Fundamentals of Nursing and Midwifery 2e

Chapter 11 Values, ethics and advocacy

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BOX 11-4 Ethics resources

The following organisations provide ethics resources for healthcare professionals: Australasian Association of Bioethics and Health Law http://aabhl.org Members are professionals interested in the relationship between law, bioethics, healthcare, public health, and global health governance. Australian Health Ethics Committee: National Health and Medical Research Council (NMHRC) www.nhmrc.gov.au/about/committees-nhmrc/australian-health-ethics-committee-ahec This federal committee considers ethical inquiries and guidelines surrounding human health and research. Centre for Human Bioethics http://artsonline.monash.edu.au/bioethics The Centre for Bioethics conducts research into many aspects of bioethics, including reproductive ethics and end- of-life decision making. Department of Health and Ageing, Australian Government www.health.gov.au/internet/main/publishing.nsf/Content/ageing-decision-restraint.htm Decision-making tool: Responding to issues of restraint in aged care. This document has been developed to assist staff and management in residential aged-care facilities to make informed decisions relating to the use or non-use Medical Research Council Good Practice for Researchers Guide (UK) www.mrc.ac.uk/Utilities/Documentrecord/index.htm?d=MRC002415 Guides for ethical policy research and development. National Reference Center for Bioethics Literature http://bioethics.georgetown.edu A U.S.-based specialised collection of library resources concerned with contemporary biomedical issues in the fields of ethics, philosophy, medicine, nursing, science, law, religion and the social sciences. New Zealand Health and Disability Ethics Committees http://ethics.health.govt.nz This site provides information for researchers and study participants about ethical review processes in New Zealand. St James Ethics Centre www.ethics.org.au This centre offers independent advice, reference material and counselling on ethical decision making. of restraint when responding to behaviours of concern. Management Support Unit (MSU) www.ncoss.org.au/msu This unit offers frameworks for ethical decision making in community development.

Assess the situation (gather data) Recognise and then describe the situation and contextual factors that give rise to the ethical problem. This involves the main people involved (their views and interests); the person’s overall nursing, medical and social situation; and relevant legal, administrative and staff considerations. Identify the ethical problem State the problem clearly. Identify your relationship to the decision. Identify time parameters. Make sure that the problem is an ethical problem as opposed to a communi- cation or legal problem. Some suggest that, whenever human dignity is being threatened, you have an ethical problem. Plan Identify options and explore the probable short-term and long-term consequences for each stakeholder. Use ethical reasoning to decide on a course of action that you can justify

ethically. Decide on the course of action you are best able to support. Consultation with a respected and wise colleague or an institutional ethics committee may be helpful at this point. Implement your decision Implement your decision and compare the outcome of your action with what you considered and hoped for in advance. Evaluate your decision What have you learned from this process that will help you in the future? How can you improve your reasoning and decision making in the future?

Ethically relevant considerations Balance between benefits and harms in patient care

Nurses and midwives are superbly positioned to contribute to reasoning about what counts as the benefits or burdens