ETHICS
Harelip or cleft palate, down syndrome with
Ethos - Greek work w/c means moral duty
         - Branch of Philosophy w/c determines right and
wrong.
- Refers to a standard to examine and understand moral
life.
MORALITY
MORALIS- greek word refers to social consensus about
moral conduct for human beings and society.
Moral - personal/private interpretation from what is
good and bad.
Ethical Principles:
Autonomy – the right/freedom to decide (the patient
has the right to refuse despite the explanation of the
nurse) Example: surgery, or any procedure
Nonmaleficence – the duty not to harm/cause harm or
inflict harm to others (harm maybe physical, financial or
social).
Beneficence- for the goodness and welfare of the
clients, acts of kindness and mercy that directly benefit
the patient.
Justice – equality/fairness in terms of
resources/personnel ( EQUITY of needs)
Veracity - the act of truthfulness.
*Benevolent deception
- Practitioner himself intentionally withholds
information according to his sound judgment when such
revelation would do more harm to an emotionally
unstable or depressed person.
Fidelity – faithfulness/loyalty to clients.
Confidentiality- the principle of confidentiality requires
that information about a client be kept private.
Moral Principles:
Golden Rule: Do unto others what you would like others
do unto you.
The principle of Totality – The whole is greater than its
parts.
Epikia – exemption to the rule.
Ex. Visiting hours.
One who acts through as agent is herself responsible –
(instrument to the crime)
Ex. abortion
No one is obliged to betray herself/ himself.
Ex. Testify before a court.
The end does not justify the means.
Ex. Giving sleeping tablet to a chronically ill person so
he/ she can die in peace morally wrong.
Defects of nature maybe corrected.
Ex.
intestinal atresia.
If one is willing to cooperate in the act, no injustice is
done to him/ her.
A little more or a little less does not change the
substance of an act.
No one is held to the impossible.
Ex. To promise that a patient with heart transplant will
live maybe an impossibility. Yet, such procedures are
done in the hope of saving or prolonging a patient’s life.
The doctor or the nurse cannot be held to the
impossible if they have done their best to take care of
the patient and the latter dies.
Morality of cooperation.
Principle relating to the origin and destruction of life
Law - Rule of conduct commanding what is right and
what is wrong. Derived from an Anglo-Saxon term that
means“that which is laid down or fixed”
Court - Body/agency in government wherein the
administration of justice is delegated.
Legal Roles of Nurses
1. Provider of service.
The nurse is expected to provide safe and competent
care so that harm ( physical, psychologic or material ) to
the recipient of the service is prevented.
2. Liability
- Is the quality or state of being legally responsible for
one’s obligations and actions and to make financial
restitution for wrongful acts.
3. Standards of care
It is by which the nurse acts or fails to act are legally
defined by nurse practice acts and by rule of reasonable
and prudent professional with similar preparation and
experience would do in similar circumstances.
4. Employee or contractor for service.
- A nurse who is employed by a hospital work as an
agent of the hospital and the nurse’s contract with the
clients is an implied one.
5. Contractual relationships.
a. Independent nurse practitioner. Contractual
relationship with the client is independent.
b. Nurse employed by a hospital.- Functions with
employer- employee relationship. The nurse represents
and acts for the hospital and therefore must function
within the policies of the agency.
Also, “ respondeat superior “- let the master answer.
The nurse may also be held liable as an individual in
case of inappropriate behavior.
Inappropriate behaviors
-hitting client in any part of the body.
-Assisting in criminal abortion.
-Taking drugs from the client’s supply for personal use
6. Citizen
The rights and responsibilities of the nurse in the role of
a citizen are the same as those individual under the
legal system.
Rights- are privileges or fundamental powers to which
an individual is entitled unless they are revoked by law.
Responsibilities- are the obligations associated with
rights.
Plaintiff - Complainant or person who files the case
(accuser)
Defendant - Accused/respondent or person who is the
subject of complaint
Witness- Individual held upon to testify in reference to a
case either for the accused or against the accused.
Written orders of court
Writ – legal notes from the court.
 1. Subpoena
        a. Subpoena Testificandum – a writ/notice to an
individual/ordering him to appear in court at a specific
time and date as witness.
        b. Subpoena Duces Tecum- notice given to a
witness to appear in court to testify including all
important documents .
Summon – notice to a defendant/accused ordering him
to appear in court to answer the complaint against him
Warrant of Arrest - court order to arrest or detain a
person
Search warrant - court order to search for properties.
Private/Civil Law - body of law that deals with
relationships among private individuals
Public law - body of law that deals with relationship
between individuals and the State/government
agencies. Laws for the welfare of the general public.
Private/Civil Law :
Contract law – involves the enforcement of agreements
among private individuals or the payment of
compensation for failure to fulfill the agreements.
Ex. Nurse and client nurse and insurance
Nurse and employer client and health agency 
An agreement between 2 or more competent person to
do or not to do some lawful act. 
It maybe written or oral= both equally binding
Types of Contract:
1. Expressed –when 2 parties discuss and agree orally or
in writing the terms and conditions during the creation
of the        contract.
Example: nurse will work at a hospital for only a stated
length of time (6 months),under stated conditions (as
volunteer, straight AM shift, with food/transportation
allowance)
2. Implied – one that has not been explicitly agreed to
by the parties, but that the law considers to exist.
Example: Nurse newly employed in a hospital is
expected to be competent and to follow hospital
policies and procedures even though these expectations
were not written or discussed.
Likewise: the hospital is expected to provide the
necessary supplies, equipment needed to provide
competent, quality nursing care
Feature/Characteristics/Elements of a lawful contract:
1. Promise or agreement between 2 or more persons for
the performance of an action or restraint from certain
actions.
2. Mutual understanding of the terms and meaning of
the contract by all.
A lawful purpose – activity must be legal
4. Compensation in the form of something of value-
monetary
Persons who may not enter into a contract: minor,
insane, deaf, mute and ignorant
Tort
- Is a civil wrong committed against a person or a
person’s property.
Person/person’s responsible for the tort are sued for
damages
Is based on:
ACT OF COMMISSION –something that was done
incorrectly
ACT OF OMMISION – something that should have been
done but was not.
Classification of Tort
Unintentional Tort -do not require intent but do require
the element of HARM
1. Negligence
Misconduct or practice that is below the standard
expected of ordinary, reasonable and prudent person.
Failure to do something due to lack of foresight or
prudence
Failure of an individual to provide care that a reasonable
person would ordinarily use in a similar circumstance.
An act of omission or commission wherein a nurse fails
to act in accordance with the standard of care.
Doctrines of Negligence:
a. Res ipsa loquitor
– the thing speaks for itself. This means that the injury
could not have happened if someone was not negligent
that no further proof is required.
b. Respondeat Superior
– let the master answer, command responsibility
c. Force majuere
– unforeseen or inevitable event, irresistible force
2. Malpractice
stepping beyond one’s authority .
 elements of proof of nursing negligence and
malpractice:
    a. Duty – the nurse must have a relationship with the
client that involves providing care and following an
acceptable  standard of care.
    b. Breach of duty on the part of the nurse.
c. An injury to the client.
d. A casual relationship between the breach of duty and
the client’s subsequent injury.
POTENTIAL MALPRACTICE SITUATIONS IN NURSING:
1.Medication error.
2.Sponge count error.
3.Burning a client
4. Clients falls.
5. Failure to observe and take appropriate actions..
6. Mistaken identity.
7. loss/ damage of client property.
8. Failure in reporting crimes, torts and unsafe practice.
c. Foreseeability – a link must exist between the nurse’s
act and the injury suffered.
 
