ETHICO-MORAL & LEGAL FOUNDATIONS OF CLIENT EDUCATION

INTRODUCTION

‣ Programs of study for Health Professionals, provide formal ethics education

‣ Healthcare providers who commit ethical infractions while in training or practice
may be referred for ethics remediation by their programs
‣ But every day, far from the spotlight, nursing students, nursing staff and clinical
instructors confront commonplace and causing ethical dilemmas

A Differentiated View of Ethics, Morality & the Law

- The complexities of contemporary life and the heightened awareness of an

educated public, ethical issues related to health care have surfaced as a major concern of
health care providers

- It is now a widely held belief that the patient has the right to know his or her:
✓ Medical diagnosis
✓ Treatments available
✓ Expected outcomes

ETHICS

- Refers to the guiding principles of behavior

✴ Ethical — Refers to norms or standards of behavior accepted by society to which a
person belongs

❖ Ethical Dilemmas — Specific type of moral conflict in w/c two or more ethical
principles apply but support mutually inconsistent course of action

MORALITY

- Expressed externally through a person’s behavior

✴ Moral Values — Refer to an internal belief system (what one believes to be right)

LEGAL RIGHTS AND DUTIES

- Refer to rules governing behavior or conduct that are enforceable by law under
threat of punishment or penalty such as a fine, imprisonment or both

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- By law, the teaching role of nurses is legally mandated in the rules and standards
of the Nurse Practice Act and the state board of nursing that exist and where the nurse
resides and is employed

- Nurse Practice Act — Document that define a profession, describe the profession’s
scope of practice, and provide guidelines, entry into a profession via licensure and
disciplinary actions that can be taken when necessary

★ Why do we have Nurse practice Acts

- It is developed to:
✓ Protect the public from unqualified practitioners
✓ Protect the professional title (e.g., RN, MT, PT, OT, RT, etc.)

Evolution of Ethical and Legal Principles

✴ Ethical Codes — Systematic guides for developing ethical behavior. This represents an
articulation of nine provisions for professional values and moral obligations with respect
to nurse- patient relationship.

❖ CODE OF ETHICS
1. Service to others
2. Integrity and objectivity
3. Professional competence
4. Solidarity and teamwork
5. Social civic responsibility
6. Global competitiveness
7. Equality of all professions

✴ Patient’s Bill of Rights — a statement of the rights to which patients are entitled as
recipients of medical care were created and has been framed and posted in every health
care facility.

✓ Right to appropriate medical care and humane treatment

✓ Right to informed consent
✓ Right to privacy and confidentiality
✓ Right to information
✓ Right to choose health care provider and facility
✓ Right to self determination
✓ Right to religious belief

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✓ Right to medical records
✓ Right to leave
✓ Right to refuse participation in research
✓ Right to receive visitors
✓ Right to express grievances
✓ Right to be informed of his rights & obligations

Application of Ethical Principles to Patient Education

- In considering the ethical and legal responsibilities inherent in the process of
patient education, nurses and nursing students can turn to a framework of six major
ethical principles.

6 MAJOR ETHICAL PRINCIPLES

✴ Autonomy — Right to self determination

✴ Veracity — Truth telling, linked to informed decision-making and informed consent
✴ Confidentiality —Personal info that is entrusted and protected as privileged info via
social contract, health care standard or code or legal covenant
✴ Nonmaleficence — Defined as do no harm and refers to the ethics of legal
determination involving negligence and/or malpractice
✴ Beneficence — Defined as doing good for the benefit of others
✴ Justice — Speaks to fairness and the equitable distribution of goods and services

SITUATIONS — ETHICAL PRINCIPLES

- Identify the major ethical principle related with each given situation:

✴ You are working in a government hospital in this time of pandemic because of COVID-
19, allocation of the PPE’s and other medical resources are distributed and allocated based
on social worth, moral goodness, and economic condition in all government hospital.
Which ethical principle is exhibited by the government?

✴ A nurse volunteers in the hospital to help patients in this time of crisis (COVID-19),
knowing the risks and continues to work to save lives and relieve human suffering. Which
ethical principle is the being shown by the nurse?
✴ A group of student nurses are conducting a case study to be presented in the classroom
and patients’ information and name was not revealed by the group during the
presentation. The student nurses exhibited what ethical principle?

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★ What is the distinction between anonymous and confidential

- Info is anonymous, for example when researchers are unable to link any subject’s
identity in the medical record of that person
- Info is confidential when identifying materials appear on subject’s records but can
be accessed only by the researchers

- Only under special circumstances may secrecy be ethically broken, such as when
the patient has been the victim or subject of a crime to which the nurse or a doctor is a
witness

- Other exceptions to confidentiality occur when nurses/other health professionals

suspect or are aware of child or elder abuse or narcotic abuse, gunshot, or threat of
violence toward someone

The Ethics of Education in Classroom & Practice Setting

THE STUDENT-TEACHER RELATIONSHIP

- What ought to be done or how health professionals behave in the education of
students for the health professions?

✓ Trust and respect

✓ Balance of power exists bet. the teacher (expert)and the student (novice)
✓ Key to student’s academic success = teacher possesses discipline specific expertise

✴ Students must be able to trust their teachers and believe that instruction provided by
them will be:

Accurate Appropriate Up to date

Legality of Patient Education and Information

- The patient’s right to adequate information regarding his or her physical condition,
medications, risks, and access to information regarding alternative treatments is
specifically spelled out in the Patient’s bill of rights.

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PROFESSIONAL STANDARDS

- Physicians are responsible and accountable for proper patient education

- However, the nurse is an appointed designee that often carries out patient
education

- Patient education — central to the culture of nursing as well as to its legal practice

✴ It is true that patient education is not necessarily one of omission in anyone’s part but
rather the heart of the matter may be proper documentation that teaching has been done.

“You will never attain integrity if you lack the courage to stand up for what you believe is
right.”
— Husam Wafaei

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