According to the deontological theory, suicide is always wrong. According to the consequentialism ethical theory, an action’s morality depends on the consequences of that action. Mary has a progressive, incurable illness that requires total care that will force her to leave the home. She wishes to stay in her home until she dies.
To honor Mary’s dignity and respect her autonomy in making treatment decisions. For Mary to experience a “good” death as she defines it, and neither hasten nor prolong her dying process through illegal or amoral interventions.
Learning activities.
(Answers to “Learning Activities” can be found in the “Answer Key” at the end of the book. Answers to interactive activities are provided as immediate feedback.)
Ethical Application & Reflection Activity
Filmmaker Lulu Wang first shared a story about her grandmother on This American Life podcast and later turned it into the 2019 movie The Farewell starring Awkwafina. Both share the challenges of a Chinese-born but U.S.-raised woman returning to China and a family who has chosen to not disclose that the grandmother has been given a Stage IV lung cancer diagnosis and three months to live. Listen to the podcast and then answer the following questions:
585: In Defense of Ignorance Act One: What You Don’t Know
1. Reflect on the similarities and differences of your family culture with that of the Billi family. Consider things such as what family gatherings, formal and informal, look like and spoken and unspoken rules related to communication and behavior.
2. The idea of “good” lies and “bad” lies is introduced in the podcast. Nai Nai’s family supports the decision to not tell her about her Stage IV lung cancer, stage a wedding as the excuse to visit and say their goodbyes, and even alter a medical report as good lies necessary to support her mental health, well-being, and happiness. Is the family applying deontological or utilitarian ethics to the situation? Defend your response.
3. Define the following ethical principles and identify examples from this story:
• Autonomy
• Beneficence
• Nonmaleficence
• Paternalism
4. Imagine this story is happening in the United States rather than China and you are the nurse admitting Nai Nai to an inpatient oncology unit. Using the ethical problem-solving model of your choice, identify and support your solution to the ethical dilemma posed when her family requests that Nai Nai not be told that she has cancer.
You are caring for a 32-year-old client who has been in a persistent vegetative state for many years. There is an outdated advanced directive that is confusing on the issue of food and fluids, though clear about not wanting to be on a ventilator if she were in a coma. Her husband wants the feeding tube removed but is unable to say that it would have been the client’s wish. He says that it is his decision for her. Her two adult siblings and parents reject this as a possibility because they say that “human life is sacred” and that the daughter believed this. They say their daughter is alive and should receive nursing care, including feeding. The health care team does not know what to do ethically and fear being sued by either the husband, siblings, or the parents. What do you need to know about this clinical situation? What are the values and obligations at stake in this case? What values or obligations should be affirmed and why? How might that be done?
1. Define the problem.
2. List what facts/information you have.
3. What are the stakeholders’ positions?
• Patient:
• Spouse:
• Family:
• Health Care Team:
• Facility:
• Community:
4. How might the stakeholders’ values differ?
5. What are your values in this situation?
6. Do your values conflict with those of the patient? Describe.
The act or process of pleading for, supporting, or recommending a cause or course of action. Advocacy may be for persons (whether an individual, group, population, or society) or for an issue, such as potable water or global health.[ 1 ]
The capacity to determine one’s own actions through independent choice, including demonstration of competence.[ 2 ]
The bioethical principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit another or others, often going beyond what is required by law.[ 3 ]
A set of ethical principles established by a profession that is designed to govern decision-making and assist individuals to distinguish right from wrong.
An ethical theory used to determine whether or not an action is right by the consequences of the action. For example, most people agree that lying is wrong, but if telling a lie would help save a person’s life, consequentialism says it’s the right thing to do.
A humble and respectful attitude towards individuals of other cultures and an approach to learning about other cultures as a lifelong goal and process.
An ethical theory based on rules that distinguish right from wrong.
Conflict resulting from competing values that requires a decision to be made from equally desirable or undesirable options.
