Ethics is defined as the

standards or principles of
moral judgment or
actions. It provides a
methodical system in
differentiating right from
wrong based on certain
belief.
"Ethics is very much
concerned with the effects
of our behavior on others,"

Etiquette is a code of behavior that

delineates expectations forsocial
behavioraccording to contemporary
conventionalnormswithin
asociety,social class, orgroup.

Values are operational beliefs an

individual chooses as the basis for
behavior which can change over time.
These beliefs serve as the building blocks
of moral and ethical development.
Morals are personal opinion or principle
that a particular action or behavior is
absolutely right or wrong in all situations.
Usually a person is reluctant or unwilling
to change his personal opinions on
specific issues of a moral nature.

Bioethics is the study of typically

controversial ethics brought about by
advances in biology and medicine. It is
also moral discernment as it relates to
medical policy, practice, and research.
Bioethicists are concerned with the
ethical questions that arise in the
relationships among life sciences,
biotechnology, medicine, politics, law,
and philosophy.

A discipline
dealing with the
ethical
implications of
biological
research and
applications
especially in
medicine

Ethics reflects the standards that

govern a proper conduct in a particular
profession. For instance, the nurse on
duty knows that she is obligated to act
for the good of the client and to
prevent any incident to harmthe
patient. This principle of doing no harm
to the client is the intervention of
knowing the ethics in nursing.

Nursing ethics provides the standards of

professional behavior for nurses and the
principles of knowing right from a wrong
conduct duringimplementationof
nursing duties and responsibilities.
Through this set of standards, nursing
duties and responsibilities of nurses
towards their clients, co-workers,
profession and community is made
known.

4 Types

Descriptive / comparative ethics

Prescriptive / Normative ethics
Metaethics
Applied ethics

Descriptive ethicsDescriptive ethics, also

known as comparative ethics, is the study of
people's beliefs about morality. This category
of ethics is the easiest to understand - it
simply involvesdescribinghow people
behave and/or what sorts of moral standards
they claim to follow.
MetaethicsThe category of metaethics, also
often referred to as analytic ethics, is perhaps
the most difficult of the three to
understand.is the study of what ethical terms
and theories actually refer to. The center of
this type is on reasonable and justifiable
judgments. It is basically concerned with
theoretical issues of meaning and its
justification.

Normative ethics prescriptive or normative ethics

is the study of ethical theories that prescribe how
people ought to act . The category of normative
ethics involves creating or evaluating moral
standards. Thus, it is an attempt to figure out what
peopleshoulddo or whether their current moral
behavior is reasonable. With this classification, a
question is raised about what is right or wrong.
Something should be done in a situation that calls
for an ethical decision. For instance, a teenager
who is maintaining a scholarship is pregnant. She
is to decide whether she will abort the baby to
avoid issues and being kicked out of the school or
sustain the pregnancy and deliver the baby.

The following examples of questions that

might be considered in each field illustrate
the differences between the fields:
Descriptive ethics: What do people think is
right?
Normative (prescriptive) ethics: How
should people act?
Meta-ethics: What does 'right' even mean?
Applied ethics: How do we take moral
knowledge and put it into practice?

The ethical principles provide a

foundation fornursing practice.
Ethical principles are defined as basis
for nurses decisions on consideration
of consequences and of universal
moral principles when making clinical
judgments. The most fundamental of
these principles is the respect for
persons.

The primary and basicethical

principlesare the following:
Autonomy
Nonmaleficence
Beneficience
Justice
The secondaryethical principlesthat can
be incorporated with the primary
principles when interpreting ethical
issues and making clinical decisions are
the following:
Veracity
Confidentiality
Fidelity

According to the American Nurses

Association (ANA), the most
fundamental principle of professional
behavior is the respect for persons. This
principle not only applies to the clinical
settings but to all lifes situations. This
principle emphasizes that all people
should treat others as a worthy
individual. Innursing practicethis
principle should be simplified. Thus,
respect for persons generally means
respecting a clients autonomy.

