Key Concepts, Chapter 6, Values, Ethics, and Advocacy

Values are beliefs about the worth of something and are formed during a lifetime,

influenced by the environment, family, and culture. Values essential to the professional

nurse include altruism, autonomy, human dignity, integrity, and social justice.

Nurses can use the process of values clarification to help themselves and patients come to

understand their own values and value systems to guide their decision making.

Ethics is the systematic inquiry into principles of right and wrong conduct, of virtue and

vice, and of good and evil as they relate to conduct and human flourishing. Examples of

types of ethics include bioethics, clinical ethics, and nursing ethics.

Ethical theories or frameworks are systems of thought that attempt to answer how we

ought to live and why. Theories are broadly categorized as action or character guiding.

The principles-based approach to ethics offers specific action guides such as autonomy,

beneficence, nonmaleficence, and justice. Other principles highly valued by nurses

include fidelity, veracity, accountability, privacy, and confidentiality.

The care-based approach to ethics prioritizes the nursepatient relationship and directs

nurses to respond to the vulnerabilities of patients as well as cultivate virtues such as

kindness, attentiveness, empathy, compassion, and reliability.

Nurses learn to practice ethical conduct by cultivating the virtues of nursing,

understanding ethical theories that dictate and justify professional conduct, and becoming

familiar with codes of nursing ethics and standards for professional nursing conduct.

Bills of rights exist for both patients and registered nurses.

Nurses can use the nursing process to guide ethical decision making. Ethically relevant

considerations include a balance between benefits and harms in the care of patients;
 disclosure, informed consent, and shared decision making; norms of family life; the

relationship between clinicians and patients; the professional integrity of clinicians; cost-

effectiveness and allocation of care; issues of culture and/or religious variation; and

considerations of power.

Patient advocacy is central to the roles and identity of professional nursing. Advocacy

may involve political activism or whistle-blowing.