Principles used to define nurses’ moral duties and aid in ethical analysis and decision-making.[ 4 ] Foundational ethical principles include autonomy (self-determination), beneficence (do good), nonmaleficence (do no harm), justice (fairness), and veracity (tell the truth).
The formal study of morality from a wide range of perspectives.[ 5 ]
A formal committee established by a health care organization to problem-solve ethical dilemmas.
An ethical principle meaning keeping promises.
A group that has been formally designated to review and monitor biomedical research involving human subjects.
A moral obligation to act on the basis of equality and equity and a standard linked to fairness for all in society.[ 6 ]
The distressing psychological, behavioral, social, and sometimes spiritual aftermath of exposure to events that contradict deeply held moral beliefs and expectations.
Personal values, character, or conduct of individuals or groups within communities and societies.[ 7 ]
The prevailing standards of behavior of a society that enable people to live cooperatively in groups.[ 8 ]
Feelings occurring when an individual is uncertain about what values or principles should be applied to an ethical issue.[ 9 ]
The willingness of an individual to speak out and do what is right in the face of forces that would lead us to act in some other way.[ 10 ]
Feelings occurring when correct ethical action is identified but the individual feels constrained by competing values of an organization or other individuals.[ 11 ]
Feelings occurring when an individual witnesses immoral acts or practices they feel powerless to change.[ 12 ]
The bioethical principle that specifies a duty to do no harm and balances avoidable harm with benefits of good achieved.[ 13 ]
The interference by the state or an individual with another person, defended by the claim that the person interfered with will be better off or protected from harm.[ 14 ]
A type of consequentialism that determines whether or not actions are right based on their consequences, with the standard being achieving the greatest good for the greatest number of people.
Individual beliefs that motivate people to act one way or another and serve as a guide for behavior.[ 15 ]
An ethical principle meaning telling the truth.
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The study reviewed 20 currently-available structured ethical decision-making models and developed an integrated model consisting of six steps with useful questions and tools that help better performance each step: (1) the identification of an ethical problem; (2) the collection of additional information to identify the problem and develop solutions; (3) the development of alternatives for analysis and comparison; (4) the selection of the best alternatives and justification; (5) the development of diverse, practical ways to implement ethical decisions and actions; and (6) the evaluation of effects and development of strategies to prevent a similar occurrence. From a pilot-test of the model, nursing students reported positive experiences, including being satisfied with having access to a comprehensive review process of the ethical aspects of decision making and becoming more confident in their decisions. There is a need for the model to be further tested and refined in both the educational and practical environments.
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IMAGES
VIDEO
COMMENTS
Problem-solving in nursing is the act of utilizing critical thinking and decision-making skills to identify, analyze, and address problems or challenges encountered by nurses in the healthcare setting. Problem-solving in nursing can be related to specific patient needs or may be related to staff issues.
Conclusion The influencing factors of clinical nurses' problem-solving dilemma are diverse. Hospital managers and nursing educators should pay attention to the problem-solving of clinical nurses, carry out a series of training and counselling of nurses by using the method of situational simulation, optimize the nursing management mode, learn to use new media technology to improve the ...
Problem solving for nurses is essential to quality patient care. Explore problem-solving examples in nursing and devise effective strategies.
This study was intended to confirm the structural relationship between clinical nurse communication skills, problem-solving ability, understanding of patients' conditions, and nurse's perception of professionalism. Due to changes in the ...
s, and problem-solving, which requires analysis. Decision-makingfree flow of ideas is essential to problem-solving and decision-making becaus. it helps prevent preconceived ideas from controlling the process. Many decisions in healthcare are arrived at by group or teams rather than by the in. vidual, and this type of decision-making requ.
The model has interrelated concepts of health and nursing problems and problem-solving, which is inherently logical in nature. Furthermore, the 21 nursing problems progressed to a second-generation development referred to as patient problems and patient outcomes.
Review methods A random-effects model was used to generate pooled standardized mean differences (SMD) for critical thinking, problem-solving, and self-confidence. The heterogeneity of each variable in the pooled estimate was determined using a random-effects model.
