Frando, Ranz Kenneth G.

BSN 4 – B

TASK 1. ASSESSING YOUR UNDERSTANDING

Instructions: Using the table below, provide a more inclusive explanation of the common ethical
principles. Fill-in reflection and experience which are necessary to understand many of the ethical
principles in the context of health care and nursing practice. (see rubrics for scoring)
Ethical Principle Example in Nursing Practice
Autonomy Autonomy means that the patients are able to make
independent decisions. This means that nurses
should be sure patients have all of the needed
information that is required to make a decision
about their medical care and are educated. The
nurses do not influence the patient’s choice.
Examples of nurses demonstrating this include
obtaining informed consent from the patient for
treatment, accepting the situation when a patient
refuses a medication, and maintaining
confidentiality.
Respect for Others "A fundamental principle that underlies all nursing
practice is respect for the inherent worth, dignity,
and human rights of every individual"
Beneficence Beneficence is defined as kindness and charity,
which requires action on the part of the nurse to
benefit others. An example of a nurse
demonstrating this ethical principle is by holding a
dying patient’s hand.
Nonmaleficence This means that nurses must do no harm
intentionally. Nurses must provide a standard of
care which avoiding risk or minimizing it, as it
relates to medical competence. An example of
nurses demonstrating this principle includes
avoiding negligent care of a patient.
Fidelity Fidelity is keeping one's promises. The nurse must
be faithful and true to their professional promises
and responsibilities by providing high quality, safe
care in a competent manner.
Veracity Veracity is being completely truthful with patients;
nurses must not withhold the whole truth from
clients even when it may lead to patient distress.
Confidentiality The principle of confidentiality is founded in the
patient's right to privacy and the preservation of the
nurse-patient relationship.
Justice Justice means being impartial and fair. Nurses
making impartial medical decisions demonstrate
 this, whether it relates to limited resources or new
treatments regardless of economic status, ethnicity,
sexual orientation, etc.
Paternalism Paternalism—choosing a course of action in the
patient’s best interest but without the patient’s
consent—serves as an integral value in ethical
decision making, both as a balance to other values
and as an ethical obligation to neither withhold
guidance nor abdicate professional responsibility to
patients
Utilitarianism Utilitarianism is the underlying principle of public
health ethics where the goal is to produce the
greatest happiness for the greatest number.
Privacy Nurses safeguard the right to privacy for
individuals, families, and communities. .
Deontology Deontological ethics are based on duties and rights
and respect individuals as ends in themselves.
Principlism The ethical principles that nurses must adhere to
are the principles of justice, beneficence,
nonmaleficence, accountability, fidelity, autonomy,
and veracity.

TASK 2. APPLYING YOUR KNOWLEDGE

Instructions: Briefly answer the following discussion questions. (see rubrics for scoring)
Scenario: Ralfa is in the hospital. She is a 47-year-old woman who has metastatic breast cancer and
does not want her family to know that she is at the end-of-life and is dying. Ralfa has low energy, and
her fatigue level now taxes her coping mechanisms, which are normally excellent; she does not feel that
she can deal with her family’s grief. Ralfa’s daughter has been discharged from the Air Force and is
returning home from an overseas deployment. The family has planned a surprise party for Ralfa in the
hospital when her daughter arrives back home and has invited many of her friends and family members.
Ralfa’s nurse is conflicted because she practices under the principle of utilitarianism and is aware of her
patient’s desire for privacy as well as the party planned by the family. Ralfa does not know about the
party and her family does not know about her prognosis.
Discussion Questions
1. Define and state the limitations of utilitarianism, privacy, and veracity
Utilitarianism is the most influential moral theory. Its core idea is that whether the actions are morally
right or wrong depends on their effects the action is performed.

Happiness is the only thing that has value in utilitarianism. If the actions are right, it provides happiness.
If wrong provides unhappiness. It considers every one’s happiness equally.

Veracity is the accuracy or conformity of truths.

privacy is something personal

In this case of Ada, she is at the end stage of life so she won't become happy. Her family members were
not aware of the poor prognosis and also, she doesn't want to spoil their happiness. In order to maintain
every one's happiness, it is not practical to follow veracity privacy, and utilitarianism.

2. What would a person of utilitarian thought do in this case?

A person of utilitarian thoughts will provide happiness to the client as she is at the end stage of life.

3. What about the unwritten nurse-patient agreement as it relates to beneficence?

The unwritten nurse - patient agreement is that the nurse will not expose the present disease condition of
client to relatives or family members. This decision is benesocial for both client and family members. In
party both of them will be happy.

4. How does this pose a conflict for a nurse practicing the ethical principle of utilitarianism?
The profession nurse must follow ethical principles like veracity. she must be accurate and truthful by
following utilitarianism it creates conflicts for the nurse.

5. Are your values regarding veracity stronger or weaker than your desire to cause no harm to
Ralfa’s feelings (nonmaleficence)?
The values regarding veracity are weaker than the desire to cause no harm to clients feeling. She is at the
end stage of life, so giving her a little bit of happiness will helps to forgot bitter feelings of disease.

The utilitarianism helps to keep everyone happy. Happiness is its main goal it is attained either morally or
by other means.

TASK 3. CASE ANALYSIS

Instructions: Briefly answer the following discussion questions. (see rubrics for scoring)

Scenario: Over the past several weeks, you have noticed that your closest friend, Rafaela, has been
erratic and has been making poor patient-care decisions. On two separate occasions, you quietly
intervened and “fixed” his errors. You have also noticed that he volunteers to give pain medications to
other nurses’ patients, and you see him standing very close to other nurses when they remove controlled
substances from the medication distribution center. Today you watched him go to the center immediately
after another colleague and then saw him go into the men’s room. Within about 20 minutes his behavior
had changed completely. You suspect that he may be taking controlled substances. You and Rafaela have
been friends for more than 20 years. You grew up together and went to nursing school together. You
realize that if you approach him, you may jeopardize this close friendship that means a great deal to you.

1. Using the MORAL ethical decision-making model, devise a plan to resolve this dilemma.
Basing on the situation, it is important first to gather the facts. One should not jump to conclusions
without the facts on hand. Gather as much facts as possible and clarify all assumptions. Identify the
ethical issue involved, the consequences afterwards and the relevant principles. It is important to do no
harm since their friendship is at stake. Check your gut as well since intuition can be a source of good
decision making in being able to know something is not right. Once you have gathered the facts,
considered the consequences, and the principles involved, we can now focus on following moral rules or
duty. Since the actions involved are during work, you can address Rafaela regarding her obligation as a
nurse and why such actions are forbidden. As friend, try to discern Rafaela's character traits that could
motivate him in doing and being better in the situation.