JENELYN V.

NAPURAN
MSN 1 B
CHAPTER 3
ETHICAL PRINCIPLES

INTRODUCTION
ETHICAL ISSUES ARE COMMONLY EXAMINED IN TERMS OF A NUMBER OF
ETHICAL PRINCIPLES. ETHICAL PRINCIPLES ARE BASIC AND OBVIOUS MORAL
TRUTHS THAT GUIDE DELIBERATION AND ACTION. IT IS VITAL FOR NURSES TO
UNDERSTAND THIS AND APPLY IT IN A MEANINGFUL AND CONSISTENT MANNER

RESPECT FOR THE PERSON

-THIS IMPLIES THAT ONE CONSIDERS OTHERS TO BE WORTHY OF HIGH REGARD.
-CERTAINLY, GENUINE REGARD AND RESPECT FOR OTHERS SERVES AS THE
CORNERSTONE OF ANY CARING PROFESSION.

AUTONOMY
-SELF-GOVERNING
-HAVING THE FREEDOM TO MAKE CHOICES ABOUT THE ISSUES THAT AFFECTS
ONE’S LIFE
-ACCORDING TO (JAMETON, 1984) THIS TERM IS MORE FREQUENTLY USED AS A
CONTRAST TO UNDESIRABLE STATES SUCH AS DEPENDENCY, COERCION,
PATERNALISM, THOUGHTLESSNESS AND HABIT.
-IT IS ALSO CLOSELY LINKED TO THE NOTION OF RESPECT FOR PERSONS AND IS
AN IMPORTANT PRINCIPLE IN CULTURES WHERE ALL INDIVIDUALS ARE
CONSIDERED TO BE UNIQUE AND VALUABLE MEMBERS OF SOCIETY.
ACCORDING TO (EDGE & GROVES, 2005) AUTONOMY IMPLIES THAT EACH
PERSON HAS THE FREEDOM TO MAKE DECISIONS ABOUT PERSONAL GOALS. IT
IS A STATE IN WHICH EACH OF US IS FREE TO CHOOSE AND IMPLEMENT OUR
OWN DECISIONS, FREE FROM LIES, RESTRAINTS, OR COERCION

4 BASIC ELEMENTS TO ASSURE AUTONOMY

1. THE AUTONOMOUS PERSON IS RESPECTED.
2. THE AUTONOMOUS PERSON MUST BE ABLE TO DETERMINE
PERSONAL GOALS.
3. AUTONOMOUS PERSON MUST HAVE THE CAPACITY TO DECIDE
ON A PLAN OF ACTION
4. THE AUTONOMOUS PERSON HAS THE FREEDOM TO ACT UPON
CHOICES

Recognizing violations of autonomy

1. Nurses may falsely assume that that patients have the same values and goals
as themselves.
2. Failure to recognize that individuals' thought processes are different.
3. Nurses assumptions about patients’ knowledge base.
4. The unfortunate fact that in some instances the “work” of nursing becomes
the major focus

Informed consent
-RELATES TO A PROCESS BY WHICH PATIENTS ARE INFORMED OF THE POSSIBLE
OUTCOMES, ALTERNATIVES, AND RISKS OF TREATMENTS, AND ARE REQUIRED
TO GIVE THEIR CONSENT FREELY.
-IT ASSURES THE LEGAL PROTECTION OF A PATIENT’S RIGHT TO PERSONAL
AUTONOMY IN REGARD TO SPECIFIC TREATMENTS AND PROCEDURES.
PATERNALISM/PARENTALISM
PATERNALISM IS A GENDER-BIASED TERM THAT LITERALLY MEANS ACTING IN A
FATHERLY MANNER. TRADITIONAL VIEW OF PATERNAL ACTIONS INCLUDES SUCH
ROLE BEHAVIORS AS LEADERSHIP, BENEVOLENT DECISION MAKING,
PROTECTION AND DISCIPLINE. THIS CARRIES A NEGATIVE CONNOTION
PARTICULARLY RELATED TO MALE VERSUS SUBMISSIVE FEMALE ROLES
PARENTALISM IS A NON-GENDER TERM THAT PARALLELS THE MEANING OF
PATERNALISM WHILE AVOIDING GENDER BIAS.
THESE TRANSLATES TO PROFESSIONALS WHO RESTRICT OTHERS’
AUTONOMY, USUALLY TO PROTECT THAT PERSON FROM
PERCEIVED OR ANTICIPATED HARM. THIS IS APPROPRIATE WHEN
PATIENT IS JUDGED TO BE INCOMPETENT OR TO HAVE DIMINISHED
DECISION MAKING CAPACITY.

NONCOMPLIANCE
-GENERALLY THOUGHT OF AS DENOTING AN UNWILLINGNESS OF THE PATIENT
TO PARTICIPATE IN HEALTH CARE ACTIVITIES.
-COMMONLY ENTAILS LACK OF PRTICIPATION IN A REGIMEN THAT HAS BEEN
PLANNED BY THE HEALTH CARE PROFESSIONAL BUT MUST BE CARRIED OUT BY
THE PATIENT.

TWO BASIC FACTORS ABOUT CARING FOR A NON COMPLIANT PATIENT

1. THE AUTONOMOUS PARTICIPATION OF THE PATIENT IN THE
HEALTH CARE PLAN IS ESSENTIAL TO SUCCESS.
2. NURSES AND THE OTHER HEALTH CARE PROFESSIONALS MUST
ASSESS PATIENTS’ ABILITIES TO FOLLOW PLANS OF CARE
BENEFICENCE
-THE PRINCIPLE THAT REQUIRES THE NURSES TO ACT IN WAYS THAT BENEFIT
PATIENTS.
-ACCORDING TO (BEAUCHAMP&WALTERS 2002) BENEFICENT ACTS ARE
MORALLY AND LEGALLY DEMANDED BY OUR PROFESSIONAL ROLE.
-THE OBJECTIVE OF BENEFICENCE PROVIDES NURSING CONTEXT AND
JUSTIFICATION
3 MAJOR COMPONENTS OF BENEFICENCE
1. WE OUGHT TO DO OR PROMOTE GOOD
2. PREVENT HARM
3. REMOVE EVIL OR HARM

NONMALEFICENCE
-THIS IS RELATED TO BENEFICENCE.
-REQUIRES US TO ACT IN A MANNER TO AVOID CAUSING HARM TO PATIENT.
-AVOIDING HARM AS A CONSEQUENCE OF DOING GOOD

IMPLICATIONS OF AUTONOMY, BENEFICENCE AND NONMALEFICENCE ON

CERTAIN SITUATIONS

1.WITHHOLDING OR WITHDRAWING LIFE SUPPORT

EUTHANASIA
2.ORDINARY VERSUS EXTRAORDINARY MEASURES
ABORTION
3.KILLING VERSUS LETTING GO
ORGAN DONATION