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ETHICO-MORAL NURSING

Jonathan M. Carretas, RN., LL.B. (ongoing)

Ethics
o Etymologically, it derives its meaning from the Greek word Ethos, which literally means customs or particular behavior. o Is a practical science dealing with the morality of the human acts or conduct. (Alora, 1997:7) o It guides the intellect in the acquisition and application of moral principles. The way to a right moral decision. (Panizo, 1964:4)

Ethics
o systematic inquiry into the principles of right or wrong conduct, of virtue or vice, and of good and evil as they relate to conduct morals, although similar in meaning to ethics, usually refer to personal standards of right and wrong in conduct, character, or attitude.

Morality o Conformity with recognized rules of correct conduct. A system of duties. (Blacks Law Dictionary) Moral Law o A collection of principles defining right and wrong conduct o A standard to which an action must conform to be right or virtuous. (Blacks Law Dictionary)

Ethical Nature of Nursing Practice


o That every nursing plan or health care action or intervention of nurses to the patient involves a human person, his needs, values, inner worth, and inherent human rights and dignity.

II. Ethical conduct essential to the practice of professional nursing described in the nursing code of ethics formal statement that determines the standards of conduct of a professional nurse

The Nursing Code of Ethics reflects the following underlying moral principles: i. Autonomy (the right to make ones own decisions) ii. Nonmaleficence (duty to do no harm) iii. Beneficence (doing good) iv. Justice (fairness) v. Fidelity (faithfulness to agreements and responsibilities one has undertaken) vi. Veracity (telling the truth)

Functions of the nursing code of ethics i. inform the public about the minimum standards of the profession and to help them understand professional nursing conduct ii. to provide a sign of the professions commitment to the public it serves iii. to outline the major ethical considerations of the profession iv. to provide general guidelines for professional behavior v. to guide the profession in self-regulation vi to remind nurses of the special responsibility they assume when caring for the sick

Ethical Principles
o 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

The most fundamental of these principles is the respect for persons. The primary and basic ethical principles are the following: o o o o Respect for autonomy Nonmaleficence Beneficience Justice

The secondary ethical principles that can be incorporated with the primary principles when interpreting ethical issues and making clinical decisions are the following: o Veracity o Confidentiality o Fidelity

RESPECT FOR PERSONS


o According to the American Nurses Association (ANA), the most fundamental principle of professional behavior is the respect for persons. This principle not only applies to the clinical settings but to all lifes situations. o This principle emphasizes that all people should treat others as a worthy individual. o In nursing practice this principle should be simplified. Thus, respect for persons generally means respecting a clients autonomy.

RESPECT FOR AUTONOMY


o Respecting a clients rights, values and choices is synonymous to respecting a persons autonomy. Informed consent is a method that promotes and respects a persons autonomy. o 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. o In clinical settings, this is promoted by proving informed consent to the client.

NONMALEFICENCE
Nonmaleficence means duty to do no harm. This is promoted by doing the following nursing interventions: o Avoiding deliberate harm, risk of harm that occurs during the performance of nursing actions. o Considering the degree of risk permissible. o Determining whether the use of technological advances provides benefits that outweigh risks.

BENEFICENCE
o Beneficence is doing or active promotion of good. This is done by: o Providing health benefits to the clients. o Balancing the benefits and risks of harm. o Considering how a client can be best helped.

JUSTICE
o Justice is the promotion of equity or fairness in every situation a nurse encounters. The following nursing implications promote justice: o Ensuring fair allocation of resources. (example: appropriate staffing or mix of staff to all clients) o Determining the order in which clients should be treated. (example: priority treatments for the clients in pain)

SECONDARY PRINCIPLES OF ETHICAL CONDUCT

o Veracity duty to tell the truth


o Confidentiality duty to respect privileged information

o Fidelity duty to keep promises

Nursing as Caring o based on relationships


o emphasizes courage, generosity, commitment, and responsibility o force for protecting and enhancing patient dignity o 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

ADVOCACY
It is protecting and supporting of another's rights by pleading the case of another

Patient Advocate
an individual who protects and supports the rights of a patient by pleading the case of the patient

Actions of Patient Advocates

i. Informing Patients
about their rights in a situation and providing them with the information they need to make an informed decision, e.g.: i. determining if the patient agrees to receiving the information ii. either having the necessary information or knowing how to get it

Actions of Patient Advocates


iii. Wanting the patient to have the information iv. Presenting the information in a way that is meaningful to the patient v. Dealing with the fact that there are those who do not wish the patient to be informed if it is wrong

ii. Supporting Patients


in their decisions in an objective manner that conveys neither approval or disapproval, even if the nurse believes in his own opinion.