Nursing ethics shares many principles with medical ethics such as beneficence, non-maleficence, and respect for autonomy. However, those in nursing can be distinguished by its emphasis on relationships, collaborative care and human dignity. Because the healthcare climate is regularly changing, as is our society, it is crucial that nurses have a grounded understanding of ethics.
Consider the following situations that nurses commonly face:
Obtaining informed consent. Unless the patient is incapacitated, the grounded practice of obtaining informed consent for any procedure should be respected by the nurse. The patient has the right to deny any proposed medical treatment. It is the nurse’s responsibility to assure that the integrity of this right is maintained.
Introducing or recognizing the advanced directive. At the time of admission or during an office visit, the patient should be presented with information on advance directives. If one is in place, it should be respected and documented by medical professionals. The advanced directive is a way to maintain patient autonomy.
Truth-telling. Patients trust nurses to give them truthful information about their condition, about proposed treatments, and about medications. Patients should have the correct information they need to make a sound decision and nurses have an ethical responsibility to work with physicians to be certain that their patients do receive truthful information. Similarly, patients trust that nurses and physicians practice without deception.
Patient confidentiality. Patient confidentiality rests on the premise of trust as well. When patients disclose information to nurses or physicians, they trust that it will only be disclosed to only those professionals who need to know. Nurses have an ethical obligation to protect this right.
Professional obligations. Patients trust that their nurses are competent in their practice. This means that nurses must be compliant with Board of Nursing standards and they must complete necessary continuing education requirements to demonstrate their competency.
Professional relationships. Along with demonstrating competency, nurses have the professional obligation to maintain professional relationships with physicians, co-workers, and their patients. If they notice that fellow staff—including their physician colleagues—are not acting in a professional fashion, they have a responsibility to report it.
Ethical issues between team members. Nurses have the right to be autonomous in their practice; but they do not have the right to act outside of this scope. Similarly, it is not considered “ethical” to allow interpersonal conflicts to hinder their nursing judgment.
Nursing as a profession is always changing and so are the ethical decisions that we face. Maintaining the integrity of the profession requires consistent evaluation of recurrent situations, and it requires a complete understanding of the American Nurses Association position statement.
What ethical issues in nursing have you encountered in the past? How did you manage? Share your experience in the comments.