Ethical Decision Making and Data Protection in Healthcare: A Focus on Nursing, Schemes and Mind Maps of English

Download Ethical Decision Making and Data Protection in Healthcare: A Focus on Nursing and more Schemes and Mind Maps English in PDF only on Docsity!

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117

Big Picture IV. ETHICAL CONSIDERATION IN LEADERSHIP AND

MANAGEMENT & ETHICAL ISSUES RELATED TO TECHNOLOGY

IN THE DELIVERY OF HEALTH CARE

Week 6-8: Unit Learning Outcomes (ULO): At the end of the unit, you are expected to:

a. Explain terms such as Discernment, well- formed conscience, Ethical dilemma. b. Discuss the strategies of moral decision making process. c. Discuss the importance of privacy data act in health care. d. Explain the International Code of ethics for nurses and code of ethics for Filipino nurses.

Big Picture in Focus: ULO 4. Explain the Ethical Consideration In

Leadership And Management & Analyze Ethical Issues Related

To Technology In The Delivery Of Health Care

Metalanguage

Discernment - is the ability to obtain sharp perceptions or to judge

well (or the activity of so doing).

Moral decision making - is the ability to produce a reasonable and defensible

answer to an ethical question.

Ethical Dilemma - is a complex situation where ethical principles or values

Ethical decision making

are in conflict.

• is a cognitive process that considers various ethical

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 principles, rules, and virtues or the maintenance of relationships to guide or judge individual or group decisions or intended actions.

Co-worker - Other nurses and other health and non-health related

workers and professionals.

Collaborative relationship - A professional relationship based on collegial and

reciprocal actions and behaviour that aims to achieve certain jointly agreed goals.

Personal information - Information obtained during professional contact that is private

to an individual or family, and which, when disclosed, may violate the right to privacy, cause inconvenience, embarrassment, or harm to the individual or family.

Related groups - Other nurses, health care workers or other professionals

providing service to an individual, family or community and working toward desired goals.

Essential Knowledge

Ethical Consideration in Leadership and Management A. Moral Decision Making

1. Principle of Moral Discernment
   • Is rooted in the understanding that God is ever at work in one’s life, “inviting, directing, guiding and drawing one” into the fullness of life”. It presupposes an ability to reflect on the ordinary events of one’s life, a habit of personal prayer, self – knowledge, knowledge of one’s deepest desire and openness to God’s direction and guidance
   • In the case of judgement, discernment can be psychological, moral or aesthetic in nature. Within judgment, discernment involves going past the mere perception of something and making nuanced judgments about its properties or qualities.
   • Considered as a virtue, a discerning individual is considered to possess wisdom, and be of good judgement; especially so with regard to subject matter often overlooked by others.
   • Discernment can be scientific (that is discerning what is true about the real world), normative (discerning value including what ought to be) and formal (deductive reasoning).

A Framework for Ethical Discernment

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Retrieved from: Appendix I of the Health Ethics Guide (2nd^ edition) printed in 2000 by the Catholic Health Alliance of Canada, Catholic Health Association of Canada.

2. Principle of Well-Formed Conscience

✓ indicates that people are obligated to inform themselves about ethical norms, incorporate that knowledge into their daily lives, act according to that knowledge, and take responsibility for those actions. ✓ Conscience is a judgment of reason whereby the human person recognizes the moral quality of a concrete act that he is going to perform, is in the process of performing, or has already completed. In all he says and does, man is obliged to follow faithfully what he knows to be just and right. It is by the judgment of his conscience that man perceives and recognizes the prescriptions of the divine law. (Catechism of the Catholic Church 1778.

3. Strategies of Moral Decision- Making Process

Ethical Decision Making Process

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)3 00 - 5456/300-0647 Local 117 Retrieved from: https://www.slideshare.net/cokyfauzialfi/ethical-decision-making-process

B. Meaning and Service Value of Medical Care

1. Allocation of Health Resources

The allocation of healthcare resources involves distributing health-related materials

and services among various uses and people. The concept of allocation can imply that

a designated individual or group is responsible for each level of decision making within

a system that is designed to distribute fixed amounts of resources.

Healthcare allocations are commonly classified in terms of two levels of

decision making:

1. Microallocation focuses on decisions regarding particular persons.

✓ It often involves "patient selection": determining which patients among those who

need a particular scarce resource, such as a heart transplant, should receive

treatment.

✓ microallocation entails deciding for an individual patient which of several

potentially beneficial treatments to provide, particularly when only a limited

time is available for treatment.

