This document provides an overview of ethics in nursing. It begins by defining ethics as the study of moral values and right versus wrong. It discusses key ethical principles like autonomy, beneficence, non-maleficence, and justice. It also distinguishes between ethics, morals, and personal values. The document outlines the steps of ethical decision making and notes that nurses use professional codes of ethics and clinical ethics committees to guide decisions involving ethical issues.

1. Ethics in Nursing
NURS90055 Nursing as Practice
Jo Martin (Subject Coordinator NURS90130 & NURS90055)
RN, BHSc Nursing, Grad Dip Cancer Care Nursing, MHSc (Clinical Education)​, Professional Doctoral
Candidate (Nursing)
jo.martin@unimelb.edu.au

2. 1. Define the term ‘ethics’
2. Discuss key ethical principles
3. Discriminate between ethical issues & legal issues
4. Identify and discuss ‘professional ethics’
5. Apply the steps of ethical decision making to nursing practice.
Learning objectives

3. Take 1 minute to consider what you believe is
meant by nursing ethics
What is ethics?
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4. Ethics is the study of moral values, of right & wrong
Ethics is concerned with determining what is good or valuable for all
people
Ethical dilemmas arise because there are often ambiguities & conflicts
with ethical issues due to differing value systems
Ethical dilemmas occur because there is no clear cut answer or single way
to view the issue
Defining Ethics

5. These dilemmas are often to do with life & death issues such as:
euthanasia, abortion, scientific research involving embryos etc.
Another ethical problem might be the allocation of scarce resources. If
there are more people needing kidneys or hearts than there are donor
organs how do we decide who will benefit?
Ethical Issues

6. Moral are similar to ethics and many people use the two words
interchangeably
Derived from the Latin “mores”, means custom or habit
Morality usually refers to an individual’s personal standards of what is
right and wrong in conduct, character, and attitude.
Morals are based on religious beliefs and social influence and group
norms
Morals and Ethics
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7. In both, we describe the behavior we observe as good, right, desirable,
honorable, fitting or proper or we might describe the behavior as bad,
wrong, improper, irresponsible, or evil. (based on our values)
There are times when a differences in values and decisions can be
accepted
Differences in values and decisions can put people into direct conflict.
Morals and Ethics
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8. A value is a personal belief about the worth you hold of an idea, custom or
object
The value reflects your cultural and social influences
Morals usually refer to judgements about behaviours
Values and Morals
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9. Personal values are ‘goals for living’, they direct our behaviour & influence the way we
communicate with others
We are often unaware of the way our values influence the decisions we make
They are often deep seated beliefs that go back to childhood when our parents
rewarded certain behaviour & punished other behaviour
People tend to be emotionally committed to their personal values hence disagreement
& even hostile responses are not uncommon when ethical issues are discussed
Personal Values

10. Our values act as a ‘filter’ through which we view the world, they colour our
perception of situations & guide our responses
Our values are not ‘set for life’, experience & education will modify them
As nurses we need to be aware that our clients may hold different values & we must
respect their right to hold different values
Personal Values

11. Where/when do we acquire our moral values that influence our response to ethical
issues?
How aware are we of our moral values?
Do we ever question our personal values?
Is there a tendency to take these values for granted & to be resistant to alternate
views?
Moral Values

12. Suggests that the best way to address an ethical problem is to appeal to
sound moral principles. This includes:
1. Autonomy (Self determination)
2. Beneficence (Prevent harm/do good)
3. Non-maleficence (Do no harm)
4. Justice (Give to each his/her right or due/fairness)
Ethical Principlism
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13. Self rule, self determining
Respect for individual choice & decision making
However, not an absolute right if individual choice interferes with
another person’s rights or well-being
Paternalism means restricting a person’s autonomy
Autonomy is restricted when there is lack of knowledge, when
information is restricted
Autonomy

14. Nurses promote autonomy by
1. Ensuring patients have information
2. Are aware of their options
So they can
1. Make informed choices
2. Give informed consent to procedures
Autonomy

