Ethics can be defined as the branch of knowledge that deals with moral principles and even more specifically regarding the government of a person’s behavior and morality. Morality is a system of principles that determine what is right or wrong. Ethics is an important aspect of real world situations as well as in a career field such as the medical field and more specifically ethics in nursing because it relates to another human’s life.
Within the medical field, ethics is examining specific clinical cases while incorporating facts, logic and using morality to determine what the best decision is for a patient.
Representation of this could be determining what condition the patient is in and whether or not they are ready to be discharged from a hospital. According to “What is Medical Ethics, why is it Important?”, an ethical decision may not always be between what is right and wrong, but “deciding between two ‘rights’—two values that are in conflict with each other —or deciding between two different value systems, such as the patient’s versus the doctor’s.
” This shows that ethical problems come up every day regarding the medical field and examples could be when a doctor withholds a treatment or prescribes a placebo to a patient.
Nursing is a more specified career within the medical field that uses ethics and morality in every situation. There is a code of ethics that all nurses are supposed to follow when making decisions regarding a patient or clinical case.
The code of ethics acts as a guide of inflexible values to abide by when making decisions especially in such a brisk paced work environment. In the code of ethics for nursing, it defines nursing practice as a “dynamic, caring, helping relationship in which the nurse assists the client to achieve and maintain optimal health” and this shows how ethical decisions are a major role in any medical situation involving another human being’s life.
The importance of nursing ethics is so that the nurse and patient are both comfortable with the decisions being made without disrespecting a patient’s moral and legal rights. A patient retains these legal and moral rights when it comes to their health which obliges nurses to “respect their needs and values, respect for client choice, confidentiality, and the dignity of clients” (Code of Ethics for Nursing). Nurses not only need to respect their patients but they also need to be rational and take responsibility for any mistakes they make concerning the patient. This represents the integrity that nurses have when assisting another human being in their health care.
Understanding nursing ethics and medical morality is one thing, but applying that knowledge is the tricky part. A nurse works in a quickly paced work environment which calls for making quickly paced decisions and making sure that it is the right decision for the correct patient. The patient believes that the medical professional is trustworthy and therefore they must be as well as respecting the autonomy of the patient.
Kant’s definition of autonomy is that a human has the capacity to make their own moral decisions. Applying this means that the patient has the right to self-govern their own health care decisions if they do not agree with what was recommended by the nurse. For instance, if a nurse recommends that the patient be prescribed a specific medicine although the patient does not want that, the patient has the right to refuse the treatment. Nurses also have autonomy to make their own decisions with a patient. According to the truthaboutnursing.org, nursing is an autonomous profession and “despite what the media may portray, nursing is not directed by physicians, even though nurses have less practical power than physicians do.” Nurses must have some sort of certification or degree proving they understand the profession and what the responsibilities are which include administering medications, observing and monitoring patients’ conditions as well as deciding treatments for such conditions.
Particular ethical dilemmas regarding the autonomy of a patient is when it comes to taking someone off of life support. The main thing to think about is if a patient is brain dead, they do not have the mental capacity to make their own autonomous decisions. Usually the decision to take the patient off of life support is made by the next of kin or whoever is the designated person to make such a decision. For instance, if the patient is a child the parent would decide or if the patient was married then the spouse would decide. Either way, the decision maker needs to take into consideration what the patient would have wanted because it is going to be the last decision ever made for them. Relating this to ethics of autonomous decisions is that the patient is incapable of making a self-governing decision, therefore the dilemma is whether or not the situation is moral.
Kant had another theory called “moral duties” which states that certain actions are never be permitted. One of those actions to never be done is lying which correlates with the ethical point of veracity in nursing. Veracity is defined in the textbook as “specifically characterized by honesty as displayed in habitual truthfulness” which means that the person has a devotion to telling the truth. This applies by using the concept of informed consent or withholding information from a patient. In past times, paternalism was a major factor in the medical field, meaning that someone else is limiting another person’s liberty without their knowledge but justifies that it is for their own good. The way that doctors would be paternalistic is by avoiding telling a female patient if she had a terminal illness, but tell her husband instead. This goes back to Kant’s philosophy of autonomy and that a patient has the right to make their own decisions regarding a treatment, not someone else.
Utilitarianism is the ethical concept of maximizing the good for all people regardless of the consequences. In the medical field, there are two terms that are part of this concept called “beneficence” and “nonmaleficence”. Beneficence is maximizing the good you can for the patient while nonmaleficence is considered to be doing no harm to the patient. While the terms are quite similar, nonmaleficence is to make sure no harm is being done regardless of the amount of good being done. Examples of beneficence are “lifting side rails on a patient’s hospital bed to prevent falls, providing vaccinations and performing daily tasks for patients who are unable to do so themselves” (Beneficence Nursing and Ethics). Nonmaleficence could be represented by the Hippocratic Oath that doctors stating “I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism” (Medical Definition of Hippocratic Oath).
A practical example of this in the medical field is similar to the trolley problem discussed in class. The trolley situation is placed where there is a track that splits into a fork, on one side of the fork there are five people and on the other side of the track there is one person. The ethical dilemma comes down to the person deciding whether to let the trolley continue and kill the five people or to switch the track to only kill the one person. Relative to the nursing, the morality is that if it is ethical to take one life to save five.
