MORAL AND

SPIRITUAL
RESPONSIBILITIES OF
NURSES
• NURSES, whatever their religion, must be God-loving and
God-fearing. They must realize that the nursing
profession is a commitment both to God and people. They
should emphasize the importance of providing spiritual
care as a vital aspect of nursing care. They must uphold
the sanctity of human life
MORAL PRINCIPLES
1. The Golden Rule. God said, "Do unto others what
you would like others do unto you."

2. The Two fold Effect. When a nurse is faced with a

situation which may have both good and bad effects, how
should she choose which one to follow?
The basis of action may be the following:
a. that the action must be morally good;
b. that the good effect must be willed and the bad effect
merely allowed;
c. that the good effect must not come from an evil action
but from the initial action itself directly; and
d. that the good effect must be greater than the bad effect
• It is not morally good if a boy steals in order to alleviate
his hunger because the action itself is already bad.
• On the other hand, if a patient who has cancer of the
uterus submits to hysterectomy she will not be able to
bear a child. If she does, not have the operation, she will
die. It is the gynecologist's intention to help the mother
and not to harm her. The surgeon's action is morally good
since saving the mother's life is of primary importance.
Also the doctor himself did not will that the patient lose
her child-bearing function
• 3. The Principle of Totality. The whole is greater than any
of its parts. Suppose a man's foot is gangrenous, should he
consent to an amputation? Since the amputation will save the
patient's life and he can still walk through the aid of crutches or
artificial limbs, he can consent to an operation.

