Nursing Ethics through the Life Span / Edition 4

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Overview

Using philosophical guidelines—and applying these guidelines throughout a patient's lifespan—this text assists readers in making ethically sound choices in nursing. It explores both traditional and contemporary ethical theories and acknowledges changing trends in the health field, incorporating issues such as managed care. Includes clinical case studies within each chapter. Incorporates a new organization in Part Two, in three sections entitled "Developmental Highlights," "Issues and Problems," and "Morally Reasoned Nursing Interventions." Provides new "What if?" questions throughout to help apply theory to real events. Offers extensive analysis of euthanasia and assisted suicide. Includes thorough coverage of the HIV/AIDS epidemic and its moral complexities. Discusses organ transplantation and experimental medical treatments in ethical context. Ideal for practicing nurses looking for a reference on professional ethics.

Nursing ethics & the problem of abortion/ethical issues in the nursing care of infants, children, adults.

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Product Details

  • ISBN-13: 9780838569764
  • Publisher: Prentice Hall
  • Publication date: 3/20/2001
  • Edition description: REV
  • Edition number: 4
  • Pages: 333
  • Sales rank: 1,101,191
  • Product dimensions: 5.98 (w) x 8.74 (h) x 0.94 (d)

Read an Excerpt

Preface

Far reaching changes have occurred in the health care delivery system that decisively affect the practice of nursing. The managed care sector attempts to justify its practices as cost containment with no loss in the quality of care. The incompatibility of these two objectives is obvious. Moves to cut costs have resulted in the restructuring of nursing staff, with reductions in the numbers and qualifications of professional nurses along with increases in nonlicensed assistive personnel. Consequently, the role of the nurse as patient advocate has never been more important to the safety of patients and the protection of their rights.

Nurses have invoked the principles of the American Nurses Association (ANA) Code for Nurses of respect for patients and safeguarding them from unsafe, incompetent, and inadequate nursing care. Nurses have successfully demonstrated and struck against hospitals, winning contracts for improved staffing and working conditions. In this way, nurses have achieved two goals: the direct improvement of conditions of patient care, and the improvement of organization ethics. Protesting nurses have forced organizations to publicly defend their stated mission and the role of moral reasoning in providing quality health care services. Demonstrating nurses have provoked positive media coverage as well as public interest, sympathy, and support. Although organizational mechanisms, such as ethics committees and patient representatives, may be broadened to address ethical health care concerns at all levels of the organization and even the community, no mechanism is as valuable or as effective as the practicing nurse who is trusted by patients to advise them regarding their rights to respect, to informed consent, and to receive and to refuse care in accordance with their values. We intend to strengthen and support nurses' determination to provide curative and preventive care to persons, to relieve their pain and suffering, and to promote public health and welfare measures. These are the goals of this text.

In this edition, we have reorganized the chapters. For the chapter on models, we applied the Emmanuel's model to nursing. In Part 1, we use a topical approach to ethics based on a philosophical examination of self-interest ethics, virtue ethics, consequentialist (utilitarian) ethics, duty-based ethics, and rights-based ethics; each is discussed in context of its historical development as well as its strengths and difficulties. Sharpening fundamental principles of each theory increases its applicability and usefulness to the student. The presentation includes the foundation of early Greek and Christian moral philosophy, including natural law, altruism, double effect, and its moral and religious impact on nursing. Consequentialist (utilitarian) ethics, with its emphasis on majority happiness and current health care delivery, is explored extensively. Kant's duty-based ethics emphasizes duty and responsibility, truth-telling, and promise keeping, and in treating humans as ends in themselves and not solely as means for other people's advantages. We then analyze rights-based ethics and its current implications for the nursing care of patients.

