cases?	xxii
Endnotes	xxiv
Part I Ethics and Values in Nursing
Values in Health and Illness	3	(30)
Identifying Evaluations in Nursing	4	(12)
Identifying Ethical Conflicts	16	(15)
Benefit to the Patient vs Benefit to Others	16	(3)
The Rights of the Patient vs the Welfare of the Patient	19	(5)
Moral Rules and the Nurse's Conscience	24	(4)
Limits on Rights and Rules	28	(3)
Endnotes	31	(2)
The Nurse and Moral Authority	33	(32)
The Authority of the Profession	35	(6)
The Authority of the Physician	41	(4)
The Authority of the Institution	45	(3)
The Authority of the Health Insurer	48	(2)
The Authority of Society	50	(5)
The Authority of the Patient	55	(3)
Endnotes	58	(7)
Part II Ethical Issues in Nursing
Benefiting the Patient and Others: The Duty to Produce Good and Avoid Harm	65	(29)
Benefit to the Patient	68	(10)
Health Benefits vs Overall Benefits	68	(5)
Benefiting vs Avoiding Harm	73	(2)
Act vs Rule Consequentialism	75	(3)
Benefit to the Institution	78	(3)
Benefit to Society	81	(3)
Benefit to Identified Nonclients	84	(3)
Benefit to the Profession	87	(3)
Benefit to Oneself and One's Family	90	(2)
Endnotes	92	(2)
Justice: The Allocation of Health Resources	94	(25)
The Ethics of Allocating Resources	95	(3)
Two Meanings of the Word Justice	95	(1)
Three Ways to Allocate Resources	95	(3)
Justice Among the Nurse's Patients	98	(9)
Justice Between Patients and Others	107	(4)
Justice in Public Policy	111	(4)
Justice and Other Ethical Principles	115	(2)
Endnotes	117	(2)
The Principle of Autonomy	119	(23)
Internal Constraints on Autonomy	120	(7)
External Constraints on Autonomy	127	(6)
Overriding Autonomy	133	(7)
Endnotes	140	(2)
Veracity	142	(25)
The Condition of Doubt	143	(4)
Duties and Consequences in Truth-Telling	147	(10)
Lying and Patient Well-Being	147	(6)
Lying and the Well-Being of Others	153	(4)
Complications in Truth-Telling	157	(7)
When the Patient Asks Not to Tell	157	(2)
When the Family Asks Not to Tell	159	(5)
The Right to Health Records	164	(2)
Endnotes	166	(1)
Fidelity	167	(25)
Promise-Keeping	168	(4)
Confidentiality	172	(19)
When the Patient May Be Harmed	176	(6)
When Others May Be Harmed	182	(7)
When Required by Law	189	(2)
Endnotes	191	(1)
The Sanctity of Human Life	192	(35)
Actions and Omissions	194	(4)
Criteria for Justifiable Omission	198	(3)
Withholding and Withdrawing	201	(6)
Direct and Indirect Killing	207	(3)
Voluntary and Involuntary Killing	210	(4)
Is Withholding Food and Water Killing?	214	(6)
Endnotes	220	(7)
Part III Special Problem Areas in Nursing Practice
Abortion, Contraception, and Sterilization	227	(19)
Abortion	228	(9)
Contraception	237	(5)
Sterilization	242	(2)
Endnotes	244	(2)
Genetics, Birth, and the Biological Revolution	246	(35)
Genetic Counseling	248	(9)
Genetic Screening	257	(5)
InVitro Fertilization and Artificial Insemination	262	(11)
Genetic Engineering	273	(4)
Endnotes	277	(4)
Psychiatry and the Control of Human Behavior	281	(18)
Psychotherapy	284	(1)
The Concept of Mental Health	284	(11)
Mental Illness and Autonomous Behavior	287	(3)
Mental Illness and Third-Party Interests	290	(5)
Other Behavior-Controlling Therapies	295	(2)
Endnotes	297	(2)
HIV/AIDS Care	299	(31)
Conflict Between Rights and Duties	300	(15)
Screening/Testing for HIV	301	(4)
Balancing Confidentiality Protection and the Duty to Warn	305	(5)
The Rights of HIV-Infected Individuals	310	(5)
Conflicts Involving the Cost of Treatment and Allocation of Resources	315	(8)
Research on HIV	323	(5)
Endnotes	328	(2)
Experimentation on Human Beings	330	(34)
Calculating Risks and Benefits	335	(7)
Protecting Privacy	342	(3)
Equity in Research	345	(3)
Informed Consent in Research	348	(13)
Endnotes	361	(3)
Consent and the Right to Refuse Treatment	364	(28)
The Right to Refuse Treatment	367	(4)
The Elements and Standards of Consent	371	(9)
Comprehension and Voluntariness	380	(5)
Consent for Incompetents	385	(5)
Endnotes	390	(2)
Death and Dying	392	(45)
The Definition of Death	394	(3)
Competent and Formerly Competent Patients	397	(9)
Treating against the Wishes of the Patient	398	(3)
The Patient in Conflict with the Physician and the Family	401	(2)
The Problem of the Ambivalent Patient	403	(3)
Never-Competent Patients and Those Who Have Never Expressed Their Wishes	406	(18)
How Much Discretion Should Family Have?	407	(5)
Nonfamily Surrogates	412	(12)
Futile Care	424	(9)
Limits Based on the Interests of Other Patients	431	(2)
Endnotes	433	(4)
Glossary	437	(8)
Index	445