A nurse’s primary responsibility is to provide safe nursing care to patients, for which she must know how to deal with ethical dilemmas. Ethical dilemmas are situations where a nurse faces difficulty in choosing between two equally conflicting courses of action. To deal with such situations knowledge regarding basic ethical principles is a must for a nurse.
The word ethics is derived from the Greek word “ethos”, the meaning of which is character. Ethics provide a framework that can help in finding what kind of actions and motives are valued. Ethics for nurses is essential to recognize the situation of ethical conflict and to make decisions based on those ethics without trespassing the professional and legal boundaries.
The basic ethical principles a nurse must cling to are:
- Justice
- Non-maleficence
- Accountability
- Autonomy
- Veracity
- Fidelity
Justice
The principle of justice states that the nurse must be fair while rendering her services to patients. A nurse should treat each of her patients equally by being impartial and unbiased. While providing services, a nurse should not discriminate against patients based on their characteristics like age, financial status, sex, and religion, etc.
Example: A Nurse who has limited food resources allocates an equal ration to the patients is following the principle of justice.
Non-Maleficence
The principle of non-maleficence has its roots in the Hippocratic Oath and which means to do “no harm”. This principle entitles a nurse to provide care without exposing patients to any type of harm either intentional or unintentional. The harm can be physical as well as psychological. A nurse can provide such care by following evidence-based practice and avoiding negligence.
Example: A nurse asking the patient for the occurrence of possible side effects of a drug and aborting the medication in case of significant side effects is following the principle of non-maleficence.
Beneficence
This principle states that the actions of a nurse should benefit the patient. It means that a nurse should render care with a desire to do good for patients and must do all that can be beneficial for the patient. A nurse should take active decisions utilizing compassion and kindness in every situation, even if the treatment involves life-threatening consequences. It is the most challenging principle in a healthcare setting, as at times a nurse has to dissipate information related to a patient’s health, that is not good without sounding brutal or to provide care that involves pain but without sacrificing, the patient’s faith in her.
Example: A Nurse caressing head of women undergoing medical termination of pregnancy is adhering to the principle of beneficence.
Autonomy
This principle focuses on the independence of the patient in making his treatment choices. According to this ethical principle, a nurse should appreciate and respect the right of the patient to make an independent decision without any interference regarding his treatment. A nurse should ensure that the patient has received all the necessary information to decide on his medical care.
Example: A nurse is educating a patient undergoing lumbar puncture about the method, risk, and possible outcomes of the procedure, and then asking the patient for his informed consent is respecting the autonomy of the patient.
Fidelity
This comprises the nurse’s responsibility for being truthful and faithful towards her patient. Trust is a very important contributor to a healthy nurse-patient relationship, and a nurse should not taint the trust that the patient put in their relationship. A nurse should always make those promises which are do-able and keep her promises, which she made with the patient. A nurse should not present false information as truth.
Example: A nurse maintains the confidentiality of the patient’s troublesome relationship with his wife on his request is following the principle of fidelity.
Accountability
Accountability principles state that a nurse is answerable to her actions and she should be able to accept the consequences of her actions. Patient care is the primary responsibility of a nurse and each nurse is individually accountable towards their nursing practice. A nurse while taking decisions and providing care should be able to justify her course of action sensibly.
Example: A senior nurse is guiding and supervising the administration of IM injection by a fresher nurse is showing accountability.
Veracity
A nurse should always share true facts related to the patient’s health status and treatment plans without withholding any sort of information from the patient and his family. The nurse must not give false statements and hope in any situation.
Example: A nurse is using the empathetic gesture of touch instead of sharing false hope with the grieving mother of a terminally ill patient.
In healthcare services, the chances of facing ethical dilemmas are very common. As nurses are one of the main caregivers in the healthcare industry they need to know basic ethics. The ethical principle guides a nurse to handle ethical conflicts appropriately and take decisions without compromising the quality of nursing care.