NURSING ETHICS

 The applied discipline that studies the ethical dimensions and issues in nursing
 practice
 The basis for the professional code of ethics in nursing.

Nursing Laws of the Philippines

 RA Act 9173 or Philippine Nursing Law of 2002

 ARTICLE VI- NURSING PRACTICE

ARTICLE VI – NURSING PRACTICE

Section 28: Scope of Nursing. A person shall be deemed to be practicing nursing within the
meaning of this Act when he/she singly or in collaboration with others, initiates and performs
nursing services to individuals, families and communities in any health care setting. It includes
but not limited to nursing care during conception, labor, delivery, infancy, childhood, toddler,
pre-school, school age, adolescence, or adulthood, and old age. As independent practitioner,
nurses are primarily responsible for the promotion of health and prevention of illness. A member
of the health team, nurses shall collaborate with other health care providers for the curative,
preventive and rehabilitative aspect of care, restoration of health, alleviation of suffering, and
when recovery is not possible, towards a peaceful death, it shall be the duty of the nurse to:

a) Provide nursing care through the utilization of the nursing process. Nursing care includes
but not limited to:
 Traditional and innovative approaches, TOS,
 Executing health care techniques,
 Essential primary health care, comfort measures, health teachings,
 And administration of written prescription for treatment, therapies, oral,
topical and parenteral medications.
 Internal examination during labor in the absence of antenatal bleeding and
delivery.
 In case of suturing of perineal laceration, special training shall be provided.
b) Establish linkages with community resources and coordination with the health team.
c) Provide health education to individuals, families and communities.
d) Teach, guide and supervise students in nursing education programs including the
administration of nursing services in varied settings such as hospitals and clinics;
undertake consulation services; engage in such activities that require the utilization of
knowledge and decision making skills of a registered nurse, and
e) Undertake nursing and health human resource development training and research, which
will include but not limited to the development of advanced nursing practice. 
Provided that this section shall not apply to nursing students who perform nursing functions
under the direct supervision of a qualified faculty: Provided further that in the practice of nursing
in all settings, the nurse is duty bound to observe the Code of Ethics for nurses and uphold the
standards of safety nursing practice.

The nurse is required to maintain competence by continual learning through Continuing

Professional Education (CPE) to be provided by the accredited professional organization or any
recognized professional nursing organization. Provided, finally that the program and activity for
the CPE shall be submitted to and approved by the Board.

Virtues: Moral Character of the Nurse

 Truthfulness
 Rectitude
 Integrity / Honesty
 Doing once work decently
 Avoiding impropriety / bad behavior 
 Being a force for good
 Maintaining self-discipline
 Standing firm on what one knows to be morally right
 Loving one's nursing work
 Liberally educated
 Love for humanity
 Genuine compassion, empathy and kindness.

Nursing Ethics is Relational Center

 It is relationally based (Fowler, 2017)
 Identify classes of relationship

Seven classes of relationship

 Those she owes
 To the family
 To the doctor
 Friends and servants of the patient
 Her own friends
 Her own hospital or school
 To other nurses

Nurse relationship
 Nurse-patient relationship
 Nurse to self
 Nurse to nurse relationship
 Nurse to physician relationship
  Nurse to society relationship

Bioethics
 Is the study of the morality of human conduct in the area of life sciences and
healthcare.
 Greek word: BIOS - life, Ethics - behavior 
 First use by VAN RENSSELAER POTTER

Bioethical issues:
 LIFE: FP, abortion, genetic screening, in vitro fertilization, single parents
 DEATH: Euthanasia, withdrawing treatment etc. 
 Human experimentation, genetics, transplants, end life issues

Threatening Conditions that Prompted the Birth of Bioethics

 1930 - 1070 - US govt had syphilis experiment among 400 black Americans and were
not treated despite of discovery of antibiotics. 
 1947 - Nuremburg Code - condemned all HE without consent
 1963 - Tumor cells injected to elderly without consent

Evolutionary Phases of Bioethical Studies

Medical Ethics
 A formulation of ethical norms for the conduct of health care professionals and the
treatment of patients. 
 Respect for the rights and acting by one’s duties will be for the good of physician and
the patient. 

Hippocratic Oath
- Oldest formulations of medical ethics
- Name after Hippocrates - Father of Medicine
 Underscores the physician’s all out concern for the patient to be kept from harm and
injustice
 Should not prescribe a fatal drug to anyone, even if asked to do so
 Oath rules out any form of abortifacient 
 Another obvious it is reference to the practice of abortion
 Prohibits sexual relations between doctors and patients
 Significance of confidentiality (Medical secrecy) 

Research Ethics
 2nd phase in the development of bioethical study in biomedical fields
 Also known as biomedical research
 Use of human as experimental specimens upon non-consenting in anatomical studies,
drug testing and experiments and researches. 
 3rd Reich 1933-1945 (Adolf Hitler)
Nuremburg Code
 Attempted humanize the barbanic and cruelty nature of human experiments.
 Takes into account the informed consent, informed decision and inform choice with
experimental subjects. 

The Principles of Nuremburg Code

1. Voluntary consent is absolutely essential.
2. The experiment should be such as to yield fruitful results for the good of the society.
3. The experiment should be designed and based on the results of animal experimentation
and knowledge of the natural history of the disease and other problem of the study. 
4. The experiment should be conducted to avoid all unnecessary physical and mental
suffering and injury.
5. No experiment should be conducted where there is a prior reason to believe that death or
injury will occur, EXCEPT in those experiments where the experimental physician also
serve as subjects. 
6. The degree of risk to be taken should never exceed that determined by the humanitarian
importance of the problem to be solve by the experiment.
7. Proper preparation should be made and adequate facilities provided to protect the subjects
against possible injury, disability or death. 
8. The experiment should be conducted ONLY by scientific qualified person.
9. During the course of the experiment, the human subject should be at liberty to bring the
experiment to an end if he has reached the physical and mental state where continuation
of the experiment seems to him to be possible. 
10. During the course of the experiment, the scientist in charge prepared to terminate the
experiment at any stage, if he has probable cause to believe, in the exercise of the good
faith, superior skill, and careful judgment required of him that a continuation of the
experiment is likely to result in injury, disability or death to the experimental subject. 

Public Policy
 3rd stage of the development of bioethical inquiry
 Accentuates the participatory aspect of decision making in a democratic set-up with
regards to the formulation of public policies for the benefit of all.
 Consulting people through surveys, meetings, conferences, convocations about their
opinions and views on particular bioethical issues.