Justice is the theory of fairness and the act of being fair which plays into nursing when it comes to the caretaking of patients. The concept of justice in nursing relates to not having any favoritism towards patients if the nurse is taking care of more than one patient. The importance of this is to have fair and equal care across all boards. This also brings in the idea of triage in the medical field which means that the severity of conditions or wounds were prioritized accordingly. Nurses and other medical care professionals need to treat the wounds and conditions of higher severity over the lesser but not completely ignore the less severe conditions.
Nurses must have the characteristics of morality when dealing with patients by being respectful, selflessness, and integrity. All of these intertwine with trustworthiness which is a major key when it comes to the patient and healthcare provider relationship. Trustworthiness is defined in the textbook as one can “depend on another to be honest, reliable, just and living a life of integrity.” Between a patient and nurse, the patient trusts that the nurse is doing the right thing for their specific case and condition.
Nurses also have to be respectful in order to earn this trustworthiness. Respect is defined in the textbook as someone being able to “show consideration for” another human being. For example, nurses have to respect the patient’s decisions when it comes to treatment as well as the confidentiality of the patient’s conditions. Patient’s confidentiality is important because to earn that honored trustworthiness, they expect the nurses to not go around the workplace discussing their conditions in a gossiping manner.
Selflessness is defined in the textbook as someone “being devoted to other’s welfare or interests and not one’s own” and relating to someone else’s life this is a very important aspect. A nurse must be selfless because there is no benefit in being a nurse when their main concern is not regarding the care of the patient. The way that a nurse acts in a selfless way is by dedicated their livelihood to the care of another human and making sure that their health is to the highest of standards. Nurses do not usually choose the path of being a healthcare provider to receive anything back but do it to serve and help those in need.
Integrity is the concept of a person having strong moral principles and not having a corruptible moral character. This is another characteristic that nurses usually portray when it comes to a patient that is a part of trustworthiness in a relationship. There are two different interpretations of the word integrity, a professional integrity and a personal integrity. Nurses have to juggle both of those. An example of this is if a nurse obeys her personal integrity by not getting a flu shot because they do not believe in it, but as a medical professional lose their professional integrity and putting their patients at risk. This represents the balancing of both parts of integrity in the workplace and how it can cause dilemmas because as a medical professional being unvaccinated, the nurse is putting patients at risk of getting even more ill than they began.
The profession of nursing is predominantly females and medical doctors is predominantly males which leads to sexist dilemmas in the workplace. Sexism is in the textbook is defined as the “discrimination against, and prejudicial stereotyping of women” but in the real world it can be applied to all genders. Although nurses are predominantly female, the male nurses also deal with sexism issues and vice versa for the female medical doctors. Issues of sexism can between the patient and healthcare provider or between two health care providers.
Some examples of patients being sexist towards a male nurse is that some have called the male nurse names such as being gay or that they do not want them to being under the care of a male nurse. Another example is that if a male nurse greets a patient, the patients have made comments towards the nurse about how they were expecting a female nurse or be mistaken for the doctor although they stated they were a nurse. On the other hand, female nurses have been mistaken to be a patient’s friend although they are in scrubs and wearing a stethoscope. Instances of sexism in the workplace between two healthcare professionals could be making negative comments towards one another, being condescending or degrading based off of gender.
These issues of sexism lead into other forms of discrimination such as racism. Racism is a major issue in the world and is defined as “any practice of discrimination based off of belief that one race is superior to another” in the textbook. Anywhere you go in the world there is going to be some form of racism and if you look in work places, it can everywhere and undetected if not acknowledged. Sexism and racism go hand in hand in the way that they are both a form of discrimination and thinking one is superior over another gender or race.
Racism can be all sorts of actions from as small as an attitude towards another person all the way to being denied a job based off of race. In the article “Unmasking Racism in Nursing”, registered nurse Sandra Webb-Booker says that “minorities, underrepresented in the nursing workforce, are not given the same consideration for job opportunities” and that Caucasian registered nurses are dominant in the nursing career field causing that to be the status quo. Workplaces are not the only places that discriminate towards minorities in races and “there’s a long history of some institutions treating foreign-educated nurses differently” which goes to show that even though the education is the same, nurses are being discriminated off of where they came from or their ethnicity.
Every person in every situation, there are going to be questions of what is the right decision or the wrong decision. This is concept of morality and everyone has their own morals or ethical principles they abide by. These principles apply to life altering decisions or decisions in the workplace. In nursing, the importance of being able to make an ethical decision and have moral principles is because another human being’s life is in the hands of the healthcare provider.
There is a set code of ethics that nurses that acts as a guide to abide by. Nurses have to respect the patient’s autonomy to make their own decisions as well as be justice in the work place. Characteristics of veracity, respectfulness, selflessness, and integrity are also an important in the nursing career field to build a trusting relationship between patients as a healthcare provider. Trustworthiness is the bond between patient and nurse that lets them be comfortable and confident in each other when it comes to treatment or care required.
The ethical theories that support these traits are the Kantian theory of autonomy and moral duty as well as the utilitarian ideas. Kant’s idea of autonomy meant that a person has the self-governing process to make decisions for themselves which plays into the part of being able to deny or accept treatment. Utilitarianism is the idea of doing the maximum amount of good for the greatest amount of people which correlates with the ideology of beneficence and maleficence. These theories and personality traits associate deeply with the ethics within the medical field and more specifically nursing careers and nurses as people with moral duties to saving people’s lives.