Introduction:

Ethics are the rules for correct behavior. Professional ethics for nurses will state the
ideal ways in which a nurse should behave in all relationships including those with the patient,
patients relatives, co-workers, members of other professions & the pubic. The discussion of
the professional adustment is complete only when ethics are included.
Definition:
Ethics is defined as, !"aws of human conduct & duties.#
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Ethics is an account of human actions & the goal of ethical deliberations is to udge
human actions.
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Ethics is concerned with doing well and avoiding harm.
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Terms used in Ethics:
Morals:
0oral refers to the actual standards of conduct observed by individuals.
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Professional Ethics:
Professional eti3uettes are good manners in professional relationship.
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Ethics Dilemma:
4n ethical dilemma is a, !Problem that involves two or more morally correct course of
action but you cant do both.
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Ethical Problems:
Ethical problems are defined as, !5ne in which two or more moral norms or principles
create a challenge about what to do.#
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Ethical Issues:
Ethical standards in which the rights of human subects are protected.
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5r
4n issue that involve the core values of practice.
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Important Ethical Concepts:
The important ethical concepts in nursing are as follows6
&. 0ake sure that the nurses & client are ade3uately informed.
1. 7mplement care systematically.
2. 0aintain your nursing knowledge and competence.
8. Protect and safeguard your client.
/. 9pholds the rights of your client.
-. Treat client with dignity.
(. 4dminister individuali:ed care.
'. 4dminister client-centered care.
&
,. 7n corporate health teaching & counseling into your plan of care.
&). 0ake sure that all data recorded appropriately & communicated clearly.
&&. 0aintain continuity of care.
&1. E;tend your nursing goals to families & the broader public through collaborative
efforts.
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Principles of Ethics:
&. .eneficence <=oing >ood?.
1. @on maleficence <4voiding harm?.
2. 4utonomy <Aelf =etermination?.
8. +ustice <Treating people fairly?.
/. Bidelity <Ceeping promises?.
-. Deracity <Truth Teling?.
(. Eonfidentiality <Fespecting Privileged information?.
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1. Beneficence: (Doing ood!
7t is viewed as a primary obligation of health care professionals.
.eneficence has two aspects6
&. Providing .enefits to the patients.
1. Geighing and balancing the benefits against any harm that might
be incurred by patient.
This involves careful assessment of the actions professional nurse takes in providing care
for their patients.
". #onmaleficence ($%oiding &arm!:
7t re3uires that in our patient care we not cause any harm. 7t highlights the
importance that !Birst of all do no harm# has as a priority over & above that of
providing benefits to patients.
2. $utonom' ((elf Determination?6
Fespect for patient autonomy is shown by providing patients with the
information they need to make their own decisions about their care.
). *ustice (Treating People fairl'!:
7t implies choosing the action that is most fair & e3uitable after reflecting on the
claims or rights of the individuals involved in the decision.
7t is applicable to the allocation of scarce resources & development of an optimal
level of care for all clients.
+. ,idelit' (-eeping promises!:
7t means that the nurse acts in good faith to keep promises made to the client and
does not make promises that cannot be kept.
.. /eracit' (Truth Telling!
7t means truthfulness clients e;pect that nurses & all health care professionals
will be truthful in their communication.
(. Confidentialit':
7t means that the nurse respects all privileged information about a client.
Code for #urses:
1
The code provides guidelines with respect to the care of individuals and for
accountability to individuals, to the profession & to society.
$merican #urses $ssociation (101+! code for #urses:
&. The @urse provides services with respect for human dignity & the uni3ueness of the
client, unrestricted by consideration of social or
economic status, personal attributes or the nature of health problems.
1. The nurse safeguards the clients rights to privacy by udiciously protecting information
of a confidential nature.
2. The nurses act to safeguard the client and the public when health care and safety are
affected by the incompetence unethical or illegal practice of any person.
8. The nurse assumes responsibility and accountability for individual nursing udgments &
actions.
/. The nurse maintains competence in nursing.
-. The nurse e;ercises informed udgments & uses individual competences &
3ualifications as criteria in seeking consultation, accepting responsibilities and
delegating nursing activities to others.
(. The nurse participates in activities that contribute to the ongoing development of the
professions body of knowledge.
'. The nurse participates in the professions efforts to implement & improve standards of
nursing.
,. The nurse participates in the professions efforts to establish and maintain conditions of
employment conducive to high 3uality nursing care.
&). The nurse participates in the professions efforts to protect the public from
misinformation & misrepresentation & to maintain the integrity of nursing.
&&. The nurse collaborates with the members of health professions & other citi:ens in
promoting community & national efforts to meet the health needs of public.
Theories of Ethics:
The maor ethical theories in deciding !Fight conduct# are as follows6
1. Teleological or conse2uentialist Theor':
These theories entail the beliefs that good is defined by the
Eonse3uences of any actions.
The focus of this theory is the result of persons or groups
actions.
The most well known conse3uentialist theory is the utilitarian
theory, which re3uire an evaluation of the benefits or harms that
may occur. .enefits are the results that are advantageous or
good, harm involves inury or hurt.
". Deontological or non conse2uentialist Theor':
7t is a theory of ethical in3uiry that view actions as right or wrong.
Fules of conduct must be autonomous choices by the one acting
in the situation. Fules must be freely chosen by the participants
in any decision making situation.
