Ideas or beliefs a person considers highly
important.
 Learned through interactions with social
systems such as family, culture, religion,
school, work, friends, etc.

Branch of philosophy dealing with
standards of conduct and moral
judgment.
 Professional ethics are values held by a
group that has standards to be upheld
by its members in all situations.
 In professional practice, nurses try to
avoid allowing personal values to bias
their treatment for patients.


Utilitarianism—base on concept of “The
greatest good for the greatest number.”
The rightness or wrongness of an action
depends on the consequences of the
action

Deontologic—ethical standards or
principles exist regardless of the ends or
consequences
American Nurse’s Association Code of
Ethics p. 100
 The Patient Care Partnership (formerly
called The Patient’s Bill of Rights) p. 132
 Principles of Healthcare Ethics p. 97

Autonomy—respecting pts choices
 Beneficence—doing good
 Nonmaleficence—avoiding harm
 Paternalism—combo platter
 Justice—being fair
 Fidelity—keeping promises
 Veracity—being honest
 Confidentiality—respecting privacy

Creating the conditions in which patients
can make their own decisions
 Informed consent and advanced directives
protecs the patient’s right for healthcare
decision making.
 Patients of sound mind can choose to be
treated or not.
 We also have to be culturally sensitive

› Navajo (to speak of ill will cause ill to happen)
› Asian (may want another to make decision)
Doing or promoting good
 Striving to achieve optimal outcomes
 Act on behalf of patients to do good as
defined by the patient.
 Administering pain meds, performing
dressing changes to promote wound
healing, and providing emotional
support are acts of goodness.

Avoiding or removing harm
 Protecting patients from impaired coworkers, identifying safety risks and
preventing them, and reporting
suspected abuse are examples of
nonmaleficence.

A combo of beneficence and
nonmaleficence
 Intentional limitation of autonomy, justified
by the welfare or needs of another
 The prevention of harm takes precedence
over any potential evil caused by
interference with the individual’s autonomy
or liberty.
 Consider nursing home placement for the
elderly and tube placement for anorexic
patients

Treating everyone with dignity and respect
Providing comparable care
A just healthcare system provides care on
the basis of medical need and the degree
of that need rather than ability to pay,
social status, racial identity, or gender.
 Deciding how much time to spend with a
patient should be based on need not how
likable they are.
 Nurses should be aware of government and
community resources for assistance



Being faithful to one’s commitments or
promises.
 Providing safe care and maintaining
competence.
 Contract that exists between the patient
and the nurse—what the patient can
expect regardless of the nurse’s age,
background, or personal values.

Telling the truth and being honest with
patients
 The right to self-determination becomes
meaningless if the patient does not
receive accurate, unbiased, and
understandable information.
 One common dilemma is whether to tell
the patient and/or family about a med
error.

Required that patient info remain private
 Professional duty and legal obligation
 Only those caring for patient have
access unless patient signs consent
 Nurses have right to access patient’s
record, but need to be sure they are
doing it for only care-related reasons.


Nurse/patient:
› Paternalism
› Withholding information
› Confidentiality
› Allocation of scarce nursing resources
› Advocacy in market driven environment
› Valid consent or refusal
› Conflict between patient/nurse interest
› Conflicts concerning new technology

Nurse/Patient cont’d
› Withdrawing or withholding tx
› Family conflicts over care
› Client mistreatment by staff
› Maternal issues
› Pain control

Nurse/HCP:
› Disagreement about proposed medical
regimen
› Conflict regarding scope of nurse’s role
› Unprofessional, incompetent, unethical, or
illegal HCP practice

Nurse/Institution:
› Short staffing and whistleblowing
› Healthcare rationing

Nurse/Nurse:
› Claims of loyalty
› Unprofessional, incompetent, unethical, or
illegal nurse practice
Ask if this is an ethical dilemma
 Gather info (assess)
 Verbalize problem
 Consider possibilities
 Examine your own values
 Negotiate the outcome
 Evaluate the action

Education
 Policy recommendation
 Case consultation or review

Being attentive and responsive to the
healthcare needs of individual patients
 Concern for patient transcends
whatever happens during the shift
 Ensuring continuity of care when leave
patient
 Try to maintain good judgment—
remember that you are not totally
responsible for the patient’s outcome.

The ability and willingness to assume
responsibility for ones actions and
accepting the consequences of one’s
behavior
 Reliable, trustworthy, credible
 ANA says, “Being answerable to
someone for something done.”
 Being fully accountable requires
autonomy and authority.

The patient
 The profession
 Other members of the healthcare team
 To the employer
 To self

ANA Code for Nurses
 Nursing Quality Assurance & Quality
Improvement Programs
 Participate as a member of professional
nursing organization(s)

Clinical competence: knowing how &
why things are done
 Safe nursing care
 Allow clients to participate in nursing
care activities, including planning
 Respect individual client differences
 Altruistic intentions
 Serve as a client advocate when the
need arises

Bring specialized nursing knowledge &
skills to the health care delivery situation
 Share information with team members
 Confront if potential errors may occur
 Perform nursing tasks with competence
 Treat members with dignity & respect

Quality of work
 Protect against unsafe practice
situations
 Attitude conveyed about the agency

Practice nursing to personal standards
using professional standards as a basis
 Be true to oneself
 Take care of personal, physical, mental,
& spiritual health
 Protect self from harm

Keeping up with new practices in your
area
 Make sure these practices are evidencebased and researched
 Maintain competency requirements set
up by the BON