Part 2 examines and applies ethics to the life span of patients; beginning with the procreative family, then proceeding through abortion, infants, children, adolescents, adults, the elderly, and the dying. Cases are distributed throughout the chapters. Problems of HIV/AIDS are included in the cases and text. Chapters on the elderly and the dying deal extensively with issues of allocation, restraint, abuse, active and passive euthanasia, and assisted suicide. Nurses play a central role in the compassionate care of dying patients, helping them to maintain their humanity, often to the last breath. We support nurses' obligations to respect and support patients' religious beliefs regardless of the content of their own beliefs.

The intent of this text is to serve a variety of uses. It can be used as the primary text for a course of ethics, either at the undergraduate or graduate level. The format of the text also lends itself to use in successive courses, based on developmental levels, as the student moves through the curriculum. Our conception is that of applied ethics "from the womb to the tomb" correlated with most nursing curricula.

We are grateful to the Board of Trustees, and to the Research and Released Time Committee of Long Island University, Brooklyn Campus, for the grant of released time to write for this fourth edition. We appreciate the help of Nancy Anselment, nursing editor of Prentice Hall Health, for her support in this effort, and also her staff. We especially thank Emily Autumn, Senior Production Editor at Clarinda Publication Services. We gained a great deal from the monthly bioethics seminars at Montefiore Hospital conducted by Nancy Dubler and Jeffrey Blustein. We are also appreciative of several computer monitors at the Holyoke Community College, especially Ms. Florence Rice, Ms. Kelly Trombley, Ms. Milly Claudio, Mr. Chuck Schumer, and Mrs. Melissa Latour. We also gained considerable computer help from Mr. Devebrata Mondale, director of the Long Island University Faculty Resource Center and to his highly capable staff members. Lastly, we wish to acknowledge, with our gratitude, three nurses whom we believe epitomize the moral ideals of nursing in their practice; Cheryl D. Smith, RN, family practitioner and nurse diabetic educator, whose generosity of heart and mind touches each of her patients; and Susan Maher, RN, President of District 1 of the Massachusetts Nurses Association, and Bonnie Pierce, RN, for their professionalism, patient advocacy and dedication. These women give meaning to the notion that ethics is practical.

Elsie L. Bandman Bertram Bandman

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Table of Contents

I. MORAL PATHWAYS IN NURSING.

1. The Moral Significance of Nursing.

2. Models of Professional Relationships.

3. Self-Interest Morality.

4. Virtue Ethics in Nursing.

5. Consequentialist or Utilitarian Ethics.

6. Duty-Based Ethics: Universal Moral Principles.

7. Rights-Based Ethics.

8. Ethical Decision Making in Nursing.

II. NURSING ETHICS THROUGH THE LIFE SPAN.

9. Nursing Ethics in the Procreative Family.

10. Ethics and the Problem of Abortion.

11. Ethical Issues in the Nursing Care of Infants.

12. Ethical Issues in the Nursing Care of Children.

13. Ethical Issues in the Nursing Care of Adolescents.

14. Ethical Issues in the Nursing Care of Adults.

15. Ethical Issues in the Nursing Care of the Elderly.

16. Ethical Issues in the Nursing Care of the Dying.

Glossary of Selected Terms.

Appendix.

Index.

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Preface

Preface

Far reaching changes have occurred in the health care delivery system that decisively affect the practice of nursing. The managed care sector attempts to justify its practices as cost containment with no loss in the quality of care. The incompatibility of these two objectives is obvious. Moves to cut costs have resulted in the restructuring of nursing staff, with reductions in the numbers and qualifications of professional nurses along with increases in nonlicensed assistive personnel. Consequently, the role of the nurse as patient advocate has never been more important to the safety of patients and the protection of their rights.

