Ethics Elements

- Serious Thoughts in a Cartoon -1st part: fundamental concepts

2006, revised nov. 2012

Margot Phaneuf, inf., Ph.D.

OBJECTIVES

. Think about some ethical aspects

related to nursing care.

. Clarify some basic principles that are

likely to orient our care.

. Realize the sources of our professional

Code.

. Discover how language and culture

might influence our understanding of

professional ethics.

WARNING

This document has no theoretical pretentions: it aims only to bring some concepts to the

students’ reach.

The main topic here is applied ethics.

All the principles of ethics are not dealt with in this document and as for the Professional Code

of Quebec, only the general articles are mentioned.

The images of this document belong to diverse sites identified in the webography. We thank

them.

Whatever our work field is, we must Whatever our work field is, we must remember that the individual must be the remember that the individual must be the

center and the measure of everything.center and the measure of everything.

La personneLa personneLa personne

A basic knowledge of ethics is needed A basic knowledge of ethics is needed to work with sick people and to work with sick people and a good understanding of our a good understanding of our professional Code is essential.professional Code is essential.

Do you know what it is, Leo?

No, but Mister Owl knows everything. He must be able to

explain it…

This course is about ethics. I do not know much about that. Is it going to be hard?

Mister Owl, what are ethics?

Yes, I would also like to know!

Mister Owl, what does the Mister Owl, what does the word word ethicsethics mean? mean?

Habit, house

Use, way of liveA way of being in oneself in

order to live better.

From its etymology From its etymology “ “ ethos ” this term means:ethos ” this term means:

Mister Owl, you are wise. Please explain what it is used for.

Hum ! Hum!!! Let’s see…!You know I am no specialist!

Ethics allows us to live better in our society by respecting ourselves

and by respecting others.

It helps us to be in harmony with well-considered principles and morally

accepted reasoning.

Our ethical principles allow us not to hide our heads in the sand and to see our

responsibilities more clearly!

But Mister Owl, how can we find our way among all those terms which are not

very familiar to us?

It is true that there are many terms, but, little Frog, some explanations

will follow!

There is the term ethics which we will see later, morals and bioethics…

Quite a lot..!

And, dear friend, do not forget clinical ethics !!!

Yet they are so important for the serious decisions we have to make while caring

for patients.

But nurses do not make those serious decisions!

Right! But they must consider situations in the care teams… and

they often can give knowledgeable opinions!

Yes, when we are on the tight rope of some serious decisions, ethical notions can shed light on

the situations!!!

You have to know, Mister, that there are situations where we do not

really know what to do!!!

Deals with what we must do or not do in Deals with what we must do or not do in a care situation. a care situation.

Proceeds by reasoning in order to fix Proceeds by reasoning in order to fix the course of action we must take in the course of action we must take in view of a decision or a difficulty with view of a decision or a difficulty with moral implications. moral implications.

Still a littlebit abstract..!!

In fact, ethics applied to nursing care …

All right, but how does that affect nurses in their everyday

work?

Guide our important decisions about Guide our important decisions about patients and orient our professional daily patients and orient our professional daily behaviour.behaviour.

They stimulate our honesty and our kind They stimulate our honesty and our kind consideration for the patients, our consideration for the patients, our intellectual rigour in care organisation, intellectual rigour in care organisation, our technical accuracy for its our technical accuracy for its application, and respect of the standards application, and respect of the standards and asepsis.and asepsis.

But Kitten and Polly… the ethical principles …

Act upon the way we approach patients, Act upon the way we approach patients, communicate with them and offer them communicate with them and offer them help when they have some problems.help when they have some problems.

They set guidelines for our professional They set guidelines for our professional and interprofessional relations.and interprofessional relations.

And, ethical principles…

My friends, ethical principles…My friends, ethical principles…

Are like personal points of reference for Are like personal points of reference for our behaviour in society whatever the our behaviour in society whatever the

situations in which we evolve, whatever situations in which we evolve, whatever their nature, social or professional.their nature, social or professional.

It is serious. An infraction of the Code of ethics can even lead to a

professional sanction !!!

Ethical principles are like professional landmarks for

our behaviour in care situations.

That is really something!!!

Gosh! I did not know that it went that far!

In every aspect!Most definitely!

But Dino, except for infractions, should we bother about ethics and

principles in our daily work?

Ethics, morals… what are they exactly ?

Can you shed light on that??? As for me, I am lost…!!!

But they do have differences!

«Morals and ethics feed each other. «Morals and ethics feed each other. Morals are to ethics what north is to a compass.»Morals are to ethics what north is to a compass.»

(Jacques Benoit, 2000, p. 33)(Jacques Benoit, 2000, p. 33)

I am anxious to knowwhat they are!

