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E-raamat: Bioethics: A Nursing Perspective

(Independent Scholar; Formerly Professor of Nursing, School of Nursing and Midwifery, Faculty of Health, Deakin University, Victoria, Australia.)
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  • Ilmumisaeg: 15-Nov-2022
  • Kirjastus: Elsevier Australia
  • Keel: eng
  • ISBN-13: 9780729589949
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  • Formaat: EPUB+DRM
  • Ilmumisaeg: 15-Nov-2022
  • Kirjastus: Elsevier Australia
  • Keel: eng
  • ISBN-13: 9780729589949
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Now in its eighth edition, Bioethics: A Nursing Perspective provides practical guidance on the ethical issues you might come across in nursing practice, with real-world examples that help to bring this important subject to life.

Author Dr Megan-Jane Johnstone AO, Australia's foremost nursing ethics scholar, provides a comprehensive framework for negotiating the ethical challenges, obligations and responsibilities you might face. The text is engaging and easy to follow, and has been fully updated to reflect current issues in health care such as nurse practitioner assisted dying, pandemic ethics, and the moral costs of misinformation and medical conspiracy theories. .

This book is a suitable companion to the law and ethics components of both undergraduate and postgraduate nursing studies, and is relevant for all nurses who encounter ethical problems in their everyday practice.

  • Written in an engaging style
  • – suitable for undergraduate as well as postgraduate students and researchers
  • Focuses on prominent and topical ethical issues facing individual nurses as well as the broader profession
  • Covers a broad range of bioethical issues in health care and how these relate to various fundamental traditions in philosophical ethics
  • Real-life case studies and hypothetical scenarios to encourage debate
  • Covers hot topics in modern nursing practice, including:
  • Professional standards
  • How to make moral decisions
  • Cross-cultural ethics, including the problem of racism
  • Dehumanisation and vulnerable populations
  • Patient rights
  • Mental health care ethics
  • End-of-life care
  • Moral politics of abortion and euthanasia
  • Moral lessons of COVID-19

Additional resources on Evolve

eBook on VitalSource

  • Questions fostering critical reflection to support learning
  • Key points and new chapter groupings for easy navigation
  • New chapter on pandemic ethics
Preface xi
Acknowledgments xiii
List of abbreviations
xiv
SECTION 1 Foundations of Nursing Ethics and Professional Conduct
1 Professional Standards and the Requirement to be Ethical
3(7)
Introduction
3(7)
Unprofessional Conduct and Professional Misconduct
4(1)
Unethical Professional Conduct
4(2)
Questioning the Requirement to be Morally Exemplary
6(1)
Nursing as a Moral Project
6(1)
National and International Standards of Conduct
7(1)
Conclusion
8(2)
2 Ethics, Bioethics and Nursing Ethics: Some Working Definitions
10(20)
Introduction
10(20)
The Importance of Understanding Ethics Terms and Concepts
10(1)
The Need for a Critical Inquiry into Ethical Professional Practice
11(1)
Understanding Moral Language
11(1)
What is Ethics?
12(1)
What is Bioethics?
13(2)
What is Nursing Ethics?
15(1)
What Ethics is Not
16(1)
Law
16(2)
Codes of Ethics
18(2)
Codes of Conduct
20(1)
Hospital or Professional Etiquette
21(1)
Hospital or Institutional Policy
22(1)
Public Opinion, Populism or the View of the Majority
22(2)
Ideology
24(1)
Following the Orders of a Supervisor or Manager
25(1)
The Task of Ethics, Bioethics and Nursing Ethics
26(2)
Conclusion
28(2)
3 Moral Theory and the Ethical Practice of Nursing
30(27)
Introduction
30(27)
Moral Justification
31(1)
Theoretical Perspectives Informing Ethical Practice
32(1)
Ethical Principlism
33(1)
What are Ethical Principles?
