What is Ethics? - Answers "A branch of philosophy that deals with questions of right and wrong
and of ought and ought not in our interactions with others"
Ethics is relevant in all aspects of care
Extends beyond the "big ticket" items that we often think of
Canadian Nurses Association (CNA) Code of Ethics - Answers "Provides guidance for ethical
relationships, behaviours and decision-making"
Nurses are to practice in accordance to the Code of Ethics
CNA Code of Ethics and Palliative Care - Answers Nurses:
Work to relieve pain and suffering
Allow patients to live and die with dignity
Encourage patients to discuss their wishes and goals
Provide a palliative approach to care throughout the lifespan and illness trajectory
Principles of Ethics - Answers Autonomy: ensuring the informed patient's right to participate in
medical desicion making
Beneficence: clinicians act in the best interests of their patients
Nonmaleficence: do no harm
,Justice: all people are to be treated well and fairly, and also that health resources be used
equitably
Ethical Dilemma - Answers When we:
Know what the issue is
Know what the two competing courses of action are
Understand that choosing one course of action means that we cannot pursue the other...
Ethical Distress - Answers When we:
Know what the issue is
Know or believe to know what course of action to take
Cannot take that action due to barriers
Sources of Ethical Distress - Answers Causing harm to patients
Treating patients as objects
Constraints related to policy
Inadequate staffing levels
Issues related to resources
Consequences of Ethical Distress - Answers Negative emotions and behaviours:
, Frustration, Anger, Guilt, Anxiety, Self-blame
Ultimately can lead to burnout
Decision Making for Minors in Canada - Answers How might the patient's age affect the
provision of care?
In Canada: "Concept" of maturity" rather than chronological age
Assessment of capacity is made on a case by case basis
Exception: MAiD
Potential Scenarios that Might Cause Ethical Challenges - Answers Do not resuscitate,
Withdrawing or withholding treatment, Pain management at the end of life, Requests from
families to withhold information, Palliative sedation, Assisted dying, Artificial nutrition and
hydration
Principle of Double Effect - Answers An action that has two distinct effects:
One anticipation and wanted, Another that is anticipated but unwanted
The intent is key
For example, aggressive pain control at the end of life
Palliative Sedation - Answers Use of medications, titrated (often high doses) to control
intractable symptoms, such as:
Pain, Shortness of breath, Suffering
The intent is NOT to hasten death
Medical Assistance in Dying (MAiD) - Answers MAiD occurs when an authorized healthcare
provider provides or administers medication that causes the individual's death