The principle of autonomy is based on the

assertion that individuals have the right to
determine their actions and the freedom to
make their own decisions.
Autonomy refers to the control individuals
have over their own lives. Respect for
individual is the cornerstone of the principle.
Autonomy applies both to decisions and
actions. Autonomous decisions are based on
(1) individual values, (2) Adequate
information, (3) Freedom from corcion, and
(4) reason and deliberation. Autonomous
actions results from autonomous decisions.

Respecting a clients rights, values and

choices is synonymous to respecting a
persons autonomy.
Informed consent is a method that
promotes and respects a persons
autonomy. For a client to make an
autonomous decision and action, he or she
must be offered enough information and
options to make up his or her mind free of
coercion or external and internal influences.
In clinical settings, this is promoted by
proving informed consent to the client.

In clinical situations nurses respect a

patients autonomy, where the patient is
allowed the freedom of choice regarding
treatment, such as in deciding whether
he/she wishes to be intubated during an
exacerbation of COPD, or deciding when
he/she wishes to forgo further dialysis. If
a patient lacks capacity for such a
decision and has an advance directive,
the person who has the durable power
of attorney can make the decision.

Beneficence is doing or active promotion

of good. According to Frankena (1988),
beneficience involves four duties:
1. Not to inflict harm or evil
2. To prevent harm or evil
3. To remove harm or evil, and
4. To promote or do good.
Beneficence is done by:
Providing health benefits to the clients.
Balancing the benefits and risks of harm.
Considering how a client can be best
helped.

An elderly patient falls at home and

has a fractured hip. In the emergency
room, the nurse acts to provide pain
medication as soon as possible in an
act of beneficence.

Nonmaleficence means duty to do no harm.

This principle is the foundation of the medical
professions Hipocaratic oath; it is likewise
critical to the nursing profession.
This is promoted by doing the following
nursing interventions:
1. Avoiding deliberate harm, risk of harm that
occurs during the performance of nursing
actions.
2. Considering the degree of risk permissible.
3. Determining whether the use of technological
advances provides benefits that outweigh
risks.

When this elderly person above received pain

medication (an act of beneficence) there are
complications that could arise. Practitioners
recognize that using a narcotic may cause
confusion. When obtaining the consent for
her hip surgery, we want to make certain that
the patient is alert enough to understand the
risks and benefits of the procedure. We must
balance the beneficence of providing the
medication quickly with the possible
maleficence of obtaining a consent when
patient does not have the capacity to make
the decision for surgery.

Justice is the promotion of equity or fairness

in every situation a nurse encounters.
In health care, the most common concern
about justice relates to allocation of
resources.
The following nursing
implications promote justice:
Ensuring fair allocation of resources.
(example: appropriate staffing or mix of staff
to all clients)
Determining the order in which clients
should be treated. (example: priority
treatments for the clients in pain)

A hospital organization wishes to

donate low or no-cost pediatric
dental services to the community.
There are openings for 45 children
per month. Justice requires a fair
method, that is free from bias, to
determine who will receive these
services.

Defined as duty to tell the truth.

It is necessary to basic communication,
and societal relationships are built on
the individuals right to know the truth.
Health care professionals are not
responsible for false information given
to them by their patients. They are
responsible, however, for information
that they give to patients.

Duty to respect privileged information.

The prohibition of some disclosures of
information gained in certain
relationships without the consent of the
original source of the information.
A nurse should be trusted. Since patients
are required to confide to the nurses
about what really happened to them,
nurses are not allowed to tell other
people about these unless it is needed
by the physician. Nurses have no right to
tell other nurses what the health
condition of their patient really is.

Refers to faithfulness (duty to keep

promises, agreements and
commitments made).
The nurse is required to remain faithful
in seriously considering all ethical
mandates related to the practice of the
profession.
When the nurse accepts licensure and
becomes a part of the profession, it is
mandated that he or she accept certain
responsibilities as part of the contract
with society.