33(1)
Autonomy
33(1)
Non-maleficence
34(1)
Beneficence
35(1)
Justice
36(2)
Moral Rules
38(1)
Problems with Ethical Principles
39(1)
Moral Rights Theory
40(1)
Moral Rights
40(1)
Moral Rights Based on Natural Law and Divine Command
40(1)
Moral Rights Based on Common Humanity
41(1)
Moral Rights Based on Rationality
41(1)
Moral Rights Based on Interests
41(1)
Moral Rights Based on Human Experiences of Grievous Wrongs
42(1)
Different Types of Rights
43(1)
Making Rights Claims
43(1)
Rights and Responsibilities
43(1)
Problems with Rights Claims
44(1)
Virtue Ethics
45(1)
The Notion of Virtue
46(1)
The Virtuous Person
47(1)
Virtue Theory, an Ethic of Care and Nursing Ethics
47(2)
Virtue Ethics and an Ethic of Care in Nursing - Some Further Thoughts
49(1)
Problems with Virtue Ethics
50(1)
Deontology and Teleology
50(1)
Deontology
50(1)
Teleology
51(1)
Moral Duties and Obligations
52(1)
Moral Duties
52(1)
Moral Obligations
53(1)
Clarifying the Difference Between Rights and Duties
53(1)
Limitations and Weaknesses of Ethical Theory
53(1)
Moral Justification and Moral Theory - Some Further Thoughts
54(1)
Conclusion
55(2)
4 Moral Problems in Nursing and Health Care Contexts
57(18)
Introduction
57(18)
Distinguishing Moral Problems from Other Sorts of Problems
57(2)
Identifying Different Kinds of Moral Problems
59(1)
Moral Unpreparedness/Moral Incompetence
59(1)
Moral Blindness
60(2)
Moral Indifference and Insensitivity
62(1)
Moral Disengagement
63(1)
Moral Fading/Ethical Fading
64(1)
Amoralism
65(1)
Immoralism
65(1)
Moral Complacency
66(1)
Moral Dumbfounding/Stupefaction
66(1)
Moral Fanaticism
67(1)
Moral Disagreements
67(2)
Moral Conflict
69(1)
Moral Dilemmas
69(2)
Moral Distress'
71(2)
Conclusion
73(2)
5 Moral Decision-Making in Nursing and Health Care Contexts
75(14)
Introduction
75(14)
Moral Decision-making -- a Working Definition
75(1)
Processes for Making Moral Decisions
76(1)
Reason and Moral Decision-Making
77(1)
Emotion and Moral Decision-making
78(2)
Intuition and Moral Decision-making
80(1)
Life Experience and Moral Decision-making
81(1)
Dealing with Moral Disagreements and Disputes
82(1)
Being Accepting of Different Points of View
83(1)
Everyday Moral Problems in Nursing
84(1)
Conclusion
85(4)
SECTION 2 Culture and Context
6 Cross-cultural Ethics and the Ethical Practice of Nursing
89(17)
Introduction
89(17)
Cross-Cultural Ethics and Nursing
91(1)
Culture and Its Relationship to Ethics
91(1)
The Nature and Implications of a Cross-Cultural Approach to Ethics
92(5)
Moral Diversity and the Challenge of Moral Pluralism
97(1)
Dealing with Problems Associated with a Cross-Cultural Approach to Ethics in Health Care
98(2)
Ethics, Cultural Competency, Cultural Safety and Cultural Humility
100(1)
Cultural Competency
100(1)
Cultural Safety
101(1)
Cultural Humility
102(1)
Conclusion
103(3)
7 Ethics, Dehumanisation and Vulnerable Populations
106(35)
Introduction
106(35)
Vulnerability
107(1)
Identifying Vulnerable Populations
107(1)
Vulnerability as a Guide to Action
108(1)
Vulnerability and Nursing Ethics
109(1)
Humanness, Dehumanisation and Vulnerability
109(1)
Humanness
109(1)
Dehumanisation
110(1)
Forms of Dehumanisation
110(1)
Explicit and Subtle Expressions of Dehumanisation
111(1)
Why Dehumanisation Occurs
112(1)
Consequences of Dehumanisation
112(1)
Deterring Dehumanisation
113(2)
Stigma
115(1)
Prejudice and Discrimination
116(1)
Disadvantage
117(1)
Identifying Vulnerable Individuals and Groups
117(1)
Older People
118(1)
Ageism
118(1)
Role of Nurses
119(1)
People with Mental Health Problems and Mental Illness
120(1)
Role of Nurses
121(1)
Immigrants and Ethnic Minorities
121(1)
Cultural Racism
122(1)
Role of Nurses
123(1)
Refugees, Asylum Seekers, Displaced People, Stateless People and Returnees
124(1)
Role of Nurses
124(1)
People with Disabilities
125(2)
Role of Nurses
127(1)
Indigenous Peoples
127(1)
Health Status of Australia's Indigenous Peoples
128(1)
Health Status of New Zealand Maori
128(1)
Global Call to Redress Indigenous Health Disparities
128(1)
Role of Nurses
128(1)
Prisoners and Detainees
128(2)
The Rights of Prisoners
130(1)
Role of Nurses
130(1)
Homeless People
131(1)
What is Homelessness?