2. Macroallocation, on the other hand, entails decisions that determine the amount of

resources available for particular kinds of healthcare services.

✓ Macroallocation decisions include how particular health-related institutions such

as hospitals or government agencies budget their spending (sometimes referred

to as mesoallocation).

✓ Macroallocation also encompasses the decisions a nation makes concerning

what resources to devote to particular institutions or, more broadly, to high-

technology curative medicine as opposed to, for example, research or

primary and preventive care.

Major Macroallocation Standards

1. the individual's claim to healthcare,

2. the community's responsibility for healthcare, and

3. the importance of efficiency in healthcare.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117

https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-

and-maps/healthcare-resources-allocation-i-macroallocation

2. Issues Involving Access to Care

✓ High cost of care.

✓ Inadequate or no insurance coverage.

✓ Lack of availability of services. Lack of culturally competent care.

These barriers to accessing health services lead to:

• Unmet health needs.
• Delays in receiving appropriate care.
• Inability to get preventive services.
• Financial burdens.
• Preventable hospitalizations.

VI. ETHICAL ISSUES RELATED TO TECHNOLOGY IN THE DELIVERY OF

HEALTH CARE

A. Data Protection and Security Data Privacy Act 2012 (RA 10173 series of 2012) An act protecting individual personal information in information and communications systems in the Government and the private sector, creating for this purpose a National Privacy Commission, and for other purposes”

KEY ROLES IN THE DATA PRIVACY ACT

Data Subjects

• refers to an individual whose, sensitive personal, or privileged information is processed personal
• controls the processing of personal data, or instructs another to process personal data on its behalf.
• organization or individual whom a personal information controller may outsource or instruct the processing of personal data pertaining to a data subject
• responsible for the overall management of compliance to dpa National Privacy Commission
• independent body mandated to administer and implement the dpa of 2012, and to monitor and ensure compliance of the country with international standards set for personal data protection Rights of the Data Subject ✓ RIGHT TO INFORMATION ✓ RIGHT TO OBJECT ✓ RIGHT TO ACCES ✓ RIGHT TO CORRECT ✓ RIGHT TO REMOVE ✓ RIGHT TO FILE COMPLAINT

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Rights Not Applicable if:

• Processed information used needed for scientific and statistical research
• Gathered for investigations relating to any criminal, administrative or tax liabilities of a data subject Main Principles that govern the approach for the Data Privacy Act

Principles that govern the approach for the Data Privacy Act

Principle of Transparency A data subject must be aware of the nature, purpose, and extent of the processing of his or her personal data, including the risks and safeguards involved, the identity of personal information controller, his or her rights as a data subject, and how these can be exercised. Any information and communication relating to the processing of personal data should be easy to access and understand, using clear and plain language. Principle of Legitimate Purpose

• The processing of information shall be compatible with a declared and specified purpose , which must not be contrary to law, morals, or public policy. Principle of Proportionality The processing of information shall be adequate, relevant, suitable, necessary , and not excessive in relation to a declared and specified purpose. Personal data shall be processed only if the purpose of the processing could not reasonably be fulfilled by other means. DATA PROCESSING AND CONSENT Consent is REQUIRED prior to the collection of all personal data. ✓ The data subject must be informed about the extent and purpose of processing ▪ For the “automated processing of his or her personal data for profiling, or processing for direct marketing, and data sharing” ▪ For sharing information with affiliates or even mother companies ✓ Must be “freely given, specific, informed,” and must be evidenced by recorded means

Classification of Personal Data

Personal Information

• Refers to any information whether recorded in a material form or not, from which the identity of an individual is apparent or can be reasonably and directly ascertained by the entity holding the information, or when put together with other information would directly and certainly identify an individual
• Refers to personal information about an individual’s: ❑ race, ethnic origin, marital status, age, color, religious, philosophical or political affiliations, health, education, genetics, sexual life, any proceeding for any offense committed or alleged to have been committed, the disposal of such proceedings, the sentence of any court in such proceedings;

