A. Introduction
This paper will look at the principles of confidentiality, ethical theories, and a presented case study on the Z family and the practitioners’ ethical decisions. It will provide a better understanding of how moral and ethical situations can be approached by the practitioner, and giving examples and theories that can be put into practice in difficult decisions.
B. Ethical Theory
The importance of ethical theory plays a large role in nursing practices. It is often difficult to understand where the lines of confidentiality should be drawn, so in order to help decipher the feelings nurse practitioners have of what they consider to be fair or unfair, there are a number of ethical theories that can be used in order to understand a problem (McGowen, 2012). Morally, each individual has their own personal compass, but in terms of medical practice, there needs to be a unanimous understanding of what constitutes correct behavior for the best interests of the patient.
Practices such as Utilitarianism, Deontology/Kantianism, Virtue Ethics and Moral Particularism all play a vital role when it comes to understanding the application of rules and consequences in nursing practice. Each theory has a specific approach for dealing with ethical issues. For example, Deontological looks at what an individual must do, based on their job descriptions and obligations to both the hospital and patients (Slowther et al, 2004). Another example is Virtue ethics, which can be viewed as the method of what nurses’ feel is the correct way to behave when working with both patients and colleagues (Slowther et al, 2004). Without these practices, there would be no trust established between patients and practitioners, which would be a detriment to ...
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...2012. Retrieved May 13, 2014 from http://www.aacn.org/wd/Cetests/media/C1252.pdf
National Institute for Health Research (2013). “Key Principles of Confidentiality”. Careers and Confidentiality. August 7, 2013. Retrieved May 15, 2014 from http://www.carersandconfidentiality.org.uk/information-sharing/key-principles-of-confidentiality/
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Slowther A, Johnston C, Goodall J, Hope T (2004) “A Practical Guide for Clinical Ethics
Support”. The Ethox Centre. Section C: Ethical Frameworks. Retrieved May 14, 2014 from http://www.ukcen.net/uploads/docs/education_resources/pack1/pack1_moral.pdf
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
Nursing ethics has a vast spectrum of subjects. The history of ethics was around way longer then the declaration of specific ethical issues. According to Fox, Myers and Pearlman (2007), the field of ethics consultation has been developing over the last three decades, (Kosnick 1974; Rosner 1985). Ethics has become an organized and accepted division of healthcare services. Gallagher (2010), discussed the purpose of nursing ethics is to help us think, speak and perform better in our practice. The Nursing Code of Ethics was addressed by Lachman (2009). “Futile care” is discussed by Sibbald, Downar, Hawryluck (2007). Ball (2009) addressed the need for clarification of DNR orders in surgery patients.
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
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 term nursing ethics means that the nurse has an obligation judge what is right and wrong in her or his duties as guided by the profession or the moral principles that govern the profession and as prescribed by the professional body. Nursing ethics initially encompassed virtues that were desired in a nurse. At the time, these virtues included physician loyalty, commitment to high moral character and obedience. Evolvement of nursing profession gradually made nurses embrace patients’ advocacy. As patient advocates, nurses work as part of an interdisciplinary team to provide patient care. Nursing ethics have kept pace with the advancement of the nursing profession to include a patient-centered focus, rather than a physician-centered focus.
Barnett, Wilson J.(1986). Ethical Dilemmas in Nursing. Journal of Medical Ethics. Retrieved on 12th July 2010 from
Ethics and integrity are essential parts of the nursing profession since they provide nurses with the capacity for weighing in on the impacts that their actions may have on the profession (Guido, 2014). However, maintaining high levels of ethics and integrity may create significant challenges for nurses some of which impact on their position as healthcare providers. One of the key challenges that nurses experience as part of their profession is increased cases of ethical dilemmas some of which impact on their abilities to make decisions based on the interests of their patients. The nursing code of ethics indicates the need for nurses to ensure that the decisions or actions they take reflect on the interests
As a nurse, it is within your role to safeguard the right to privacy for individuals. To ensure that nurses are adhering to this, ethical strategies have been proposed and implemented from a legal and regulatory body.
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
In order for nurses to practice ethically they must understand the meaning behind each professional value. The first value is human dignity. With each patient we encounter we must show them respect as individuals. It does not matter what the medical condition is, race, ethnicity, culture, religion or gender of the individual. The dignity of a person must be protected. As nurses we must respect the uniqueness of each individual we care for, as this is a fundamental right of all humans. A person with dignity feels a sense of self-worth and as nurses we must do our best to help our patients maintain that feeling of worthiness.
The writer discusses a situation of the doctor failing to disclose the nature of important medical condition which can jeopardize several of the patient’s family members and puts the doctor at odds with them. The problem is also discussed by Sutrop (2011) who show how protecting the patient’s confidentiality and self- decision capacity has actually caused severe hindrances to the field of scientific development and research.
The four fundamental nursing responsibilities of promoting health, preventing illness, optimizing health and alleviating the ill are represented in the code of ethics. (Arnold & Boggs, 2016) One can say that the code of ethics are rules that a nurse needs to follow in order to effectively communicate and protect the patients. The American Nurse Association provided the code of ethics to guide nurses to ensure that patient’s care, safety, rights and health are well cared for and well managed. Models like Utilitarian, deontological, and the human rights-based all contribute in answering dilemmas that can arise with a patient. Thus, explaining what some of the code of ethics are, and how the code of ethics influence our responsibilities as a nurse will impact the overall care of the
Integrity, respect for persons, justice, non-maleficence, and responsibility are all identified within the code, however compassion is not directly stated but is implied. To show compassion for others during suffering is an almost automatic response in nursing. When nurses decide to act either beneficently or non-maleficently they are doing a service to those being cared for. When dealing with human lives moral value becomes especially important, and is not situationally dependent. Ethical neutrality does not have a place in professional ethics, and an obligation to respect the moral values is necessary. The code deals with specific issues related to the nursing profession, and ensures standards are upheld. Creation of code of ethics within a profession limits misconduct, create safeguards, promote trust for the profession within society, and preserves the integrity of the profession (Soskolne, 1984) It is important for me to emphasize the difference between the nurse’s code of ethics and the Hippocratic Oath. The nurses ethical code is tailored toward the care provided to the patient, and not the involved science and diagnostic aspect of the
Confidentiality is defined as the protection of personal information. It means keeping a client’s information between the health care providers and the client. Every single patient has the right to privacy regarding their personal information from being released to anyone outside of their health care providers. Health care providers have a legal and ethical responsibility to protect all information regarding patients by not disclosing their information to anyone without their written consent from the patient.
6). Good intention is the main moral principle considered and consequences are irrelevant (Joel, 2013, p. 526). Seemingly, the deontological ideology focuses on the actions of the agent and would disregard patient focus and individuality. It is difficult to apply contemporary ethical theories to the nurse because of the values of the nursing profession. “Contemporary ethical theories do not lend themselves to the health-care professions or to ethically defensible decisions in health-care practice. None of the dominant ethical theories could be discovered in, or derived from, the profession of nursing” (Joel, 2013, p. 526). Casuistry, while not an ethical theory, is a case-based approach to practical decision-making. Cases that have set precedence are identified and comparisons are made using similarities, differences, and previous experiences. This concept is used to complement ethical theories in patient decision making by clinical ethics committees (Slowther, Johnston, Goodall, & Hope, 2004, § C4). Personally and professionally balancing ethical perspectives to be able to consider all details on a case by case basis seems like a more appropriate