Ethics guide how we should treat one another, how we should act, and what we should do. As nurses, we've all dealt with difficult ethical issues, even dilemmas
, in our practice. They can sometimes be more challenging than the physical care we provide for our patients.
Nursing ethics are the values and principles governing nursing practice, conduct, and relationships between the nurse and patient, patient’s family, other healthcare professionals, and the public. Regardless of practice setting or specialty, nurses face ethical challenges every day. Make sure you are familiar with the ethical principles below.
As advocates, nurses help patients navigate the healthcare system and communicate with members of their care team, including when patients cannot speak for themselves. This also involves preserving dignity and ensuring equitable care. Nurses must also advocate for themselves to prioritize a safe work environment.
The use of sound clinical judgment to make nursing decisions is the foundation of autonomy. These decisions and nursing care must be within the nurses’ scope of practice as determined by the state and institution where they work.
Autonomy also relates to the right of patients to make decisions for their care, even if their choices are different from the beliefs or recommendations of the providers and caregivers.
In nursing, beneficence refers to making sure patients’ best interests are considered, understanding that what is best for one patient may not be best for another. Oftentimes beneficence involves going beyond what is required.
Confidentiality is the right for personal details and health care information to be protected and private unless permission is given to share. The Health Insurance Portability and Accountability Act of 1996
(HIPAA) is a federal law that includes standards to protect sensitive patient health information.
Fidelity refers to fulfilling commitments and staying true to professional promises and responsibilities, such as providing high quality, competent and safe patient care. Demonstrating fidelity helps to maintain credibility.
6. Informed consent
With informed consent
, communication between a patient and a health care provider results in the patient’s agreement to undergo a procedure or treatment. It is both a legal and ethical obligation. Nurses are key participants in the informed consent process, in both educating the patient of the potential risks involved in the procedure and verifying understanding.
Nurses – who approach care holistically – are ideal advocates for justice. We are trusted by the public and are the largest group of health care professionals. Justice refers to the fair and equal treatment of all, protection of rights, equitable distribution of resources, and ensuring that decisions are unbiased.
8. Moral distress
Moral distress, or moral injury
, refers to a situation when it is impossible or nearly impossible to do the morally right thing due to institutional, procedural, or social constraints.
Avoiding harm is the heart of nonmaleficence. Also, it involves balancing unavoidable harm with benefits of good.
The Code of Ethics for Nurses
differentiates the respect for autonomy and the respect for persons. The first focuses on allowing others to make their own decisions and to act upon those decisions as long as harm to others is not a result. The latter is based on the fact that all
persons have value and should be treated with respect.