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 Ethics is a term derived from the Greek word "ethos"
meaning "character"
 Ethics is defined as moral principles or standards
that govern the conduct of a person or group,
especially a member or members of a profession.
( Oxford Dict)

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 Ethics refers to an individual's system of rules that
guides behavior, conduct, and decision-making about
good or bad in the larger society.
 These rules serve as a standard and as a bunch of
unshakeable principles that are usually grounded in
long-established values.
 These values might include justice, fairness, respect,

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 As a philosophical discipline, ethics is a systemic
approach to understanding, analyzing, and
distinguishing matters of right and wrong, good and
bad, and admirable and deplorable as they exist along
a continuum and as they relate to the well-being of
and the relationships among sentient beings.
 Ethical determinations are applied through the use of
formal theories approaches and code of conduct.
 Ethics is an active process rather than a static

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 Nursing ethics is a branch of applied ethics that
concerns itself with activities in the field of nursing.
 It can be distinguished by its emphasis on
relationships, human dignity and collaborative care.
 Nursing ethics initially include virtues that were
desired in a nurse. These virtues at that time included
physician loyalty, commitment to high moral character
and obedience.
 But as the profession evolved, nurses gradually
embraced patient advocacy.
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Distinctive nature
 Nurses work alone and with other healthcare
professionals. This collaboration between nurses,
colleagues and physicians is important to the safety
and quality of patient care.
 Nurses perform duties based on physicians’
instructions and use their own judgment as necessary
as possible.
 The nature of nursing means that nursing ethics tends
to examine the ethics of ‘caring ‘rather than 'curing' by
exploring the everyday interaction between the nurse
and the person in care

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 Nurses' focus on care and nurture, rather than cure of
illness, results in a distinctive ethics.
 Nursing ethics emphasizes the ethics of everyday practice
rather than moral dilemmas.
 Nursing ethics is more concerned with developing the
caring relationship than broader principles, such as
beneficence and justice. Eg, a concern to promote
beneficence may be expressed in traditional medical ethics
by the exercise of paternalism, where the health
professional makes a decision based upon a perspective of
acting in the patient's best interests.
 However, it is argued by some that this approach acts
against person-centred values found in nursing ethics.

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Development of ethics in nursing
 Early work to define ethics in nursing focused more on
the virtues that would make a good nurse, which
historically included loyalty to the physician, rather
than the focus being on nurse's conduct in relation to
the person in the nurse's care.
 In recent times, the ethics of nursing has also shifted
more towards the nurse's obligation to respect the
human rights and dignity of the patient and this is
reflected in a number of professional codes for nurses,
 such as in the latest code from the International
Council of Nurses.

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 Ethics in nursing includes fair and equable treatment
of all patients regardless of their economic status, age,
ethnicity, citizenship, disability, sexual orientation or
political colours.
 The ethical responsibilities of nurses include
promoting health, preventing disease and alleviating
 Nurses are responsible for the care not only of patients
but also their families, sometimes the patient is more
than an individual.

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 So, nurses need to inform families, business associates
or communities about a patient’s treatment and
progress when it is appropriate for the patient.
 Nurses must maintain professional competency by
continuing their education and participating in
professional development.
 Nursing ethics differ from medical ethics because of
their focus on ‘caring’, rather than ‘curing’

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The importance of ethics in nursing
 They guide nurses in their practice on a daily basis.
 They help nurses distinguish between right and
wrong when the correct path is unclear.
 Ethical dilemmas may arise out of patient care
situations or interactions with co-workers.
 At times, nurses may be asked to do things by other
health care providers or employers that are out of their
comfort zone.

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 Ethics can also come into play when a nurse is off-
duty, and find him/herself in a position to make an
ethical choice to provide care to a stranger should they
come upon a road traffic accident or any situation that
one experience a heart attack.
 A nurse may not be legally bound to provide care, but
may have an ethical obligation to help.

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 These are the situations where nurses must employ
their personal and professional ethical decision
making skills to determine how to respond.
 It is necessary to employ ethical decision making as
part of the care of patient throughout the day.

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Ethics and morals
 In contrast to ethics, morals are specific beliefs,
behaviours, and ways of being derive from doing
ethics. Ones morals are judged as being good or bad
through systematic ethical analysis.
 Morality is that a person’s behaviour is in conformity
with the societal, religious, cultural, or professional
ethical standards and principles.
 The term ethics and morals are used interchangeably
when referring to the collection of actual beliefs and

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Categories of ethical inquiries

Ethics is categorized according to three inquiry or study;

normative ethics, meta-ethics, and descriptive ethics.
 Normative ethics; this is an attempt to decide or
prescribe values behaviours. This enquires are made
about how humans should behave, what ought to be
done in certain situations, or what type of character
one should have or how one should be.