132(1)
Causes of Homelessness
132(1)
Homelessness and the Right to Health
132(1)
Role of Nurses
133(1)
Sexual Minorities (LGBTIQA+ People)
133(2)
Role of Nurses
135(1)
Conclusion
136(5)
SECTION 3 Ethics in Practice
8 Patients' Rights to and in Health Care
141(24)
Introduction
141(24)
What are Patients' Rights?
142(1)
The Right to Health and Health Care
143(1)
The Right to Equal Access to Health Care
144(1)
The Right to have Access to Appropriate Care
145(1)
The Right to Quality Care
145(1)
The Right to Safe Care
146(1)
Challenges Posed by the Right to Health and Health Care
146(1)
The Right to Make Informed Decisions
147(1)
Informed Consent and the Responsibility of Nurses
147(1)
What is Informed Consent?
148(1)
The Analytic Components and Elements of an Informed Consent
148(1)
Informed Consent and Ethical Principlism
149(1)
The Right Not to Know
149(2)
Informed Consent and the Sovereignty of the Individual
151(1)
Paternalism and Informed Consent
151(1)
Is Paternalism Justified?
152(1)
Applying the `Paternalistic Principle' in Health Care
153(1)
Informed Consent and the Right to Refuse Nursing Care
153(1)
The Right to Confidentiality
154(1)
Confidentiality as an Absolute Principle
155(2)
Confidentiality as a Prima-facie Principle
157(1)
The Right to be Treated with Dignity
158(1)
What is Dignity?
158(1)
Dignity and the Right to Dignity
159(1)
Dignity Violations
160(1)
The Right to be Treated with Respect
161(1)
The Right to Cultural Liberty
162(1)
Conclusion
162(3)
9 Ethical Issues in Mental Health Care
165(25)
Introduction
165(25)
Human Rights and the Mentally Ill
167(2)
Recovery-Oriented Services
169(1)
Coercion and Competency to Decide
170(1)
Evidencing a Choice
171(1)
Reasonable Outcome of Choice
171(1)
Choice Based on `Rational' Reasons
171(1)
Ability to Understand
171(1)
Actual Understanding
171(5)
Psychiatric Advance Directives
176(1)
Striking a Balance Between Promoting Autonomy, Supporting Decision-Making and Preventing Harm
176(1)
Origin, Rationale and Purpose of Psychiatric Advance Directives
177(1)
Forms and Function of Psychiatric Advance Directives
177(1)
Anticipated Benefits of Psychiatric Advance Directives
178(1)
Anticipated Risks of Psychiatric Advance Directives
179(1)
Current Trends in the Legal Regulation of Psychiatric Advance Directives
179(1)
Ethical Issues in Suicide and Parasuicide
180(1)
Contemporary Definitions and Classifications of Suicide
180(1)
Social Media and Cybersuicide
181(1)
The Moral Challenge of Suicide
182(1)
Distinguishing Suicide from Euthanasia
183(1)
Ethical Dimensions of Suicide
183(1)
Autonomy and the Right to Suicide
183(3)
The Ethics of Suicide Prevention: Some Further Considerations
186(1)
Conclusion
187(3)
10 Ethical Issues in End-of-Life Care
190(24)
Introduction
190(24)
Not For Treatment (NFT) Directives
191(1)
The Problem of Treatment in Medically Hopeless' Cases
191(1)
Who Decides?
