Ethico-moral principles

and concepts

RAFFY V. TABALBAG RN
 Ethics

• Ethics- Ethos
- comes from Greek word w/c
means character/culture
- Branch of Philosophy w/c determines or study morality (right
and wrong)
- Systematic inquiry into principles of right, from good & evil
as they relate to conduct
• Moral
- personal/private interpretation from what is good and bad.
• Morality (from the Latin moralitas "manner, character,
proper behavior") is the differentiation of intentions,
decisions, and actions between those that are "good" (or
right) and those that are "bad" (or wrong).

• Ethics (also known as moral philosophy) is that branch

of philosophy which addresses questions about morality.
The word 'ethics' is "commonly used interchangeably with
'morality' ... and sometimes it is used more narrowly to
mean the moral principles of a particular tradition, group,
or individual."
• Autonomy -Respect for autonomy is a norm that obliges us to
respect the decisions (self-determination) of adults who have
decision-making capacity. Three conditions must exist for
autonomous action by those with capacity to choose:
• 1.Intentionality
• 2.Understanding
• 3.Absence of controlling influences that determine their action.
The following moral rules or obligations are derived from the
application of the principle of respect for autonomy:
• 1.Tell the truth.
• 2.Respect the privacy of others.
• 3.Protect confidential information.
• 4.Obtain consent for interventions with patients
 Beneficence
The principle of beneficence is a moral obligation to act for the benefit of others.
There are 2 aspects of beneficence:

• 1.Providing benefits
• 2.Balancing benefits and risks/harms.

The principle of beneficence supports the following moral

rules or obligations:
• 1.Protect and defend the rights of others.
• 2.Prevent harm from occurring to others.
• 3.Remove conditions that will cause harm.
• 4.Help persons with disabilities.
 Nonmaleficence
The principle of nonmaleficence holds that there is an obligation not to inflict harm on others. It
is closely associated with the maxim primum non nocere (first do no harm). The principle of
nonmaleficence supports the following rules

• 1.Do not kill.

• 2.Do not cause pain or suffering.
• 3.Do not incapacitate.
• 4.Do not cause offense
 Justice
The principle of justice obliges us to equitably distribute
benefits, risks, costs, and resources. The following arguments
(rules) are supported by the principle of justice

• 1.To each person an equal share

• 2.To each person according to need
• 3.To each person according to effort
• 4.To each person according to contribution
• 5.To each person according to merit
• Accountability is accepting responsibility for one's
own actions. Nurses are accountable for their
nursing care and other actions. They must accept all
of the professional and personal consequences that
can occur as the result of their actions.
• Fidelity self-detis keeping one's promises. The nurse
must be faithful and true to their professional
promises and responsibilities by providing high
quality, safe care in a competent manner.

• Veracity is being completely truthful with patients;

nurses must not withhold the whole truth from clients
even when it may lead to patient distress.
 Moral Principles:
• 1.Golden Rule
• 2.The principle of Totality – The whole is greater than its parts
• 3.Epikia – There is always an exemption to the rule
• 4.One who acts through as agent is herself responsible – (instrument to
the crime)
• 5.No one is obliged to betray herself – You cannot betray yourself
• 6.The end does not justify the means
• 7.Defects of nature maybe corrected
• 8.If one is willing to cooperate in the act, no justice is done to him
• 9.A little more or a little less does not change the substance of an act.
• 10.No one is held to impossible
Ethical theories and
frameworks
 teleology
• teleology views the rightness or wrongness of an action as being
dependent upon the consequences the action produces
emphasizes happiness, pleasure, and absence of pain
 Utilitarianism:
• emphasizes the utility or inutility of an action, or its instrumental value
• utile act:
brings the greatest amount of good into existence for the greatest
number of people
thus the end justifies the means utilized to obtain it
• inutile act
produces harmful effects
• Utilitarianism applied to euthanasia:
"euthanasia, which ends unbearable suffering, is not murder, and
morally right"
• Deontology
deontology views an action as right or wrong
independent of the consequences it produces
emphasizes duty, rationality, and obedience
to rules
• Kantian theory:
emphasizes that respect for persons is
the primary test of one's duties with three
components to this imperative:
• that all persons must be respected as
persons
• that all persons must respect their own
 Institutionism

• the notion that people inherently know what is right or wrong

• as such, right or wrong actions do not need to be taught
 caring
• based on relationships
• emphasizes courage, generosity, commitment, and responsibility
• force for protecting and enhancing patient dignity
• uses touch and truth-telling to affirm patients as persons rather than objects
and to assist them to make choices and find meaning in their illness
Types of ethical problems
 Decision-focused ethical problems
• difficulty lies in what to do
• typically, two or more moral principles can apply
• results in a moral dilemma
• can be resolved by improving one’s decision-making skills
• to deal successfully with these problems, the nurse must
shift attention to "making the right decision" by improving
his/her decision-making skills
 Action-focused ethical problems
• difficulty lies not in what to do, but in implementing it
• typically, the nurse feels secure in the decision about what
is right, but to act on his/her decision puts him/her at
personal risk
• results in moral distress
• cannot be resolved by improving one’s decision-making
skills
• to deal successfully with these problems, the nurse must
shift attention from "making the right decision" and focus on
factors that are preventing the "right action"
 steps to resolve ethical problems
by use of a decision-making
model
• identify the moral aspects of nursing care
•gather relevant facts related to the case
•determine ownership of the decision
• clarify and apply personal values
• identify ethical theories and principles
• identify applicable laws or agency policies
• utilize competent interdisciplinary resources
• develop alternative actions and project their
outcomes on the patient and family
• apply the nursing code of ethics to help guide
 common ethical
problems faced by
nurses
 Between nurses and patients

• Paternalism
•Deception
•Confidentiality
 Between nurses and physicians

• disagreements about the proposed

medical regimen.
• conflicts regarding the scope of the
nurse's role
• physician incompetence
 Between nurses and nurses

• claims of loyalty
• nurse incompetence