Abstract This paper analyses the role of problem solving in nursing practice including the process, acquisition and measurement of problem-solving skills It is argued that while problem-solving ability is acknowledged as critical if today's nurse practitioner is to maintain effective clinical practice, to date it retains a marginal place in nurse education curricula Further, it has attracted ...
What Is Critical Thinking in Nursing? Critical thinking in nursing involves identifying a problem, determining the best solution, and implementing an effective method to resolve the issue using clinical decision-making skills.
Abstract The COVID-19 pandemic made creative problem-solving, a skill that nurses have long possessed, more observable and valued. This article presents a new professional practice model for nursing innovation that facilitates practice improvements and leverages skills, strengths, and values that are integral to nursing.
Problem-based learning (PBL) is a student-centered approach to teaching that has been applied in medical and nursing education. The effectiveness of PBL in promoting critical thinking in nursing students has been studied extensively with mixed results.
Critical thinking is applied by nurses in the process of solving problems of patients and decision-making process with creativity to enhance the effect. It is an essential process for a safe, efficient and skillful nursing intervention. Critical thinking according to Scriven and Paul is the mental active process and subtle perception, analysis ...
The results showed that structured social problem-solving training could improve cognitive problem-solving, critical thinking, and decision-making skills. Considering this result, nursing education should be presented using new strategies and creative and different ways from traditional education methods.
This paper reviews the literature surrounding the research on how individuals solve problems. The purpose of the review is to heighten awareness amongst nurses in general, and nurse academics in particular about the theories developed, approaches taken and conclusions reached on how clinicians problem-solve.
Nurse leaders perceive their role as a problem-solver, which is a necessary step in advocacy. 27 Problem-solving is a process that contains the elements of decision-making and critical thinking. 28 The theory that emerged from the core categories explicitly focused on the central phenomenon of LHV in the nursing work environment.
As such, I offer the following more nursing-centered and practical definition: EBP for nursing is a way of entering the situation with curiosity and engagement that follows the nursing process by responding to the issue or problem using the best available evidence.
Problem-solving ability is an important competency for nursing students to enable them to solve various problems that occur in dynamic clinical settings. The purpose of this cross-sectional study was to identify the factors that affect the problem-solving ...
Abstract. This paper analyses the role of problem solving in nursing practice including the process, acquisition and measurement of problem-solving skills. It is argued that while problem-solving ability is acknowledged as critical if today's nurse practitioner is to maintain effective clinical practice, to date it retains a marginal place in ...
1. Background The nursing process is a widely recognized theoretical model in nursing education playing a central role in the nurse's competence. This process serves as a theoretical problem-solving model (Fertelli, 2019) in nurse's clinical decision-making, leading to individually adapted patient-safe care (Alfaro-LeFevre, 2013).
Strategies for Problem Solving Nursing students will be expected to have or develop strong problem-solving skills. Problem solving is centered on your ability to identify critical issues and create or identify solutions. Well-developed problem solving skills is a characteristic of a successful student. Remember, problems are a part of everyday life and your ability to resolve problems will ...
The knowledge-driven model emphasizes the organization and availability of relevant content knowledge stored in memory as the prime determinant of clinical problem solving. This contention is discussed in relation to the development of a clinical problem-solving task for nursing students and its implications for nursing curricula.
The nursing process is a structured problem-solving approach that nurses may apply in ethical decision-making to guide data collection and analysis. See Table 6.3b for suggestions on how to use the nursing process model during an ethical dilemma.
Methods. A quasi-experimental design was used. Participants were 161 undergraduate nursing students from two levels of a university, 88 subjects in the experimental group were taught using Simulation with problem-based learning and 73 subjects in the control group were taught using Problem-based learning.
Abstract. The study reviewed 20 currently-available structured ethical decision-making models and developed an integrated model consisting of six steps with useful questions and tools that help better performance each step: (1) the identification of an ethical problem; (2) the collection of additional information to identify the problem and ...