192(1)
Not For Resuscitation (NFR)/Do Not Resuscitate (DNR) Directives
193(2)
Issues Raised
195(1)
Problems Concerning NFR/DNR Decision-Making Criteria, Guidelines and Procedures
195(1)
Criteria and Guidelines Used
195(1)
The Exclusion of Patients from Decision-Making
196(1)
Misinterpretation of Directives
196(1)
Problems Concerning the Documentation and Communication of NFR/DNR Directives
196(1)
Problems Concerning the Implementation of NFR/DNR Directives
197(1)
Improving NFR/DNR Practices
197(1)
Medical Futility
198(3)
Quality of Life
201(1)
Origin of the Phrase
202(1)
Defining Quality of Life
202(1)
Why Defining Quality of Life is Difficult
202(1)
Different Conceptions of Quality of Life
203(1)
Using Quality-of-Life Considerations to Inform Treatment Choices
204(1)
Three Senses of Quality of Life
204(1)
Descriptive Sense of Quality of Life
204(1)
Evaluative Sense of Quality of Life
204(1)
Prescriptive Sense of Quality of Life
204(1)
Advance Directives
205(1)
What is an Advance Directive?
206(1)
How Do Advance Directives Work?
206(1)
Risks and Benefits of Advance Directives
206(2)
Advance Care Planning
208(2)
Respecting Patient Choices
210(1)
Rethinking `End-of-Life Care'
210(1)
Conclusion
211(3)
11 The Moral Politics of Abortion and Euthanasia
214(36)
Introduction
214(36)
Morality Policy
215(1)
Moral Politics
216(1)
Abortion
216(2)
What is Abortion?
218(1)
Arguments for and Against the Moral Permissibility of Abortion
219(1)
The Conservative Position
219(1)
The Moderate Position
219(2)
The Liberal Position
221(1)
Abortion and the Moral Rights of Women, Fetuses and Fathers
222(2)
Anti-Abortion Politics -- Will it Ever be Reconciled?
224(1)
Euthanasia
225(1)
Euthanasia/Assisted Suicide and its Significance for Nurses
225(1)
Definitions of Euthanasia, Assisted Suicide and Mercy Killing'
226(1)
Euthanasia
226(1)
Assisted Suicide
227(1)
Mercy Killing
228(1)
Views For and Against Euthanasia/Assisted Suicide
228(1)
Views in Support of Euthanasia/Assisted Suicide
228(2)
Counter-Arguments to Views Supporting Euthanasia/Assisted Suicide
230(2)
Specific Arguments Against Euthanasia/Assisted Suicide
232(7)
The Doctrine of Double Effect
239(1)
Palliative Sedation
240(1)
Definition, Purpose and Intention of Palliative Sedation
240(1)
Palliative Sedation in Existential Suffering
241(1)
Nurses' Attitudes and Experiences
242(1)
Withholding or withdrawing Clinically Assisted Nutrition and Hydration
242(2)
Position Statements and the Nursing Profession
244(1)
Taking a Partisan Stance
244(1)
Taking a Non-Partisan (Neutral) Stance
245(1)
The Need for a Systematic Response
246(1)
Conclusion
247(3)
12 Professional Judgment, Moral Quandaries and Taking `Appropriate Action'
250(26)
Introduction
250(26)
Moral Conflict and Professional Judgment
251(1)
Making `Correct' Moral Judgments
251(1)
Common Situations Involving Moral Conflict
252(1)
Professional Judgment
252(1)
The Nature and Moral Importance of Professional Judgment
253(1)
Conscientious Objection
254(1)
The US Case of Corrine Warthen
255(1)
The US Case of Frances Free
256(1)
The UK Case of Two Catholic Midwives
256(1)
The Nature of Conscience Explained
257(1)
Conscience as Moral Reasoning
257(1)
Conscience as Moral Feelings
257(1)
Conscience as Moral Reason and Moral Feelings
258(1)
How Conscience Works
258(1)
Bogus and Genuine Claims of Conscientious Objection
259(1)
Conscientious Objection to the Lawful but Morally Controversial Directives of an Employer/Manager
260(1)
Conscientious Objection and the Problem of Conflict in Personal Values
260(1)
Conscientious Objection and Policy Considerations
261(3)
Whistleblowing in Health Care
264(1)
The Moylan Case (Australia)
265(1)