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 Eg: the common morality consists of normative belief
and behaviours that the members of society generally
agree about and that are familiar to most human
 A normative belief in nursing profession is that nurses
ought to be compassionate, that is, nurses should work
to relieve suffering.

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 Meta-ethics: is concerned with understanding the
language of morality through an analysis of the
meaning of ethically related concepts and theories,
such as the meaning of good, happiness, and virtuous
 Eg: a nurse who is actively engaging in meta-ethical
analysis might try to determine the meaning of a good
nurse-patient relationship.

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 Descriptive ethics: this is the approach used when
researchers what to describe what people think about
morality or when they want to describe how people
actually behave.
 Professional moral values and behaviours can be
described through nursing research.
 Eg: a research that identifies nurse’s attitude regarding
telling patient the truth about their terminal illness.

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 Theory is a coherent statement or set of ideas that

explains observed facts or phenomena, or which sets
out the laws and principles of something known or
observed. ( Oxford DECT.)
 Theory is an underlining principles or methods of a
given technical skill, act etc.
 It is a set of rules, principles, or ideas that a practical
method or skill is based on,
E.g. Marxist economic theory

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 Theory is an idea or set of ideas intended to explain
something, E.g. Darwin’s theory of evolution

 let’s see some theories in ethics.

 Deontological ethics
 Teleological ethics
 Virtue ethics
 Ethical Relativism

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 "Deontology is derived from the Greek words ‘that

which is proper’, ‘ knowledge’ meaning the knowledge
of what is right and proper; and it is specially applied
to the subject of morals.
 Deontology is the study of that which is an "obligation
or duty", and consequent moral judgment on the actor
on whether he or she has complied.
 Deontology focuses on the consequences of your
actions and believes that when faced with life choices,
you should operate according to responsibility and

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 It is sometimes described as "duty" or "obligation-" or
"rule-" based ethics, because rules "bind you to your
 A deontologist believes that morality is a
responsibility for everyone as well as a duty.
 For example, if a man steals three loaves of bread and a
gallon of milk to feed his family, it would be supported
by deontology because of the moral responsibility and
obligations of the man to care for his family.

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 Eg: an employer has deontic authority in the act of issuing
an order that the employee is obliged to accept and obey
regardless of its reliability or appropriateness
 As an art: it is the doing what is fit to be done
 As a science: the knowing what is fit to be done on every
 Kantianism
 Moral absolutism
 Divine command theory
 Contemporary deontology
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Kantianism (Kentian deontology)

 Immanuel Kant’s theory of ethics is considered

deontological for several different reasons.
 First: Kant argues that to act in the morally right way,
people must act from duty (deon).
 Second: Kant argued that it was not the consequences
of actions that make them right or wrong but the
motives of the person who carries out the action.

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 Kant's argument that, to act in the morally right way
one must act purely from duty,
 He begins with an argument that the highest good
must be both good in itself and good without
 Something is "good in itself" when it is intrinsically
good, and "good without qualification", when the
addition of that thing never makes a situation ethically

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 Kant then argues that those things that are usually
thought to be good, such as intelligence, perseverance
and pleasure, fail to be either intrinsically good or
good without qualification.
 Pleasure, for example, appears not to be good without
qualification, because when people take pleasure in
watching someone suffer, this seems to make the
situation ethically worse.

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 He concludes that there is only one thing that is truly good:
Nothing in the world—indeed nothing even beyond the
world—can possibly be conceived which could be called
good without qualification except a good will.
 Kant then argues that the consequences of an act of willing
cannot be used to determine that the person has a good
 good consequences could arise by accident from an action
that was motivated by a desire to cause harm to an
innocent person, and bad consequences could arise from
an action that was well-motivated.

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 Instead, he claims, a person has a good will when he
'acts out of respect for the moral law'. People 'act out
of respect for the moral law' when they act in some
way because they have a duty to do so.
 So, the only thing that is truly good in itself is a good
will, and a good will is only good when the willer
chooses to do something because it is that person's
duty, i.e. out of "respect" for the law.
 In fact, having ones action motivated by duty is
superior to acting from motivation of love.

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Moral absolutism

Moral absolutists;
 deontologists, who believing that certain actions are
absolutely right or wrong, regardless of the intentions
of the moral agent or the resultant consequences, they
argued that the only absolutely good thing is a good
will, and so the single determining factor of whether
an action is morally right is the will, or motive of the
person doing it.
 If they are acting on a bad maxim, e.g. "I will lie", then
their action is wrong, even if some good consequences
come of it.

