Group 2 Presentation Class 3B Ilmu Keperawatan (S-1)

Nur Indah Puspitasari (213114045)

Indah Sari Febriany (213114055)
Saeful Wardani (213114065)
Lukman Latif Nurhakim (213114075)
Sinta Diana Rahayu (213114085)

Ethical Principles of Nursing

The ethical principles provide a foundation for nursing practice. Ethical principles are
defined as basis for nurses decisions on consideration of consequences and of
universal moral principles when making clinical judgments.

Autonomy - agreement to respect another's right to self-determine a course of

action; support of independent decision making.
Informed consent is a method that promotes and respects a persons autonomy. For
a client to make an autonomous decision and action, he or she must be offered
enough information and options to make up his or her mind free of coercion or
external and internal influences. In clinical settings, this is promoted by proving
informed consent to the client.

Example: In clinical situations nurses respect a patients autonomy, where the

patient is allowed the freedom of choice regarding treatment, such as in deciding
whether he/she wishes to be intubated during an exacerbation of COPD, or
deciding when he/she wishes to forgo further dialysis. If a patient lacks capacity for
such a decision and has an advance directive, the person who has the durable
power of attorney can make the decision.

Nonmaleficence (no harm) - avoidance of harm or hurt; core of medical oath

and nursing ethics.
Often in modern times, nonmaleficence extends to making sure you are doing no
harm in the beneficent act of using technology to extend life or in using
experimental treatments that have not been well tested.
This is promoted by doing the following nursing interventions:

1. Avoiding deliberate harm, risk of harm that occurs during the performance of
nursing actions.
2. Considering the degree of risk permissible.
Determining whether the use of technological advances provides benefits that
outweigh risks.
Example: When this elderly person above received pain medication (an act of
beneficence) there are complications that could arise. Practitioners recognize that
using a narcotic may cause confusion. When obtaining the consent for her hip
surgery, we want to make certain that the patient is alert enough to understand the
risks and benefits of the procedure. We must balance the beneficence of providing
the medication quickly with the possible maleficence of obtaining a consent when
patient does not have the capacity to make the decision for surgery.

Beneficience (doing good) - compassion; taking positive action to help others;

desire to do good; core principle of our patient advocacy.
Beneficence is doing or active promotion of good. This is done by:

1. Providing health benefits to the clients.

2. Balancing the benefits and risks of harm.
3. Considering how a client can be best helped.

Example: An elderly patient falls at home and has a fractured hip. In the
emergency room, the nurse acts to provide pain medication as soon as possible in
an act of beneficence.

Justice - this principle refers to an equal and fair distribution of resources, based
on analysis of benefits and burdens of decision.
Justice implies that all citizens have an equal right to the goods distributed,
regardless of what they have contributed or who they are. For example, in the US,
we all have rights to services from the postal service, firefighters, police, and
access to public schools, safe water, and sanitation.
Justice is the promotion of equity or fairness in every situation a nurse encounters.
The following nursing implications promote justice:

1. Ensuring fair allocation of resources. (example: appropriate staffing or mix of

staff to all clients)
2. Determining the order in which clients should be treated. (example: priority
treatments for the clients in pain)

Example: A hospital organization wishes to donate low or no-cost pediatric dental

services to the community. There are openings for 45 children per month. Justice
requires a fair method, that is free from bias, to determine who will receive these
services.
 Veracity (honesty) - the principle of truth telling, and it is grounded in respect for
persons and the concept of autonomy.
In order for a person to make fully rational choices, he or she must have the
information relevant to his or her decision. Moreover, this information must be as
clear and understandable as possible. Truth telling is violated in at least two ways.
The first is by the act of lying, or the deliberate exchange of erroneous information.

Example: Measures infusion must be conducted in accordance with standard

operating procedures that apply where the client was treated.

Confidentiality (secrecy) respect privileged information; information about the

client must be maintained client privacy.
Documentation about the state of health of clients can only be read for the
purposes of treatment and health improvement of clients. Discussion on clients
outside the service area should be avoided

Example: Nurses should not be confiding client to someone else, unless the
permission of the client or the permission of the family for the sake of the law.

Fidelity (keeping promises) - this principle requires loyalty, fairness, truthfulness,

advocacy, and dedication to our patients.
It involves an agreement to keep our promises. Fidelity refers to the concept of
keeping a commitment and is based upon the virtue of caring.

Example: A patient asks the nurse not to reveal the fact that she is dying or give her
diagnosis to his family. The nurse asks why she does not want her family advised.
The patient explains that her family is very emotional and has stated they would do
everything to keep her alive, even if it required long-term mechanical ventilation.
The patient has explained multiple times that she does not want mechanical
ventilation. The nurse recognizes that keeping of this information in confidence,
while supporting the family, is an example of exercising fidelity.

Accountability definite standard that measures a professional can be

assessed in a situation that is unclear or signs exception.

Example: Nurses are accountable for themselves, the profession, clients, fellow
colleagues, employees, and communities. If the nurse gave the wrong dose of
medication to clients nurse may be sued by clients who received the drug,
physicians who provide discretionary task, and communities demanding
professional skills.
Resources:
http://nursingcrib.com/nursing-notes-reviewer/fundamentals-of-nursing/ethical-
principles/
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-
Definitions.pdf
https://rhchp.regis.edu/HCE/EthicsAtAGlance/Veracity/Veracity.pdf