Ethics in Nursing: Cases, Principles, and Reasoning Book

Cases|xiii

1 Moral Dilemmas and Ethical Inquiry 3

1 Moral dilemmas in nursing 3

2 Ethical codes: uses and limitations 6

3 The fundamental question of morality 10

4 Ethical inquiry 11

5 Ethical autonomy and institutional-hierarchical constraints 22

2 Unavoidable Topics in Ethical Theory 27

1 Basic ethical principles 28

2 Comprehensive ethical theories 38

3 Moral pluralism 40

4 A comprehensive ethics of care? 42

5 Ethical reasoning 44

6 Ethics, law, and religion 51

3 Nurses and Clients 56

1 Parentalism 58

2 Deception 69

3 Confidentiality 77

4 Personal risks and professional obligations 83

5 Conflicting claims 89

4 Recurring Ethical Issues in Interprofessional Relationships 94

1 Conflicts between nurse and other health care providers 94

2 Nurse autonomy 107

3 Collaboration 118

4 Integrity-preserving compromise 122

5 Conscientious refusal 126

6 Determining responsibility 134

5 Ethical Dilemmas Among Nurses 138

1 Tensions between nurses 138

2 Respect for persons 146

3 Professional obligations 150

4 Administrative dilemmas 158

6 Personal Responsibility for Institutional and Public Policy 166

1 The scope of individual responsibility 166

2 Institutional policies and strikes 170

3 Institutional ethics committees 178

4 Blowing the whistle 182

5 Public policy: advance directives 188

6 Public policy: workplace violence 192

7 Putting it all together 193

7 Cost Containment, Justice, and Rationing 197

1 Cost containment and the claims of justice 199

2 Access to care 205

3 The concept of rationing 207

4 The Oregon proposal 208

5 Toward ethical rationing 213

6 Rationing and the importance of nursing care 219

7 The expanding scope of nursing ethics 221

Appendix A The International Council of Nurses Code of Ethics for Nurses 225

Appendix B The Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities 229

Appendix C Cases for Analysis 233

Notes 249

Suggestions for Further Reading 269

Index 275