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So today let's talk about
Public Health Ethics.
00:04
Before we get into the details,
I want to remind everyone of the
most recent Gallup poll results.
00:10
Once again,
we see nurses at the very top,
we're the most trusted profession
in the United States.
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So what does that mean for us?
Well, it means a lot.
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It means that we're in
a very unique position.
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A position where the
general public trust us
more than any other professional,
including other
health care workers.
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So because of this,
we have a responsibility
to practice in an ethical,
value based manner
at all times.
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Not only do we want to stay
at the top of the list,
but our patients are
looking to us to be leaders
to be leaders among other
health care professionals.
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And it's important that we
take this honor very seriously.
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This is especially important
in public health nursing.
00:48
Many of the communities
that we work with
have been treated unfairly,
or unethically in the past.
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This historical context means
that we may have to work
a little harder
to be trusted.
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So let's look at
how we can do that.
01:02
So what is ethics?
Well, if you were to
ask 10 different people,
you'd probably get
10 different answers.
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Some people might say
that ethics is a feeling
A feeling of right or wrong.
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Others would say
that ethics our responsibility
to follow laws or rules,
even when people
aren't watching us.
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Others might say that ethics
are related to religion.
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Well, none of these really
explained what ethics are.
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If we focus on our feelings,
we have to recognize
that our feelings aren't always
based on ethical principles.
01:39
And while we hope that our laws
are based on ethics,
we cannot assume this.
01:43
Pre civil rights laws
that made slavery legal
are an example of how laws
are not always ethical,
and ethics cannot be tied
to religion
is that would make us assume that
only individuals who identify
as being religious can be ethical.
02:00
So how do we define ethics then?
Ethics is based on standards
of right and wrong.
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Ethics relate to rights obligations,
benefits to society, and fairness.
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Simply put, ethics are often
thought of as what we ought to do.
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So let's take some
time now to explore
seven different ethical principles.
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George has been working closely
with Theo and his family
to ensure that he gets
ethical treatment
as he manages his
chronic liver disease.
02:28
We'll explore what this looks like
for each of the seven
ethical principles.
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The first is respect.
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The principle of respect
refers to treating people
as unique and equal individuals.
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This principle emphasizes
one's own responsibility
as a member of the community,
and a member of the
healthcare team,
And public health nursing
as a result of respect,
we acknowledge community members as
essential and valued participants
in shaping their own and their
communities health outcomes.
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We treat all community members as
equals on the health care team.
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We hold them and their
views and high regard.
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Now remember, Theo,
he has chronic liver disease.
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It's been recommended
that he received
frequent blood transfusions
as a treatment to prolong his life.
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Let's work with him
to ensure that he's being treated
in an ethical manner.
03:20
To ensure that he's
treated with respect,
we must make sure that he has
a voice in his treatment plan.
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We must value his opinion.
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Next, we have autonomy.
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This is the freedom of choice.
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An individual's right to
making their own decisions.
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Public health nurses apply autonomy
by the promotion of individuals
and groups rights to
and involvement in decision making.
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When we work with Theo,
we must ensure that his freedom
does not result in harm
to the well being of others.
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For example, if he needs
frequent blood transfusions,
will this take away
resources from others?
Will this do harm to others?
We need to make sure
that he is fully informed
and his decisions
are made deliberately
with careful considerations
of the consequences.
04:03
Now there are times when
as public health nurses,
we might not accept
a client's choice
as one that we would
make ourselves.
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However,
we can respect that choice.
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Remember, it's our role to ensure
that individuals and communities
are given accurate information,
information they need to be
able to exercise autonomy,
and make a choice on their own.
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Beneficence
is pretty straightforward.
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It means doing good.
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Beneficence is taking action
to ensure positive outcomes
on behalf of our clients.
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As public health nurses,
this is our goal.
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Our goal is to take action to
promote positive health outcomes
for communities,
for individuals, for families.
