Ethical Morality

Problems in Nursing
Rina Annisa
Euthanasia??
?
 In nursing practice, there are five
basic issues about ethical principles
considerations:
1. The quantity versus life quality
Euthanasia
2. Freedom versus treatment and
prevention of dangers
An elderly client refuses to wear a
belt to help him walk, because he
want to walk free.
3. Tell the truth versus tell a lie
A nurse find her close friend using
narcotics.
4. The desire to knowledge as opposed
to philosophy, religion, politics,
economics, and ediologi.
A client chose to the removal of sin
than visit the doctor.
Anti-smoking vs economic policy.
5. Funds allocation for military research
is greater than the health research
funds.
 Scientific therapy versus
conventional therapy is not scientific
Indonesian society (conventional
therapy, people usually use a variety
of intermediaries such as shamans,
kris, stone, etc)
Ethics theory
system
 Basic ethical concepts
The standard of best interest

Applied when a decision must be made

about a patients health care and
the patient is unable to make an
informed decision

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 Ethical theories
1- Teleology
2- Deontology
3- Institutionism
4- Ethic of caring

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Ethical theories.(continue)
Teleology: looks to the consequences
of an action in judging whether that
action is right or wrong

Deontology: proposes that the

mortality of a decision is not
determined by its consequences. It
emphasizes duty, rationality, and
obedience to rules

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Ethical theories.(continue)
The difference between
Teleology and Deontology can
be seen when each approach
is applied to the issue of
abortion
Ethical theories..(continue)
Example:
Teleology approach/abortion:
saving the mothers life (the
end, or consequence) justifies
the abortion (the mean, or
act)

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Ethical theories.(continue)
Deontology approach/abortion:
consider any termination of life as a
violation of the rule do not kill and
therefore, would not abort the fetus,
regardless of the consequences to
the mother
Ethical theories..(continue)
Institutionism: summarized as the
notion that people inherently know
what is right or wrong; determining
what is right is not a matter or rational
thought or learning (e.g. the nurse
inherently knows it is wrong to strike a
client, the nurse does not need to be
taught this or to reason it out)
The preceding three theories are based
on the concept of fairness (justice)
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Ethical theories..(continue)
Ethic of caring: it is based on
relationships.
Caring is a force for protecting and
enhancing client dignity
Caring is of central importance in the
client-nurse relationship (e.g. nurses
use trust-telling to affirm clients as a
persons rather than objects and to
assist them to make choices and find
meaning in their illness experiences)
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Ethics principle on
nursing
Moral/ethical principles (concepts)

Are statements about broad, general

philosophic concepts such as
autonomy and justice
They provide the foundation for
moral values, which are specific
prescriptions for actions (e.g. people
should not lie (rule) is based on the
moral principle of respect of
autonomy for people.

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Basic ethical concepts
1. Rights
2. Autonomy
3. Beneficence and Nonmaleficence
4. Justice
5. Fidelity
6. Veracity
7. The standard of best interest

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Right
Rights form the basis of most
professional codes and legal
judgments
Self-determination rights

Rights and cultural relativism

Rights of the unborn

Rights of privacy and confidentiality

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Autonomy
Involves the right of self-determination,
independence, and freedom.
It refers to the right to make ones own
decisions
Respect for autonomy means that nurses
recognize the individuals uniqueness,
the right to be what that person is, and
the right to choose personal goals
Nurses who follow the principle of
autonomy respect a client's right to make
decisions even when those choices seem
not to be in the clients best interest

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Autonomy.. (continue)

Respect for people also means

treating others with consideration
In the clinical setting, this principle
is violated when a nurse disregards
client's subjective accounts of their
symptoms (e.g. pain)
Patients should give informed
consent before tests and
procedures are carried out
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Beneficence and
Nonmaleficence
Beneficence: means doing good

Nurses should implement actions

that benefit clients and their
support persons. However, in an
increasing technologic health
care system, doing good can also
pose a risk of doing harm (e.g.
intensive exercise program).

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Nonmaleficence: means the duty to do no harm.

This is the basic of most codes of nursing

ethics.
Harm can mean deliberate harm, risk of harm,
and unintentional harm.
In nursing, intentional harm is always
unacceptable.
The risk of harm is not always clear
A client may be at risk of harm during a
nursing intervention that is intended to be
helpful (e.g. medication)
Justice

Is often referred to as fairness

Nurses frequently face decisions in
which a sense of justice should
prevail (succeed)
E.g. busy unit, new admission

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Fidelity

Means to be faithful to agreements and

responsibilities one has undertaken
Nurses have responsibilities to clients,
employers, government, society, the
profession, and themselves
Circumstances often affect which
responsibilities take precedence at a
particular time

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Verasity

Refers to telling the truth

As a nurse should I tell the truth
when it is known that doing so will
cause harm?
Does tell a lie when it is known that
the lie will relieve anxiety and fear?
Should I lie to dying people?

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