Dear colleague, please give us precise definitions. We need more complete

explanations and if possible more concrete…

Morals is a normative construct of good and evil. It imposes duties, taboos and interdictions. Its ultimate goal is good. It raises the individual awareness of good and evil and makes one conscious of their relations with others.

Listen carefully, Kitty…

Ethics is the fundamental art ofEthics is the fundamental art of managing our personal conduct.managing our personal conduct. It covers a large field of humanIt covers a large field of human consciousness. consciousness. It opens us to values of integrity andIt opens us to values of integrity and social responsibility, to public-social responsibility, to public- spiritedness, environmental protection,spiritedness, environmental protection, humanism in patient care, life’s value,humanism in patient care, life’s value, quality of life, etc.quality of life, etc. It applies to all human beings It applies to all human beings whatever their religion. whatever their religion.

Be attentive Puppy…!!!

Ethics introduces reflection on principles Ethics introduces reflection on principles common to all mankind.common to all mankind. It tends to make all human groups moreIt tends to make all human groups more aware and focused and to penetrate ouraware and focused and to penetrate our functioning in society.functioning in society.

Hey! Kittens, do you see how marvelous and important it is for our

profession!!!

So our professional lives are happier and more fulfilling

Differences between morals and ethics

MoralsMorals - has a religioushas a religious connotation, connotation, - it is outside of theit is outside of the

individual, individual, - it calls upon us withit calls upon us with

authority,authority,- it presupposes obedienceit presupposes obedience- it is an unbreakable rule.it is an unbreakable rule.

Ethics- has a non-religioushas a non-religious c connotation,onnotation,- it comes from our inner self,it comes from our inner self,- it makes us aware of our it makes us aware of our

responsibilities, responsibilities, - it brings discernment andit brings discernment and

knowledgeable judgment,knowledgeable judgment,- it is judged individually. it is judged individually. (Jacques Benoit, 2000, p. 33)

Is it now a little clearer?

I will see with the applications.

I think that in spite of the numerous currentreferences to ethics, morals maintain all their

value. They support all the reasoningin our personal and professional conduct.

But if we have ethics, are morals still needed?

What do you think, Toucan?

Morals are at the base of all those ethical principles !

Oh yes, Little Devil!!! They are not outdated..!

Thus, morals remainthe basis for our conduct???

We need more clarification! MisterOwl, please give us some concrete

definitions before Kitty is tangled up!

Yes, that might help me!

With pleasure, Toucan!

Applied ethicsApplied ethics

Is an ethical problem-solving approach as Is an ethical problem-solving approach as those problems lived and dealt with are in those problems lived and dealt with are in various milieus of life. To solve them calls for various milieus of life. To solve them calls for an individual and collective critical-thinking an individual and collective critical-thinking process. process.

It took root in the situational ethics movement It took root in the situational ethics movement introduced by Joseph Fletcher and Jonsen introduced by Joseph Fletcher and Jonsen and Toulimin. and Toulimin.

Gosh! Another term!!!

Oh la la! It’s getting complicated!!!

Applied Ethics Applied Ethics

This philosophical way of thinking distanced This philosophical way of thinking distanced itself from traditional moral thinking and itself from traditional moral thinking and renewed casuistry (part of morals which tries renewed casuistry (part of morals which tries to solve consciousness problems) by urging to solve consciousness problems) by urging ethicians to play a part in social issues. ethicians to play a part in social issues. http://www.usherbrooke.ca/cirea/recherche/lexique.html#%C9thique%20ahttp://www.usherbrooke.ca/cirea/recherche/lexique.html#%C9thique%20appliqu%E9eppliqu%E9e

Watch out kittens!!!

Clinical EthicsClinical Ethics introduces thinking about ethics in the core of the introduces thinking about ethics in the core of the practices in the field of health.practices in the field of health. it deals with clinical practice and patient care.it deals with clinical practice and patient care. Its objectives are:Its objectives are:

clinical consultation, clinical consultation, lines of action and recommendations about the lines of action and recommendations about the norms to be applied for ethical problems in thenorms to be applied for ethical problems in the hospital,hospital, ethical sensitisation to the milieu. (information &ethical sensitisation to the milieu. (information & formation). formation). http://www.ethique.msss.gouv.qc.ca/site/download.php?http://www.ethique.msss.gouv.qc.ca/site/download.php?id=3758544,75,1id=3758544,75,1

40

BioethicsBioethics

““It is a thoughtful consideration of moral problems It is a thoughtful consideration of moral problems related to research on living beings and its applications. related to research on living beings and its applications.

Bioethics deals with ideas to ensure the respect and Bioethics deals with ideas to ensure the respect and protection of individual life in the face of the evolution protection of individual life in the face of the evolution of scientific knowledge and its possible applications: of scientific knowledge and its possible applications: for example, euthanasia, organ transplant, cloning, for example, euthanasia, organ transplant, cloning, stem cell research, etc. stem cell research, etc.

