NURS 3510 Final Test
What is Ethics? ANS: "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 ANS: "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 ANS: 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 ANS: 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 ANS: 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 ANS: 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 ANS: Causing harm to patients
Treating patients as objects
,Constraints related to policy
Inadequate staffing levels
Issues related to resources
Consequences of Ethical Distress ANS: Negative emotions and behaviours:
Frustration, Anger, Guilt, Anxiety, Self-blame
Ultimately can lead to burnout
Decision Making for Minors in Canada ANS: 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 ANS: 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 ANS: 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 ANS: 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) ANS: MAiD occurs when an authorized healthcare provider provides
or administers medication that causes the individual's death
Must occur at the request of the individual
The individual must meet critters including:
Have a serious and incurable illness, disease or disability; In advanced state of decline; Suffering
unbearably; 18 or over; Informed consent; Make a voluntary request (without outside influence)
Palliative care does not aim to hasten death BUT important to remember our roles as nurses
Good communication!
Resources are available:
MAID Guidelines for Manitoba Nurses; The provincial MAID team
Requests from Family to Withhold Information ANS: Empathy
What is Ethics? ANS: "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 ANS: "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 ANS: 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 ANS: 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 ANS: 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 ANS: 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 ANS: Causing harm to patients
Treating patients as objects
,Constraints related to policy
Inadequate staffing levels
Issues related to resources
Consequences of Ethical Distress ANS: Negative emotions and behaviours:
Frustration, Anger, Guilt, Anxiety, Self-blame
Ultimately can lead to burnout
Decision Making for Minors in Canada ANS: 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 ANS: 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 ANS: 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 ANS: 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) ANS: MAiD occurs when an authorized healthcare provider provides
or administers medication that causes the individual's death
Must occur at the request of the individual
The individual must meet critters including:
Have a serious and incurable illness, disease or disability; In advanced state of decline; Suffering
unbearably; 18 or over; Informed consent; Make a voluntary request (without outside influence)
Palliative care does not aim to hasten death BUT important to remember our roles as nurses
Good communication!
Resources are available:
MAID Guidelines for Manitoba Nurses; The provincial MAID team
Requests from Family to Withhold Information ANS: Empathy
