ETHICS

 ETHOS- custom or guiding belief

 Method of inquiry that helps people to understand the morality
of human behavior.
 Refers to expected standards of behaviour of a particular
group.
 Bioethics- ethics applied to life.
 Nursing ethics- refers to ethical issues involved in nursing
practice.
 ETHICAL PRINCIPLES
 Autonomy
 Beneficence
 Non-maleficence
 Justice
 Fidelity
 Veracity
 Accountability
 responsibility
  Right to make decisions

AUTONOMY
 BENEFICENCE

 Doing good
 Nurses should carry out actions that benefit clients
and support persons
 Eg-Teaching clients exercise, if he does not have
any complication.
 NON-
MALEFICENCE

 Do no harm
 Harm can be intentional, unintentional or putting
at risk for harm
 “ Does this treatment cause more harm or more
good to the patient?”
 While administering medications, monitor patient
for any side effects, take measures to prevent side
effects.
 JUSTICE

 Fairness, impartial
 Provide care to clients irrespective of caste, creed,
religion, nationality, socio-economic status etc.
 Distributive justice- fair distribution of both benefits
and burdens.
- Allocating resources
- Fair access to care
 Compensatory justice- compensation for wrongs done
to individuals or groups.
 Procedural justice- same procedures apply to all, in the
same way

JUSTICE CONTD……….
 FIDELITY

 Faithful to agreements and promises made.

 Nurse should carry out the promises that she has made to the
patient.
 Make promises in a thoughtful, careful manner to maximize
likelihood that you can keep up the promises.
 Meeting the reasonable expectations of your patients.
VERACITY

 Telling the truth

 ACCOUNTABILIT
Y

 Answerable to oneself
and others for one’s
own actions.
RESPONSIBILIT
Y
Special accountability or liability associated with
the performance of duties of a particular role.
 CODE OF ETHICS
 Is a set of principles that are accepted by all
members of a profession.
 A professional code of ethics is a set of collective
statement about group’s expectations and
standards of behaviour, and serves as a guide to
assist members of a profession to take decisions
about correct behaviour
NURSING CODE OF
ETHICS

 A code of ethics is a formal statement of

group’s ideals and values.
 It is a set of ethical principles that :
A. is shared by members of the group
B. Reflects their moral judgments over time &
C. Serves as a standard for their professional
actions
 PURPOSES

1. Inform the public about the minimum standards of the

profession and help them understand professional
nursing conduct.

2. Provide a sign of the profession’s commitment to the

public it serves.

3. Outline the major ethical considerations of the

profession.
PURPOSES CONTD……..

4. Provide ethical standards for professional behaviour.

5.Guide the profession in self-regulation.

6. Remind nurses of specific responsibility they assume when

caring for the sick.
 ICN CODE OF ETHICS FOR NURSES
 1953
 Revised in 2005
 Has 4 principal elements
Practice
 ELEMENTS OF THE CODE
 Nurses & the people
 The nurses' primary responsibility is to people requiring
nursing care.
 The nurse promotes an environment in which rights, beliefs
& values of an individual, family are respected.
 The nurse makes sure that patient receives enough
information based on which to consent for care.
 NURSES & THE PEOPLE CONTD……

 The nurse holds in confidence personal information and

uses judgment in sharing this information.
 The nurses shares with society the responsibility for
initiating & supporting action to meet the health and
social needs of the public.
 Responsible to sustain and protect the natural
environment.
 NURSES & PRACTICE
 Nurses carry personal responsibility and are accountable for
nursing practice.
 Maintains standards of personal health.
 Maintains standards of personal conduct.
 Uses judgment regarding individual competence when
accepting or delegating responsibility.
 Ensures that use of technology is compatible with safety,
dignity and rights of people.
 NURSES & PROFESSION

 Assumes major role in determining and implementing

acceptable standards of clinical nursing practice,
management, education.
 The nurse is active in developing a core of research-based
professional knowledge.
 The nurse acts through professional organisation,
participates in creating & maintaining equitable social and
economic working conditions in nursing.
 NURSES AND COWORKERS.

 The nurse sustains a cooperative relationship with coworkers

in nursing and other field.
 The nurse takes appropriate action to safeguard individuals
when their care is endangered by another person.
INC CODE OF ETHICS
Provides care
 without consideration of caste, creed, religion, culture, ethnicity etc
considering the beliefs, values and cultural sensitivities
Appreciates the place of individual in the family and community and involves
others in the care.
 trustful relationship with individual(s)
 Recognizes uniqueness of response

1. The nurse respects the uniqueness of

individual in provision of care
 Appreciates individual’s right to make decisions about their care
 Respects the decisions made by individual(s) regarding their care
 Protects public from misinformation and misinterpretations
 Advocates special provision to protect vulnerable
individuals/groups.