A patient asks the nurse not to reveal the

fact that she is dying or give her diagnosis
to his family. The nurse asks why she does
not want her family advised. The patient
explains that her family is very emotional
and has stated they would do everything to
keep her alive, even if it required long-term
mechanical ventilation. The patient has
explained multiple times that she does not
want mechanical ventilation. The nurse
recognizes that keeping of this information
in confidence, while supporting the family, is
an example of exercising fidelity.

Ethics is a branch of philosophy that, at

its core, seeks to understand and to
determine how human actions can be
judged as right or wrong. We may make
ethical judgments, for example, based
upon our own experience or based upon
the nature of or principles of reason.
Those who study ethics believe that
ethical decision making is based upon
theory and that these theories can be
classified.

1.
2.
3.
4.

Consequentialism / Teleology
Deontologism
Natural Law
Virtue Ethics

Ethical theories that fall under the

classification of consequentialism posit
that the rightness or wrongness of any
action must be viewed in terms of the
consequences that the action produces.
In other words, the consequences are
generally viewed according to the extent
that they serve some intrinsic good.
The most common form of
consequentialism is utilitarianism (social
consequentialism) which proposes that
one should act in such a way to produce
the greatest good for the greatest
number.

The utilitarian ethical theory is founded on the

ability to predict the consequences of an action.
To a utilitarian, the choice that yields the
greatest benefit to the most people is the choice
that is ethically correct. One benefit of this
ethical theory is that the utilitarian can compare
similar predicted solutions and use a point
system to determine which choice is more
beneficial for more people. This point system
provides a logical and rationale argument for
each decision and allows a person to use it on a
case-by-case context.

There are two types of utilitarianism, act

utilitarianism and rule utilitarianism. Act utilitarianism
adheres exactly to the definition of utilitarianism as
described in the above section. In act utilitarianism, a
person performs the acts that benefit the most
people, regardless of personal feelings or the societal
constraints such as laws. Rule utilitarianism, however,
takes into account the law and is concerned with
fairness. A rule utilitarian seeks to benefit the most
people but through the fairest and most just means
available. Therefore, added benefits of rule
utilitarianism are that it values justice and includes
beneficence at the same time

Deontologism is a position based,

predominately, on the work of Immanuel Kant.
Most simply, deontologism suggests that an
act must be performed because the act in
some way is characterized by universality (i.e.
appropriate for everyone) or that it conforms
with moral law (formal rules used for judging
the rightness or wrongness of an act).
According to this theoretical position, the
rightness or wrongness of some acts are
independent of the consequences that it
produces and the act may be good or evil in
and of itself.

The deontological theory states that people

should adhere to their obligations and duties
when analyzing an ethical dilemma. This means
that a person will follow his or her obligations to
another individual or society because upholding
one's duty is what is considered ethically
correct. For instance, a deontologist will always
keep his promises to a friend and will follow the
law. A person who follows this theory will
produce very consistent decisions since they
will be based on the individual's set duties.

This theoretical position suggests that

one may, through rational reflection on
nature (especially human nature),
discover principles of good and bad that
can guide our actions in such a way
that we will move toward human
fulfillment or flourishing.
This position suggests that human
beings have the capacity within
themselves for actualizing their
potential.

The virtue ethical theory judges a

person by his character rather than by
an action that may deviate from his
normal behavior. It takes the person's
morals, reputation and motivation into
account when rating an unusual and
irregular behavior that is considered
unethical.
One weakness of this ethical theory is
that it does not take into consideration
a person's change in moral character.

Virtue ethics consists of two differing

approaches to ethics and can, therefore,
be confusing to understand.
Very briefly, the first approach to ethics
in this theoretical orientation proposes
that there are certain dispositional
character traits (virtues) that are
appropriate and praiseworthy in general
and or in a particular role.
More formally, virtue ethics represents a
"systematic formulation of the traits of
character that make human behavior
praiseworthy or blameworthy.