HMAF,PhDN RN

AT THE END OF LESSON 2, THE STUDENTS WILL BE

ABLE TO:

1. UNDERSTAND THE MEANING OF ETHICS

2. ANALYZE HOW ETHICS EMERGED AS A
DISCIPLINE.
3. EXPLAIN THE ROLE OF ETHICS IN NURSING

HMAF,PhDN RN
 TABLE OF CONTENTS
A. INTRODUCTION TO ETHICS
a) Definition of Ethics b) Brief History of
Ethics

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• Ethics is a system of moral principles. They
affect how people make decisions and lead
their lives.

• It is concerned with what is good for

individuals and society and is also described as
moral philosophy.

• The term is derived from the Greek word ethos

which can mean custom, habit, character or
disposition.
HMAF,PhDN RN
 ✓How to live a Good Life
✓Our Rights and Responsibilities
✓The Language of Right and Wrong
✓Moral Decisions - What Is Good and Bad?

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✓ Philosophers nowadays tend to divide ethical theories
into three areas: metaethics, normative ethics and
applied ethics.

✓ Meta-ethics deals with the nature of moral

judgement. It looks at the origins and meaning of
ethical principles.
✓ Normative ethics is concerned with the content of
moral judgements and the criteria for what is right
or wrong.
✓ Applied ethics looks at controversial topics like
war, animal rights and capital punishment
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 ✓ Provides a Moral Map
✓ Gives Several Answers
✓ Source of Group Strength
✓ Pinpoints a Disagreement
✓ Source of Group Strength
✓ Doesn't Give Right Answers
✓ Goodness of People as Well as Good Actions
✓ Searching for the Source of Right and
Wrong
HMAF,PhDN RN
• The known history of pure ethics or ethics
(moral) theories begin with ancient Greek
philosophers (Sophists, Socrates, Socratic
schools, Plato, Aristotle, Epicurus, Stoics) and
after recovered by early English, positivists has
been the main topic of discussions in the
Medieval times in Europe.

• As the scholastic doctrines are by-passed, we

come to the illuminated times after the
Medieval, and continue with Hobbes, the Father
of Modern Ethics. HMAF,PhDN RN
Ethics in nursing offers a framework to help them
ensure the safety of patients and their fellow
healthcare providers. The nationally accepted guide
is the Code of Ethics for Nurses with Interpretive
Statements, or The Code, issued by the American
Nurses Association.

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Contains the framework
for ethical decision-
making and analysis for
nurses in all roles, at
levels and in all settings.

HMAF,PhDN RN
 CASE STUDY:

Nurse P is a staff nurse in the coronary care unit of a large

medical center. One morning he is informed that a patient
from the recovery room will soon be admitted to the coronary
care unit and assigned to him. The patient, a white man, 67
years of age, with known history of myocardial infarction,
also has cancer of the prostate. The initial hospital admission
was for a transurethral resection, which had been aborted in
the operating room when the patient developed cardiac
changes following spinal anesthesia. The patient had been
transported to the recovery room with the diagnosis of
possible myocardial infarction and was to be transferred to
the coronary care unit for management and evaluation.

HMAF,PhDN RN
 CONT:

Nurse P heads to the recovery room with a bed to pick up the

patient. When he arrives, the patient is being coded. He had
apparently gone into ventricular tachycardia/ventricular
fibrillation in the recovery room and had required
countershock, cardiopulmonary resuscitation (CPR),
intubation, lidocaine, and vasopressors to maintain his blood
pressure. A Swan-Ganz catheter was put in place. Recovery
rhythm was sinus bradycardia to sinus tachycardia with
occasional pauses. The patient was acidotic, in pulmonary
edema by chest x-ray with an alveolar oxygen partial pressure
(PaO2) of 50–60 mm Hg, a fraction of inspired oxygen (FIO2)
of 100%.

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 CONT:

During the events of the code, an attending cardiologist (Dr.

D) passed by, observed the code, and made the following
statement to the recovery room staff and coronary care unit
resident: "Say, that's Mr. S. I know him from his last
hospitalization of 1 month ago when I was attending in
coronary care unit. I believe he has a living will." While the
patient is stabilized, Dr. D calls the patient's relative, who
happens to work in another part of the medical center. The
relative also expresses the belief that Mr. S has a living will
and does not want to receive extraordinary support measures.
Dr. D relays this information to the other physicians, and
there is general agreement that conservative measures to
ensure support are indicated while the living will is located.

HMAF,PhDN RN
 CONT:

The coronary care unit resident and Nurse P transport Mr. S to

the coronary care unit. When admitted, the patient's systolic
blood pressure is 70 mm Hg while on dobutamine 8 mcg/kg
and dopamine 26 mcg/kg. The patient occasionally responds
to verbal commands, opens his eyes, grips Nurse P's hands,
and responds to pain in the upper extremities (his lower
extremities are still under the effects of the spinal
anesthesia). Cardiac monitoring shows that the patient is still
having sinus tachycardia.

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 CONT:

At this point, the coronary care unit resident and an intern

approach Nurse P and inform him that they believe that the
present treatment of the patient is cruel. Upon locating old
medical records, they learned that the patient had been
designated "do not resuscitate" (DNR) on his last admission,
and the patient is supposed to have a living will, although it
has still not yet been located. They order Nurse P to slowly
turn off the intravenous (IV) drip of dopamine and
dobutamine. Nurse P is faced with an ethical dilemma.

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 REFERENCES:

1. http://www.bbc.co.uk/ethics/introduction/intr
o_1.shtml
2. https://www.britannica.com/topic/ethics-
philosophy
3. https://www.encyclopedia.com/humanities/enc
yclopedias-almanacs-transcripts-and-
maps/ethics-history
4. https://degree.lamar.edu/articles/nursing/ethi
cs-in-nursing/