2. INTRODUCTION
The contribution of nursing to the alleviation of
suffering and to protection and promotion and
restoration of health is a proud in the history. The
image of any organization depends upon the behaviour
of people who constitute it. So, there is great obligation
on the part of employees to behave in an ethical way at
the work place.
This is equally applicable to the nurses who are
working in different sectors of health care delivery
system. The way nurses behave, reflect the image of
that organization. Today the nurses face a variety of
ethical problems than ever before.
3. LEGAL STANDARDS: Some things are right or
wrong by laws
NURSING ETHICS: A standard for professional
behaviour. A guide to identify our conduct in
relation to
PATIENTS
FELLOW NURSES
HEALTH CARE TEAM
OUR COMMUNITY
OUR PROFESSION
4. MEANING
The word Ethics is derived from Greek word “Ethos”
which means customs or guiding beliefs (character).
5. DEFINITIONS
It can be viewed as a generic term for several ways of
examining the morale of life. -BEAUCHAMP TL
Ethics is the study of good conduct, character and
motives.
-POTTER
6. ETHICAL PRINCIPLES
1. AUTONOMY
Autonomy can be defined as „ self-rule with no
control, undue influence or interference from
other”.
Refers to make one’s own decision.
Nurses recognize the individual’s uniqueness.
It is about respecting other people’s wishes and
supporting them in their decisions.
7. 2. BENEFICENCE
This can be defined as “the principle of doing well
and providing care to others”
Refers to taking positive actions to help others.
As employees are we properly trained and
competent to carry out the tasks we are providing
to our children/families/clients/customers.
Eg : child’s immunization may discomfort during
administration, but the benefit of protection from
disease for the individual and society, outweigh the
temporary discomfort.
8. 3. NON-MALEFICENCE
Refers to avoidance of harm or hurt.
“Obligation not to inflict harm on others”
Nurses tries to balance the risks and benefits of a plan of
care. .
However, do we sometimes cause short term harm for
long term good .
4. JUSTICE
Simply defined as “equal treatment of equal cases” or the
principle of fairness.
Treat all clients equally and fairly.
However, some people need to be treated differently if
they require special care over and above what other
people may need.
9. 5. CONFIDENTIALITY
It refers to the rights of clients for protection of privacy
without diminishing access to quality care.
It is important for trusting relationship.
Nurses will not share information about the client
unless it is agreement from the client or required by
the law.
10. 6. ACCOUNTABILITY:
It is an ability to answer for one’s own action.
Nursing professional must agree to evaluate practices
and actions and to take action to preserve nursing
excellence.
7. VERACITY
It is concerned with being open, honest and truthful with
people.
It is also the accurate transfer of information in a way
that is suitable for the individual to understand
“This is not always an easy principle to maintain when
you are asked difficult questions, or your answer may be
distressing”
11. 8. FIDELITY
Fidelity is about
Being Faithful
keeping promises
always doing what is right
being trust worthy
Confidential
Showing respect and dignity
respecting autonomy
Acting in their best interest.
12.
13. INTERNATIONAL CODE OF
NURSING ETHICS
THE ICN CODE OF ETHICS FOR NURSES
An international code of ethics for nurses was first
adopted by the International Council of Nurses (ICN)
in 1953.
14. ELEMENTS OF THE CODE
1. NURSES AND PEOPLE
In providing care, the nurse promotes an environment in
which the human rights, values, customs and spiritual
beliefs of the individual, family and community are
respected.
The nurse holds in confidence personal information and
uses judgement in sharing this information.
15. 2. NURSES AND PRACTICE
The nurse carries personal responsibility and
accountability for nursing practice.
The nurse at all times maintains standards of personal
conduct.
The nurse, in providing care, ensures that use of
technology and scientific advances are compatible
with the safety, dignity and rights of people
16. 3. NURSES AND THE PROFESSION
The nurse assumes the major role in implementing
acceptable standards of clinical nursing practice,
management, research and education.
