According to Butts (2007), nursing is a profession that has its code of conduct, philosophic views, and its place in the health care industry. Customarily, nurses tend to work under their own license and are completely responsible for their work. To guarantee sanity and effectiveness in the profession, there are various legal and ethical frameworks that exist to provide guidelines for standards of care and professional practice in the entire health care sector (Koutoukidis, Stainton & Hughson, 2012). It is important to note that nurses at all levels and areas of their practice as health care professionals have certain legal and ethical responsibilities and obligations that must strictly be adhered to. Considering that moral responsibilities in the nursing profession are far-reaching, nursing ethics isn’t confined to particular sets of problems and issues or an exploration of the nurse-patient relationship. The nursing practice involves a complex interaction among various societal relationships (Basford & Slevin, 2003).
As pointed out by Koutoukidis et al. (2012), the health care environment today is very complex and inherent with different kinds of legal and ethical concerns that have serious implications for those in the professional nursing practice. In the present health care environment, emphasis is on client or person-centered care and this places the onus on nurses to value the client’s needs and to act in the interest of the person in their care. As a result, it is imperative for nurses as members of the health care team to understand the legal and ethical frameworks within which they function to ensure the provision of safe and competent care (Basford & Slevin, 2003).
What are Ethical Principles?
According to Grace (2009), ethical principles are rules, standards, or guidelines for action that are derived from theoretical propositions regarding what is good for humans. Important principles emerge over time as their usefulness in imposing order on a situation, highlighting important considerations in solving issues, locating the proper object of decision making, or enhancing social harmony is realized. Ordinarily, they tend to reflect philosophical, cultural, religious, and societal beliefs about what is valuable (Roy & Jones, 2006). Thus, priority principles in one profession may not be taken as important in another profession.
Legal Aspects of Nursing Practice
In various countries across the world, the legal framework around nursing practice is based on the common laws and acts of parliament that are relevant to the nursing practice (Basford & Slevin, 2003). It is generally vital for nurses to be aware of their legally defined rights and responsibilities, and should have an understanding of the laws that govern their personal and professional lives. In today’s world, ignorance of a law is not accepted as an excuse for violation of that law. As health care professionals, nurses have the legal responsibilities common to all members of the society, and also the responsibilities imposed by the nature of their work, which may be defined as responsibilities in respect of the provision of safe effective nursing care, the health of the community, the employing authority, and the nursing profession (Koutoukidis et al., 2012). Typically, the law serves several functions in nursing. First, it provides a framework for determining which nursing actions in the care of clients are legal and ethical. Second, it helps to differentiate the nurses’ responsibilities from those of other health professionals. Third, it helps to establish the boundaries of independent nursing action. Finally, laws assist in maintaining a standard of nursing practice by making nurses accountable under the law.
To ensure that nursing professionals are guided appropriately, nursing regulations must be in place. This section will therefore dwell on nursing regulation. In addition, professional boundaries as an area of ethical concern will also be discussed.
The main function of the nursing regulatory authority is to protect the health and safety of members of the public by ensuring that nurses are competent and fit to practice. To ensure that this takes place effectively, the registration and accreditation of nurses in most countries are done by a body established by an Act of Parliament (Roy & Jones, 2006).
By defining the terms under which a nurse may practice, the law protects the community by deeming the qualified nurse to be safe and competent enough to practice nursing (Leininger, 1990). Nurses who do not fulfill the requirements of the standards, codes, and guidelines for the nursing profession may not be allowed to practice as nurses. It is a requirement in many countries for all health professionals, nurses included, to obtain an annual practicing certificate or renewal of registration from a nursing regulatory authority. The important responsibility for ensuring that registration or enrolment fees are paid each year and for demonstrating competence fit for practice rests with the individual nurse. Every nurse is required to meet the standards and requirements for registration or enrolment that govern professional practice. If a nurse acts contrary to his or her profession, the nursing regulatory authority has the mandate to him or her.