15. Means ‘for the benefit of another’ / ‘to do good’
It is an essential component of nursing to ‘do good’ by promoting health &
alleviating suffering
Sometimes this becomes difficult in health care when treatments may in
fact cause harm to a patient
Beneficence

16. This is the basis of most codes of nursing ethics
‘Do no harm’/ acting in such a way as to avoid causing harm to others
Duty to take ‘due care’ (this is also a legal requirement known as ‘duty of
care’)
Non-maleficence

17. To act fairly
To treat equally
Nurses care for all people without consideration of class, status, religion,
culture or beliefs
This concept of equity can be difficult when resources are limited, even
resources such as nurses’ time
Nurses frequently face decisions in which a sense of justice should prevail
Justice

18. There can be conflict between the various ethical principles
For example between autonomy & non-malificence or non-malificence &
beneficence
Can you think of any examples?
Conflict between

19. There are no easy answers with ethical issues, no hard & fast rules
Every situation is different & must be dealt with on an individual basis
So what do we do when faced with ethical problems?
Ethical Decision Making

20. Hospitals have ethical committees which function is to
1. Check the appropriateness of research projects (research projects must
be approved by a Research Ethics Committee)
2. Provide a forum for discussion of particular ethical concerns in relation
to clinical practice (Clinical Ethics Committee)
Ethics Committees

21. Ethical decision making involves a process or series of steps
These steps are similar to those for solving any difficult problems
What steps would you use if you had to solve a problem?
What is the first thing you would do?
Ethical Decision Making

22. 1. Gather all the relevant information
2. Clarify the problem
3. Evaluate all the options
4. Consider short & long term consequences (will it promote good,
prevent harm, respect autonomy, be fair?)
5. Decide on option
6. Implement action
7. Evaluate
Steps in Ethical Decision Making

23. Provide a set of rules or expectations for guiding professional behaviour
They the reflect moral values held to be important by the particular
professional group
They indicate what professionals ought to do (or not do)
They often incorporate the moral aims of the profession (what is held to
be important)
Professional Ethics

24. They do NOT provide answers for particular ethical dilemmas however
They are general guidelines indicating how to behave in a way that is
appropriate to your profession
Professional Ethics

25. Guide to professional ethical standards of conduct
Stated that the fundamental responsibility of the nurse is to promote
health, prevent illness, restore health & alleviate suffering
Inherent in nursing is respect for life, dignity and human rights
It describes expectations for ethical practice and outlines the nursing
profession’s duties in relation to the rights of individuals for whom they
care
Code of Ethics for Nurses in Australia

26. Nurses are morally accountable & responsible for their actions
Nurses must maintain professional competence & provide quality care
They must ensure client wellbeing, respect privacy & confidentiality &
promote informed choice
Code of Ethics

27. Take a moment now to consider what tools and guidelines nurses
use when making ethical decisions. Write down your thoughts in
your notebook
What else do we use to guide ethical decisions?

28. Choose correct moral language
Often, the way in which you initially conceptualize a situation will affect
what moral conclusions you will make
Be as clear as you can about the facts, both empirical and philosophical
Use/refer to relevant supporting documents and scope of practice
Consider the relevant moral principles and rules, and make your best
judgment
Guidelines for making ethical decisions
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29. Atkins, K., de Lacy, S., & Britton,B. (Eds) (2017). Ethics & Law for Australian Nurses (2nd
Ed.). Port Melbourne: Victoria. Cambridge University Press
Chang, E., Daly, J. (Eds) (2016). Transitions in Nursing Preparing for Professional
Practice (4th Ed.). Chatswood: NSW. Elsevier.
Staunton, P., & Chiarella. M. (Eds) (2017). Law for Nurses and Midwives (8th Ed.).
Chatswood: NSW. Elsevier.
International Council of Nurses. https://www.icn.ch/sites/default/files/inline-
files/2012_ICN_Codeofethicsfornurses_%20eng.pdf
Resources

30. Thank you