4. NURSES AND CO-WORKERS
The nurse sustains a co-operative relationship with co-
workers in nursing and other fields.
The nurse takes appropriate action to safeguard
individuals, families and communities when their
health is endangered by a co- worker or any other
person
17. 5. NURSES AND SOCIETY
Participate and share responsibility with other citizens
& other health professionals.
Recognize and perform the duties of citizenship
Aware of laws and regulations which affect the
practice of nursing.
18. INC CODE OF ETHICS FOR NURSES
IN INDIA
The nurse respects the uniqueness of individual in
provision of care.
Provides care for individuals without consideration of
caste, creed, religion, culture, ethnicity, gender, socio-
economic and political status, personal attributes, or
any other grounds.
Individualizes the care considering the beliefs, values
and cultural sensitivity.
Appreciates the place of the individual in family and
community and facilitates participation of significant
others in the care.
19. Develops and promotes trustful relationship with
individual(s).
Recognizes uniqueness of response of individuals to
interventions and adapts accordingly.
The nurse respects the rights of individuals as partner in
care and helps in making informed choices
Appreciates individual’s right to make decisions about
their care and therefore gives adequate and accurate
information for enabling them to make informed choices.
The nurse respects the rights of individuals as partner in
care and helps in making informed choices
Respects the decisions made by individual (s) regarding
their care.
Protects public from misinformation and
misinterpretations.
20. Advocates special provisions to protect vulnerable
individuals/groups.
The nurse respects individual’s right to privacy,
maintains confidentiality, and shares information
judiciously.
Respects the individual’s right to privacy of their
personal information.
Maintains confidentiality
Nurse maintains competence in order to render Quality
Nursing Care.
Nursing care must be provided only by registered nurse.
Nurse strives to maintain quality nursing care and
upholds the standards of care.
21. Nurse values continuing education and utilizes all
opportunities for self-development.
The nurse is obliged to practice within the framework of
ethical and legal boundaries
Adheres to code of ethics and code of professional
conduct for nurses in India developed by Indian Nursing
council.
Nurse is obliged to work harmoniously with the
members of the health team.
Appreciates the team efforts in rendering care.
Cooperates, coordinates and collaborates with the
members of the health team to meet the needs of the
people.
Demonstrates personal etiquettes in all dealings.
Demonstrates professional attributes in all dealings.
22. (FOR
NURSES IN INDIA)
1. PROFESSIONAL RESPONSIBILITY AND
ACCOUNTABILITY:
Nurse Maintains standards of personal conduct. It is
accountable for his/her own decisions and actions.
Carries out responsibilities.
Is accountable for own decisions and actions
Is responsible for continuous improvement of current
practices
Provides adequate information to individuals that allows
them informed
23. 2. NURSING PRACTICE :
Provides care in accordance with set standards of
practice
Treats all individuals and families with human dignity.
Respects individual and families in the context of
traditional and cultural practices and discouraging
harmful practices.
Promotes participation of individuals and significant
others in the care
Ensures safe practice
24. 3. COMMUNICATION AND INTERPERSONAL
RELATIONSHIPS:
Establishes and maintains effective interpersonal
relationship with individuals, families and communities
Maintains effective interpersonal relationship with
them
Cooperates with other health professionals to meet
the needs of the individuals, families and community
25. 4. VALUING HUMAN BEING
Takes appropriate action to protect individuals from
harmful unethical practice
Encourage and support individuals in their right to
speak for themselves on issues affecting their health
and welfare
Respects and supports choices made by individual
26. 5. MANAGEMENT
Ensures appropriate allocation and utilization of
available resources
Communicates effectively following appropriate
channels of communication
Participates in performance appraisal
Participates in evaluation of nursing services
27. ETHICAL ISSUES IN NURSING
1.UNSAFE PATIENT TO NURSE RATIO:
2. INAPPPROPRIATE MEDICATION ORDER
3. UNRESPONSIVE
4. INAPPROPRIATE TASK
5.LIFE THREATNING PATIENT DECISIONS
28.