Professional nursing practice requires nurses to be aware of and understand the legal and professional boundaries within which they must function. Professional boundaries in nursing are the parameters that govern nursing practice, to ensure that the limits of professional and therapeutic relationships with clients in their care are not crossed (Leininger, 1990). When a nurse crosses professional boundaries then such an action is deemed as unprofessional conduct or behavior. It is regarded as a misuse of the power vested in the profession over a vulnerable person in their care.
Regardless of the health care setting, nurses in daily professional practice are often faced with difficult decisions linked to professional boundaries. It is critical that nurses, as health care professionals, recognize the lines of separation from the person in their care and apply sound judgment in managing issues around professional boundaries (Leininger, 1990). Common examples of professional boundary concerns in nursing practice are accepting gifts and services, entering into sexual relationships, entering into financial arrangements, access to health information, and disclosing clients’ health information without seeking their consent. In nursing practice, caring, engagement with the patient, and knowing the patient within his or her context are vital principles associated with professional nursing practice (Grace, 2009).
As noted by Butts (2007), professional ethical codes serve as useful guidelines for providing direction and shaping behavior. Although professional ethical codes apply to all nurses regardless of their role, no single code can provide a complete and absolute set of rules that are free of conflict and ambiguity, a rationale often cited in favor of the use of virtue ethics as a better approach to ethics. Some people, however, are fully convinced that nurses who are without an upright character can not be depended on to act in good or moral ways, even with a professional code as a guide (Butts, 2007).
As can be deduced from the discussions in this paper, it is imperative for nursing professionals to have a clear understanding of ethical issues related to their profession. The importance of attention to ethics in health care is absolutely necessary because of factors such as the rapid advancement in medical care and technology, issues in allocation of limited health care resources, questions related to the quality of life and issues in prolonging life, and protection of client rights (Benner, Tanner & Chesla, 2009). The primary concern of the health care team must be the provision of the very best standard of client care and, in order to achieve this, it is necessary for all team members to respect the abilities and functions of their co-workers and to observe ethical standards.
Generally, professional nursing practice must be guided by a code of ethics that consists of standards of conduct to be followed by nursing professionals. The greatest impact of ethics in the nursing profession is, therefore, to ensure that all nursing professionals behave in a reputable manner (Benner, Tanner & Chesla, 2009). Besides treating all clients equally and with all fairness, it is imperative for all nursing professionals to respect and cooperate with others so as to reinforce the ethical requirements in the profession. As noted earlier, the present health care environment requires those in the nursing profession to ensure that the rights of the clients or any person under their care are fully respected. More than anything else, nursing professionals are expected to act in good faith and in the interest of any person put under their care. It is, therefore, quite obvious that nursing professionals must have a deep understanding of the legal and ethical frameworks within which they function to ensure the provision of safe and competent care.
Basford, L., & Slevin, O. (2003). Theory and Practice of Nursing 2nd Ed: An Integrated Approach to Caring Practice. Cheltenham, UK: Nelson Thornes.
Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in Nursing Practice, Second Edition: Caring, Clinical Judgment, and Ethics. New York, NY: Springer Publishing Company.
Butts, J. B. (2007). Ethics in Professional Nursing Practice. Sudbury, MA: Jones & Bartlett Learning LLC.
Grace, P. (2009). Nursing Ethics and Professional Responsibility in Advanced Practice. Sudbury, MA: Jones & Bartlett Publishers.
Koutoukidis, G., Stainton, K., & Hughson, J. (2012). Tabbner’s Nursing Care: Theory and Practice. Chatswood NSW, Australia: Elsevier Australia.
Leininger, M. M. (1990). Ethical and Moral Dimensions of Care. Detroit, Michigan: Wayne State University Press.
Roy, S. C., & Jones, D. A. (2006). Nursing Knowledge Development and Clinical Practice: Opportunities and Directions. New York, NY: Springer Publishing Company.