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When working with Theo,
we need to ensure
that we're working towards
those positive health outcomes,
while also considering
other ethical principles.
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Principles such as
respect and autonomy.
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It's important that
Theo's voice is heard
and that he has a say
in the decisions
regarding his plan of care.
05:00
What does doing good mean
to him in this scenario?
Does he see prolonging
his life as doing good?
Next we have nonmaleficence.
This means to do no harm.
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This is avoiding or
preventing harm to others
as a consequence
of our choices and actions.
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These include our personal and our
professional choices and actions.
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Nonmaleficence involves taking steps
to avoid negative consequences
for all of those around us.
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Now, when working with Theo,
we must ensure that our actions
that are intended to help
don't do more harm than good.
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This is a decision that we need
to include the Owen.
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From his perspective,
what does this mean?
What treatment would be more
harmful or beneficial for him?
Maybe he would prefer to not
receive blood transfusions,
would rather spend his remaining
days at home with his family.
05:51
Justice refers to
treating people fairly,
it means the fair distribution
of both benefits and costs
among all society's members.
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The principle of justice
seeks to improve equity.
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When we consider our
treatment plan with Theo,
we must understand if the treatment
will result in equal benefit
and cost for him and others.
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What are those consequences?
There are several types of justice
that are important
to public health nurses.
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So let's take a look at those.
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When we discuss justice,
there are three different
views and allocation
of what it means to distribute both
benefits and costs across society.
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The first approach is
distributive justice.
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From this perspective,
benefits should be given first
to those who need them the most.
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decisions based on this approach
help individuals and communities
who are most in need.
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Even if that means withholding
goods or benefits from others
who also may be deserving,
but have less need.
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By talking to Theo,
we understand that this is
one of his main concerns.
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He's concerned that
there are other people
who need blood transfusions
more than he does.
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He's worried about the
distribution of this resource.
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On the other hand,
a egalitarian justice
promotes decisions based on
equal distribution to benefits
to everyone regardless
of their need.
07:07
So no matter the need,
everyone gets the same benefit.
07:11
Well, Theo's concerned
about distributive justice,
the nurses explained to him that
everyone deserves this treatment,
the treatment of
blood transfusions,
regardless of whether or not Theo
thinks others deserve it more.
07:25
The third type of justice,
restorative justice.
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Restorative justice states
that benefits should go primarily
to those who've been wronged
by a prior injustice.
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Oftentimes,
we see this type of justice
through programs that are in
place to compensate victims
for their injury,
or families for their loss.
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This is seen as a beginning
step to restore justice.
07:47
Now,
Theo's chronic liver disease
is a result
of an occupational exposure
to a harmful chemical.
07:52
His company is paying for him to
receive the blood transfusions
as his treatment.
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This is an example of
restorative justice.
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And then finally,
we have social justice.
08:04
This refers to the fair and
equitable distribution of wealth,
economic opportunity, and access
to privileges in our society.
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This is the idea that everyone
deserves equal economic,
political and social rights
and responsibilities.
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This is really Theo's
biggest concern.
08:21
Before agreeing to this treatment,
he wants to make sure that
everyone who needs this treatment
has fair access to it.
08:30
Okay, just a couple more left.
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Here we have veracity.
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This means telling the truth.
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The idea here is that individuals
and communities deserve to be given
accurate information
in a timely manner.
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When we make sure that Theo has
accurate, truthful information,
this increases the opportunity for
him to have greater involvement
in the decision making process.
08:54
And lastly,
we have fidelity.
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This is keeping one's promises,
following through and doing
what you say you will do.
09:02
Public health nurses
must be faithful
to their
professional responsibilities
by providing high quality
safe care in the community.
09:09
Again, we accomplish this by
doing what we say we will do.
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When we're working with Theo it's
important to stand by his decision.
09:16
Once his decision has been made
we support, Theo.
09:19
We carry out the plan as intended
the way that we've promised, Theo,
we will.