Foundations of Health Ethics and Nursing Practice

Exam Tip: If a question asks about a nurse's personal belief system that drives their decision-making, look for the term "Values." If it asks about societal standards of right and wrong, look for "Morals."

Core Ethical Principles

The framework for ethical decision-making in healthcare is built upon four primary pillars. These principles provide a universal language for clinicians to evaluate the morality of an action.

• Beneficence: This involves taking positive, proactive steps to help others and promote their well-being.
• Nonmaleficence: This is the fundamental obligation to "do no harm" and to avoid causing hurt or injury to the patient.
• Justice: This principle focuses on fairness and the equitable distribution of healthcare resources among all individuals.
• Fidelity: This refers to the commitment to being faithful, keeping promises, and maintaining loyalty to the patient and the profession.

The Professional Nursing Code of Ethics

While individual morals guide personal life, professionals are guided by a Code of Ethics—a set of guiding principles accepted by all members of a specific profession.

For nurses, the Code of Ethics for Nursing outlines the specific duties required to maintain professional integrity. This code is built upon four key pillars:

1. Advocacy: Acting in the best interest of the patient and protecting their rights.
2. Responsibility: Fulfilling the duties associated with the nursing role.
3. Accountability: Being answerable for one's own actions and the outcomes of those actions.
4. Confidentiality: Protecting the patient's private information and maintaining trust.

Navigating Ethical Challenges

In clinical practice, ethical issues rarely present themselves as simple "right vs. wrong" scenarios. Instead, they often manifest in two complex ways:

• Ethical Dilemma: A situation where two or more ethical principles conflict, and choosing one may result in violating another.
• Moral Distress: This occurs when a clinician knows the ethically correct action to take but feels unable to carry it out due to institutional constraints or other barriers.

When these challenges become too complex for an individual to manage alone, healthcare providers can turn to ethics committees for guidance and multidisciplinary support.

Processing an Ethical Problem: A Seven-Step Approach

When a nurse identifies an ethical issue, they should not react impulsively. Instead, a systematic process should be followed to ensure a thorough and fair resolution.

By following these steps, the nurse moves from emotional reaction to professional, evidence-based ethical reasoning.