ETHICAL ISSUES GROUP 12

IN NURSING
 INTRODUCTION
The nursing profession uses regulatory mechanisms, code of ethics and ethical principles to
ensure ethical behaviour among the practitioners. The Nigerian nurses, just like their
counterparts globally operate under the tenets of the International Council of Nurses’ (ICN)
code of ethics. To achieve professional standard, nurses have four fundamental ethical
responsibilities, which include promoting health, preventing illness, restoring health and
alleviating suffering.
 THEORETICAL FRAMEWORK
• Principlism Approach

Principlism provides a practical and widely recognized theoretical framework for addressing
ethical issues in nursing, ensuring a holistic approach that aligns with the core principles of
autonomy, beneficence, non-maleficence, and justice.
 OBJECTIVES
• Examine the role of nursing in contemporary society
• Explore and comprehend ethical concepts, principles, rights, and related dilemmas
• Analyze ethics in nursing education and research
• Investigate approaches to ethical reasoning
• Understand ethical decision-making process
• Propose the way forward
 NURSING IN THE CONTEMPORARY
SOCIETY
International Council of Nurses (ICN), (2007):

Nursing encompasses autonomous and collaborative care of

individuals of all ages, families, groups and communities,
“sick or well and in all settings. Nursing includes the promotion
of health, prevention of illness, and the care of ill, disabled and
dying people. Advocacy, promotion of a safe environment,
research, particularly in shaping health policies and in patients and
health systems management and education are also key nursing roles”.
Nurses follow the International Council of Nurses' (ICN) code of ethics to ensure ethical
behavior. The ICN definition of nursing emphasizes autonomous and collaborative care for
individuals of all ages, families, groups, and communities. Nursing responsibilities include
promoting health, preventing illness, restoring health, and alleviating suffering.
 ETHICAL CONCEPTS, PRINCIPLES, AND
RIGHTS, AND RELATED DILEMMAS
• Ethical concepts involve the science of morality, guided by codes of ethics.
• The universal code of ethics in healthcare emphasizes respect for life, altruism, integrity, and
justice.
• The ICN code of ethics outlines nurses' responsibilities, including promoting health,
respecting human rights, and addressing ethical dilemmas.
• Ethical principles such as safe and competent care, attention to health and well-being,
autonomy, dignity, confidentiality, justice, accountability, and truthfulness guide nursing
practice.
• Ethical dilemmas arise when nurses face conflicting duties and responsibilities.
 ETHICS IN NURSING EDUCATION
AND RESEARCH
• Nursing code of ethics applies to nursing education and research to protect subjects.
• Ethical principles, such as voluntary and informed consent, confidentiality, protection from
harm, and respect for human dignity, guide research involving human participants.
• Issues like concealment and deception in research raise ethical concerns.
 CHALLENGES IN IMPLEMENTING
ETHICAL DECISIONS
• Lack of education on ethics and ethical decision-making.
• Ethical violations may occur when nurses are aware of potential problems but fail to take
action.
• Ethical distress arises when nurses cannot fulfill their ethical obligations due to
circumstances beyond the nurses’ control.
• Nurses may face uncertainty in applying ethical principles or values.
 APPROACHES TO ETHICAL
REASONING
• Consequential or Utilitarian Approach:
Considers right or wrong actions based on expected outcomes. Focuses on maximizing good
(pleasure) and minimizing harm.

• Challenges:
Allows bad actions with good outcomes.
Ignores specific moral relationships.
Prioritizes majority over minority.
Rejected as "the end justifies the means" by some.
• Non-consequential (Deontological) Approach:
Decision-making based on unchanging moral rules and principles. Emphasizes acting in
accordance with moral duties.

• Challenges:
No direction when basic principles are conflicting.
Few decision makers follow this approach.
• Principles of Autonomy, Justice, Beneficence, and Non-maleficence Approach:
Decision-making based on the ethical principles of autonomy, justice, beneficence, and non-
maleficence. Allows for weighing and balancing ethical principles.

• Challenges:
No absolute guide for a specific action when principles conflict.
Difficult decision making due to many conflicting principles.
Response to autonomy is different in cultures/community.
• Ethical Decision-Making Approach Based on Virtues:
Considers the character of the decision-maker and their virtues. Reflects on attributes like
honesty, courage, integrity, trustworthiness, and justice.

• Challenges:
It lacks consensus in action.
The decision maker maybe good but performs a bad action.
 ETHICAL DECISION-MAKING
PROCESS
• Collection, Analyzing, and Interpreting Data:
Involves understanding client and family wishes, physician beliefs, and personal orientations.
• Stating the Dilemma:
Clearly identifies and states the ethical dilemma. Focuses on understanding ethical principles.
• Considering Choices of Action and Ethical Approaches:
Involves seeking input from external sources.
• Analyzing Advantages and Disadvantages:
Considers the pros and cons of each course of action.
• Making the Decision:
Involves choosing and implementing the decision.
 IMPLEMENTING ETHICAL
DECISION IN NURSING: THE WAY
FORWARD
• Ethical decision-making is a skill that can be learned through understanding ethical
principles, theories, and decision-making processes.
• Nurses need continuous education on ethics, and regular workshops and seminars can
provide opportunities for dialogue on ethical problems.
• Ethical committees should address ethical issues not only in research but also in all areas of
nursing practice.
• Nurses should engage in ongoing reviews of their practice, considering encountered ethical
problems and their resolutions.
 CONCLUSION
Essential ethical nursing practice is guided by autonomy, justice, beneficence, and non-
maleficence principles. Ethical dilemmas navigated through consequential, non-consequential,
virtue-based, and care-based reasoning. Decision-making involves data collection, dilemma
identification, choice consideration, analysis, and decisive action.
Continuous education vital for skill enhancement. Ethical decision implementation requires
advocacy, addressing quackery, acquiring new skills, and promoting professional standards.
Ethical committees should expand beyond research to address challenges in all nursing areas.
THANK YOU.