Why Ethics in Nursing Matters

According to Gallup polls, nursing has ranked as the most honest and ethical profession 22 years in the running. Nursing has been highly regarded since Florence Nightingale, the founder of modern nursing, made it into a reputable, moral profession.

In fact, the ethical principles in nursing, which now guide contemporary nursing, have many ties to Nightingale's theories.

What are the Ethics in Nursing?

Once you earn a nursing degree and begin working as a nurse, you will face ethical situations daily at the societal, organizational and clinical levels. Ethics in nursing encompasses the fundamental principles that guide nurses’ practice, ensuring they deliver care that is compassionate, respectful and centered on the patient's needs and rights.

Ethical challenges can range from respecting patient autonomy while ensuring safety to managing conflicts between patient needs and resource limitations. Preparing for these challenges involves continuous education, reflective practice and support from ethical committees and experienced colleagues.

Ethics in nursing is necessary because it provides a framework that helps nurses navigate the complex and often sensitive situations they encounter. It ensures that patient care prioritizes dignity, respect and compassion, fostering trust in the nurse-patient relationship.

Moreover, a strong ethical foundation in nursing contributes to the overall integrity of the healthcare organization, ensuring that patient welfare is always at the forefront of care decisions and actions.

What are the Four Principles of Ethics in Nursing?

The four principles of ethics in nursing include autonomy, beneficence, non-maleficence and justice, and they optimize patient care and outcomes: 

Respect for Autonomy

Autonomy means that the patients can make independent decisions. This means that nurses should be sure patients have all the information they need to make a decision about their medical care and be educated. The nurses do not influence the patient's choice.

Examples of nurses demonstrating this include obtaining informed consent from the patient for treatment, accepting the situation when a patient refuses a medication, and maintaining confidentiality.

Non-maleficence

This means that nurses must do no harm intentionally. Nurses must provide a standard of care that avoids risk or minimizes it as it relates to medical competence.

An example of nurses demonstrating this principle includes avoiding negligent care of a patient.

Beneficence

Beneficence is defined as kindness and charity, which requires action on the part of the nurse to benefit others.

An example of a nurse demonstrating this ethical principle is by holding a dying patient's hand.

Justice

Justice means being impartial and fair.

Nurses making impartial medical decisions demonstrate this, whether it relates to limited resources or new treatments, regardless of economic status, ethnicity, sexual orientation, etc.

Nursing Code of Ethics

Another valuable resource for nurses is the American Nurses Association (ANA) Code of Ethics.

Originally adopted in 1950, the Code is used in challenging situations and is considered to be non-negotiable. The Code was last revised in 2015 and includes interpretive statements, which can provide specific guidance for nurses in practice.

Wondering what's included in the Code of Ethics?

• Provision 1 – Nursing requires compassion and respect for every person.
• Provision 2 – Nursing's commitment is to the patient and family, group, community or population.
• Provision 3 – Nursing advocates for patients' rights, health and safety.
• Provision 4 – Nursing includes the authority, accountability and responsibility to foster health and care.
• Provision 5- Nursing must also be responsible for promoting health, integrity, competence and growth personally and professionally for themselves.
• Provision 6 – Nursing must maintain and improve ethical work settings and conditions.
• Provision 7 – Nursing advances the profession through research, scholarly inquiry, standards development and health policy.
• Provision 8 – Nursing collaborates interprofessionally to protect health and reduce health disparities.
• Provision 9 – Nursing, collectively, maintains the values and integrity of the profession, integrating social justice into policy.

The Code applies to all positions in nursing, from researchers to managers, staff nurses and public health nurses. At times, nurses may also need to address ethical situations from a team approach, as the most challenging decisions are not to be made by just one person. This interprofessional team (which can be comprised of doctors, nurses, pharmacists, social workers, etc.) is commonly called the ethics committee.

Ethics in nursing will continue to prove crucial as healthcare is ever-changing and challenging the status quo. Nurses must comprehend the ethical principles to recognize and consider ethical dilemmas. This must be discussed early in your educational journey, and nurses must be held accountable to the standards and principles set forth as they shape the future of nursing.

Dr. Stacey Rosenberg is the associate chief nursing administrator at Southern New Hampshire University. She is a board-certified adult health clinical nurse specialist and a certified nurse educator with clinical experience in acute and skilled care, and employee, community and public health.