This new primary ethics textbook is uniquely designed to integrate ethics content into the clinical nursing curriculum and to be used throughout the nursing curriculum. This textbook is designed to ensure that the nursing student benefits from a systematic coverage of clinical ethics, moving from simple ethical issues to more complex. The book covers clinical ethics in theory and practice by building upon the foundations of ethics using the traditional clinical practice content areas such as children and adolescents, adult, critical care, and women's health.

Unit 1 Components of Clinical Ethics 1 xii Contents Chapter 5 Ethical Decision-Making 85 Marcia Bosek Ethical Decision-Making 86 Ethical Decision-Making Goals 87 Realities in Decision-Making 88 Ethical Decision-Making Using the Nursing Process 89 Decision Analysis Model 92 Resources for Facilitating Ethical Decision-Making 93 Chapter 6 Confidentiality 103 Marcia Bosek Confidentiality Defined 104 Rationale for Keeping Information Confidential 104 What Information Is Confidential? 106 Who Can Access Confidential Information? 107 Chapter 7 Truth-Telling 113 Marcia Bosek The Importance of Truth-Telling 114 The Obligation to Tell the Truth 115 Discriminating Between Truth and Nontruth 115 Chapter 8 Advocacy 125 Teresa Savage What Is Advocacy? 126 The Call to Advocacy 127 The Strength to Advocate 127 Relationships Between Health Care Professionals 129 Uncertainty, Dilemma, and Distress 131 Learning How to Advocate 133 Advocacy for the Profession 133 Chapter 9 Allocation of Resources 139 Teresa Savage Justice in Health Care 140 The U.S. Health Care System 140 Unit 2 Ethical Themes and Research Ethics 101 Access to Care 143 Managed Care 143 What to Do? 146 Nurses' Role in Macro Allocation 147 Nurses' Role in Micro Allocation 148 Special Topic: Using Research in Resource Allocation 154 Chapter 10 Research Ethics 159 Teresa Savage Ethical Themes 160 History of Research Ethics 162 Institutional Review Boards 165 Informed Consent 167 Contents xiii Chapter 11 Nursing of Children and Adolescents 183 Teresa Savage Section 1: Ethical Themes: Building From the Basic to the Complex 184 Truth-Telling 184 Confidentiality 185 Advocacy 188 Allocation of Resources 194 Section 2: Decision-Making 203 Surrogate Decision-Making 203 Section 3: The Moral Status of Children 208 Personhood 209 Section 4: Genetics 215 Eugenics 215 Genetic Testing 216 Linkage Analysis 218 Implications for the Family 218 Newborn Screening 219 Chapter 12 Nursing of the Adult 225 Marcia Bosek Section 1: Ethical Themes: Building From the Basic to the Complex 226 Confidentiality 226 Truth-Telling 228 Unit 3 Clinical Ethics Issues 181 Advocacy 231 Allocation of Resources 232 Section 2: Nursing of the Adult: Advance Directives 235 Autonomy 235 Before the Advent of Advance Directives 237 Other Life-Saving Interventions 238 The Patient Self-Determination Act of 1990 240 Advance Directives 241 Values Clarification 242 Do Not Resuscitate Orders 255 The Nurse's Role 257 Section 3: Nursing of the Adult: End-of-Life Choices 260 Autonomy and End-of-Life Choices 261 Section 4: Nursing of the Adult: Adult-Onset Genetic Issues 269 Ethical Issues of Presymptomatic Diagnosis 269 Actions That Promote Informed Consent 271 Special Topic: Medical Directive Project 273 Special Topic: It's Over, Debbie 274 Chapter 13 Women's Health Nursing 281 Teresa Savage Section 1: Ethical Themes: Building From the Basic to the Complex 282 Confidentiality 282 Truth-Telling 283 Advocacy 285 Allocation of Resources 286 Section 2: Informed Decision-Making 290 Balancing Maternal and Fetal Interests 290 Pregnancy and HIV 291 Mandatory Bed Rest 292 Pregnancy and Delivery 292 Contraception 293 Abortion 294 Sterilization 295 Complementary and Alternative Medicine (CAM) 296 Menopause 297 Caregiver Burden 297 Section 3: Assisted Reproduction 299 Infertility 299 Assisted Reproduction 299 Fetal Surgery 303 xiv Contents Section 4: Genetics in Women's Health 304 Genetics 304 Prenatal Testing 305 Chapter