Health care is a critical aspect of the well-being and health of every nation. It is important to understand the necessary morality and ethics for both the client and the service provider on behalf of successful service delivery.
Ethics and morality create such circumstances as a nurse – penitent relationship, quality and the value of life from the standpoint of nurse and patient, resource allocation, respect for autonomy and personal business, compassion, and personhood. These values provide a finding of the right solution on how to deal with particular situations that may arise in the working field of nurses and help to gain an important competence in resolving conflicts that, if not observed, may lead to moral or ethical crises.
Concepts of ethics in nursing practice
Various concepts of ethics and morality are important in the nursing field for proper services. They include autonomy, beneficence, non-maleficence, and double effect. Autonomy is a concept that considers the right of an individual to make decisions. It’s primarily based on the community’s respect for persons and lets people make decisions concerning themselves while beneficence involves actions geared to the interest of the patient. Beneficence is the primary principle for health care ethics, (Ellis et al, 2012).
Non-maleficence is an ethical concept that involves the evaluation of measures before administering treatment to the patients. Such evaluation ensures that the treatment administered will not do harm to patients. Double effect is a combination of both autonomy and beneficence concepts in ethics.
Nurses are agents of morality who are to define patients’ needs through using their professional skills for the wellbeing of a patient. However different ethical theories are involved in making decisions and these may include:
Consequentialism; includes an understanding that the right moral response relates to the result or effect of the act. It maximizes the greatest “good” for a bigger number of beneficiaries. In this context the “good” involves happiness and other valuable life-enhancing results. Consequentialism may include the use of life-prolonging therapies to patients.
Deontology; this is a combination of respect and rights based on duties that place values of a patient on a second place regardless of the action outcome. It focuses on the obligations and responsibilities of the care provider, not the patient. Deontology in most cases happens when the patient is unable to make a decision for himself.
Virtue Ethics; this is an important theory in ethical decision-making that has emerged due to the difference between deontology and consequentialism. It involves characters that are considered to be truth-telling, trustworthiness that is socially valuable. Examples are code of conduct exercised by professional regulators like the nursing and midwifery council.
Principle theory; this emphasizes ethical principles such as autonomy and beneficence and blends them with wisdom. It is an attempt to incorporate all elements of the moral theory that is acceptable by society and individual patients. It is the most popular framework for ethical decision-making.
Effects of religion and social factors on ethics
In decision-making, personal religion and philosophic points should be considered. Different religions and beliefs affect values and taken decisions. People tend to decide in respect to the doctrine that they believe in and may sometimes face certain working conditions unfavorable to them. One of the fundamental factors that may influence decision-making is the working environment at the workplace. People always look for working areas with fewer number of conflicts with nearly similar fundamental beliefs and support of the personal values.
Framework for moral decision-making
- Identify the ethical problem and observe clinically and other relevant factors such as family dynamics and support?
- Discuss various processes for an appropriate decision-making process such as: who is responsible, what is the right time to make a decision, those involved in the process and the relevant procedures.
- Find out the available options
- Identify morally significant issues for the available options that include; expectations of the patient, competence of the patient and projected consequences.
- Find out what the law says about each option
- Identify possible moral arguments in favor and against each option
- The choice considered is based on the merits that include determining the best interests and validity of the arguments.
- The option should respect individuals involved and the implication of the chosen decision as a general rule.
- Analyze strongest counter-argument to the selected option
- Discuss the counter argument and make a decision
- Review your decision in relation to the reality and observe it.
Following ethical standards in the nursing practice is important for improving both qualified professionals and the nurse-patient relationship.
All options and considerations are involved in decision-making through ethical standards. It enhances the service for both the caretaker and the patients. Ethics may be affected by work situation, for example, obligations related to a chemically impaired nursing colleague may present a threat to your standards. In such circumstances, identifying the person and addressing the situation through your employers and other colleagues or similar measures will help you to maintain your ethics.
Professional boundaries in nursing
Professional boundaries are very important as an ethical aspect in caregiving, and its violation sets caregivers to victims. Patients trust nurses and go to them at a time of need and, as a result, a violation of boundaries affects the comfort of the patient. Observing and adhering to professional boundaries maintains a balance and a good relationship between the patient and the caregiver.
Ellis, J. R. & Hartley, C. L. (2012). Nursing in today’s world: Trends, Issues & Management, Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.