Nurses have invoked the principles of the American Nurses Association (ANA) Code for Nurses of respect for patients and safeguarding them from unsafe, incompetent, and inadequate nursing care. Nurses have successfully demonstrated and struck against hospitals, winning contracts for improved staffing and working conditions. In this way, nurses have achieved two goals: the direct improvement of conditions of patient care, and the improvement of organization ethics. Protesting nurses have forced organizations to publicly defend their stated mission and the role of moral reasoning in providing quality health care services. Demonstrating nurses have provoked positive media coverage as well as public interest, sympathy, and support. Although organizational mechanisms, such as ethics committees and patient representatives, may be broadened to address ethical health care concerns at all levels of the organization and even the community, no mechanism is as valuable or as effective as the practicing nurse who is trusted by patients to advise them regarding their rights to respect, to informed consent, and to receive and to refuse care in accordance with their values. We intend to strengthen and support nurses' determination to provide curative and preventive care to persons, to relieve their pain and suffering, and to promote public health and welfare measures. These are the goals of this text.

In this edition, we have reorganized the chapters. For the chapter on models, we applied the Emmanuel's model to nursing. In Part 1, we use a topical approach to ethics based on a philosophical examination of self-interest ethics, virtue ethics, consequentialist (utilitarian) ethics, duty-based ethics, and rights-based ethics; each is discussed in context of its historical development as well as its strengths and difficulties. Sharpening fundamental principles of each theory increases its applicability and usefulness to the student. The presentation includes the foundation of early Greek and Christian moral philosophy, including natural law, altruism, double effect, and its moral and religious impact on nursing. Consequentialist (utilitarian) ethics, with its emphasis on majority happiness and current health care delivery, is explored extensively. Kant's duty-based ethics emphasizes duty and responsibility, truth-telling, and promise keeping, and in treating humans as ends in themselves and not solely as means for other people's advantages. We then analyze rights-based ethics and its current implications for the nursing care of patients.

Part 2 examines and applies ethics to the life span of patients; beginning with the procreative family, then proceeding through abortion, infants, children, adolescents, adults, the elderly, and the dying. Cases are distributed throughout the chapters. Problems of HIV/AIDS are included in the cases and text. Chapters on the elderly and the dying deal extensively with issues of allocation, restraint, abuse, active and passive euthanasia, and assisted suicide. Nurses play a central role in the compassionate care of dying patients, helping them to maintain their humanity, often to the last breath. We support nurses' obligations to respect and support patients' religious beliefs regardless of the content of their own beliefs.

The intent of this text is to serve a variety of uses. It can be used as the primary text for a course of ethics, either at the undergraduate or graduate level. The format of the text also lends itself to use in successive courses, based on developmental levels, as the student moves through the curriculum. Our conception is that of applied ethics "from the womb to the tomb" correlated with most nursing curricula.

We are grateful to the Board of Trustees, and to the Research and Released Time Committee of Long Island University, Brooklyn Campus, for the grant of released time to write for this fourth edition. We appreciate the help of Nancy Anselment, nursing editor of Prentice Hall Health, for her support in this effort, and also her staff. We especially thank Emily Autumn, Senior Production Editor at Clarinda Publication Services. We gained a great deal from the monthly bioethics seminars at Montefiore Hospital conducted by Nancy Dubler and Jeffrey Blustein. We are also appreciative of several computer monitors at the Holyoke Community College, especially Ms. Florence Rice, Ms. Kelly Trombley, Ms. Milly Claudio, Mr. Chuck Schumer, and Mrs. Melissa Latour. We also gained considerable computer help from Mr. Devebrata Mondale, director of the Long Island University Faculty Resource Center and to his highly capable staff members. Lastly, we wish to acknowledge, with our gratitude, three nurses whom we believe epitomize the moral ideals of nursing in their practice; Cheryl D. Smith, RN, family practitioner and nurse diabetic educator, whose generosity of heart and mind touches each of her patients; and Susan Maher, RN, President of District 1 of the Massachusetts Nurses Association, and Bonnie Pierce, RN, for their professionalism, patient advocacy and dedication. These women give meaning to the notion that ethics is practical.

Elsie L. Bandman
Bertram Bandman

Read More Show Less

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