Ethics is defined as the knowledge of the principles of good and evil. Sensitivity to ethical issues should be prerequisite for any profession that holds public trust. Nursing holds a public trust and therefore we must be aware of ethical concerns when dealing with patients (Barry, 2002). Ethical dilemmas such as consent force nurses to decide on possible actions to take. By discussing the ethical principles of autonomy, beneficence and non-maleficence and applying the ethical theories I hope to make it clear how nurses justify their actions. My understanding of ethical accountability is that I am answerable to myself; I must always be truthful, fair and respectful and I believe I must treat others as I would like to be treated. Nurses faced with an ethical dilemma have to decide which possible action is the right action to take and how choice of this action over others is justified (Singleton and McLaren, 1995). During the module we have looked at various ethical models including Seedhouse’s Ethical Grid (1998) and Curtin’s Ethical Decision Making Model (1982) which provide guidance toward the resolution of clinical dilemmas; some of the aspects of these models will be evolved in the next section of this assignment. Rumbold (1999) insists that respect for a person’s autonomy is one of the crucial principles in nursing ethics and ethical models. Gillon (1986, pp.56) defines autonomy as “the capacity to think, decide, and act on the basis of such thought and decision, freely and independently and without let or hindrance”. Therefore, it can be said that patients can expect to be fully informed of any methods of treatment available to them, in order to exercise their rights to consent to or refuse such treatment. In order for a nurse to fully respect patients autonomy, she must respect whatever decision the patient makes, and to act otherwise is to disregard the patient as an autonomous being (Fletcher et al., 1995). Fletcher, Holt, Brazier et al. (1995) discuss that when considering patient well-being, nurses may demonstrate paternalism towards their patients. Paternalism is to believe that it is right to make a decision for someone without taking into consideration those persons wishes, or even to override their wishes; therefore overriding autonomy. This happens all the more in Mental Health and Learning Disability services because people assume that they may not have capacity to make decisions for themselves. Singleton and Mclaren (1995) suggest that justification for nursing interventions rest on the concept that the principle of beneficence and non-maleficence takes precedence over considerations of respect for the patient’s autonomy.
Ethical principles are judgments that serve as a basic justification for the ethical evaluation of one’s action. They are the viewpoints from which guidance can be obtained along the pathway to a decision. According to the Journal of the American Nurse Association, ethical principles are the general goals that each theory tries to achieve in order to be successful. The widely accepted prima facie ethical principles are; Autonomy, duty to respect one’s right. Beneficence, the desire to do good. Non-maleficence refers to avoidance of harm or hurt. Justice, duty to treat one fairly. (Beauchamp, 2004). While some of the ethical dilemmas includes: ensuring informed consent, determining decision-making capacity, promoting advance care planning, surrogate decision-making, withdrawing and withholdi...
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
The ethical principle of non-maleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with non-maleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, the suffering of the patient and family would be evident. Autonomy is the right to make your own decisions and freedom to choose a plan of action.
In the code of ethics, the very first ethical principles that nurses are expected to uphold in order to exemplify that they are competent professionals are autonomy, beneficence, and nonmaleficence. That is, nurses as professionals are expected to advocate for their patients while preserving their respect and dignity and
In the medical profession, doctors and nurses run into ethical dilemmas every day whether it be a mother who wants to abort her baby or a patient who has decided they want to stop cancer treatment. It is important for the nurse to know where they stand with their own moral code, but to make sure they are not being biased when educating the patient. Nurses are patient advocates, it is in the job description, so although the nurse may not agree with the patient on their decisions, the nurse to needs to advocate for the patient regardless.
During week 4, we became familiar with the application of ethics in the nursing practice settings. We learned about ethical theories and principles, which are crucial when practicing in any clinical settings during ethical decision-making and while facing one or multiple ethical dilemmas. Also, we were introduced to the MORAL model used in ethical decision – making progress. The MORAL model is the easiest model to use in the everyday clinical practice, for instance at bedside nursing. This model can be applyed in any clinical settings and its acronyms assist
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
Autonomy is identified as another professional value and one that the nurse must possess. Autonomy is the right to self-determination. Nurse’s respect the patient’s right to make a decision regarding their healthcare. Practical application includes, educating patients and their families on their choices, honoring their right to make their own decision and stay in control of their health, developing care plans in collaboration with the patient (Taylor, C. Lillis, C. LeMone, P. Lynn, P,
As nurses, it is important that we “be both empowered and competent enablers of patient empowerment.” (Burkhardt & Nathaniel, 2014, p. 493) We take an oath to follow an ethical code which requires us to act as our patient’s advocate while providing safe nursing care. Nevertheless, we cannot make any medical choice or decision on their behalf. We also cannot empower them, “because to do so removes the element of choice.”
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
The American Nurses Association Code of Ethics for Nurses has five elements that pertain to the Principle of Autonomy. Each individual element applies to “respect individual persons” (Baillie, McGeehan, Garrett T, M., Garrett R. M., 2013, p.33). In Chapter 2 of the Health Care ethics: Principles and problems text, it discusses thouroghly the consent of an individual to make their own decisions regarding their health and future requests of care. As a nurse or within all heath care professions, we must treat each individual patient with care, respect, and to remain mindful to the patient regarding any aspect of their lives. In the ANA Code of Ethics for Nurses, it explains ways of maintaining the empathy required in the health field. It further discusses that the respect for human dignity must be a priority, relationships to patients must remain neutral, the severity of the situation, the right to self-rule, and the professionalism that must be upheld by the nurse and their associates.
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be
Ethics asses the values, morals, and principles of nurses. Legal codes or laws are rules established by our government. It’s important that nurses have a clear and comprehensive understanding of ethical and legal codes within their career. The understanding of these codes is essential for nurses to safely practice and to protect their patients. Nurses must abide by these principles or face the consequences of legal action. These principles include autonomy, utilitarianism, confidentiality, and many others. Autonomy is the agreement to respect ones right to determine a course of action, while utilitarianism is what is best for most people as defined in American Nurses Association. In order to give you a
Theory development and research have provided a framework and body of knowledge for nursing to maintain autonomy and improve quality of care. As early as the 1800s, nursing and non-nursing theorists had developed theories and models which are continually applied to nursing practice (KEEP OR GET RID OF?). Nursing theorist Imogene King developed the theory of goal attainment which focused on interacting systems that affected a person’s ability to attain goals (Frey, Sieloff, & Norris, 2002). Psychologist Laurence Kohlberg created the theory of stages of moral development which places moral reasoning and ethical behavior into six identifiable stages based on a person’s response to moral dilemmas (Kohlberg, 1984). Although King and Kohlberg created theories in different fields, nurses can utilize both to improve patient care. The purpose of this paper is to analyze both theories based on major precepts, usefulness, and application to nursing practice.