The Ethical Component of Nursing Education

Unit 1Components of Clinical Ethics 1xii ContentsChapter 5 Ethical Decision-Making 85Marcia BosekEthical Decision-Making 86Ethical Decision-Making Goals 87Realities in Decision-Making 88Ethical Decision-Making Using theNursing Process 89Decision Analysis Model 92Resources for Facilitating EthicalDecision-Making 93Chapter 6 Confidentiality 103Marcia BosekConfidentiality Defined 104Rationale for Keeping Information Confidential 104What Information Is Confidential? 106Who Can Access Confidential Information? 107Chapter 7 Truth-Telling 113Marcia BosekThe Importance of Truth-Telling 114The Obligation to Tell the Truth 115Discriminating Between Truth and Nontruth 115Chapter 8 Advocacy 125Teresa SavageWhat Is Advocacy? 126The Call to Advocacy 127The Strength to Advocate 127Relationships Between Health Care Professionals 129Uncertainty, Dilemma, and Distress 131Learning How to Advocate 133Advocacy for the Profession 133Chapter 9 Allocation of Resources 139Teresa SavageJustice in Health Care 140The U.S. Health Care System 140Unit 2Ethical Themes and Research Ethics 101Access to Care 143Managed Care 143What to Do? 146Nurses Role in Macro Allocation 147Nurses Role in Micro Allocation 148Special Topic:: Using Research in Resource Allocation 154Chapter 10 Research Ethics 159Teresa SavageEthical Themes 160History of Research Ethics 162Institutional Review Boards 165Informed Consent 167Contents xiiiChapter 11 Nursing of Children and Adolescents 183Teresa SavageSection 1:: Ethical Themes:: Building From the Basic to the Complex 184Truth-Telling 184Confidentiality 185Advocacy 188Allocation of Resources 194Section 2:: Decision-Making 203Surrogate Decision-Making 203Section 3:: The Moral Status of Children 208Personhood 209Section 4:: Genetics 215Eugenics 215Genetic Testing 216Linkage Analysis 218Implications for the Family 218Newborn Screening 219Chapter 12 Nursing of the Adult 225Marcia BosekSection 1:: Ethical Themes:: Building From the Basic to the Complex 226Confidentiality 226Truth-Telling 228Unit 3Clinical Ethics Issues 181Advocacy 231Allocation of Resources 232Section 2:: Nursing of the Adult:: Advance Directives 235Autonomy 235Before the Advent of Advance Directives 237Other Life-Saving Interventions 238The Patient Self-Determination Act of 1990 240Advance Directives 241Values Clarification 242Do Not Resuscitate Orders 255The Nurses Role 257Section 3:: Nursing of the Adult:: End-of-Life Choices 260Autonomy and End-of-Life Choices 261Section 4:: Nursing of the Adult:: Adult-Onset Genetic Issues 269Ethical Issues of Presymptomatic Diagnosis 269Actions That Promote Informed Consent 271Special Topic:: Medical Directive Project 273Special Topic:: Its Over, Debbie 274Chapter 13 Womens Health Nursing 281Teresa SavageSection 1:: Ethical Themes:: Building From the Basic to the Complex 282Confidentiality 282Truth-Telling 283Advocacy 285Allocation of Resources 286Section 2:: Informed Decision-Making 290Balancing Maternal and Fetal Interests 290Pregnancy and HIV 291Mandatory Bed Rest 292Pregnancy and Delivery 292Contraception 293Abortion 294Sterilization 295Complementary and Alternative Medicine (CAM) 296Menopause 297Caregiver Burden 297Section 3:: Assisted Reproduction 299Infertility 299Assisted Reproduction 299Fetal Surgery 303xiv ContentsSection 4:: Genetics in Womens Health 304Genetics 304Prenatal Testing 305Chapter