Prepared by: Ana Lee Pendon, RN ,MAN

Reference books:
1. Professional Nursing in the Phil. , 10th edition
By Lydia M. Venzon, RN, MAN, FPCHA,
and Ronald M. Venzon, RN, MAN
2. Nursing Law, Jurisprudence & Professional Ethics
By Atty. Rustico T. De Belen, BA, BSN, LLB, MNSA, PhD
and Donna Vivian S. De Belen, BSN, RN, CCRN, CRNA, MS Anesthesia

ETHICO-MORAL ASPECT OF NURSING

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A. ETHICS
 from Greek word Ethos which means
custom or particular behavior.
 Defined as a “practical science
dealing with the morality of the human
acts or conduct”.(Alora, 1997:7)
 “Determines which values are truly
human, that is, which actions or things
help us fulfill truly human needs
whether innate or created, and helps
us decide what to do when values
seem to be in conflict”. (Ashley and
O’Rourke, 1986: 2)
 A system of moral principles or moral
standards governing conduct. It is a
particular system of principles and
rules concerning duty; it is a system of
rules of practice applied to a single
class of human actions, as for
example: legal ethics, medical ethics,
or nursing ethics. (Robles and
Dionisio, 2001).
B. MORALS
 Comes from Greek word moralis
which refers to social consensus
about moral conduct for human
beings and society
 guides- human decency, right or
wrong, good or evil, proper or
improper, cruel or benevolent acts
 (Ethicist Joseph Fletcher) what you
believe is right and good
C. NURSING ETHICS
 Is a system of principles governing the
conduct of nurses; it deals with the
relationship of a nurse to the patient,
the patient’s family, her associates
and fellow nurses, and the society at
large. (Robles and Dionisio, 2001)
 “ the study of the historical and
contemporary foundations of
professional nursing action in order to
understand what is the ‘good’ that
nursing provides for individuals and
society and an analysis of potential or
actual professional nursing actions
(individual or disciplinary) for the
ability of these to facilitate the ‘good
proposed’”. (Grace, 2000)
 Defined as the “examination of all
ethical and bio-ethical issues from the
prospective of nursing theory and
nursing ethics. (Johnston)
D. NURSING
PROFESSIONAL
ETHICS
 deals with the moral and ethical
behavior of nurses in the practice of
the nursing profession.
 concerned with the ethical norms,
standards and principles, and good
moral conduct of nurses as they relate
to their fellow nurses, their profession,
other health care professionals, their
clients and the general public.
 concerned with the set of documents
pertaining to ethical codes and rules,
moral values and principles, policy
protocols, and competency standards
applicable to nurses in the practice of
their profession.
 W.D. Ross considers consequences
to have value in his theory of “prima
facie duties,” which means “what one
should do when other relevant factors
in a situation are not considered.”
These are:
1. Duties of fidelity – telling the truth,
keeping actual implicit promises
2. Duties of reparation – righting the
wrong we have done to others
3. Duties of gratitude- recognizing the
service other have done for us;
4. Duties of justice – preventing
distribution of pleasure or happiness
that is not in keeping with the merit of
people involved;
5. Duties of beneficence – helping to
better the condition of other beings
6. Duties of self-improvement –
bearing ourselves with respect to
virtue or intelligence
7. Duties of nonmaleficence – avoiding
or preventing injury
E. BASIC ETHICAL PRINCIPLES
1. Autonomy – involves self-determination
and freedom to choose and
implement one’s decision, free
from deceit, duress, constraint
or coercion. Ex. Informed
consent
2. Veracity – the patient and the health
care providers are bound to
tell the truth. The patient has
the responsibility to provide, to
the best of his knowledge,
accurate and complete
information about his
complaints, past illness,
previous hospitalizations,
medications being taken,
allergies, religious restrictions,
and other matters relevant to
is health.
3. Beneficence – promotes
doing acts of kindness
and mercy that directly
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 benefit the patient. These acts
promote the health of the
patient, prevent illness or
complications, alleviate
suffering and assist towards
peaceful death if the inevitable
comes.
4. Nonmalefiscence – an admonition in
the negative form to remind
health practitioners to do no
harm.
5. Justice – refers to the right to demand to
be treated justly, fairly and
equally.
F. CODE OF ETHICS FOR REGISTERED
NURSES
BON Board Resolution No. 220, s. 2004
promulgated on July 14, 2004
This Code of Ethics for RNs observes and