Gith in our society social & professional contracts have established many of our
dictates for proper behaviors. These contracts develop & maintain relationship
2
of trust between individuals or groups. @urses establish relationship with their
patients in which they ointly agree to work for the accomplishment of shared
goals for their care. @urses also have established relationship with physician
that involves a duty to carry out the medical orders.
Ethical ('stem:
&. The Recognition of principles & values that are in conflict.
1. The Selection of a response to the conflict.
2. The Intention to act in a morally correct manner.
8. The Performance of the chosen behavior to resolve the dilemma.
Ethical Decision Ma3ing Model:
Ethical Decision Ma3ing6
Ethical decision making in nursing practice re3uires determining facts, identifying the
ethical problem, analy:ing options by applying ethical theories & principles and making
choices. .ecause health care is ideally delivered by a team, many ethical decisions should be
team based. That team includes not only nurses & other health providers but also client &
families.
Murph' and Murph' model of ethical Decision Ma3ing: (104.!
This model clearly identifies concern for conse3uences in the process of ethical decision
making. 7t re3uires assessment, problem identification, identification of decision makers, and
e;ploration of alternatives, decision making evaluation & identification of possible
modifications arising from the evaluation
7dentify the health Problem
7dentify the ethical Problem
Atate who is involved in making decision
7dentify the nurses role
Eonsider as many alternatives as possible.
Eonsider the long range & short range conse3uences of each alternative decision
Feach a decision
Eonsider how this decision fits into your general philosophy of patient care
Bollow this situation until the actual results of the decision are visible and use this information
to help make future decision.
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8
5ole of Ethics Committee:
5ne avenue that may be of help to health care providers with
moral conflicts is the hospital ethics committee.
Purposes of institutional ethics committee6
&. Ataff & community education.
1. Ease consultation & review.
2. =evelopment & review of institutional policies on ethical
issues.
@urses in hospitals or agency have developed their own nursing
ethics committees that encourages6
&. The education of nurses in ethical decision making.
1. =iscussion of ethical issues uni3ue to nursing.
2. 7nvolvement of nursing in institutional ethical concerns,
policy making & committee work.
,unctions of a code for #urses:
&. The code for nurses provides moral guidelines to nursing practices in accordance with
consumers health care interest & rights.
1. The code holds nurses accountable for professionally acceptable standards of nursing
care.
2. To upgrade the nursing profession thus benefiting both patients & nurse by investing
nurses with rights & responsibilities.
8. 9pgrading the 3uality of health care.
5ole of #urses in Ethics:
7n &,,1 the 4@4 released its health care reform agenda of universal health care with an
emphasis on primary care & prevention.
The statement recommends a national health insurance programme national co-ordination
of planning for integrated system of health care, new approaches to the delivery of health
care services with nurses prepared for roles in primary care, accountability of the
professions for monitoring member services, health education, home care, and a national
policy on the aged, mentally ill & children.
5ole of #urse in 5esol%ing Ethical Problems:
*ameton6s model for resol%ing Ethical Problems:
1. Identif' the problem:
Ghat is at issues <Dalues, conflicts?H
Ghat is your relation to the problemH
Ghat are the time parametersH
". ather Data:
Gho are the main people involvedH
Ghat does the patient wantH
Eonstruct the case storyH
7. Identif' options:
Ghat courses of action are openH
Ghat are possible outcomesH
Ghat are the potential impacts of outcomesH
/
Ghat future decisions are likelyH
). Thin3 the ethical problem through6
Eonsider basic conventional principles
Eonsider basic human values
+. Ma3e a decision:
Ehoose course of action that best reflects your udgments.
.. $ct 8 $ssess:
Eompare the actual outcome with the proected outcome.
%ow would you improve the process the ne;t timeH
Gould you generali:e this decision to future situations having similar
characteristicsH
(ummar':
Ao far 7 have discussed the definitions, codes for nurses, ethical principles, Theories of
ethics, ethical decision making, role of ethics committee, functions of a code for nurses, role of
nurse in ethic & the role of nurses in resolving ethical problems.
Bibliograph':
&. =eloughery ". >race <&,,/?, !7ssues and Trends in @ursing# second Edition, 0osby
Publishers, 0issouri, pp. 112-188.
1. .andman ". Elsie <&,,/?, !@ursing Ethics# Third Edition, 4ppleten Publishers, @ew
+ersey, pp.2-8).
2. Iwemer +.4nn <1))-?, !Professional 4dustments & Ethics for @urses in 7ndia# &
st
edition, ..7. Publishers, Ehennai, pp.,/-,'.
8. Eooper, 0.E. <&,,&?, !Principle 5riented Ethics & the Ethics of Eare6 4 creative
Tension# +ournal of 4dvances in nursing sciences, &8 <1?6 11.
/. 0iedema B.4. <&,,2?, !The @urses Fole on the %ealth Eare Ethics Eommittee, %BE
Borum /<1?6 ''.
-. .lack 0. +oyce <1))2?, !Elinical 0anagement for Eontinuity of Eare# -
th
Edition,
Aaunders Publishers, Pennsylvania, pp. 2,-/).
(. %arman .eebe "aurinda <1))-?, !Ethical Ehallenges in the 0anagement of %ealth
7nformation# 1
nd
Edition, +ohn & .artlett Publishers, 0assachusetts, pp.2-1).
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