Nursing Ethics and Legal Issues
Ethics deals with standards of conduct and moral judgment. The major principles of healthcare ethics that must be upheld in all situations are beneficence, nonmaleficence, autonomy, and justice. Beneficence means promoting or doing good. Nurses work to promote their clients' best interests and strive to achieve optimal outcomes. Nonmaleficence means avoiding harm. Nurses must maintain a competent practice level to avoid causing injury or suffering to clients. The principle of nonmaleficence also covers reporting suspected abuse to prevent further victimization and protecting clients from chemically impaired nurses and other healthcare practitioners. Autonomy stands for independence and the ability to be self-directed. Clients have the right of self-determination and are entitled to decide what happens to them; therefore, competent adults have the capacity to consent to or refuse treatment. Nurses must respect the client's wishes, even if they don't agree with them. Finally, justice requires that all clients be treated equally and fairly. Nurses face issues of justice daily when organizing care for their clients and deciding how much time they will spend with each based on client needs and a fair distribution of resources.
Nurses need to distinguish between their personal values and their professional ethics. Personal values are what nurses hold significant and true for themselves, while professional ethics involve principles that have universal applications and standards of conduct that must be upheld in all situations. Nurses thus avoid allowing personal judgments to bias client care. They are honest and fair with clients, and they act in the best interest of and show respect for them.
Since nurses address complex ethical and human rights issues on a regular basis, the American Nurses Association Board of Directors and the Congress on Nursing Practice first initiated the Code of Ethics for Nurses in 1985 to delineate the code of responsibilities and conduct expected of nurses in their practice. Nurses are held responsible to comply with the standards of ethical practice and to ensure that other nurses also comply. The code was revised in 2001 to include issues of advancing nursing science and is based on the opinions and experience of a wide range of nurses. The ANA approved nine provisions that address ethical practice issues such as compassion and respect, the nurse's primary commitment to the patient, patient advocacy, responsibility and accountability, duties, participation in the healthcare environment, advancement of the profession, and collaboration. You can read or purchase the ANA Code of Ethics for Nurses with Interpretive Statements at www.nursingworld.org.
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