adheres to the universal principle as
enunciated in the Universal Declaration of
Human Rights that “health is the fundamental
right of every individual. It has 7 articles. The
most important articles are summarized
below, as follows:
1. Registered nurses and people.
• RNs are required to:
a) Respect the values, customs and
spiritual beliefs of individuals;
b) Respect individuals freedom to
make rational and unconstrained
decisions; and
c) Hold in strict confidence personal
information acquired in the process
of giving nursing care
2. Registered nurses and practice.
• RNs must adhere to the following
principles and goals:
a) The inviolability of human life;
b) The goal of quality and excellent
care;
c) The accountability for accurate
documentation of actions and
outcomes;
d) The advocates of patients by
respecting the Patient’s Bill of
Rights;
e) The awareness of the professional,
ethical, moral and legal dimensions
of their actions; and
f) The goal of striving to perform their
work in the best interest of all
concerned.
3. Registered nurses and co-workers.
• RNs are required to:
a) Be in solidarity with other members
of the health team for the best
interest of the patient; and
b) Maintain collegial and collaborative
working relationships with
colleagues and other health care
providers.
4. Registered nurses, society and
environment
• RNs are committed to:
a) The preservation of life, respect for
human rights, and promotion of a
healthy environment; and
b) The establishment of linkages with
the public in promoting local,
national, and international efforts to
meet health and social needs of
the people.
5. Registered nurses and the profession
• RNs are dedicated to the following
principles/ commitments of the
profession:
a) Maintenance of loyalty to the
nursing profession;
b) Compliance with the by-laws of the
PNA, and other professional
organizations of registered nurses;
c) Commitment to continual learning
and active participation in the
development and growth of the
organization; and
d) Contribution to the improvement of
the socio-economic conditions and
general welfare of nurses through
appropriate legislation.
6. Sanctions
• For violation of any provision of this
Code and RA No. 9173 and its IRR
pertaining to this Code, the certificate
of registration of RNs is subject to
suspension or revocation, after due
proceedings.
G. A Patient’s Bill of Rights
Nurses are patient
advocates. The nurse
shall conduct his or
her professional
duties and
responsibilities in
consideration of the rights a patient, a
recipient of medical and nursing care, is
entitled to.
Since student nurses provide supervised
nursing care to patients during clinical
rotation, they are expected to be very familiar
with the patient's basic rights in order to
render care in a manner consistent with the
standards of nursing practice.
The patient's Bill of Rights are as follows:
1. The patient has the right to considerate
and respectful care.
2. The patient has the right to and is
encouraged to obtain from physicians
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 and other direct caregivers relevant,
current, and understandable information
concerning his or her care, except in
emergencies when the patient lacks
decision-making capacity and the need
for treatment is urgent. He also has the
right to know the identity of persons
involved in his or her care and the
immediate and long-term financial
implications of all treatment choices.
3. The patient has the right to make
decisions about the plan of care prior to
and during the course of treatment and
to refuse a recommended treatment or
plan of care to the extent permitted by
law and hospital policy and to be
informed of the medical consequences of
this action.
4. The patient has the right to have an
advance directive (such as a living will,
health care proxy, or durable power of
attorney for health care) concerning
treatment or designating a surrogate
decision maker with the expectation that
the hospital will honor the intent of that
directive to the extent permitted by law
and hospital policy.
5. The patient has the right to every
consideration of privacy. Case
discussion, consultation, examination,
and treatment should be conducted so
as to protect each patient's privacy.
6. The patient has the right to expect that
all communications and records
pertaining to his/her care will be treated
as confidential by the hospital, except in
cases such as suspected abuse and
public health hazards when reporting is
permitted or required by law.
7. The patient has the right to review the
records pertaining to his/her medical
care and to have the information
