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Ethical Theories
Monday, August 22, 2022 2:55 PM

The Hippocratic Oath Virtue Ethics Ethics and Ethical Principles

○ An oath of ethics historically • Virtue (Aretaic) Ethics “Nursing encompasses an art, a humanistic orientation, a feeling for the value of the
taken by physicians Aristotle (384-322 BC) individual, and an intuitive sense of ethics, and of the appropriateness of action taken.”
○ One of the most widely • Virtue = Gk. arete —MYRTLE AYDELOTTE
known of Greek medical ○ Focus is on excellence primarily on the heart of the person
texts doing the act UNIVERSAL PRINCIPLES OF BIOMEDICAL ETHICS
• Relieve pain • A Way of Living Ethical Principles used in Health Care
• Reduce violence of disease ○ Learned through experiences; good habits that are used to 1. Autonomy
• Refrain from trying to cure whom regulate emotion 2. Confidentiality
the disease has conquered • Heart-Focused 3. Veracity
○ Good traits that are naturally right and useful for getting what 4. Non-Maleficence
one wants 5. Veracity
• Cardinal Virtues 6. Justice
Ethical Theories (Normative Ethics or Approaches) ○ WISDOM, COURAGE, TEMPERANCE, JUSTICE 7. Beneficence
Immanuel Kant (1724-1804)
• Christian Virtues
• Deontology
○ Deon = duty, necessary
○ FAITH, HOPE, LOVE Autonomy
• Example: • Auto = self
○ Nonconsequentialist Theory
○ A person who has developed the virtue of courage will stand • Nomos = rule, law, governance
• A person is morally good and admirable if his actions are
firm in response to feelings of fear when in danger • A strong sense of personal responsibility and moral decision for one’s own life
done from a sense of duty or reason
• Principle of obligation must be followed by all • The patient must have a strong sense of personal responsibility and moral decision
irregardless of the consequences The Virtues for his or her own life.
• Even when a person does not want to do his duty, he is The Mean (Average) of the Two Extremes PRINCIPLE OF AUTONOMY APPLIED
required to do so. • Allow patient to refuse treatment if he or she so decides
• The basic rightness or wrongness of an act depends on • Allow patient to disclose his or her ailments
its intrinsic nature rather upon the situation or • Allow the patient to choose the mode of treatment
consequence • Allow the patient to maintain confidentiality of treatment
Example: • Allow the patient to determine what should be done to his or her body
- Suppose a nurse is a assigned to care for a patient with • You shall not treat a patient without the informed consent of the patient or his or
AIDS. Could she reasonably refuse to care for the patient her lawful surrogate, except in narrowly defined emergencies
on the ground that the patient's condition may threaten
her health? As practitioners of the healing art, nurses are Confidentiality
to take care of the sick even if patients have conditions Eudaimonia • state of keeping or being kept secret or private
that threaten their personal health. Nurses, however, - Not just personal happiness but human flourishing • non disclosure of private or secret information with which one is entrusted
must observe the necessary precautions to protect their • duty to respect privileged information.
health The Virtuous Man • Confidential communication is privilege communication or professional secrecy
• A person who does all these is the happy and good person who will because it is given based on trust
John Stuart Mill (1806-1873) always do good • Both legal and moral obligation of health care providers
• Teleology 1. Satisfaction for Accomplishment • The patient and his or her family are entitled to known information or facts within
○ Telos = goal, end 2. Accomplishment gained by working hard to improve self the limits determined by the physician.
○ Consequentialist Theory 3. Continually learns • The nurse may repeat what the doctor wishes to disclose.
○ Situation Ethics 4. Hones skills • Any information gathered by the nurse during the course of caring for the patient
• Based on the consequences of human action; action is should always be treated confidential until the patient’s death
morally right if the consequences of such action are Virtues for Nurses • Nurses must assure the patient that information gained in the interview will be
favorable • Truthfulness treated utmost confidentiality.
• Decisions are often made through risk-benefit analysis ○ • Build trust. Think a million times before sharing a millionth information about a
Jeremy Bentham (1748-1832) ○ Truth-telling is a key issue within the nurse-patient patient.
• Judge morality of action by the good or bad relationship. Nurses make decisions on a daily basis regarding
consequences of an act what information to tell patients. Veracity
• Good is the general goodwill or love for humanity • Integrity • Practice of telling the Truth
• If an act helps people, then it is good. If it hurts people, ○ The ability to keep confidences and overall trustworthiness • habitual truthfulness or conformity to facts
then it is bad. that your patients see who you are and count on you to do the • Attitude and personal qualities that demonstrate truth.
• UTILITARIANISM right thing, as it pertains to their care and comfort • The doctor tells the patient and the family of the patient the truth about the
Example: • Humility diagnosis, plan of care, treatment with all the possible risks involved, length of
- The City Health Department is planning for their annual ○ A display of meekness and calmness even in difficult moments. treatment, possible expenses and other options they may take if there be any
budget. To which program should they a lot a bigger • Thankfulness • When applied to the nurse, it is the nurse’s responsibility NEVER to mislead or
budget? The modernization of the city hospital or the ○ Contrasted with constant complaining of situations around deceive a patient.
Nutrition and Immunization Programs of the poverty- • Compassion 3 STRONG REASONS TO APPLY VERACITY
stricken families in the city? Will promotion of health and ○ Capacity to care regardless of the situation • Obligation of respect
prevention of illness have priority over treatment of
○ In asking patients their consent, respect necessitates truth
illness and rehabilitation • Promise keeping
- Before any treatment is given to the patient, all ○ There is a mutual understanding with regards to truth telling and keeping the
treatment options must be discussed to enable the truth safe for the sake of a fruitful medical output
patient to choose which treatment will produce the • Trust building
greatest amount of relief and the least amount of danger ○ Truth leads to reliance and confidence
How do all these theories and approaches affect us?
Fidelity
• This is the main principle that supports the concept of accountability between
nurses and patients
• LOYALTY
○ Loyalty within the nurse- patient relationship.
• COMMITMENT
○ Faithfulness and practice of keeping promises and commitments.

Non-Maleficence
• Expressed in the Hippocratic oath:
• “I will use treatment to help the sick according to my ability and judgment, but will
never use it to injure or harm them.”
• Typical examples according to Bernard Gert, a bioethicist:
• Do not kill.
• Do not cause pain or suffering to others. Do not incapacitate others
• Do not deprive others of the goods of life.
• More practically for nurses,
• Do not assist in performing abortion.
• Do not assist someone who wants to commit suicide.
• Do not willfully subject patients to experimental drugs whose potential harm may
be greater tan the benefit.
• Do not harm a person’s reputation by revealing confidential information.

Beneficence
• Practice of doing acts of goodness, kindness and charity Maxim : Do good
Actions that promote the well being of others