This document discusses cultural and ethical issues in medical surgical nursing. It addresses key aspects of Indian culture including religion, language, social structure, family structure, health beliefs, diet and nutrition. It also discusses implications of cultural issues for healthcare, including family dynamics, diet, health remedies and cultural practices. The document then examines ethical issues nurses may face in clinical practice, with employers, colleagues, and in upholding personal excellence and the nursing profession. Specific bioethical issues are explored, such as end of life planning, euthanasia, organ transplantation, and frameworks for ethical decision making. Resources for addressing ethical dilemmas are also presented.