NCM 114 Ethical Aspects of Care Promotion

Ethical aspects in the Care and Health Promotion in Older Adults
Ethical Considerations in the Care of Older Adult
What is Ethics in Geriatric Care?

• For the elderly, ethics is about how they want to be treated and allowed to make their own decisions.
• For family members as caregivers, ethics is about doing what is right even when no one is looking.
• For professionals providing eldercare, ethics is about adherence to established canons of ethics promulgated by
organizations.
Key Ethical Principles in the Care of Older Adults
1. The right to quality health care.

- means that they have adequate access to quality care.
- they have a right to the same high standards of health care as those in any age group
2. Respect for the individual person.
- Kant explicates this fundamental principle in ethics as follows :
- “So act that you treat humanity in your own person and in the person of everyone else, as an end and never merely
as a means“
3. Autonomy or Self – determination
- Respecting the principle of autonomy means that older patients will be respected as decision-makers about their
own care.
- All competent older persons have a perspective of their own best interests, shaped by their values and beliefs
developed over a lifetime, that defines each individual as a unique person.
- If a patient lacks the capacity for such a decision and has an advance directive, the person who has the durable
power of attorney can make the decision.
- Paternalism occurs when the nurse does not respect the patient’s right to autonomy by acting as if he or she knows
what is best for the patient, rather than the patient (Silva & Ludwick, 1999).
- Paternalism disempowers the patient
- Informed consent involves the patient’s right to autonomy and self-determination
Three Elements of Informed Consent

Informed - sufficient information must be provided
Competent - involves the capacity to weigh out the potential benefits in comparison to the risks by applying “rational
reason”
Voluntary - the patient is not coerced into participation and that consent can be withdrawn at any time
4. Privacy and Confidentiality

- Involves sharing only patient information on a need-to-know basis.
- There may also be instances when a clinician may be obligated to override the duty to maintain confidentiality
5. Beneficence
- The principle of beneficence or “doing good “ means that the highest good will be done for older people in a
particular situation.
6. Nonmaleficence
- Do no harm
- Concept originated from the Hippocratic Oath
- Applied to nursing by not causing injury, whether it be a physical, psychological, emotional, or financial injury to
patients (Silva & Ludwick, 1999)
6. Justice
- Right to be treated equally, and in some cases equal access to treatment and allocation of resources
7. Veracity
- truthfulness
- Principle of veracity also compels that the truth is completely told.
- Quality of the relationship between nurse & patient is based on trust & integrity
 
 
 

 
 
 
 
 

 
 
 
 
 
 
 

 
 
 
 
 
 

 
 
 
 

 
 
 
 

 
 
8. Fidelity
- It involves an agreement to keep our promises. Fidelity refers to the concept of keeping a commitment and is
based upon the virtue of caring.
- means to respect our words and duty to elder patients
What is an ethical dilemma?
Situations that produce conflicts:
• Between nurses’ values and external systems affecting their decisions
• Between rights of patients and nurses’ responsibilities to those patients actual conflicts of interest arising when
family members and professional caregivers assist or represent the elderly
Measures to Help Nurses Make Ethical Decisions

1. Encourage patients to express their desires.
2. Identify significant others who impact and are impacted.
3. Know thyself.
4. Read.
5. Discuss.
6. Consult
7. Share
8. Form an Ethics Committee
9. Evaluate Decisions
Philippine Laws related to Care of the Older Persons

1987 Philippine Constitution, Art. XV, sec. 4
• It is the duty of the family to take care of its older person members while the state may design programs of social
security for them.
RA 7432 “Senior Citizens Act of 1992"
◦ An act to maximize the contribution of senior citizens to nation-building, grant benefits & special privileges
& for other purposes.
REFERENCES
Robnette, Regula et al (2020), Gerontology for Health Care Professional, 4th ed. Jones Bartlett Learning, Burlington MA(
Williams, Patricia. (2016). Basic geriatric nursing. 6th ed. St. Louis, Missouri Elsevier. [Nsng/618.970231/W674/2016]
 

 
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Ethical aspects in the Care and Health Promotion in Older Adults

Ethical Considerations in the Care of Older Adult

What is Ethics in Geriatric Care?

Key Ethical Principles in the Care of Older Adults

1. The right to quality health care.

Three Elements of Informed Consent

4. Privacy and Confidentiality

Measures to Help Nurses Make Ethical Decisions

Philippine Laws related to Care of the Older Persons

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