The Pugmire Case (New Zealand)
266(1)
The Bardenilla Case (USA)
266(1)
The MacArthur Health Service Case (Australia)
266(1)
The Bundaberg Base Hospital Case (Australia)
267(1)
The Notion of Whistleblowing/Whistleblowers
268(1)
The Act of Whistleblowing
269(1)
Deciding to `Go Public'
269(1)
Risks of Whistleblowing
269(1)
Whistleblowing and Clinical Risk Management
270(1)
Whistleblowing in the Context of the COVID-19 Pandemic
271(1)
Whistleblowing as a Last Resort
272(1)
Preventing Ethics Conflicts
272(1)
The Ethics-Quality Linkage
272(1)
Appropriate Disagreement
273(1)
Conclusion
273(3)
13 Professional Obligations to Report Harmful Behaviours: Risks to Patient Safety, Child Abuse and Elder Abuse
276(23)
Introduction
276(23)
Reporting Notifiable and Health-Impaired Conduct of Practitioners and Students
277(1)
Legal Requirements to Report Wrongdoing
277(2)
Professional Requirements to Report Wrongdoing
279(1)
`No Blame' Culture and Patient Safety
280(1)
Nurses' Attitudes to Peer Reporting of Poor Care and Behaviour
281(1)
Interpersonal Relationships, Patient Safety and the Question of Loyalty
282(1)
Reporting Child Abuse and Elder Abuse
283(1)
Child Abuse and Neglect
284(1)
Defining Child Abuse
284(1)
Redressing Child Abuse
285(1)
Elder Abuse and Neglect
285(1)
Defining Elder Abuse
286(1)
Redressing Elder Abuse
287(1)
Ethical Issues Associated with Protecting Children and Elderly People from Abuse
287(1)
Why the Maltreatment of Children and Elderly People Constitutes a Moral Issue
287(1)
The Ethical Implications of Maltreating Children and Elderly People
288(1)
The Moral Demand to Report Child and Elder Maltreatment
288(1)
The Notion of Harm and its Link with the Moral Duty to Prevent Child and Elder Abuse
289(1)
Considerations Against Reporting the Maltreatment of Children and Elderly People
289(1)
The Professional--Client Relationship
290(1)
Families
291(1)
Maltreated Children and Elderly People
291(1)
Response to the Criticisms
292(1)
The Problem of Maintaining Confidentiality
292(1)
The Problem of Being `the Arm of the State'
293(1)
Preserving the Integrity of the Professional--Client Relationship
294(1)
Upholding the Interests of Families
294(1)
The Importance of a Supportive Socio-Cultural Environment in Abuse Prevention
294(1)
Conclusion
295(4)
SECTION 4 Nursing Ethics Futures -- Challenges in the 21st Century and Beyond
14 Pandemic Ethics
299(21)
Introduction
299(21)
The COVID-19 Pandemic
300(1)
Ethical Imperatives
301(1)
Impact on the Nursing Profession
302(1)
A Question of Nursing Ethics
303(1)
The `Duty to Care'
304(1)
The Duty to Care Dilemma
304(1)
Nurses' Duty to Care
304(2)
The Willingness to Respond
306(1)
The Duty of the Public and the Value of Solidarity
307(1)
Solidarity Ethics
307(1)
Solidarity Derelictions
308(1)
The Bogus `Right' not to Wear a Mask
308(1)
De-prioritising Those Who have Forfeited their Rights
308(1)
Encouraging Solidarity
308(1)
The Moral Costs of Making Tragic Choices
309(1)
The Nature of Tragic Choices
309(1)
Guidelines and Protocols
309(1)
The Moral Costs of Medical Conspiracy Theories
310(1)
Medical Conspiracism and the Nursing Profession
311(1)
Responding to Medical Conspiracism
312(1)
Vaccine Ethics
313(1)
Vaccine Equity
314(1)
Vaccine Hesitancy
315(1)
Conclusion
316(4)
15 Ethics and Public Health Emergencies: Climate Change, Antimicrobial Resistance, Health Inequities and Emergency Preparedness
320(12)
Introduction
320(12)
Public health emergencies
321(1)
Crisis Standards of Care
322(1)
Climate Change
322(2)
Antimicrobial Resistance
324(2)
Inequalities in Health and Health Care
326(2)
Emergency Preparedness
328(1)
Conclusion
329(3)
Bibliography 332(65)
Index 397