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300- 06 47 Local 117 ❑ Also includes information issued by government agencies peculiar to an individual which includes, but not limited to: ❑ social security numbers, previous or current health records, licenses or its denials, suspension or revocation, and tax returns Personal Information Sensitive Personal Privileged Information Information (List based on IRR) Name Race Data received within the context of Address Ethnic origin a protected relationship - husband Place of work Marital status and wife Telephone number Age Gender Color Data received within the context of Location of an individual at a Religious affiliation a protected relationship - attorney particular time and client IP address Philosophical Affiliation Birth date Political Affiliation Birth place Health Data received within the context of Country of citizenship Education a protected relationship - Priest Citizenship status Genetics and penitent Payroll & benefits information Sexual life Proceeding for any offense Data received within the context of committed or alleged to have a protected relationship - doctor Contact information been committed, the disposal and patient of such proceedings, the sentence of any court in such proceedings Social security number Licenses or its denials, suspension or revocation Tax returns Other personal info issued by government agencies Bank and credit/debit card numbers Websites visited Materials downloaded Any other information reflecting preferences and behaviours of an individual Grievance information Discipline information Leave of absence reason

Health Insurance Portability And Accountability Act (HIPAA)

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117

• One of the most recent developments in PATIENT CONFIDENTIALITY has been addressed through HIPAA(1996)
• Every medical office needs to provide a notice of privacy practices to every patient(signed and in the patient’s chart) This has the following SIX COMPONENTS : ✓ How a patient’s protected information is used and disclosed ✓ The provider's duties to protect the patient privacy ✓ Written notice of the provider’s practices to ensure each patient’s privacy ✓ The term of the provider’s notice ✓ The patient’s individual right concerning protected health information ✓ How to contact the office to obtain further information or to file a complaint B. Benefits and Challenges of Technology The impact of technology on healthcare includes three main areas:

1. quality of human life,
2. healthcare jobs, and
3. the world economy. ✓ Among the advantages of technology in healthcare we can also count the decline in preventable death cases, along with a general improvement of patient well-being. ✓ Treatment and recovery time have been reduced significantly. https://aimseducation.edu/blog/benefits-of-technology-in-healthcare

Technology and Nursing:

New developments that combine technology and nursing are known as telehealth and telemedicine. Telehealth - is a newer nursing career path that allows nurses to deliver exceptional patient care in a “hands-off way.” allows people to get healthcare advice, medication, and some treatment from a distance. “tele” means “at a distance,” which means that telemedicine is medical care that comes from a distance or away from the office. Telenursing - is defined as “the use of technology to deliver nursing care and conduct nursing practice.” Advantages of Technology in Nursing

1. Improved Communication Leading to Improved Patient Care:
2. Better Education:
3. Improved Treatment:
4. Better Kept Records: Electronic Health Record allow healthcare professionals to keep track of patient stats and data in a simple and accurate way, leading to fewer medical error and better quality

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 patient care. Information is saved securely and easily accessible, making it simple to find certain data, notice patterns, and more. Disadvantages of Medical Technology:

1. Increased Cost of the Treatment for the Patients: Mostly all the treatments and surgeries through the technology are very costly, like robotic surgery, and another kind of technological machinery surgeries. Technology increased health care but also increased the cost of that. Which is impossible for the patients to pay.
2. Show Wrong Result of the Patients condition: One of the cons of medical technology is sometimes the machinery or technological devices show the wrong result. Sometimes it didn’t show the accurate result of the patients to the doctor. The technological machines are made by engineers and programmers. Sometimes the errors and bugs come in it. Then it didn’t work properly. If it shows the wrong result and the doctor gives the wrong diagnosis to the patients then it takes the patient’s life into danger. This is one of the most dangerous cons of medical technology for the patients.
3. Lack of Information of the Patients: Lack of information is also the disadvantage of medical technology. Safety and privacy are some of the laws of hospitals.to protect the patient’s privacy. But by technology, this law can be a break. The information of the patients which are stores in the computer database of the hospitals can be a leak. The computer systems can be a hack and the secret information about the patient’s treatment can be stolen and also can be changed. If someone changes the complete history of the patient’s treatments. So, it can be a danger for the patient’s next treatments.
4. Time-Consuming in Recovery: The technological machines and gadgets which are used in the hospital for treatments and checkups of the patients are made by the engineers and programmers. If there come some kind of faults and errors, and no one can fix it because they didn’t have the knowledge of recovering and fixing that machine. It required the specific person who has knowledge of it. The engineers who made it can fix it. It consumes a lot of time fixing and recovering the machines.
5. Damaging Cells and Organs of the Body of the Patients: Now a day’s lasering surgeries are very famous. Which has a lot of bad effects on the human body. The lasers can damage the cells of the body. It can damage other internal organs in the body, which is very harmful,
6. Patients Online Treatment Through Technology: Nowadays the doctors do online treatments. The patients contact them online and the suggest the diagnosis to take. The patients have not to go to the clinic of the doctors. They can easily get the treatment at home. Without any checkup and analysis of the patient’s the doctor gives them the diagnosis. Which can be wrong and can be dangerous for the patient’s health.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117