Bioethical rules are those which regulate research on Bioethical rules are those which regulate research on living beings and its uses”. living beings and its uses”. (http://www.dictionnaire-(http://www.dictionnaire-biologie.com/biologie/definition_48.html biologie.com/biologie/definition_48.html

I knew that bio means life… but I never thought it would imply such

complex realities!!!

It is important to understand those concepts well !

Yet one more thing!!!

Are there any other terms???

What is that Prof. Bookworm?

Yes! Because we live in Quebec, We also need to have an idea

of the term  deontology .

43

The French language makes a difference between the words

ethics and deontology and their application to a

profession like nursing.

Why do I have to know that?

Yes why???

44

Because if you ever work in a hospital or an organization

where French is spoken, you will have to make the

distinction. Yes, that’s interesting!

But tell us what it is ?

Deontology was developed by the philsopher Kant. It encourages us to

act so that we treat humanity, both in our own person and in that of

another, always as an ends and never merely as a means.

It is a program in itself. Here are a few details about it

This principle is interesting!

Deontology is a duty-based ethics: it judges morality by examining

the nature of actions and the will of

agents rather than goals achieved.

But Kitty, deontology applies to a limited field of a profession or a corporation. Listen to the

next definition.

I am not sure I understand!!!

Differences between Differences between deontology and ethicsdeontology and ethics

in Frenchin French

The word deontology comes from the Greek root The word deontology comes from the Greek root “deont” which mean “need” or “deont” which mean “need” or

“ “obligation”.obligation”. ““ Deontology is a standard of behaviour, Deontology is a standard of behaviour,

but it operates within a corporatebut it operates within a corporate

domain. domain. A professional community is A professional community is

linked by a savoir-faire that itslinked by a savoir-faire that its

standards aim to protect and promote standards aim to protect and promote ””..

Then this is the difference!!!

Differences between Differences between deontology and ethicsdeontology and ethics

““ Deontology is not universal, but Deontology is not universal, but unique to a given community.unique to a given community.

As with law, deontology is sanctioned  As with law, deontology is sanctioned  ””.. ( (Jean de Maillard, magistrate, and André Jean de Maillard, magistrate, and André

Comte-Sponville, philosopher)Comte-Sponville, philosopher) http://www.bourin-conseil.fr/com/focus/citoyenhttp://www.bourin-conseil.fr/com/focus/citoyenneteuk.phpneteuk.php

Interesting!!!

Differences between Differences between deontology and ethicsdeontology and ethics

Some ethical principles are assembled Some ethical principles are assembled in a Code of deontology (what we call in a Code of deontology (what we call our Code of ethics) particular to each our Code of ethics) particular to each profession. profession.

Within this Code are added some Within this Code are added some professional rules professional rules (OIIQ c.1-8, r.4.1)(OIIQ c.1-8, r.4.1)

We have to be careful!

All those principles are listed in a professional Code of deontology which is

the equivalent of our Code of ethics.

We have to walk the line.

So if I understand, there is always a moral responsibility in our

actions...!!!???

And this responsibility is made explicit in our Code of Ethics…

But do we really need that in nursing??

It is absolutely essential!!!Is it not Mister Owl?

That is right, Kitty andfor many reasons…

We need ethics in nursingWe need ethics in nursing

the pressure for individual rights and thethe pressure for individual rights and theneed to find an optimal balance between need to find an optimal balance between individual rights and collective rights. individual rights and collective rights.

Because ofBecause of

the need to adapt our behaviour rulesthe need to adapt our behaviour rules to the constant changes in our society. the constant changes in our society.

We need ethics in nursingWe need ethics in nursing

Because ofBecause of

the evolution in mentalities and valuesthe evolution in mentalities and valuesinfluenced by social development and influenced by social development and the fast circulation of information. the fast circulation of information.

the progression of knowledge and the the progression of knowledge and the dehumanising progress of technology. dehumanising progress of technology.

But where can we apply that ?

Everywhere andalways???

Execution /protocols & technical applications/helping relationship

Assessment and

data/communication

Interpretation/nursing diagnosis

Decision making/planning

Evaluation

Care documentation

Ethics applies to all the steps of the

nursing process

It also applies to diverse nursing functions !!!

Ethics applies whateveryour professional status and

the type of your work…If you are a manager,

or work with patients in a hospital, in the community,

in research, or in teaching!!!

Ethics must really penetrate all Ethics must really penetrate all the actions of our lives, whether the actions of our lives, whether personal or professional, in personal or professional, in order to give all of us a just, order to give all of us a just, logical orientation. logical orientation.

Mister Wizard, is there a recipe for ethics?

Yes, serious thinking, and a few principles…

To continue…

63

End of the 1st part. Come and visit us for the 2nd

part…!

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