CHARINA AUBREY RIODIL
BSN-II
Nurses have the responsibility to recognize and identify ethical issues that
affect staff and patients. For example, providing nursing care for clients undergoing
an abortion may raise ethical and moral concerns and issues for some nurses; and
some patients may be affected with a liver transplant rejection because donor livers
are not abundant enough to meet the needs of all patients who request it.
Many hospitals, medical centers and other healthcare facilities have
multidisciplinary ethics committees that meet as a group and resolve ethical
dilemmas and conflicts. Nurses should avail themselves to ethicists and ethical
committees within their facility when such ethical resources and mechanisms are
present in order to resolve ethical concerns and ethical dilemmas.
In addition to utilizing these resources, the nurse can take appropriate actions
when faced with an ethical dilemma by understanding and applying the ethical
guidelines provided in the American Nurses Association's Code of Ethics, the
American Medical Association's Code of Ethics, the World Medical Association's
Code of Ethics, the American Nurses Association's Standards of Care and
Standards of Practice, American Nurses Association's position papers such as that
which describes the ethical use of narcotic analgesics at the end of life even if this
medication hastens death, state board of nursing declaratory statements, and the
International Nurses Association's Code of Ethics.
The steps of the ethical decision making process, like the problem solving process,
are:
Problem Definition. Problem definition is the clear description of the ethical
dilemma and the circumstances revolving around it.
Data Collection. During this phase of the ethical decision making process
includes a review of ethical codes, published evidence based practices,
declaratory statements, professional position papers and the professional
literature.
Data Analysis. The collected data is then organized and analyzed.
The Identification, Exploration and Generation of Possible Solutions to the
Problem and the Implications of Each. All possible solutions and alternatives to
resolve the ethical dilemma are explored and evaluated.
Selecting the Best Possible Solution. All potential solutions and alternatives
are considered and then the best and most ethical action is taken.
Performing the Selected Desired Course of Action to Resolve the Ethical
Dilemma
Evaluating the Results of the Action. Like the evaluation phase of the Nursing
Process, actions to resolve ethical issues are evaluated and measured in terms
of their effectiveness to resolve the ethical dilemma.
Informing the Client and Staff Members of Ethical Issues Affecting Client Care
Nurses have the responsibility to identify ethical issues that affect staff members and
patients; and they also have the responsibility to inform staff members and affected
clients of ethical issues that can and do affected client care. For example, providing
nursing care for clients undergoing an abortion may raise ethical and moral concerns
and issues for some nurses; and some patients may be affected with a liver
transplant rejection because donor livers are not abundant enough to meet the
needs of all patients who request it.
Although a rare occasions, a patient may, at times, ask you to do something that is
not ethical. For example, a patient may ask a nurse to assist in their suicide at the
end their life or they may inquire about another patient in terms of their diagnosis.
When something like this occurs, the nurse must inform the client that they cannot
do it for ethical and legal reasons.
Clients may also need information about ethics can affect the care that they choose
or reject. For example, a client may ask the nurse about whether or not it is
permissible ethically and legally to reject CPR at the end of life or to take pain
medications even if it hastens their death.
Ethics, simply defined, is a principle that describes what is expected in terms
of right and correct and wrong or incorrect in terms of behavior. For example, nurses
are held to ethical principles contained within the American Nurses Association
Code of Ethics. Ethics and ethical practice are integrated into all aspects of nursing
care.
The two major classifications of ethical principles and ethical thought are
utilitarianism and deontology. Deontology is the ethical school of thought that
requires that both the means and the end goal must be moral and ethical; and the
utilitarian school of ethical thought states that the end goal justifies the means even
when the means are not moral.
6 Ethical Principles in Nursing
Nonmaleficence – Remain competent in the field and report suspected abuse.
- is doing no harm, as stated in the historical Hippocratic Oath. Harm can be
intentional or unintentional.
Beneficence – Have compassion, take positive actions to help others and follow
through on the desire to do good.
- is doing good and the right thing for the patient.
Fidelity – Keep commitments, based on virtue of caring.
- is keeping one's promises. The nurse must be faithful and true to their
professional promises and responsibilities by providing high quality, safe care
in a competent manner.
Autonomy – Respect patient’s wishes, even when you do not agree with them.
- are upheld when the nurse accepts the client as a unique person who has the
innate right to have their own opinions, perspectives, values and beliefs.
Nurses encourage patients to make their own decision without any judgments
or coercion from the nurse. The patient has the right to reject or accept all
treatments.
Principles of totality & integrity – Consider the entire person when deciding which
therapies, medications or procedures a patient should receive.
Justice – Treat all patients fairly and equally.
- is fairness. Nurses must be fair when they distribute care, for example, among
the patients in the group of patients that they are taking care of. Care must be
fairly, justly, and equitably distributed among a group of patients.
The most commonly occurring ethical issues and concerns in healthcare include
the allocation of scarce resources and end of life issues.
Bioethics is a subcategory of ethics. Bioethics addresses ethical concerns like
those that occur as the result of advancing science and technological advances.
Some of the most common, current bioethical issues revolve around stem cells,
cloning, and genetic engineering.
