Nursing ethics
Nursing ethics is a specialized area within applied ethics that focuses on the moral principles guiding nurses' interactions with patients and their involvement in healthcare decisions. It recognizes nurses as essential agents of care, distinct from their traditional role as extensions of physicians. This field has evolved significantly, reflecting the complex realities nurses face daily, including dilemmas surrounding patient dignity, privacy, and the right to know about treatments. Nursing ethics encompasses a broad spectrum of challenges, such as managing end-of-life decisions and facilitating collaboration among healthcare professionals.
The foundation of nursing ethics is built on principles like autonomy, beneficence, nonmaleficence, and justice, outlined in various ethical codes developed over time, such as the Florence Nightingale Pledge and the American Nurses Association's Code of Ethics. These codes have been adapted to address advancements in technology and shifts in societal norms, emphasizing the importance of compassionate, professional care. By incorporating ethical training into nursing education, future nurses are better equipped to navigate the nuanced moral landscape of patient care, affirming the human dignity of each individual in their charge.
On this Page
Subject Terms
Nursing ethics
In the broad field of applied ethics—that is, classroom disciplines in which specific difficult real-life situations and possible courses of actions are weighed against moral imperatives as part of the process of training professionals—nursing ethics looks particularly at the relationship levels of nurse–patient care, specifically the nurse’s role in the variety of difficult decisions that are part of day-to-day recovery care and rehabilitation. The field of nursing ethics reflects a significant development in the perception of the role of nurses and nursing. Conventional wisdom long held that nurses were to be regarded as extensions of physicians and that their ultimate responsibility—indeed their duty—was to back up decisions about treatment as outlined by the lead doctors. Nursing ethics was, for years, little more than a list of unchallengeable adjectives that made for good nurses: compassionate, selfless, competent, dedicated, and patient. In the twenty-first century, nurses are recognized as a far more complicated element of the care and recovery environment, and nursing ethics reflects that perception, underscored by the growing complexity (and volume) of nursing behavior codes and the increasingly complicated legal proscriptions involving nursing responsibilities.
Overview
The ethical guidelines for both nursing care and nursing responsibilities center on the assumption that nurses, while not involved in treating and/or diagnosing patients, are central agents in caring for them. While attention in nursing ethics is often focused on only the broadest ethical areas, most notably on nurses’ responsibilities with patients involved in right-to-die cases and how to assist families struggling with complicated emotional issues, as well as the concerns about the patient’s best interests, the reality is that nursing ethics covers a far more comprehensive range of interactions that nurses must routinely engage in. These issues include, for instance, how best to maintain patient dignity in the event of machine-assisted recovery and/or muscle and nerve system incapacitation; how to guarantee the preservation of a patient’s right to privacy, including the protection of sensitive treatment information in an age of widespread dissemination of data through digital sources; how to negotiate complicated responsibilities about a patient’s right to know about their treatment, specifically whether full disclosure would be in the patient’s best interest; how to coordinate and facilitate collaborative care between doctors who may perceive a patient’s condition differently and/or between personnel on different nursing shifts; and, finally, how to involve family in both care and recovery of patients and whether such assistance is in the patient’s best interest.
These issues each explore the difficult levels of nurse responsiveness, that is, how best to apply a nurse’s compassion and sense of the dignity and worth of each patient in situations that do not come with readily apparent right and wrong solutions. Nursing ethics reminds nurses of the human factor in the recovery operations of hospitals and how critical nurses are to creating and preserving an environment of professionalism, compassionate care, and respect. By introducing these questions in a classroom as part of nurse training, medical ethicists aim to better prepare nurses to react to these dilemmas on the job.
In 1893, Lystra Gretter, the principal of the Farrand Training School for Nurses in Detroit, Michigan, led the school's development of the Florence Nightingale Pledge, an oath to adhere to nursing ethics and principles that is most often used in the United States. Nurses recite the pledge at graduation or pinning ceremonies. Inspired by the founder of modern nursing, Florence Nightingale, and the ethical principles she espoused, the pledge is similar to the Hippocratic Oath for doctors. Gretter updated the Nightingale Pledge in 1935 to reflect the expanded role of nurses in public health and human welfare. In the 1950s, the American Nurses Association (ANA) codified professional ethical standards in its Code of Ethics for Nurses, which outlined four principles of ethics: autonomy, beneficence, nonmaleficence, and justice. In 1953, the International Council of Nurses (ICN) first published The ICN Code of Ethics for Nurses. Both codes have been revised and updated several times since their original publication. Such updates have reflected technological advances, societal changes, advanced practice nursing, education and research, health policy, and administration.
Bibliography
Benjamin, Martin, and Jon Curtis. Ethics in Nursing: Cases, Principles, and Reasoning. Oxford UP, 2010.
Butts, Janie B., and Karen L. Rich. Nursing Ethics. Jones & Bartlett, 2012.
Butts, Janie B., and Karen L. Rich. Nursing Ethics: Across the Curriculum and into Practice. Jones & Bartlett, 2007.
Dunn, Hannah. "Ethical Decision-Making: Exploring the Four Main Principles in Nursing." Nursing Standard, 22 July 2024, doi:10.7748/ns.2024.e12346. Accessed 24 Oct. 2024.
Fry, Sara T., et al. Case Studies in Nursing Ethics. Jones & Bartlett, 2010.
Haddad, Lisa M., and Robin A. Geiger. "Nursing Ethical Considerations." StatPearls, StatPearls Publishing, 14 Aug. 2023. NCBI Bookshelf, www.ncbi.nlm.nih.gov/books/NBK526054/. Accessed 24 Oct. 2024.
"The Importance of Ethical Principles in Nursing." Nevada State University, 22 May 2024, nevadastate.edu/son/rn-bsn/the-importance-of-ethical-principles-in-nursing/. Accessed 24 Oct. 2024.
Ulrich, Connie M. Nursing Ethics in Everyday Practice. Sigma Theta Tau Intl., 2012.
Volbecht, Rose Mary. Nursing Ethics: Communities in Dialogue. Prentice, 2001.
Westrick, Susan J. Essentials of Nursing Law and Ethics. Jones & Bartlett, 2013.