week 5 conceptual basis of nursing practice (ethical and legal consideration)_without video version
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7/29/2019 Week 5 Conceptual Basis of Nursing Practice (Ethical and Legal Consideration)_without Video Version
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CCN 2258Fundamental Concepts of Health
and NursingThe Conceptual basis of Nursingpractice
Ethical and legal consideration
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Ethical and legal consideration
After completing this lecture, you will be ableto:
Describe the purpose and essential elements of
informed consent Understand the privacy, organ donation and legal
termination of pregnancy briefly
Identify the code of ethics for nurses in Hong
Kong
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Informed consent
Purpose Provides client with complete information prior to
obtaining agreement by client to accept a course oftreatment or procedure
Express Consent Oral or written agreement
Implied Consent
Individuals nonverbal behavior indicates agreement
Medical emergency when a person cannot expresscontent because of physical condition
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Informed consent
Three major elements must be given voluntary
must be given by client or individual with capacityto understand
must be given enough information to be theultimate decision maker
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Informed consent
Three groups of people cannot provideinformed consent a person 18 years or younger (provided by a parent or
guardian)
the unconscious or person injured in such as way that they
are unable to consent (by provided necessary care for theclients emergency condition)
a mentally ill person judged by professionals to beincompetent (by an appointed guardian)
Hong KongStatutory law
Section 59ZB(2) Part IVC of Mental Health Ordinance (Cap136)
A mentally incapacitated person is incapable of givingsuch consent if that person is incapable of understandingthe general nature and effect of the treatment or specialtreatment. Statute (Hong Kong)5
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Informed consent
Important to consider the problem of illiteracy andother language barriers
The consent must be read to the client or aninterpreter appropriately used to be certain client
understands Nurses Role
Client gave consent voluntarily
Signature is authentic
Client appears competent to give consent Remind client they have the right to refuse after
signature on form continues after signing consent
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Privacy
Hold in confidence personal information obtained ina professional capacity
The nurse ensures that the information given by theclients in confidence will only be used for the purposes for
which it was given The nurse protects the information obtained in the course
of professional practice and discloses only with thepatients/clients consent, or in exceptional circumstances,
such as where a court is made for disclosure
When personal information is required for teaching,research or quality assurance procedures, the nurse takescare to protect the patients/clients anonymity and privacy
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l f l f l d
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Some examples of laws of HK related
to nursing practice
Antibiotics Ordinance
Births and Deaths RegistrationOrdinance
Coroners () Ordinance
Dangerous Drug Ordinance
Defamation () Ordinance
Hong Kong Bill of RightsOrdinance
Hospital Authority Ordinance
Hospitals, Nursing Homes andMaternity Homes RegistrationOrdinance
Human Organ TransplantOrdinance
Interpretation and GeneralClauses Ordinance
Medical (Therapy, Education andResearch) Ordinance
Mental Health Ordinance
Midwives Registration Ordinance
Nurses Registration Ordinance
Occupational Safety and Health
Ordinance Offences Against the Person
Ordinance
Personal Data (Privacy)Ordinance
Pharmacy and Poisons Ordinance
Prevention of Bribery Ordinance
Quarantine () and Preventionof Disease Ordinance
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Organ donation
Number of organ / tissue donation & patient waiting fortransplantation under H.K. Hospital Authority (1994 2011)
(Department of Health, Hong Kong, 2012)9
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(Apple daily, 2013)10
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Organ donation policy
Opting-in (
) Require individuals to sign the consent to indicate the
individuals wishes
The consent of the relatives has to be secured before theorgan can be retrieved for transplantation
United Kingdom, United State, Australia, Taiwan, Japan,Hong Kong
Opting-out () Require individuals to sign to indicate objection to the
taking of organs by others after death Austria, France, Brazil, Spain, Singapore
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Applying for legal Termination of
Pregnancy
Section 47 of the Offences Against the Person Ordinance Termination of pregnancy requires two registered medical
practitioners to concur that:
continuing the pregnancy would involve risk to the life of the pregnantwoman or of injury to the physical or mental health of the pregnant
woman greater than if the pregnancy were terminated; or
there is a substantial risk that if the child were born, it would sufferfrom such physical or mental abnormality as to be seriouslyhandicapped; or
the woman is with child before attaining the age of 16; or
the woman is the victim of incest, rape, drug rape, intercourse bythreats, or intercourse by false pretences, and has made a report tothe police within 3 months after the date of such offences
Legal termination of pregnancy must not be performed after
the 24th week of pregnancy12