The nurse respects the rights of individuals as

partner in care and help in making informed
choices
 Respects the individual’s right to privacy
 Maintains confidentiality of privileged information.
 Takes informed consent and maintains anonymity
 Limits the access to all personal records.

The nurse respects individual’s right to privacy,

maintains confidentiality, and shares
information judiciously
 Nursing care only by registered nurse
 Maintain quality nursing care and upholds the standards of care
 Nurse values continuing education, initiates and utilizes all
opportunities for self development.
 Nurses values research as a means of development of nursing
profession and participates in nursing research

Nurse maintains competence in order to

render quality nursing care
 Adheres to code of ethics and code of professional
conduct
 Familiarizes with relevant laws and

The nurse is obliged to practice within the

framework of ethical, professional and legal
boundaries
 Appreciates the team efforts in rendering care
 Cooperates, coordinates and collaborates with
members of the health team to meet the needs of
people

Nurse is obliged to work harmoniously with

members of the health team
CODE OF PROFESSIONAL CONDUCT
FOR NURSES IN INDIA
 1. PROFESSIONAL RESPONSIBILITY AND
ACCOUNTABILITY
 Nurse
 1.1Appreciates sense of self-worth and nurtures it
 1.2Maintains standards of personal conduct reflecting credit upon the profession
 1.3Carries out responsibilities within the framework of the professional boundaries
 1.4 Is accountable for maintaining practice standards set by Indian Nursing Council
 1.5 Is accountable for own decisions and actions
 1.6 Is compassionate
 1.7 Is responsible for continuous improvement of current practices
 1.8 Provides adequate information to individuals that allows them informed choices
 1.9 Practices healthful behavior
 Nurse
 2.1 Provides care in accordance with set standards of practice
 2.2Treats all individuals and families with human dignity
 2.3Respects individuals and families
 2.4 Presents realistic picture truthfully
 2.5 Promotes participation of individuals and significant others in the care
 2.6Ensures safe practice
 2.7Consults, coordinates, collaborates and follows up appropriately when
individuals’ care needs exceed the nurse’s competence

2. NURSING PRACTICE
 Nurse
 3.1Establishes and maintains effective interpersonal relationships with
individuals, families and communities
 3.2Upholds the dignity of team members and maintains effective
interpersonal relationship with them
 3.3Appreciates and nurtures professional role of team members
 3.4Cooperates with other health professional to meet the needs of the
individuals, families and communities /

3. COMMUNICATION AND
INTERPERSONAL RELATIONSHIPS
 Nurse
 4.1Takes appropriate action to protect individuals from harmful
unethical practice
 4.2Considers relevant facts while taking conscience decisions in the
best interest of individuals
 4.3Encourages and supports individuals in their right to speak for
themselves on issues affecting their health and welfare
 4.4Respects and supports choices made by individuals

4. VALUING HUMAN BEING

 Nurse
 5.1Ensures appropriate allocation and utilization of available resources
 5.2 Participates in supervision and education of students and other formal care providers
 5.3Uses judgment in relation to individual competence while accepting and delegating
responsibility
 5.4 Facilitates conductive work culture
 5.5Communicates effectively
 5.6 Participates in performance appraisal
 5.7 Participates in evaluation of nursing services
 5.8 Participates in policy decisions
 5.9Works with individuals to identify their needs and sensitizes policy makers and funding
agencies for resource

5. MANAGEMENT
 Nurse
 6.1Ensures the protection of the human rights while pursuing the advancement of
knowledge
 6.2Contributes to the development of nursing practice
 6.3 Participates in determining and implementing quality care
 6.4Takes responsibility for updating own knowledge and competencies
 6.5Contributes to core of professional knowledge by conducting and participating
in research

6. PROFESSIONAL ADVANCEMENT
 VALUES
 A value is a belief you have about the worth of something; it serves
as a principle or a standard that influences decision-making.
 Values are ideals, beliefs, customs, modes of conduct, qualities or
goals that are highly prized or preferred by individuals , groups or
society.
 Examples- love, freedom, courage, honesty, punctuality, sincerity,
loyalty, patriotism.
VALUES ARE:
 Freely chosen
 Often taken for granted
 Learned in conscious and unconscious ways.
 Learned through observation and experience in
social groups.
VALUES :
 Become a part of the person.
 Give direction to life.
 Can be individual or shared.
 Vary from person to person.
 Can change over time.
 May be expressed overtly or manifested indirectly.
VALUES, BELIEFS, ATTITUDES
 Value set- is the list of values that one has. It gives
direction for life and forms as a basis for behaviour.
 Value system- is your value set with the values
ranked on a continuum from most important to least
important.
 Attitudes are mental dispositions or feelings towards
a person, object or idea.
 Beliefs are sometimes based on facts and some on
faith.
 Beliefs may or may not be true
 Beliefs may or may not involve values.
 CLASSIFICATION OF VALUES