7. Automatic Machine Treatment: There is a kind of machine which is fixed in the patient’s body. It analyzes the patient’s body and inserts the medicines in patients’ bodies according to their body conditions. These machines are made by programming in their programming if there come some errors and bugs. Then it is very harmful to the patients because it can insert the wrong diagnosis in the patient’s body. Which causes the critical condition and death of the patient. What are Ethical Issues in Healthcare? A standard approach to health ethics, developed by Tom L. Beauchamp and James F. Childress, often refers to the following four basic principles when evaluating the merits and difficulty of a medical procedure:

• Autonomy: Determine the wishes of the patient to protect their autonomy.
• Justice: Follow the due process to determine limits on healthcare and treat patients alike.
• Beneficence: Seek the patient’s best interest and assess what counts as goods to be pursued
• Non-maleficence: Determine what counts as harms to avoid. ❖ These principles can help healthcare professionals identify ethical dilemmas and find solutions by having conversations with patients about their needs and desires. **Ethical Issues in Healthcare

1. Do-Not-Resuscitate Orders** A Do-Not-Resuscitate (DNR) order is written by a doctor and it instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient stops breathing or if their heart stops beating. The DNR doesn’t have instructions for any other treatment and can only be permitted after a physician speaks with the patient. Ethical concerns can arise when it’s not clear if a patient was capacitated to choose a DNR. In 2017, the case of a Florida man who was rushed to the hospital unconsciously with a “do-not-resuscitate” tattoo across his chest rose questions amongst the hospital staff. After questioning the seriousness of the tattoo and his critical existing medical conditions, the ICU unit decided to honor the message expressed in the tattoo, despite the man’s inability to talk. According to the ethics consultation on the case, “…the law is sometimes not nimble enough to support patient-centered care and respect for patient’s best interests.” Hospital administrators should consider that CPR can sometimes worsen preexisting conditions. In such cases, questioning if the degree of pain is worth the benefits can help professionals navigate severe situations that involve life or death. 2. Doctor and Patient Confidentiality

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Violating a patient’s confidentiality can have legal and ethical consequences for healthcare providers, according to the Health Insurance Portability and Accountability Act (HIPPA). The act requires physicians to protect the privacy and security of a patient’s medical records. HIPPA also sets forth who can see the confidential information and who cannot. Despite the law’s straightforwardness, there are some gray areas. For example, withholding information about a patient’s condition could be unethical because it could harm the patient or someone else. The opposite can be harmful too. A health practitioner could be suspended or, in some cases, fired for posting information about cases on social media. Despite how unintentional a practice like that can be, HIPPA laws prohibit any disclosure of health information on social media channels, arguing that a patient loses their privacy immediately after the fact.

3. Malpractice and Negligence Medical errors are the third leading cause of death in the U.S., according to a study published in the BMJ journal. Despite the decreasing rate of malpractice suits, patients who are affected by it may never recover. For others, it may take years. The high-risk nature of the healthcare atmosphere can increase the likelihood of malpractice. Administrators, as well as physicians and nurses must cover the essential responsibilities of patient care to avoid litigation. In the case of hospitals, ordinary negligence can be due to defective medical equipment, a misdiagnosis or a delayed diagnosis. Sometimes conditions can come up in unusual ways that wouldn’t make sense unless a doctor was looking for the symptoms. Lines can be blurred when doctors disagree about procedures or necessary tests to provide accurate treatment. In cancer cases, a diagnosis can be challenging to prove, as there is a possibility that cancer would have progressed the same way regardless of when doctors started a treatment. **4. Access to Care

