7. Values is quite important to the life of nurses.

Nurses, as the largest health care group, have well-

known and important professional values. 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 [4, 5]. Professional values are a source to promote nurses’ ethical competencies in
clinical settings and dealing with ethical concerns in the present era [6]. Most nurses are aware of ethical
issues, but they do not use them in their clinical practice. Furthermore, in many cases, they lack
sufficient power and support to demonstrate their reaction in this regard [7] or they are not aware of its
importance [8]. Thus, professional values are a solution to the current problems in nursing profession
[6]. Today, globalization, migration, nursing shortage, new diseases, ageing population, and demand for
high-quality care are complicated issues that result in ethical problems for nurses [9]. Therefore, they
are expected to be aware of professional values and apply them to their decision makings while dealing
with such ethical problems [10, 11].

Values are acquisitive; this means they learned either directly or indirectly by observing others’
behavior [12, 13]. Following academic education, development of professional values in nurses is mainly
influenced by experts in the profession, colleagues, patient care situations, and organizational values
[14, 15].
CITE:

Poorchangizi, B., Farokhzadian, J., Abbaszadeh, A., Mirzaee, M., & Borhani, F. (2017). The importance of
professional values from clinical nurses' perspective in hospitals of a medical university in Iran. BMC
medical ethics, 18(1), 20. https://doi.org/10.1186/s12910-017-0178-9

8. Health care ethics is the field of applied ethics that is concerned with the vast array of moral
decision-making situations that arise in the practice of medicine in addition to the procedures
and the policies that are designed to guide such practice. Of all of the aspects of the human body,
and of a human life, which are essential to one’s well-being, none is more important than one’s
health.

8. Nursing Code of Ethics

Ethical practice guidelines have been around since the early days of nursing.
An ethical pledge for nurses—a modified version of the Hippocratic Oath
called the Nightingale Pledge—was developed by Lystra Gretter in 1893. The
first code of ethics for nurses was suggested by the American Nurses
Association in 1926 and adopted in 1950 (Lyons, 2011).

The American Nurses Association maintains the current code of ethics for the
nursing profession; it is called A Code of Ethics for Nurses with Interpretive
Statements; last modified in 2015, it contains nine provisions, which detail
“the ethical obligations of all nurses.” It “addresses individual as well as
collective nursing intentions and actions; it requires each nurse to
demonstrate ethical competence in professional life” (ANA, 2015).
Codes of ethics are broadly written and are not meant to serve as a
blueprint for ethical decision making. They are intended to provide a
reminder of standards of conduct: that the nurse has a duty to keep
confidentiality, maintain competence, and safeguard patients from unethical
practice (Lyons, 2011).

Situations that create ethical conflicts highlight the difficulty involved in

making the right decision. Andrew Jameton identified three types of ethical
conflicts that nurses may experience in the clinical setting that can cause
distress:

1. Moral uncertainty
2. Moral dilemma
3. Moral distress (Falcó-Pegueroles et al., 2013)
https://www.atrainceu.com/content/5-ethical-and-legal-practice

9. i. Informed Consent
Concerns about patient autonomy give rise to the concept of “informed consent.” For, if
one believes that the patient, indeed, does have a moral right to self-determination
concerning one’s own health care, then it would seem to follow that health care
professionals, especially physicians, ought not to prescribe any therapeutic measure in
the absence of the patient’s informed consent.

Informed consent is intended to be not only a moral but also a legal safeguard for the
respect of the patient’s autonomy. Furthermore, informed consent is designed to
promote the welfare of the patient (that is, to ensure the patient’s right to beneficence)
and to avoid the causing of any harm to the patient (that is, to ensure the patient’s right
to nonmaleficence).

Other areas of moral concern include the clinical relationship between the health care
professional and the patient; biomedical and behavioral human subject research; the
harvesting and transplantation of human organs; euthanasia; abortion; and the
allocation of health care services. Essential to the comprehension of moral issues that
arise in the context of the provision of health care is an understanding of the most
important ethical principles and methods of moral decision-making that are applicable
to such moral issues and that serve to guide our moral decision-making. To the degree
to which moral issues concerning health care can be clarified, and thereby better
understood, the quality of health care, as both practiced and received, should be
qualitatively enhanced.

9. Box 1: The importance of informed consent

 Among the possible arguments for informed consent are:
o – That it safeguards patient autonomy.
o – That it is a requirement of justice, understood in terms of patient
empowerment.
o – That it is a central feature of the covenant relationship between
professional and patient, expressing the professional virtue of
fidelity.
 A supplement and corrective to mainstream accounts of professional-
patient relationships that focus on autonomy and justice is offered by
a care approach which calls for qualities such as “sympathetic
understanding”.
Different theoretical accounts of professional-patient relationships and informed
consent may have relatively little to say about the choice of tests for competence,
though Beauchamp and Childress comment on the close affinity between their
accounts of competence and autonomy (p 72).14 These accounts have more to
say about what should be done, and why, when patients are incompetent to
consent, As competence is the first of the requirements for informed consent, one
should know how to detect incompetence. Standards (used singly or in
combination) that are generally accepted for determining incompetence are based
on the patient’s inability to state a preference or choice, inability to understand
one’s situation and its consequences, and inability to reason through a
consequential life decision [16].

Med Princ Pract 2021;30:17–28

https://doi.org/10.1159/000509119
https://www.karger.com/Article/FullText/509119#