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Divine command theory
Ralph Cudworth, William of
Ockham, René Descartes
 This theory states that an action is right if God has
decreed that it is right.
 The Divine Command Theory is a form of deontology
because, according to it, the rightness of any action
depends upon that action being performed because it
is a duty, not because of any good consequences
arising from that action.
 If God commands people not to work on Sabbath, then
people act rightly if they do not work on Sabbath
because God has commanded that they do not do so

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 If they do not work on Sabbath because they are lazy,
then their action is not truly speaking "right", even
though the actual physical action performed is the
 William of Ockham a et all accepted versions of this
moral theory, they all held that moral obligations arise
from God's commands

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 One thing that clearly distinguishes Kantian
deontology from divine command deontology is that
Kantianism maintains that man, as a rational being,
makes the moral law universal, whereas divine
command maintains that God makes the moral law

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Teleological ethics

 Teleological ethics (Greek telos, ‘end’): is an ethical

theory that holds that the end or consequences of an
act determine whether the act is good or evil.
These threories are:
1. Consequentialism
2. Mohist consequentialism
3. Utilitarianism

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1. Consequentialism
 Holds the view that, the consequences of one's
conducts or actions are the ultimate basis for any
judgment about the rightness or wrongness of that
 Thus, from a consequentialist standpoint, a morally
right act or omission from acting is one that will
produce a good outcome, or consequence.

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 In an extreme form, the idea of consequentialism is
commonly encapsulated in the saying, "the end
justifies the means", meaning that if a goal is morally
important enough, any method of achieving it is

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2 Mohist consequentialism:

 This is also known as ‘state consequentialism,’ is an

ethical theory which evaluates the moral worth of an
action based on how much it contributes to the
welfare of a state.
 The basic goods in Mohist consequentialist thinking
are... order, material wealth, and increase in
 During Mozi’s era, war and famines were common,
and population growth was seen as a moral necessity
for a harmonious society

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 The "material wealth" of Mohist consequentialism
refers to basic needs like shelter and clothing,
 David Shepherd Nivison: writes that the moral goods
of Mohism "are interrelated more basic wealth, then
more reproduction; more people, then more
production and wealth...
 if people have plenty, they would be good, filial, kind,
and so on unproblematically".

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 The Mohists believed that morality is based on
"promoting the benefit of all under heaven and
eliminating harm to all under heaven
 it is not hedonistic or individualistic.
 The importance of outcomes that are good for the
community outweigh the importance of individual
pleasure and pain

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 According to Jeremy Bentham, Nature has placed

mankind under the governance of two sovereign
masters, pain and pleasure.
 It is for them alone to point out what we ought to do,
as well as to determine what we shall do.
 On the one hand the standard of right and wrong,
and the chain of causes and effects, are fastened to
their throne.
 They govern us in all we do, in all we say, in all we
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 They believe that actions are judge by their utility, they
are evaluated according to the usefulness of the
 They believe that it is useful to achieve the greatest
good to the greatest number of people who may be
affected by a rule or action.
 They place great emphasis on what is best for the
collective groups, not individual people.

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 e.g Julie walks into a hostage situation. There are 20
hostages and she is told that if she shots one hostage,
she will save the lives of the other 19.
 Utilitarianism would support Julie’s killing of one of
the hostages because the other 19 lives are a greater
benefit, regardless of the fact that the cost would be
one person’s life.

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Virtue ethics

 It looks at a person’s individual character, not

necessarily his actions.
 When observing an unethical position, the virtue
theory considers the person's reputation and purpose
for committing the act.
 eg: if a high school student is temperate, modest,
witty and intelligent and plagiarized on a class writing
assignment, the virtue theory would analyze the
student's past personality traits and interpersonal
skills in order to determine whether the student is
truly guilty.

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 They seek to answer questions such as
 What sort of person must I be to be an excellent
person? what is my duty?
 Virtues of humans are habitual, excellent traits that
are internationally developed throughout one’s life.
 According to Aristotle: a person of virtue is one who is
excellent friend to other people, an excellent critical
thinker, and an excellent citizen of a community

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He categorized virtue into two
 Intellectual virtue: this comes into existence as a
result of teaching, and require experience and time.
 Moral virtue: this results from habituation
 He went ahead to say that but the two can not be
distinctly separated.

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Ethical Relativism
 Relativism: is a theory that deems your moral obligations
and beliefs to be based on the individual environment.
 eg; In American culture cannibalism is considered taboo,
while in other cultures the act of consuming other human
flesh is accepted as a sacrifice or ritual.
 Relativism determines morals and ethics according to the
society that is being observed.
 Relativism argues that every society and culture beliefs
differently and thus, each culture must be evaluated
according to its particular cultural patterns and influences.

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There are two types
 Ethical subjectivism: they belief that individuals
create their own morality and that there are no
objective moral truths, only individual opinions.
 People’s beliefs about actions been right or wrong,
good or bad depend on how they feel about the action
rather than reason or systematic ethical analysis.

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 Cultural relativism: it is belief that moral evaluation
is rooted in and can not be separated from the
experience, beliefs and behaviours of a particular
 What is wrong in one culture may not be so in another.
 Eg; female circumcision is a moral practice, though
not considered to be religious ritual, this act is
considered ethically acceptable by some groups in
countries that have a Muslim or Egyptian Pharaonic

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