5. Physician-Assisted Suicide** Physician-assisted suicide is the act of intentionally killing oneself with the aid of someone who has the knowledge to do so. In the most basic sense, the only person fully qualified to participate in the process is a physician. PAS is subject to criminalization by the state only. According to federal law, legalizing PAS is a matter of states’ rights. ✓ In states where PAS is allowed, a patient who qualifies must be terminally ill, can take the assisted drug themselves and is mentally capacitated to understand what they’re doing. Actions to legalize PAS are increasing despite its ethical prohibitions, according to the American College of Physicians (ACP). PAS is currently legal in seven states and the District of Columbia. In Montana and California, the assistance is an option given to patients via court decision. States that oppose the practice raise the following concerns: ✓ Legalizing PAS can cause pressure on terminal patients who fear their illness is a burden to their families ✓ PAS is incompatible with a physician’s roles as a healer and the American Medical Association’s Code of Ethics. ✓ The dilemma leaves the states to reason with residents’ rights to autonomy and healthcare providers’ beliefs of what they ought to do, based on their code of ethics.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 https://www.floridatechonline.com/blog/healthcare- management/current-ethical-issues-in- healthcare/HE ICN CODE OF ETHICS FOR NURSES

The ICN Code of Ethics for Nurses

An international code of ethics for nurses was first adopted by the International Council of Nurses (ICN) in 1953. It has been revised and reaffirmed at various times since, most recently with this review and revision completed in 2012. Preamble Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal. Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status. Nurses render health services to the individual, the family and the community and coordinate their services with those of related groups. The ICN CODEHE ICN CODE The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct. ELEMENTS OF THE CODE

1. Nurses and people The nurse’s primary professional responsibility is to people requiring nursing care. In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected. The nurse ensures that the individual receives accurate, sufficient and timely information in a culturally appropriate manner on which to base consent for care and related treatment. The nurse holds in confidence personal information and uses judgement in sharing this information. The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 The nurse advocates for equity and social justice in resource allocation, access to health care and other social and economic services. The nurse demonstrates professional values such as respectfulness, responsiveness, compassion, trustworthiness and integrity.

2. Nurses and practice The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. The nurse maintains a standard of personal health such that the ability to provide care is not compromised. The nurse uses judgement regarding individual competence when accepting and delegating responsibility. The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance its image and public confidence. The nurse, in providing care, ensures that use of technology and scientific advances are compatible with the safety, dignity and rights of people. The nurse strives to foster and maintain a practice culture promoting ethical behaviour and open dialogue. 3. Nurses and the profession The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education. The nurse is active in developing a core of research-based professional knowledge that supports evidence-based practice. The nurse is active in developing and sustaining a core of professional values. The nurse, acting through the professional organisation, participates in creating a positive practice environment and maintaining safe, equitable social and economic working conditions in nursing. The nurse practices to sustain and protect the natural environment and is aware of its consequences on health. The nurse contributes to an ethical organisational environment and challenges unethical practices and settings.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117

4. Nurses and co-workers The nurse sustains a collaborative and respectful relationship with co-workers in nursing and other fields. The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a co-worker or any other person. The nurse takes appropriate action to support and guide co-workers to advance ethical conduct. SUGGESTIONS FOR USE of the ICN Code of Ethics for Nurses The ICN Code of Ethics for Nurses is a guide for action based on social values and needs. It will have meaning only as a living document if applied to the realities of nursing and health care in a changing society. To achieve its purpose the Code must be understood, internalised and used by nurses in all aspects of their work. It must be available to students and nurses throughout their study and work lives. APPLYING THE ELEMENTS of the ICN Code of Ethics for Nurses The four elements of the ICN Code of Ethics for Nurses: nurses and people, nurses and practice, nurses and the profession, and nurses and co-workers, give a framework for the standards of conduct. The following chart will assist nurses to translate the standards into action. Nurses and nursing students can therefore: - Study the standards under each element of the Code. - Reflect on what each standard means to you. Think about how you can apply ethics in your nursing domain: practice, education, research or management. - Discuss the Code with co-workers and others. - Use a specific example from experience to identify ethical dilemmas and standards of conduct as outlined in the Code. Identify how you would resolve the dilemmas. - Work in groups to clarify ethical decision making and reach a consensus on standards of ethical conduct. - Collaborate with your National Nurses Association, co-workers, and others in the continuous application of ethical standards in nursing practice, education, management and research. Element of the Code # 1: NURSES AND PEOPLE Practitioners and Managers Educators and Researchers National Nurses Associations