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Several Examples of ethical
principles
Respect for autonomy Right to choose
Beneficence
Acting in the patients best interest
Nonmaleficence Doing no harm to patients
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Code of Ethics for Nurses in Hong
Kong
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Organized around four broad valuestatements and seventeen provisions ()
that represent the morals and ideals of theprofession and are regarded as central to
ethical nursing practice The four broad value statements are:
1. Respect life, and improve quality of life
2. Respect individual rights and dignity
3. Be responsive to societys needs, and work towardsa healthy community through partnership
4. Strive for excellence, and assure quality of care
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Code of Ethics for Nurses in Hong
Kong
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The provisions articulated in each value statementare ethical responsibilities that nurses should actupon in order to enact the broad values in practicesituations
For each of these statements, the scope ofresponsibilities identified extends beyondindividuals to include families, communities andsociety
By upholding these values in practice, it isenvisaged that nurses can improve their personalquality, provide quality nursing care and earn thetrust of those under their care
Th l b d
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The 4 value statements are based on
the following general principles :
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People's needs are universal. Nursing service isprovided for people throughout their life span
Inherent in nursing is the respect for life, dignity andrights of individuals, and improvement in the quality of
life Nurses should serve all people irrespective of race,
nationality, creed, colour, age, gender, politics orsocial status
The fundamental responsibilities of nurses are topromote health, prevent illness, restore health, andalleviate suffering caused by ill health
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1. Respect Life, and Improve Quality
of Life
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1.1 Nurses should encourage the individual, the family andthe community to improve the quality of life
1.2 Nurses should ensure patient/client safety whendelivering nursing services
1.3 Nurses should provide information and consultation inaccordance with and adjustable to patients'/clients' andtheir families capacity and needs
1.4 Nurses should respect the wishes of the dyingpatients/clients, and ensure that they have peace anddignity at the time of death
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2. Respect Individual Rights and
Dignity
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2.1 Nurses should respect the individuals spiritualbeliefs, values and customs.
2.2 Nurses should hold in confidence patients'/clients'information and be prudent in their use of theinformation.
2.3 Nurses should respect patients'/clients' and theirfamilies wishes, encouraging them to participate in
planning and implementing nursing care.
2.4 Nurses should take appropriate action to safeguardthe individuals rights and dignity.
2.5 Nurses should value truthfulness and integrity andput oneself in the place of another.
3 Be Responsive to Societys Needs and Work
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3. Be Responsive to Societys Needs, and Work
towards a Healthy Community Through
Partnership
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3.1 Nurses should share the responsibility in raising thehealth consciousness of the community
3.2 Nurses should collaborate with others in initiatingand supporting actions that work towards the goal ofhealth for all
3.3 Nurses should use health care resources efficientlyand effectively through partnerships with thecommunity
3.4 Nurses should coordinate their services with those ofmedical and social groups in rendering healthservices to individuals, families and the community,as appropriate
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4. Strive for Excellence, and Assure
Quality of Care
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4.1 Nurses should seek truth from facts, and usescientific evidence in finding the best possible waysto provide nursing services for the wellbeing ofpatients/clients.
4.2 Nurses should maintain the highest standards of
nursing care possible, actually seekingimprovement on the existing service.
4.3 Nurses should exercise professional judgment inaccepting responsibilities and delegating nursing
activities to others.
4.4 Nurses should value research and development forthe promotion of nursing knowledge and skills.
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References Department of Health, Hong Kong. (2012). Statistics ( Milestones of
Hong Kong Organ Transplantation ). Retrieved fromhttp://www.organdonation.gov.hk/eng/statistics.html
Kozier, B., Berman, A. & Snyder, S. (2012). Kozier & Erb'sfundamentals of nursing : concepts, process, and practice(9th ed.).Upper Saddle River, N.J. : Pearson.
Legislative Council of the Hong Kong Special Administrative Region of
the Peoples Republic of China. (2000). Mental health ordinance
(chapter 136). Retrieved from http://www.legco.gov.hk/yr99-00/english/bc/bill_81/general/81_brf.pdf
The Family Planning Association of Hong Kong. (2013). Unplannedpregnancy. Retrieved fromhttp://www.famplan.org.hk/fpahk/en/template1.asp?style=template1.asp&content=sexual/what.asp
The Nursing Council of Hong Kong. (2002). Code of professionalconduct and code of ethics for nurses in Hong Kong. Retrieved fromhttp://www.nchk.org.hk/filemanager/en/pdf/conduct eng.pdf21
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