What are ethics? Is there a difference between ethics in nursing and ethics of other health care professions? Merriam-Webster (2012) defines ethics as a set of moral principles; the principles of conduct governing an individual or group. Confusion of the terms ethics and morals is not unusual; ethics are generally considered professional behaviors, morals are personal and societal behaviors. With these in mind let’s explore ethics in nursing practice.
The American Nurses Association (ANA) Code of Ethics for Nurses defines ethics for the nursing profession and sets the standard of how nurses must act when carrying out professional duties. This Code of Ethics requires that all nurses care for others with compassion, respect, dignity and to treat each person we interact with as someone who has worth regardless of their social, economic or professional status.
The Nightingale Pledge also helps define nursing ethics. Many of us recited this when we graduated from nursing school and dedicated ourselves to practicing nursing ethically. The words continue to resonate in our hearts and minds as we provide care:
I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician, in his work, and devote myself to the welfare of those committed to my care.
Nursing ethics share many principles with medical ethics including beneficence (promoting others’ well-being), non-maleficence (causing no harm) and autonomy (supporting patients to make own decisions). Nursing ethics are set apart from medical ethics in emphasizing collaborative care, human dignity and nurturing. Medical ethics concentrates on the “curing”; nursing concentrates on the “caring”. Nursing ethical standards have evolved to embrace nursing’s obligation to respect human rights as well as the required care.
Nurses must be aware of their personal moral and ethical stances and how these may influence their professional decision-making. Self-examination is a first and vital step to practicing nursing in an ethical manner. Looking into one’s own beliefs can be difficult at first. One suggestion is to consider your personal experiences, religious, cultural and political beliefs and apply to an ethical situation you have experienced or have read about. Look at such issues as end-of-life care, removal of ventilators or feeding tubes, abortion or patients refusing treatment; compare your personal beliefs to your professional duty. You may wish to discuss these with a trusted colleague or spiritual advisor. Examining these potential personal biases before an ethical situation arises will prepare you to make the best decision possible if or when the time comes.
Every day we are faced with ethical decisions; some we might not even consider to be such while other situations are readily identifiable as an ethical dilemma. Consider where you work, type of patients you provide care for, what issues you deal with routinely; compare your own and your colleagues’ actions during these situations. Are the actions in line with the Code of Ethics and the Nightingale Pledge? Has the obligation to provide care to the highest quality possible been met? We can always learn from right decisions but at least for me I remember and learn the most from the situations I handled incorrectly.
As nurses, every decision we make carries with it a level of ethical decision-making. Are medication administration times charted accurately? Were the "Five Rights" for medication dispensing followed? Have we followed protocol in high alert medications? Have we treated the patient with dignity and respect? Do we turn our backs to incivility towards nursing students and new graduate nurses? Have we fulfilled the principles of ethical behavior?
Each of us is a “work in progress” and we learn and grow every day. Reviewing the Code of Ethics and Nightingale Pledge helps remind us of the very high standard we are required to conduct ourselves. Next time you have to ask yourself “Is this the right thing to do?” consider the ethical principles on which we practice the art and science of nursing.
American Nurses Association. (2012). Code of Ethics for Nurses with
Interpretive Statements. Retrieved from www.nursingworld.org