Nursing ethics.final

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Ethical Issues in
Nursing
Prof. Dr. Ram Sharan Mehta
Head, Medical-Surgical Nursing Department, CON,
BPKIHS

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Objectives
 Terms: Ethics, Bioethics, Values, Morals
 Ethical principles
 CNA Code of Ethics and primary values
 Nursing Standards definition
 6 standards of nursing practice
 Framework for processing an ethical
dilemma

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Values and ethics
 Values and ethics are inherent in all
nursing acts.
 A value is a strong personal belief;
an ideal that a person strives to
uphold.
 Your values reflect cultural and social
influences, relationships and
personal needs. Vary among people
and develop and change over time.

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What is Ethics?
 Branch of philosophy concerned with
determining right and wrong in relation to
people’s decisions and actions.
 Morals and ethics are often used
interchangeably but morals are often
stated as private, personal standards of
what is right and wrong, ethics reflect a
commitment to standards beyond
personal preferences.

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Nursing Ethics
 An expression of how nurses ought
to conduct themselves. Refers to
ethical standards that govern and
guide nurses in everyday practice
such as “being truthful with clients”
“respecting client confidentiality” and
“advocating on behalf of the client.”

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Ethical Theories
 Ethics of Care-refers to care as a
central activity of human behavior.
Focus is on a more female-based
understanding of relationships and
valuing personal narratives.

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Ethical Theories
 Relational Ethics-used to explain
some of the complexities of nurses
moral obligation to the client.
 It is focused on how we treat others

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Ethical Theories
 Bioethics: Addresses issues relevant
to health care.
 It addresses general ethical
principles in health care.

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Ethical Principles
 Autonomy
 Nonmaleficence
 Beneficence
 Justice

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Ethical Principles
 Autonomy- refers to a person’s
independence, self-determination,
self-reliance. A patient has the right
to make decisions about her/her
care. Ex. Signing a consent form for
surgery

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Ethical Principles
 Nonmaleficience - refers to the
avoidance of causing any harm to clients.
Try to balance the risks and benefits of a
plan of care, while striving to do no harm.
Ex: bone marrow transplant promises to
bring a cure but there may be a long
period of pain and suffering.

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Ethical Principles
 Beneficence- means promoting good
or doing good for others. Take positive
steps to help others. It helps to guide
difficult decisions where the benefits of a
treatment maybe challenged by the risk to
the client’s well-being or dignity. The best
interests of the client must be upheld. Ex:
immunization

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Ethical Principles
 Justice- refers to fairness or equity.
Clients need to be treated in a manner
that they deserve. Ex. Both clients receive
the same treatment when being admitted
for surgery, fair resources etc.

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What does a code of ethics do?
 Gives guidance for decision making
about ethical matters by providing a
set of values that are basic to
nursing practice.

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The Code of Ethics
 Provide rules of ethical or moral
behavior for every circumstance.
 Offer guidance about which values
should take priority or how they can
be balanced in practice.

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Values and The Code of Ethics
Primary values that are central to ethical
nursing practice.
The 7 values include:
1. Providing safe,
2. Compassionate competent and
3. Ethical care,
4. Promoting health and well-being,
5. Promoting and respecting informed
decision-making,
6. Maintaining privacy and confidentiality,
7. Promoting justice and being accountable

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Providing Safe, Compassionate
Competent and Ethical Care
 Nurses value the
ability to provide
safe, compassion,
competent and
ethical care that
allows them to fulfill
their ethical and
professional
obligations to the
people they serve.

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Promoting Health and Well
Being
 Nurses value health
promotion and well being
and assist persons to
achieve their optimum
level of health in
situations of normal
health, illness, injury,
disability or at the end of
life.

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Promoting and Respecting
Informed Decision-Making
 Nurses provide
persons with
appropriate
information and
services so they can
make informed
decisions. Ensure
nursing care is given
with informed
consent

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Preserving Dignity
 Recognize and respect the inherent
worth of each person and advocate
for respectful treatment of all
persons.

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Maintaining Privacy and
Confidentiality
 Nurses safeguard the trust
of clients that information
learned in the context of a
professional relationship is
shared outside the health
care team only with the
clients permission or as
legally required or where
failure to disclose would
cause significant harm.

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Promoting Justice
 Nurses apply and promote principles
of equity and fairness to assist clients
in receiving unbiased treatment (social
justice) and a share of health services
and resources proportionate to their
needs. Safeguard human rights.

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Being Accountable
 Nurses act in a manner consistent
with their professional responsibilities
and standards of practice and are
answerable for their practice.

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Definition of Nursing Standards
 Describes the desirable and achievable
level of performance expected of
registered nurses in their practice against
which performance can be measured
 Benchmark for assessing the professional
conduct of all registered nurses.

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Six Standards of Nursing Practice
 Accountability
 Continuing Competence
 Application of Knowledge, Skills and
Judgment
 Professional Relationships and Advocacy
 Professional Leadership
 Self-Regulation

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Standard 1 and 11
 Accountability
 Accountable to the
public to ensure that
clients receive
competent, safe,
and ethical care.
 Continuing Competence
 The registered nurse
attains and maintains
competence relevant to
their own scope of
nursing practice

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Standard III, IV
 Application of
Knowledge, Skills and
Judgment
 The registered nurse
demonstrates
competencies relevant
to their own scope of
nursing practice.
 Professional
Relationships and
Advocacy
 Establishes a
professional
therapeutic
relationship and is an
advocate for clients.

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Standard V, VI
 Professional
Leadership
 Demonstrates
leadership when
providing quality
nursing care and health
care services to clients.
 Self-Regulation
 Personally accountable to
practice nursing in a
competent and ethical
manner.

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Ethical Decision Making Process
 Guide for ethical discussion
within the context of health
care practice. It
incorporates theories,
principles and codes into the
decision making process.
 An ethical dilemma often
forces a choice between one
or more ethical principles
 Deciding in favor of one
principle can often violate
another principle
 There is often no clear
answer/decision in resolving
ethical dilemmas
 Often ethical dilemmas pose
more questions than provide
answers

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How to Process an Ethical
Dilemma
 1) Is this an ethical
dilemma?
 2) Gather all the
information relevant to
the case
 3) Examine and
determine your own
values on the case
 4) Verbalize the
problem
 5) Consider
possible courses of
action
 6) Negotiate the
outcome
 7) Evaluate the
action

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Summary
 Terms: Ethics, Values, Morals
 Ethical principles
 Code of Ethics and primary values
 Nursing Standards definition
 6 standards of nursing practice
 Framework for processing an ethical
dilemma

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