29. MEANING
The word law is derived from an Anglo-Saxon term
meaning that which is laid down or fixed.
DEFINITION
Law is a body of rules of conduct inherent in human
nature and essential to human society and guide
human functions.
30. PURPOSES
1. Safeguarding the public:
The public safety is guaranteed
The individual is secure to the event of sickness or
disability with no fear of anxiety of being cared for by
a competent person.
It protects the patients /clients against deliberate
injury by a nurse.
31. 2. Safe guarding the nurse:
It protects the nurses also against the legal action if
she renders right care.
Good rapport
32. LEGAL LIABILITY IN NURSING
1. UNINTENTIONAL TORTS:
These types of torts are accidents that cause injury to
another person or property.
NEGLIGENCE: Nursing negligence usually means failure
by the nurse to take the appropriate action to protect the
patient from harm.
E.g.: Burns, falls, medication errors, failure to observe, use
of defective equipment’s, loss of patient property, patient
mix up.
MALPRACTICE: Medical malpractice is an act by a health
care provider which deviates from accepted standards of
practice in the medical community and which cause injury
to the patient.
33. ELEMENTS OF MALPRACTICE
DUTY- (relationship) nurse’s responsibility to provide
care in an acceptable manner.
BREACH OF DUTY- failed to provide care in acceptable
manner.
INJURY (DAMAGES)- nurses act caused harm.
Leaving foreign objects like sponge or forceps, inside a
patient during surgery.
Failing to assess and observe patient as directed.
Failing to report a change in a patient’s condition such
as vital signs, circulatory status and level of
consciousness.
Failure to select appropriate site by the nurse to
administer intramuscular injection that causes
permanent damage to patient’s extremity.
Falling to obtain an informed consent.
34. 2. INTENTIONAL TORTS:
These types of torts are deliberate actions in which the
intent is cause injury to a person or property.
ASSAULT: Assault is the threat of unlawful touching of
another, the wilful attempt to harm someone. Assault
can be verbally threatening a patient.
BATTERY: Battery is the unlawful touching of another
without consent or justification. In legal medicine
battery occurs if a medical or surgical procedure is
performed without patient consent.
35. 3. QUASI INTENTIONAL TORTS:
It is usually involving situations of communication and
often violates a person’s reputation, personal privacy
or civil rights.
Defamation : It is the issuance of a false statement
about another person which causes that person to
suffer harm. (the action of damaging the good
reputation of someone)
Fraud: Fraud is a crime or offence of deliberately
mislead another in order to damage another to obtain
property or services and a civil law violation.
Invasion of privacy: Clients have claims for invasion
of privacy , e.g. their private affairs, with which the
public has no concern, have been publicized.
36. LEGAL ISSUES IN NURSING
PRACTICE AREA
Patients property
Caring patients with AIDs
Living wills and health care surrogates
Deaths and dying
Autopsy and organ donation
37. LEGAL RESPONSIBILITIES OF
NURSES
1. AT ADMINISTRATIVE AND SUPERVISORY LEVEL
Appointing and assigning the nurses
Quality control
Material management
Proper documentation system
Staff management
38. 2. AT OPERATIONAL LEVEL
Carrying out physician’s orders
Alert for mishap
Maintaining safe environment
Use of safe equipment's
Maintenance of proper records
39. OTHER ISSUES
PATIENT CARE ISSUES
Nursing shortage
Low salaries
Standard care
MANAGEMENT ISSUES
Turnover
Funding
Workload
Issues regarding malpractice in nursing management
Issues of delegation and supervision
Issues related to staffing
Collaboration issues
40. EMPLOYMENT ISSUES
Issues related to nursing shortage
Issues in nurse migration
The right to work and right to practice
Exploitation and discrimination
Misconduct and imposition of punishment
Sexual harassment at the workplace
Renewal of nursing registration
Specialization in clinical area
Nursing care standards