d. Causation – it must be proved that the harm occurred
as a direct result of the nurse’s failure to follow the  
standard of care and the nurse should or could have
known that the failure to follow the standard of care
could  result in such harm.
    e. harm/injury –physical, financial, emotional as a
result of the breach of duty to the client .
Example: physical injury, medical cost/expenses, loss of
wages, pain and suffering
    f. damages – amount of money in payment of
damage/harm/injury
Intentional Tort
Intentional tort – the act was done on PURPOSE or with
INTENT
No harm/injury/damage is needed to be liable 
No expert witnesses are needed
Assault
An attempt or threat to touch another person
unjustifiably .
Example:
A person who threatens someone with a club or closed
fist.
Nurse threatens a client with an injection after refusing
to take the meds orally.
Battery
Willful touching of a person, person’s clothes or
something the person is carrying that may or may not
cause harm but the touching was done without
permission, without consent, is embarrassing or causes
injury.
Example: 
A nurse threatens the patient with injection if the
patient refuses his meds orally. If the nurse gave the
injection without client’s consent, the nurse would be
committing battery even if the client benefits from the
nurse’s action.
False Imprisonment
Unjustifiable detention of a person without legal
warrant to confine the person
Occurs when clients are made to wrongful believe that
they cannot leave the place
Example:
Telling a client no to leave the hospital until bill is paid
Use of physical or chemical restraints
False Imprisonment Forceful Restraint=Battery
Invasion of Privacy
intrusion into the client’s private domain
right to be left alone
Types of Invasion the client must be protected from: Euthanasia. “ mercy killing”. Legally and morally
use of client’s name for profit without consent – using WRONG.
one’s name, photograph for advertisements of HC 3. Do not resuscitate orders ( DNR ).
agency or provider without client’s permission for the clients in terminal/ irreversible illness.
Unreasonable intrusion – observation or taking of Should be clearly documented.
photograph of the client for whatever purpose without As requested by the client/ significant others.
Public disclosure of private facts – private information is 4. abortions- legally and morally WRONG.
given to others who have no legitimate need for that.
Putting a person in a false/bad light – publishing
information that is normally considered offensive but
which is not true. client’s consent.
Defamation
communication that is false or made with a careless
disregard for the truth and results in injury to the
reputation of a person

   Types:
Libel
– defamation by means of print, writing or picture
Example:
writing in the chart/nurse’s notes that doctor A is
incompetent because he didn’t respond immediately to
a call

Slander
– defamation by the spoken word stating unprivileged
(not legally protected) or false word by which a
reputation is damaged
Example:
Nurse A telling a client that nurse B is incompetent
Person defamed may bring the lawsuit
The material (nurse’s notes) must be communicated to a
3rd party in order that the person’s reputation maybe
harmed
SELECTED FACTS OF NURSING PRACTICE:
1. Informed consent.
- Is an agreement by a client to accept a course of
treatment or procedure after complete information,
including the risks of treatment and facts relating to it. H
2. Death and related issues.
Postmortem care. Requires pronouncement of death by
the physician.
Autopsy. Requires consent from significant others
( closest relative ).
Organ donation. Requires consent from client. If the
client is dead, the family may authorize organ
donation.as been provided by the physician.
Inquest ( legal inquiry into the cause of death).