ethics and informed consent

Question 1

What are common ethical issues nurses face?

Answer 1

Informed consent, confidentiality, withholding/withdrawal of treatment, organ/tissue transplantation, distribution of health care resources

Question 2

What are warning signs of an ethical dilemma?

Answer 2

Emotionally charged situations, significant change in pt condition, confusion about facts, hesitancy about what is “right,” deviation from usual practice, secrecy about proposed actions

Question 3

What should nurses avoid during ethical dilemmas?

Answer 3

Imposing their own value system

Question 4

What is the nurse’s primary role during ethical dilemmas?

Answer 4

Advocacy

Question 5

What is the principle of autonomy?

Answer 5

Pt’s right to self-determination regarding medical care

Question 6

When can a patient exercise autonomy?

Answer 6

When they are competent and fully informed

Question 7

What is beneficence?

Answer 7

Duty to prevent harm, remove harm, and promote good

Question 8

What is nonmaleficence?

Answer 8

Obligation to not intentionally inflict harm

Question 9

What is justice?

Answer 9

Treat patients fairly and ensure equitable access to care

Question 10

What is fidelity?

Answer 10

Keeping promises and maintaining professional trust

Question 11

What is accountability?

Answer 11

Accepting responsibility for your actions and decisions

Question 12

What is veracity?

Answer 12

Being truthful and honest with patients and families

Question 13

What formal ethical resources are available to nurses?

Answer 13

Ethics Committee and Risk Management

Question 14

What additional ethics opportunities exist for ICU/critical-care nurses?

Answer 14

Multi-professional roundtables, QI committees/Unit Practice Councils, IRB participation

Question 15

What is informed consent?

Answer 15

A voluntary agreement to treatment after being fully informed of risks, benefits, and alternatives

Question 16

What is the disclosure component of informed consent?

Answer 16

Pt receives clear info on diagnosis, purpose of treatment, risks/benefits, and alternatives (including doing nothing)

Question 17

What is comprehension in informed consent?

Answer 17

Pt understands the information provided

Question 18

What is competence in informed consent?

Answer 18

Pt is legally and mentally able to make decisions

Question 19

What is voluntariness in informed consent?

Answer 19

Decision is made without coercion or pressure

Question 20

What is the nurse’s role in informed consent?

Answer 20

Ensure pt understanding, witness signature, advocate for questions, call provider if pt lacks understanding or capacity

Question 21

Who signs consent for minors or incapacitated patients?

Answer 21

Legal guardian or health care surrogate

Question 22

What is the exception for minors signing their own consent?

Answer 22

Pregnant minors may consent for treatments related to pregnancy

Question 23

When is consent implied?

Answer 23

Emergencies when immediate care is needed to save life or prevent serious harm

Question 24

How does culture impact informed consent?

Answer 24

Nurses must respect patient beliefs, values, and language needs