• 4. Epikia. "Exception to the general rule." It is a reasonable

presumption that the authority making the law will not wish to
bind a person in some particular case, even though the case is
covered by the letter of the law. If a mental patient went
berserk and the doctor could not be contacted, the patient may
be restrained by virtue of epikia. Another example of this is
allowing a relative to see a seriously ill patient who expresses
the desire to see the former although it is not yet visiting hours
• 5. One who acts through an agent is himself
responsible. For example, a patient wants to have an
abortion and asks a nurse if she can do it. The nurse
refuses, but then recommends a doctor who is capable of
performing an abortion. The nurse becomes liable to such
a crime, since he/she is an accomplice of the said doctor.
• 6. No one is obliged to betray himself/herself .In
testifying before a court, no one can force any person to
answer a question if such will incriminate him/her.
• 7. The end does not justify the means. Giving a sleeping
tablet to a chronically ill person so he/she can die in peace is
morally wrong.
• A physician in the United States assisted a woman,
diagnosed as having Alzheimer's disease, in committing
suicide. This is both legally and morally wrong.
• 8. Defects of nature may be corrected. Patients with a
harelip or cleft palate may have their defects corrected by
plastic surgery.
• What shall be the role of the nurse in a case in which
parents of a severely deformed newborn child (Down's
Syndrome with intestinal atresia) refuse to feed and allow their
child to starve to death?
• Withholding nutrition can constitute nursing neglect and
expose the nurse to criminal charges of negligence or
conspiracy to commit murder.
• 9. If one is willing to cooperate in the act, no injustice is
done to him/her. Suppose a patient subjects himself/herself
willingly to an experimental drug and he/she has been told of
the possible effects of the same, is of right age, and is sane,
there is no violation of human rights.
• 10. A little more or less does not change the substance of an
act. If a nurse gets medicine from a hospital stock without
permission or without prescription, he/she will be guilty of theft
even if he/she got only one tablet of the same.
• 11. The greatest good for the greatest number. During an
epidemic, immunization against communicable diseases is
administered to the people. Although there may be some who
may have slight reactions to the vaccine, the greater majority of
the population shall be considered rather than the isolated few.
This is called the utilitarian principle.
• 12. No one is held to the impossible. To promise that a patient with
heart transplant will live may be 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.
• 13. The morality of cooperation. Formal cooperation in an evil act
is never allowed. Immoral operations such as abortion shall not be
participated upon by a nurse even if the doctor commands it.
• 14. Principle relating to the origin and destruction of life. one of
God's commandments is "Thou shall not kill." If God has given man a
life, will it mean that God has already ceded his right to man? And if
life contains with it a free will for man to perform what he thinks is best
for him and his environs, where, then, does the right of God begin?
Where does the right of man begin or end? Assuming that God gave
life to man, who will know that God does abhor a man who takes his
own life? Man may appear only a puppet of God, if God will not let go
of his creation—man— to do what is best for him, i.e., including
euthanasia.
• Euthanasia is direct killing of people who may not have
committed any crime deserving of death, but because of
mental or physical defects, are considered worthless to society.
Mercy killing is not allowed because it will lessen the incentive
for medical research. It will also be possible to arrange for the
death of an enemy or a wealthy relative. Many patients surprise
doctors by recovering from illness. In legalized euthanasia,
they are already dead.
• Giving of narcotics to a dying person shall be withheld if
there is no physical pain. He must be left conscious for as long
as God does not take his consciousness away.
• The state recognizes the sanctity of human life. It shall
protect the life of the mother and the unborn from the time of
conception. Any direct attack on the life of a fetus for whatever
cause is immoral. A fetus shall be buried in consecrated
grounds. If it is dead and came from a dead mother, it shall be
buried with the mother
SPIRITUAL COMMITMENT OF
NURSES
• The Code of Ethics' for Filipino nurses lists provision of spiritual
environment as one of the responsibilities of the nurse Christian
nurses often refer to the Bible for inspirational passage that will
enhance and strengthen their love and concern for their fellowmen.
Muslims find appropriate passages in their Quran.
• St. Paul's message to the Colossians is very apt for nurses. He
said, "You are the chosen people of God. He loves you and chose
you for His own. So then, clothe yourselves with compassion,
kindness, humility, gentleness, and patience." The nurse's ministry is
reflected in God's two great commandments: "Love the Lord God with
all your heart, and with all your soul and with all your mind" and "Love
your neighbors as yourself."
• The role of nurses in providing non-prejudicial, non-
discriminatory care can well be based on the story of the good
Samaritan. God has asked us to love one another as He loves us
• Jesus' healing ministry includes among others, enabling
blind men to see' and the hemorrhaging woman to be
healed as she touched His garment.' He has exhorted us,
"not to become tired of doing good, for if we do not give
up, the time will come when we will reap the harvest."
• Doing one's duties with a cheerful heart does good
like medicine but a broken spirit makes one sick.
• God gave assurance that man will inherit the
kingdom of God, "for whenever we feed the hungry, give
water to the thirsty, take in a stranger, and visit those in
prison, we have done these to God."
• Patients and families who are troubled with illness or anxiety
will certainly look up to a compassionate nurse for
understanding and kindness. There are times, however, that
the patient and/ or his family may need the assistance of a
nurse in calling a priest or minister of their faith. Many hospitals
have resident priests or chaplains and addresses of ministers
or imams who can be called immediately upon request.
• Stillbirths of Catholic parents are given emergency
baptism by saying, "I baptize you (give the name), in the name
of the Father, and of the Son, and of the Holy Spirit."
• If there is danger of death, Roman Catholic patients are
obliged to receive the sacraments. Confession and communion
are recommended. If the patient is admitted to the hospital, he/
she must be informed of the availability of a priest to care for
his/her spiritual needs. The nurse is obliged to call the priest
when needed.
• When danger of death is remote, reference when priest is
making rounds is sufficient. When a patient is receiving;
opiates, delay its administration until the priest arrives so
that the patient can have the opportunity to express
sorrow for his/her sins and make his/her confession.
• The non-Roman Catholic patient likewise looks up to
his or her minister for spiritual guidance. A prudent nurse
anticipates this need of the patient and makes
arrangements that the minister or imam is contacted. In
the absence of one, a nurse can read favorite passages
from the Bible for the patient. The Lord's Prayer may be
recited for or with the patient
• Muslim nurses provide comfort and prayers to patients of the
same faith by quoting passages from the Quran. "Patients are
encouraged to put their trust in Allah for He is compassionate
and merciful and shall relieve them of their burdens."
• "Allah is the Lord of kindness to believers; He is their
protector and the best of their helpers;" He loves those who put
their trust (in Him)" and He loves those who do good. In serving
the sick and the dying, Allah assures that for those who keep
their duty to the Lord, for them are Gardens underneath which
rivers flow, wherein they will be safe forever."
• In general, it is the nurse who recognizes the spiritual
needs of the patient and gives the latter peace of mind and
comfort to face what lies ahead of him/her.
THE GOOD SAMARITAN LAW
• There are many persons who refuse to give emergency aid to victims
of accidents due to liabilities they may incur later. Although no one is
legally compelled to do so, it will not be ethically and morally right to
leave persons without aid especially if one has the skill and the
knowledge to save lives.
• In the United States, the Good Samaritan Law has been
passed to encourage on-the-spot volunteer first aid in emergency
situations by persons with the proper knowledge and skill. A nurse
therefore who renders first aid or treatment at the scene of an
emergency and who does so within the standard of care, acting in
good faith, is relieved of the consequences of the act.
• The Good Samaritan Act is based on the biblical story of a man
who aided an injured person who was waylaid by thieves and was left
half-dead. The Samaritan took care of him with compassion, bound
up his wounds, brought him to an inn, and took care of him." Jesus
told the story of the good Samaritan to illustrate how we can love our
neighbors
NURSES AND SUFFERING
• Nurses observe human suffering everyday—patients in pain,
others suffering emotionally, or may even be dying. Nurses
who have emotional and spiritual maturity are more able to
assist patients who are depressed, fearful or confused about
the outcome of hospitalization or illness to them.
• A Christian nurse's duty is not only to give physical care
but to pray for or with them so that they may also have spiritual
healing and to make them feel that God is with them always.
Psalm 23 says, "Ye though I walk through the valley of the
shadow of death, I shall fear no evil, for Thou art with me —Thy
rod and Thy staff they comfort me." This will make them feel
that God cares for them so that they may find strength and
encouragement in the midst of pain and suffering.'
LIFE IN GOD'S SERVICE
• Nurses can use their different gifts in accordance with the
grace that God has given them. If their gift is to speak
God's message, they should do it according to the faith
that they have; if it is to serve, they should serve; if it is to
teach, they should teach; if it is to encourage others, they
should do so. Whoever shares with others should do so
generously; whoever has authority should work hard;
whoever shows kindness to others should do so
cheerfully
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