PROFESSIONAL ADJUSTMENT

Bioethical Principles Document – Hospital Information – Patient

o Subpoena Ad Testificandum – court order asking a
 Autonomy (Self Governance) – right of patient to person to appear in court to testify.
decide for his own healthcare. Ordinary Witness – matters within personal
- Accept the decision of client knowledge.
- Signing of waiver – Doctor Expert Witness – gives testimony in their field of
- Priority: Document specialization or expertise.
- Inform MD (Physician is going to change or stop Summon – Notice/Informing him to appear in
the decision) court, informing him of the nature and the cause
- Article 3 Section 6: Accurate documentation of of accusation in him, Asking him to appear in court
actions and outcomes of delivered care is the or to answer in a specified date and time.
hallmark of nursing accountability Anonymity – not disclosing name of the patient to
Paternalism protect their identity.
- “Paternal” father: head of family – decision maker Privacy – includes private moments, parts, properties.
- Withholding the autonomy of the patient for the Justice – equal or fair treatments to all patients that are
benefit of the patient because the patient’s similarly situated.
condition might be unstable. Fidelity – Loyalty or Faithfulness, need to be a member
- MD decides for the patient of PNA.
Informed consent Advocacy – active support of an idea or cause
Criteria:
- Legal Age (18 and above): Can sign the contract Code of Ethics for Registered Nurses
except Marriage contract (needs parent consent - Board Resolution No. 220, Series of 2004 approved
if 21 years old below) July 14, 2004
- Conscious - First and Last Code of Ethics
- Sound Mind (Coherent, No presence of alcohol) - RA 9173 “Philippine Nursing Act of 2002” signed in
- If minor, Majority of age will sign October 2002
- ER – No waiving of Informed consent - IRR – BON Resolution 425 Series of 2003
- Life threatening situation – Waived consent form 3 Branches of Government
- DNR: Advance directives from the patient  Legislative
 Patient – gives the consent - Upper house (Senate) and Lower house (House of
 Doctor – obtain informed consent Representative)
 Nurse – Witness (Signing) - Comprises the Congress
o Actual conversation between MD and patient - Create, Amend (Change), Repeal (Invalid) the Law
o Full explanation coming from the doctor  Executive
o The patient fully understands - Execute, implements and enforce the law
o Patient voluntarily consented (Absence of Force)  Judiciary
o Patient voluntarily signed the consent - Apply and interpret the law

 Veracity – telling the truth Article 1: Preamble

- Benevolent Deception – Withhold the truth from Section 1
the patient for the benefit of the patient because - Health is a fundamental right of every individual
the patient’s condition might be unstable. - As RN, Primary responsibility is to preserve health
- MD – has the right to tell the truth at all cost.
 Beneficence (To Do)– Do good - 4-fold Responsibility: Promotion of health,
Ex. The patient has fever, and you perform TSB Prevention of Illness, Alleviation of suffering,
 Non-Maleficence (To prevent/protect) – Do no harm Restoration of health, Assistance towards a
Ex. You pick up the banana feel in the hospital to peaceful death
prevent harm Section 2
Principle of Double Effect – good effect should always - RN must gain SKA
outweigh the bad effect. But once the bad effect - Utilizing the therapeutic process
outweighs good effect -> STOP - Cultural Diversity, Political, Socio-economic status
 Confidentiality – not disclosing any information or are inherent factors to effective nursing care.
case of the subjects. (Professionally, directly Section 3
involved, Law) - Purpose of COE: Highest possible degree of ethical
o Subpoena Duces Tecum – court orders asking the conduct
person to appear in court to bring documents in Article 2: RN and People
court within his control. Section 4 (Ethical Principles)
Who owns the Chart? - Values, Customs and Spiritual beliefs
 PROFESSIONAL ADJUSTMENT
- Individual Freedom (Autonomy) Section 15 (Guidelines to be observed)
- Strict confidence (Confidentiality) - Be conscious of their obligations as citizens
Section 5 (Guidelines to be observed) - Take active roles in primary health care
- Individuality and totality of patients (Holistic care) - Image that uplift the nursing profession
- Spiritual beliefs and practices, diet and treatment Article 6: RN and the profession
- Uphold the rights Section 16 (Ethical Principles)
- Consider the culture and values - Loyalty to nursing profession
Article 3: RN and Practice - PNA
Section 6 (Ethical Principles) - Continual learning
- Human life is inviolable Section 17 (Guidelines to be observed)
- Quality and excellence in care of patients - Accredited Professional Organization (PNA).
- Accurate documentation is hallmark of nursing Article 7: Administrative Penalties, Repealing clause
accountability. and effectivity
Section 7 (Guidelines to be observed) Section 18
- Know the definition and scope of nursing practice - Revoked or suspend
- Be aware of duties and responsibilities
- Acquire and develop KSA Negligence and Malpractice
- Administrators, Be responsible in providing Negligence (Carelessness) - You did not practice due
favorable environment diligence)
- Nursing Specialty Certification Council (NSCC) – 4 Elements of Negligence
ensure that the program is properly implemented.  Existence of a duty
- Optimum Standard of nursing care  Failure to meet the standard
- Safe nursing practice  Foreseeability of the harm/Proximate Causation
- Patient’s record: Professionally and directly  Injury – Essential element (Absence=No Negligence)
involved and required by law Malpractice
Section 8 (Ethical Principles) - Professional Negligence – There is injury
- Advocates right and privileges - Stepping beyond one’s authority Ex. Prescription
Section 9 (Guidelines to be observed) - Improper or unskillful care of a patient - Skill
- Patient bill of rights - Incompetence – Gross incompetence
- Provide patient with all pertinent information
except benevolent deception
- Uphold the patient’s rights when conflict arises
regarding management of their care.
Section 10 (Ethical Principles)
- Professional, ethical, moral and legal dimensions.
Section 11 (Guidelines to be observed)
- Perform duties in conformities with laws
- Not allow themselves to be used in advertisement
- Decline any gift, favor or hospitality (Capitalizing)
- Not demand and receive any commission, fee or
emolument
- Avoid any abuse of the privilege relationship
Article 4: RN and Co-workers
Section 12 (Ethical Principles)
- Solidarity with other members of HCT
- Collegial and collaborative working relationship
Section 13 (Guidelines to be observed)
- Maintain their professional role (Fidelity)
- Acceptable ethico-legal standards
- Actively participate in professional organizations
- Honor and safeguard the reputation and dignity of
the members of nursing and other professions.
- Respect the rights of their co-workers
Article 5: RN, Society and Environment
Section 14 (Ethical Principles)
- Preservation of life, respect for human rights and
promotions of healthy environment
- Establishment of linkages with the public