 Operative values- those values that are indicated by a specific

behaviour.
 Eg: being honest in all actions may indicate honesty is a value
for that person
 Terminal values – those values that are regarded as good in
themselves, shape long term goals
 Moral values –involve correct behaviour (doing right or wrong)
 Personal values
 Personal values are values internalized from the society or culture
in which one lives. People need societal values to feel accepted, and
they need personal values to have a sense of individuality.
 Professional values
 Professional values are values acquired during socialization into
nursing from codes of ethics, nursing experiences, teachers, and
peers.
 VALUE CLARIFICATION
 Is a method of self discovery by which people identify
their personal values and their ranking
 Step 1 - Choosing Freely.
 Step 2 - Choosing from Alternatives.
 Step 3 - Choosing after Consideration.
 Step 4 - Prizing and Cherishing.
 Step 5 - Affirming.
 Step 6 - Acting upon Choices.
 Step 7 - Repeating.
 PERSONAL VALUE
SYSTEM

 Is a set of values that the person has

reflected on and chosen that will help one
to lead a good life.
 Professional values-values acquired
through the learning and experience from
profession.
 IMPORTANCE OF VALUES IN NURSING

 Professional values are defined as whatever is good or desirable

for the member of a given profession.
 These values are related to personal beliefs and root in personal
values.
 Nursing is a profession rooted in professional ethics and ethical
values, and nursing performance is based on such values.
 Core values of nursing include altruism, autonomy, human
dignity, integrity, honesty and social justice
 are standards for action which have been accepted by a professional group
and provide a framework for the evaluation of the values and beliefs that
affect behaviors.
 Professional values are a significant part of nursing.
 have close relationship with nurses' professional ethics,
 guide their professional decision-making, professional practice, and
professional behaviors, and
 thereby, can significantly affect patient care quality.
 help nurses better manage care-related ethical conflicts
 professional values are considered as the guideline and
motivation of professional behavior for the members
of a profession.
 According to Weis and Schank, professional values
are standards for action that are accepted by
professional groups and individuals, and are used to
evaluate the integrity of the individual or organization.
 are necessary to reinforce individuals’ the professional
identity and performance
IMPORTANCE OF VALUES CONTD…….

 The use of these values in nursing practice

increased the quality of patients care, nurses’
occupational satisfaction, their retention in
nursing and commitment to the organization .
 Professional values are a source to promote
nurses’ ethical competencies in clinical settings
and dealing with ethical concerns in the present
era.
 are fundamental to the practice of nursing.
 They guide standards for action, provide a
framework for evaluating behaviour and influence
practice decisions.
 ● Caring. Delivering empathy for the patient as they
cope with their condition.
● Integrity. Remaining respectful of the patient’s
dignity, regardless of illness or issue.
● Diversity. Honoring patient individuality, regardless
of race, religion, or values.
● Excellence. Working toward delivering the most
optimal care possible in all situations.

THE NATIONAL LEAGUE FOR

NURSING (NLN) CORE VALUES
MODEL
  Altruism- a concern for the welfare and well-being of others.
Eg; advocates for patients especially the vulnerables.
 Autonomy- right to self-determination.eg- plans care in
partnership with clients.
 Human dignity- respect for inherent worth and uniqueness of
individuals and populations. Eg- preserves the confidentiality
of patients.

PROFESSIONAL VALUES
 ALTRUISM

 means supporting patients and nurses’ concern about the well-

being of patients within their professional capacity.
 is described as an engagement in caring acts toward others
without expecting something in return.
 is the most commonly reported motivation by people that have
chosen nursing as their profession.
 nursing has an altruistic nature, and people interested in
helping patients are attracted to this profession.
 Altruism is the name for the feeling that people
should help one another without regard for
compensation or reward.
 People display altruism when they do things for other
people with the other person's well-being in mind.
 An unidentified person was admitted in the hospital
following accident in medical college Trivandrum.
Doctors, nurses, nursing assistants, other patient’s
relatives took care of this patient- bringing food for
him, buying clothes, bathing and cleaning him and
finally identified his relatives in Calicut through their
personal effort.
PROFESSIONAL VALUES
CONTD………..

 Integrity- acting in accordance with appropriate

code of ethics and accepted standards of
practice.eg; provides honest information to
patients and public.
 Social justice- upholding moral, legal and
humanistic principles. Eg; supports fairness and
non-discrimination in the delivery of care.
 MODES OF VALUE TRANSMISSION

 Modeling- children learn values from a variety of role models.

 Moralizing- values are taught in an authoritarian approach.
 Laissez-faire- allowed to explore differing sets of values on their
own with little guidance or discipline.
 Reward & punishment- behaviour controlled by rewards and
punishments.
 Responsible choice- a balance of freedom and restriction to select
values, explore new behaviours and experience econsequences