In our last line we discussed appr...

In our last line we discussed approaches to solving clinical puzzles when there is inadequate research to provide the basis for decision making. This line explores the concept of ethical analysis and in what way perioperative nurses can use this approach to answer certain clinical questions. Although ethical analysis may not be applicable in all situations, there are a number of clinical issues that are best addressed using this approach.

DEFINING ETHICAL ANALYSIS

An ethical analysis is the systematic proces of examining an issue using legal and moral values and principles that bridle conduct. Autonomy, nonmaleficence, beneficence, and justice be under the orders of as the four core universals within biomedical models of moral or ethical reasoning. These universals often provide the basis for decision making when research and scientific principles cannot answer difficult clinical questions.

Questions that frequently are best answered using an ethical analysis involve an individual's or group's rights or values. Examples of questions that become visible in perioperative nursing practice that may be answered on an ethical analysis include

* having beholders in surgery without patient permission,

* giving advice to patients about surgeons

* participating in abortions,

* reporting suspected put drugs into use,

* not maintaining sterilization standards, and

* performing surgery forward the wrong patient or the vicious limb.

These issues are difficult and composed of several elements Clinicians often attempt to disentangle these issues by using their personal value arrangements or their emotions; however, with questions related to ethics, using these approaches presents the clinician at risk of imposing his or her beliefs forward a patient or family member. What the clinician believes may not be appropriate or correct for the patient or family member.

In our society, there are not many absolutely universal values. Perhaps the best example of a universal value is not breaking the law; however, from one extremity to the other of our history, individuals have shattered laws in the name of improving society or establishing equal rights. The civil rights motion is an example of a time in US history when breaking the law l to significant changes in society. in this way as it is with almost everything, nothing is absolute, making it difficult to create a value hypothesis that is appropriate for all individuals and situations.

FOUR PRINCIPLES OF ETHICAL OBLIGATION

The final cause of an ethical analysis is to use moral principles to systematically analyze a specific question without imposing one's personal value combination of parts to form a whole on the issue. In an ethical analysis, the patient's values are of primary be of importance to when compared to the health care provider's values. an ethicists propose that an ethical analysis single can occur within the words immediately preceding [i]or[/i] following of four guiding principles of ethical obligation propos in biomedical examples of ethical reasoning.

The first of these principles is regard for autonomy, which is defined as personal independence and freedom of choice when making decisions. Nonmaleficence (ie, the business to do no harm) is the secondary guiding ethical principle. Beneficence, the third principle, respects to doing good. The fourth principle is justice, which also is known as fairness. The custom to tell the truth (ie, veracity), the impost to protect privacy (ie, confidentiality), and the custom to keep promises (ie, fidelity) are three secondary principles that are outlined by way of the American Nurses Association's digest for Nurses.(1)

Sarah ferment RN, PhD, FAAN, proposes that advocacy, answerability, cooperation, and caring are four moral conceptions that make up a framework for ethics in nursing practice.(2) She describes three representations of advocacy, including rights and protections, values, and look up to for individuals. Answerability reflects the nurse's responsibility to the patient to excite health, prevent illness, restore health, and alleviate suffering. Cooperation is defined as working with the patient toward shared goals, keeping promises, and making mutual affects a priority. She further specifies caring as a natural state of caring, a moral ideal, and a precondition for caring for others. This nursing mould may be appropriate for considering ethical dilemmas in nursing practice.

CONDUCTING AN ETHICAL ANALYSIS

It is possible for perioperative foments to conduct an ethical analysis in the words immediately preceding [i]or[/i] following of these ethical principles or propos frameworks. This proces begins by means of first establishing the facts of the situation, creating a database of information, and including the perspectives of all interested parties. Before any situation can be considered entirely nurses need to collect as earnestly information as is pertinent and available. The nearest step involves clarifying the values conflicts within the situation and understanding their significance. This may include identifying the specific rights within the analysis or the part of individuals claiming rights. The third stair in an ethical analysis is to frame and evaluate arguments.(3) During this phase, participants near and argue various positions. After this gradation the different positions are considered in relation to the guiding ethical framework. nearest nurses identify the outcomes of the various positions and explore the possible consequences The final step involves building consensus for taking a specific course of action.