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Provide care that respects human In curriculum include references to Develop position statements and rights and is sensitive to the values, human rights, equity, justice, solidarity guidelines that support human customs and beliefs of people. as the basis for access to care. rights and ethical standards. Provide continuing education in ethical Provide teaching and learning Lobby for involvement of nurses in issues. opportunities for ethical issues and ethics committees. decision making. Provide sufficient information to permit Provide teaching/ learning Provide guidelines, position informed consent to nursing and/or opportunities related to informed statements, relevant medical care, and the right to choose consent, privacy documentation and continuing or refuse treatment. and confidentiality, beneficence and (^) education related to informed maleficence. (^) consent to nursing and medical care. Use recording and information Introduce into curriculum concepts of Incorporate issues of management systems that ensure professional values. confidentiality and privacy into a confidentiality. national code of ethics for nurses. Develop and monitor environmental Sensitize students to the importance of Advocate for safe and healthy safety in the workplace. social action in current concerns. environment Element of the Code # 2: NURSES And PRACTICE Practitioners and Managers Educators and Researchers National Nurses Associations Establish standards of care and a work Provide teaching/ learning Provide access to continuing setting that promotes quality care. opportunities that foster life - long education, through journals, learning and competence for practice. conferences, distance education, etc. Establish systems for professional Conduct and disseminate research Lobby to ensure continuing education appraisal, continuing education and that shows links between continual opportunities and quality care systematic renewal of licensure to learning and competence to practice. standards. practice. Monitor and promote the personal Promote the importance of personal Promote healthy lifestyles for nursing health of nursing staff in relation to health and illustrate its relation to other professionals. Lobby for healthy their competence for practice. values. workplaces and services for nurses. Element of the Code # 3: NURSES AND THE PROFESSION Practitioners and Managers Educators and Researchers National Nurses Associations Set standards for nursing practice, Provide teaching/ learning Collaborate with others to set research, education and management. opportunities in setting standards for standards for nursing education, nursing practice, research, education practice, research and management. and management. Foster workplace support of the Conduct, disseminate and utilise Develop position statements, conduct, dissemination and utilization research to advance the nursing guidelines and standards related to of research related to nursing and profession. nursing research. health. Promote participation in national Sensitise learners to the importance of Lobby for fair social and economic nurses’ associations so as to create professional nursing associations. working conditions in nursing. Develop favourable socioeconomic conditions position statements and guidelines in for nurses. workplace issues. Element of the Code # 4: NURSES AND CO-WORKERS Practitioners and Managers Educators and Researchers National Nurses Associations

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 overl apping functi ons and the potenti al other w ork ers.^ Stimulate co-operation with other related Create awareness of specific and Develop understanding of the roles of for interdisciplinary tensions and disciplines. create strategies for conflict management.support c ommon professional ethic al professi ons. Develop awareness of ethical issues of other Develop workplace systems that Communicate nursing ethics to other values and behaviour.indivi dual, family or c omm unity when the indivi dual, family or c ommunity professions.Provide guide lines, position stateme nts a nd Develop mechanisms to safeguard thetheir care is endangered by health Instill in learners the need to safeguardwhen care is endangered by health (^) discussion fora related to safeguarding people when their care is endangered by health care care personnel. care personnel. personnel. DISSEMINATION of the ICN Code of Ethics for Nurses To be effective the ICN Code of Ethics for Nurses must be familiar to nurses. We encourage you to help with its dissemination to schools of nursing, practising nurses, the nursing press and other mass media. The Code should also be disseminated to other health professions, the general public, consumer and policy-making groups, human rights organisations and employers of nurses. All rights, including translation into other languages, reserved. This work may be reprinted and redistributed, in whole or in part, without alteration and without prior written permission, provided the source is indicated. Copyright © 2012 by ICN – International Council of Nurses, 3, place Jean-Marteau, 1201 Geneva, Switzerland ISBN: 978 - 92 - 95094 - 95 - 6 https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf

Code of Ethics for Filipino Nurses

THE CODE OF ETHICS FOR FILIPINO NURSES

What are CODES OF ETHICS? ✓ These are systematic guides for developing ethical behavior ✓ They answer normative questions of what beliefs and values should be normally accepted ✓ Promulgated by the Professional Regulation Commission, July 23, 2003 ✓ States that :

