Group 3
Group 3
Group 3
DECISION MAKING
GROUP 3
Bao, Hanna C.
Candillada, Leira Mae G.
Castillo, Anna Abigail R.
Dagatan, Hazel Mae T.
Dalman, Grace M.
The evolution of nursing as a profession has been intimately linked with society’s moral
philosophy, because the work of caring for and treating the sick and comforting the suffering, are
themselves morally worthy work. – (Jameton, 1984)
Moral Philosophy
- Consist of beliefs and assumptions about what is right and wrong.
The basis of ethics that prescribes the proper action to take in given situation.
Ethics
- Translates the moral philosophies into action.
The ANA and CNA code of ethics are sets of principles or standards guiding
professional nursing practice.
Morals and philosophic beliefs are constituted within the social, historical, and
cultural experiences of a society. These beliefs evolve as normative patterns or sets of
assumptions and beliefs that serve as an implicit framework to guide the actions and
thoughts of group members. These normative patterns or sets of assumptions and beliefs
may or may not be shared by persons outside the cultural group.
Naturalism vs Rationalism
- Two philosophic theories of ethics, naturalism and rationalism stemmed from the era of
enlightenment.
Naturalism - Holds that all people have similar psychological tendencies and capacities.
Divergence in moral codes is attributed to differences in social conditions such as poverty
or lack of education. Once social conditions are ameliorated, it is presumed that uniform
morality can be achieved.
Utilitarianism - believes in the idea of the “greatest good for the greatest number”.
Consequentialism - believes in the idea that the utility or consequence of an action is the
only relevant consideration in judging behaviors.
Categorical imperative - states that every human being has a moral obligation to act in
such a way that his or her actions could become a moral law for everyone (Paton, 1961).
Based on the deontological theory of ethics, a professional code of ethics serves as a guide to
actions by members of the nursing profession (Burkhardt & Nathaniel, 1998).
Deontological
- Is a duty based, w/in duty or obligation of a nurse to do the right thing to do goodness to
the patient.
Teleological
- Is an approach to look for outcome or the end of the result. When the outcome is good
then it is good.
1. Autonomy - the right/freedom to decide (the patient has the right to refuse despite the
explanation of the nurse) Example: surgery, or any procedure. Patient Self Determination Act of
1991- is a legal protection of a person’s autonomy or self-determination in these situations
through advance directives.
2. Beneficence - Is obligation to do good or for the goodness and welfare of the clients.
3. Nonmaleficence - Is obligation to prevent harm or the duty not to harm/cause harm
maybe physical, financial or social)
4. Justice - relates to the fair, equitable, and appropriate treatment or use of resources in
light of what a person needs, weighed against the needs of others.
5. Fidelity - faithfulness/loyalty to clients.
6. Veracity - the act of truthfulness.
The philosophic traditions of universalism and rationalism have shaped the western
concept of the person as the focus of moral reasoning. In contrast, to the western value of
individualism, members of the Xhosa tribe in South Africa emphasize collective decisions about
individual member’s care. Elders in the tribe make major decisions about the distribution of
human and material resources to provide care for their members.
Western
- Emphasis on self-determination, many societies value collective harmony and
relationships of individuals with one another.
Orthodox Jewish
- Beliefs uphold the sanctity of life. Euthanasia may not acceptable
A Hmong Family
- Fediman’s (1997) story about a Hmong Family’s experience with healthcare in Merced,
California, portrays two contrasting explanatory models for illness (Epileptic Seizures)
Studies done, according to Holland, Geary, Marchum, & Tross, 1987 in;
Africa Shows that fewer than 40% of oncologists avoid using the word
"cancer" or "terminal" when talking to patients. Valle (2001) also
Hungary notes that among communitarian groups such as Mexicans, Chinese,
and Koreans, patient autonomy and truth telling are secondary to
Japan beneficence and nonmaleficence in ethical decisions.
Portugal
Italy
Spain
Muslim Religion
- Defines the role of the individual, the family, and the physician in life transitions such as
illness and death. The physician is viewed as a trusted family member and an instrument
of God, who is part of the extended family.
● Decisions regarding full disclosure about an illness or prognosis need to take into account
the religious and moral contexts of people's lives.
● Accommodating their system of meanings can prevent divisions within a family unit.
The Filipino Family Health care practitioners are mandated to provide patients with
information about advance directives. Asking a Filipino patient if he or she has a living will is
likely to produce a negative answer. Planning for one's illness or death-events considered beyond
one's control is viewed as tempting fate and will likely bring the potential event into reality.
Among traditional Filipinos, a sense of fatalism that is deeply rooted in their religious
and supernatural beliefs conditions an individual to attribute either positive or negative events to
God's will.
Filipino and Chinese nurses’ express discomfort in discussing advance directives with
hospitalized patients because they see their role as caregivers to patients. As with many Filipinos,
the patient's welfare is entrusted to family members, who will act according to his or her best
interests. Many Blacks equate advance the directives as legitimizing abandonment by
practitioners. Interest is taken for granted as the inherent responsibility of the Cohesiveness and
mutuality among members removes the necessity for an individual to worry about his or her
future, because the individual's goals and aspirations are deeply embedded in the group.