6 Key Ethical Principles of Nursing

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Nursing ethics refers to moral judgment and standards of conduct. There are specific principles of health care ethics that have to be adhered to in every situation:

1. Nonmaleficence

Nurses have to remain competent in their field to avoid causing suffering or injury to patients. This is the core of nursing ethics, and all health care professionals take this oath. Nonmaleficence also encompasses reporting any suspected abuse.

An example of nonmaleficence: If an incompetent, or chemically impaired, health care practitioner is taking care of patients, a nurse should report the abuse to protect the patient.

2. Beneficence

This is the core principle of doing good and patient advocacy. To have compassion, take positive actions to help others and follow through on the desire to do good. Nurses concentrate on ensuring that their clients receive the best treatment to achieve optimal results.

An example of beneficence: If a nursing home patient falls and fractures his hip, a nurse should provide him pain medication as quickly as possible.

3. Autonomy

Clients are given the right of self-determination, independence and the ability to self-direct. They are entitled to decide what will happen to them. Because of this, competent adults have the ability to either refuse or consent to treatment. All nurses are required to respect their clients’ wishes, even when they do not agree with them.

Congress passed the Patient Self-Determination Act in 1990. This act states that competent individuals have the right to make their wishes known in reference to their end-of-life experience. This act also includes the durable power of attorney. The durable power of attorney designates a competent individual to assist in making health care decisions for an individual if he or she is no longer able to make those decisions because of critical health issues or incompetence.

An example of autonomy: If a patient has an advance directive or lacks the capacity to decide whether to continue cancer treatment, the individual who is the durable power of attorney can decide for her.

4. Justice

All clients must be treated fairly and equally. Nurses face issues of justice every day as they organize care for their clients: They must decide how much time they have to spend with each client, taking patient needs into consideration, and then fairly distributing the resources accordingly.

An example of justice: If a hospital organization decides to donate no-cost eye exams and hearing tests to 10 elementary schoolchildren each month, a fair, unbiased method must be used to determine which children receive these services.

5. Fidelity

This principle stands for many things, including dedication, loyalty, truthfulness, advocacy and fairness to patients. Nurses are encouraged to keep their commitments, based on their virtue of caring.

An example of fidelity: A patient requests that a nurse not reveal his terminal diagnosis to his family. The patient explains that his family would probably disregard his wishes and keep him alive no matter the circumstances. The nurse must recognize the obligation to keep this information in confidence and still support the patient’s family.

6. Principles of totality and integrity

These principles state that the entire person needs to be taken into consideration when deciding which therapies, medications or procedures a patient should undergo.

For example, if a therapeutic procedure is likely to harm the patient or cause undesirable side effects, the patient’s benefit from the procedure must be proportionately justified.

edited by Kevin Phang

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