This document defines and describes the principle of autonomy in nursing practice. Autonomy refers to self-governance and respecting an individual's thoughts and actions without coercion, as long as they do not infringe on others' freedom. In nursing, autonomy means respecting patients' values and choices in care. The document also discusses ethical dilemmas as situations where moral principles conflict, such as allocating limited healthcare resources between critical patients. Examples of ethical dilemmas in nursing include treatment refusal due to cultural beliefs and not informing patients of their conditions.

1. THE PRINCIPLE
OF AUTONOMY

2. OBJECTIVE:
Defining autonomy
Describing the principle.
How the principle relates to nursing
practice.

3. PRINCIPLE OF AUTONOMY
 Autonomy is the term derived from Greek word ‘auto’
meaning ‘self’ and ‘nomos’ denoting governance, ‘self-
governance’.
 It expresses respect for unconditional worth for individuals,
respect for individual’s thought and action.
-Their decisions should however not infringe(limit) freedom of
others.

4. PRINCIPLE OF AUTONOMY
- People also have freedom to choose to either act or
not but they have to accept responsibility for their
actions. It applies in both decisions and actions.
 Autonomous decisions are based on individual
values, relevant information, free from coercion(force)
and based on reason and deliberation(carefulness).

5. AUTONOMY IN NURSING PRACTICE
 A nurse must always respect the actions and values of
his/her patient without expressing any force on the
patient, acknowledging her choices which are based
on their beliefs.
 Clinical autonomy; The authority, freedom, and
discretion of nurses to make judgements about the
patient care.

6. ETTHICAL DILEMMAS

7. AN ETHICAL DILEMMA
 Is a situation in which two or more moral principles
conflict with one another in a decision-making
process.
OR
 Process of evaluating and choosing among
alternatives in a manner consistent to ethical
principles.

8. DIFFERENCE BETWEEN A
PROBLEM AND A DILEMMA
 Problems can be solved with a single,
discrete(separate/distinct) solution while dilemmas do not
present a clear solution and in most cases are unable to be
solved, but have to be managed overtime towards a solution.
 Problem is a difficulty that has to be resolved or dealt while a
dilemma is a circumstance in which a choice must be made
between two or more alternatives that seem equally
undesirable.

9. DIFFERENCES Cont.
 Problems can be solved but dilemmas can only be
managed as its not possible to give people all their
desires.
 Dilemmas are content specific as they deal with many
targets of which others are compromised whereas a
problem is target specific as it focuses on that one
particular target.

10. Examples of ethical dilemmas in
nursing
 Limited health care resources for too many critical
patients(which patient in ICU should get high level of care to
increase survival rates & which should get lower levels of care
that could decrease their survival rates.
 Refusal of treatment by the patient due to cultural beliefs even
though the health facility can provide treatment.
 Some families request patients should not be told about their
medical condition which can lead the patient into depression.

11. ETHICAL DILEMMAS
1. Allocation of resources
2. Abortion
3. In vitro fertilization
4. Surrogacy
5. Organ transplant
6. Euthanasia
7. Assisted suicide

12. 1. ALLOCATION OF RESOURCES
 It refers to the process of portioning/allocating available facilities in a fair
manner in an organisation.
 Ethical principles to be involved here are; justice-fair distribution of
benefits and harms, beneficence and autonomy. They also include right of
the patient, rights and obligations of both a nurse and the society.
 nurse’s obligation is to ensure fair distribution of resources to the people
to meet health needs as well as protecting individual’s rights(benefits and
harms evenly distributed with available assets).

13. ALLOCATION OF RESOURCES
 Nurse’s obligation is again collaboration with other health professionals
to ensure access to needed health and nursing care requiring ethical
decisions.
 Ethical problems arise where other people are given better health
resource than other of which questions of justice are posed.
- they arises again where a policy developed, accommodate those of
high status neglecting the need of the under-privileged.
 Resources should be balanced; ensuring that all citizens are able to secure
adequate level of care, there are no limited access to resources to the
most vulnerable group in the society.