explained or interpreted as necessary,
except when restricted by law.
8. The patient has the right to expect that,
within its capacity and policies, a hospital
will make reasonable response to the
request of a patient for appropriate and
medically indicated care and services.
The hospital must provide evaluation,
service, and/or referral as indicated by
the urgency of the case.
9. The patient has the right to ask and be
informed of the existence of business
relationships among the hospital,
educational institutions, other health care
providers, or payers that may influence
the patient's treatment and care.
10. The patient has the right to consent to or
decline to participate in proposed
research studies or human
experimentation affecting care and
treatment or requiring direct patient
involvement, and to have those studies
fully explained prior to consent.
11. The patient has the right to expect
reasonable continuity of care when
appropriate and to be informed by
physicians and other caregivers of
available and realistic patient care
options when hospital care is no longer
appropriate.
12. The patient has the right to be informed
of hospital policies and practices that
relate to patient care, treatment, and
responsibilities.
H. Bill of Rights for Registered Nurses
1. Nurses have the right to practice in a
manner that fulfills their obligations to
society and to those who receive nursing
care.
2. Nurses have the right to practice in
environments that allow them to act in
accordance with professional standards
and legally authorized scopes of practice.
3. Nurses have the right to a work
environment that supports and facilitates
ethical practice, in accordance with the
Code of Ethics for Nurses and its
interpretive statements.
4. Nurses have the right to freely and openly
advocate for themselves and their
patients, without fear of retribution.
5. Nurses have the right to fair
compensation for their work, consistent
with their knowledge, experience and
professional responsibilities.
6. Nurses have the right to a work
environment that is safe for themselves
and their patients.
7. Nurses have the right to negotiate the
conditions of their employment, either as
individuals or collectively, in all practice
settings.
I. PATIENTS’ RESPONSIBILITIES
1. Providing information
2. Complying with instruction
3. Informing the physician of refusal to
treatment
4. Paying hospital charges
5. Following hospital rules and regulations
6. Showing respect and consideration
J. CONFIDENTIAL INFORMATION
1. Also termed as privileged communication
because it is given based on trust.
2. Pt and/or their relatives are expected to
give the necessary information so that
proper diagnosis and treatment could be
made.
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3. The pt. and his/her family are entitled to
know information or facts within the limits
determined by the physician.
4. The nurse may only repeat what the
doctor wishes to disclose
5. Confidentiality extends even after the pt’s
death “The human mind plans the way, but
6. Confidential information may be revealed the Lord direct the steps.”
only when: -Prov. 16:9
a. The patient himself permits such
revelation as in the case of claim for
hospitalization, insurance benefits,
among others;
b. The case is medico-legal such as
attempted suicide, gunshot wounds
which have to be reported to the local
police or NBI;
c. The pt is ill of communicable disease
and public safety may be jeopardized
d. Given to member of the health team if
information is relevant to his care.

K. Basic Human Rights of Research

Subjects
(Nursing ethics, Professional Nursing)

1. Right to informed consent. Research

subjects must understand the risks and
benefits involved in their participation in
the study.
2. Right to refuse and/or withdraw from
participation.
3. Right to privacy. The privacy of subjects'
thoughts, opinions, records, and physical
presence should be protected. The
subjects also decide on the time, extent,
and circumstances they will participate in
the study.
4. Right to confidentiality or anonymity of
data. Data about the research subjects
should be handled anonymously and shall
be made available only to staff directly
involved in the study. Data should not be
used other than the specific purpose for
which research subjects gave consent to.
Upon completion of the study, all data by
which the subjects can be identified shall
be destroyed.
5. Right to be protected from harm. There
shall be a balance between potential
benefits and risks involved in the study.
The benefits should outweigh the risks
involved. Referral to counseling shall be
made available to research subjects if
necessary.