Ethical issues related to the care – This course is designed to understand the concept of community health nursing: nurses’ roles and interventions in family health, school health, occupational health, environmental health, elderly health care, gender issues, disaster management, and principles and terminology of epidemiology. The aim of the course is to acquire knowledge and skills in community health nursing.
Ethical issues related to the care
Definition of Ethics:
Ethics are the rules or principles that governs conduct. They deal with what is good and bad with moral duties and obligations.
The word ethics is derived from the Greek work “Ethos” which means customs or guiding beliefs. Ethics are characteristics of a profession and are called as a “code”.
(Ref by- Capt. (Retd) Alphonsa Jacob/Fundamentals of Nursing/Vol-1/6/28)
Ethics is a term with many meanings. Simply stated ethics is concerned with how people ought to act and how they ought to be in relation with others.
(Ref by-SN. Nanjunde Gewda/24/14)
Ethics or moral philosophy is a branch of philosophy that involves systematizing, defending, and recommending concepts of right and wrong conduct.
Types of Ethics:
There are mainly three types of ethics-
A. Bioethics: Bioethics as encompassing a number of fields and disciplines grouped broadly under the rubric “the life sciences”.
B. Clinical ethics: Clinical ethics is that branch of bioethics literally concerned with ethical problems “at the bedside,” that is, ethical concerns that arise within the context of caring for
actual patients, wherever they are found.
C. Nursing ethics: Nursing ethies, which is a subset of bioethics, is the formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments.
Ethical Principles in Nursing:
Ethical principle actually controls professionalism nursing practice much more than to ethical theories. Principles encompass basic premises from which rules are developed. Principle is the moral norms that nursing as a profession both demands and services to implement to everyday clinical practice.
Ethical principles that the nurse should consider when making decision are as follows-
1. Respect for person
2. Respect for autonomy
3. Respect for freedom
4. Respect for beneficence (doing good)
5. Respect for maleficence (avoiding harm to others)
6. Respect for veracity (truth telling)
7. Respect for justice (fair and equal treatment)
8. Respect for rights
9. Respect for fidelity (fulfilling promises)
10. Confidentiality (protecting privileged information)
(Ref by- BT Basavanthappa/2/76)
Purposes of Code of Ethics:
The purposes of the Code of Ethics for Nurses are:
1. Identify the fundamental ethical standards and values to which the nursing profession is committed, and that are incorporated in other endorsed professional nursing guidelines and standards of conduct
2. Provide nurses with a reference point from which to reflect on the conduct of themselves and others
3. Guide ethical decision-making and practice, and
4. Indicate to the community the human rights standards and ethical values it can expect nurses to uphold.
Professional Code of Ethics of Nursing:
The ethics of nursing provides professional standards for nursing activities which protect the nurse and the patient. The international code of nursing ethics is given below
1. The fundamental responsibility of a nurse is to conserve life and to promote health. Every nurse as a teacher of health by example
2. A nurse must be adequately prepared to practice nursing and be willing to continue to learn new ideas by reading and attending meetings
3. The nurse must learn to respect authority
4. The nurse must carry out the doctors order accurately and sustain confidence in the doctor, and all members of the health team
5. The nurse should report any unusual condition or symptoms to the doctor or in-charge nurse.
6. The religious beliefs of a patient should be respected.
7. The nurse should hold confidential all information given to her.
8. When a patient requires continued nursing care, the nurse must remain with the patient until adequate relief is available
9. The nurse has obligation to give conscientious service and in return is entitled to just remuneration.
10. A patient should always be called by his full name
11. Punctuality is very important for every nurse.
12. Obedience is very important in observing rules and regulation 13. Every nurse must have respected for authority and for rules and regulation
14. Economy is important for all nurses to practice..
(Ref by- Capt. (Retd.) Alphonsa Jacob/Fundamentals of Nursing/Vol-1/6/28)
High ethical standards are necessary for healthcare. These standards fall under the umbrella of health or medical ethics, the field of applied ethics that is concerned with moral decision making applied to medical practices and policies.
A standard approach to health ethics, developed by Tom L. Beauchamp and James F. Childress, often refers to the following four basic principles when evaluating the merits and difficulty of a medical procedure:
➤ Autonomy: Determine the wishes of the patient to protect their autonomy.
➤ Justice: Follow the due process to determine limits on healthcare and treat patients alike.
➤ Beneficence: Seek the patient’s best interest and assess what counts as goods to be pursued
➤ Non-maleficence: Determine what counts as harms to avoid.
These principals can help healthcare professionals identify ethical dilemmas and find solutions by having conversations with patients about their needs and desires.
When a healthcare provider oversees a patient’s health, disagreements about treatment decisions, waiting lists and access to resources can be some of the challenges that pose ethical dilemmas.
➤ Ethical decisions don’t have the same consequences as unlawful practices. If a healthcare administrator faces the challenge of a busy emergency room, they are not lawfully required to promise people that the process will speed up. But it can be ethically responsible for them to raise the concern with the board of administrators.
➤ Healthcare institutions may create ethical committees to facilitate reasonable decision making that respects value and concerns of patients, their families and healthcare providers.
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