• The hallmark of all professionals is their willingness to accept a set of professional and ethical principles which they follow in the conduct of their daily lives.
• The acceptance of these principles requires the maintenance of a standard of conduct higher than what is required by law. ✓ This code is adopted by the Professional Regulation Commission and the 42 Professional Regulatory Boards to cover an environment of good governance in which all Filipino professionals shall perform their duties.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 General Principles: ✓ Service to Others ✓ Integrity and Objectivity ✓ Professional Competence ✓ Solidarity and Teamwork ✓ Social and Civic Responsibility ✓ Global Competitiveness ✓ Equality of All Professions After consultation on October 23, 2003 at Iloilo City with the accredited professional organization of registered nurses, the code was adopted under the Republic Act 9173 and promulgated by the Board of Nursing under Resolution No. 220 Series of 2004 last July 14, 2004 ARTICLE I Preamble Sec. 1. Health is a fundamental right of every individual. The Filipino registered nurse believes in the worth and dignity of each human being, recognizes the primary responsibility to preserve health at all cost. The Filipino registered nurse believes in the worth and dignity of each human being, recognizes the primary responsibility to preserve health at all cost. Sec 2. To assume this responsibility, registered nurses have to gain knowledge and understanding of a man’s cultural, social, spiritual, psychological, and ecological aspects of illness, utilizing the therapeutic process. Cultural diversity and political and socio-economic status are inherent factors to effective nursing care. Sec 3. The desire for the respect and confidence of clientele, colleagues, co

• workers, and the members of the community provides the incentive to attain and maintain the highest possible degree of ethical conduct. ARTICLE II REGISTERED NURSES AND PEOPLE Sec.4 Ethical Principles Values, customs, and spiritual beliefs held by individuals shall be represented. Individual freedom to make rational and unconstrained decisions shall be respected. Personal information acquired in the process of giving nursing care shall be held in strict confidence. Sec 5. Guidelines to be observed REGISTERED NURSES MUST: ✓ Consider the individuality and totality of patients when they administer care;

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 ✓ Respect the spiritual beliefs and practices of patients regarding diet and treatment; ✓ Uphold the rights of individuals; and ✓ Take into consideration the culture and values of patients in providing nursing care. However, in the conflicts, their welfare and safety must take precedence. ARTICLE III REGISTERED NURSES AND PRACTICE Sec. 6. Ethical Principles

1. Human life is inviolable.
2. Quality and excellence in the care of patients are the goals of nursing practice.
3. Accurate documentation of actions and outcomes of delivered care is the hallmark of nursing accountability. Sec.7. Guidelines to be observed Registered Nurses must: a. Know the definition and scope of nursing practice which are in the provisions of R.A. No. 9173, known as the “Philippine Nursing Act of 2002” and Board Res. No. 425, Series of 2003, the “Rules and Regulations Implementing the Philippine Nursing Act of 2002”, (the IRR); b. Be aware of their duties and responsibilities in the practice of their profession as defined in the “Philippine Nursing Act of 2002” and the IRR; c. Acquire and develop the necessary competence in knowledge, skills and attitudes to effectively render appropriate nursing services through varied learning situations; d. If they are administrators, be responsible in providing favorable environment for the growth and development of Registered Nurses in their charge; e. Be cognizant that professional programs for specialty certification by the BON are accredited through the Nursing Specialty Certification Council (NSCC); f. See to it that quality nursing care and practice meet the optimum standard of safe nursing practice; g. Ensure that patient’s records shall be available only if they are to be issued to those who are professionally and directly involved in their care and when they are required by law. h. Insure that modification of practice shall consider the principles of safe nursing practice; i. If in position of authority in a work environment, be normally and legally responsible for devising a system of minimizing occurrences of ineffective and unlawful nursing practice. Sec. 8. Ethical Principle
   4. Registered Nurses are the advocates of the patients: they shall take appropriate steps to safeguard their rights and privileges. Sec. 9. Guidelines to be observed Registered Nurses must

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 a. Respect the “Patient’s Bill of Rights” in the delivery of nursing care; b. Provide the patients or their families with all pertinent information except those may be deemed harmful to their well-being and c. Uphold the patient’s rights when conflict arises regarding management of their care. Sec. 10. Ethical Principle

5. Registered Nurses are aware that their actions have professional, ethical, moral and legal dimensions. They strive to perform their work in the best interest of all concerned. Sec. 11. Guidelines to be observed Registered Nurses must a. Perform their professional duties in conformity with existing laws, rules, regulations, measures, and generally accepted principle of moral conduct and proper decorum; ARTICLE IV REGISTERED NURSE AND CO- WORKERS Sec.12. Ethical Principles 1.Registered Nurse is in solidarity with other members of the healthcare team in working for the patient’s best interest. 2.The Registered Nurse maintains collegial and collaborative working relationship with colleagues and other health care providers. Sec.13. Guidelines to be observed Registered Nurse must a. Maintain their professional role/identity while working with other members of the health team; b. Conform with the group activities as those of a health team should be based in acceptable, ethico-legal standards; c. Contribute to the professional growth and development of other members of the health team; d. Actively participate in professional organization; e. Not act in any manner prejudicial to other professions; f. Honor and safeguard the reputation and dignity of the members of nursing and other profession; refrain from making unfair and unwarranted comments or criticisms on their competence, conduct, and procedures; or not do anything that will bring discredit to a colleague and to an member of other professions; and g. Respect the rights of their co-workers. ARTICLE V REGISTERED NURSE, SOCIETY AND ENVIRONMENT Sec.14. Ethical Principles The preservation of life, respect for human rights, and promotion of healthy environment shall be a commitment of a Registered Nurse.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 The establishment of linkages with the public in promoting local, national, and international efforts to meet health and social needs of the people as a contributing member of society is a noble concern of a Registered Nurse. Sec.15. Guidelines to be observed Registered Nurse must: a. Be conscious of their obligations as citizens and, as such, be involved in community concerns; b. Be equipped with knowledge of health resources within the community, and take active roles in primary health care; c. Actively participate in programs, projects, and activities that respond to the problems of society; d. Leads their lives in conformity with the principles of right conduct and proper decorum; and e. Project an image that will uplift the nursing profession at all times; ARTICLE VI REGISTERED NURSE AND THE PROFESSION Sec.16. Ethical Principles

1. Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal.
2. Compliance with the by-laws of the accredited professional organization (PNA) and other professional organizations of which Registered Nurse is a member is a lofty duty.
3. Commitment to continual learning and active participation in the development and growth of the profession are commendable obligations.
4. Contribution to the improvement of the socio-economic conditions and general welfare of nurses through appropriate legislation is a practice and visionary mission. Sec.17. Guidelines to be observed Registered Nurse must a. Be members of the accredited professional organization which is the PNA. b. Strictly adhere to the nursing standards; c. Participate actively in the growth and development of the nursing profession; d. Strive to secure equitable-economic and work conditions in nursing through appropriate legislation and other means; e. Assert for the implementation of labor and work standards. ARTICLE VII ADMINISTRATIVE PENALTIES, REPEALING CLAUSE ANDEFFECTIVITY Section 18 The Certificate of Registration of the Registered Nurse shall either be revoked or suspend for violation of any provisions of this Code pursuant to Sec. 23 (f), Art.IV of R.A. No. 9173 and Sec.23 (f), rule III of Board Res. No. 425, Series of 2003, the IRR.

3 rd^ Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 https://inba.info/the-code-of-ethics-for-filipino-nurses_58534c9cb6d87fdbae8b5b27.html

Self-Help: You can also refer to the sources below to help you

further understand the lesson.

1. Butts, J. (2020). Nursing ethics: across the curriculum and into practice. 5th Edition. Burlington, MA: Jones & Bartlett Learning.
2. Edge, R., Groves, R.(2019). Ethics of Health Care: A guide for clinical practice. 4th Edition. Australia: Cengage Learning.
3. Stanford, C.(2020). Applied Law and Ethics for Health Professionals. 2nd Edition. Burlington, MA: Jones & Bartlett Learning.
4. Bryant, J., La Velle, L. (2019). Introduction to Bioethics. 2nd Ed. Hoboken NJ: Wiley- Blackwell.
5. Morison, E.,Furlong, B. (2019). Health care Ethics. 4th Edition. Sudbury Mass Jones & Bartlett Learning.
6. Nguyen, J. (2019). Legal and Ethical Issues for Health Professions. 4th Edition. St. Louis, Missouri: Elsevier.
7. Hammaker, D. Knadig, T. (2018). Health Care Management and Law. 2 nd^ Edition. Burlington, MA: Jones & Bartlett Learning.
8. Cranmer, P. Nhemachena. J.(2013). Ethics for Nurses; THEORY AND PRACTICE. Open University Press McGraw-Hill Education McGraw-Hill House Shoppenhangers Road Maidenhead Berkshire England SL6 2QL
9. Timbreza, F.(2007). Bioethics and Moral Decisions. C& E Publishing,Inc. 1672 Quezon Avenue, South Triangle, Quezon City

10. Blomberg AC., Bisholt B., Lindwall L. Responsibility for patient care in

perioperative practice. Nursing Open. 2018; 5 :414–421. 10.1002/nop2.153

[CrossRef] [Google Scholar]

11. https://www.slideshare.net/CathAlmonte/chapter4-ethical-issues

12. https://inba.info/the-code-of-ethics-for filipino nurses_58534c9cb6d87fdbae8b5b27.html