INTRODUCTION OF ETHICS
Ethics is used worldwide in large companies and
The word ethics is derived from the Greek word “ethos”,
which means custom or guiding beliefs. Ethics is defined
as a set of rules or principles that govern right conduct
and is designed to protect the rights of a human being.
Ethics is a branch of philosophy; it is moral philosophy
or philosophical thinking about morality, moral
problems, and moral judgements. Nursing ethics
provides the professional standards for nursing
activities, which protect the nurse and the patient.
DEFINITION
 Ethics may be defined as the system or code of
conduct and morals advocated by a particular
individual or group. It is also the study of acceptable
conduct and moral judgement.
 Ethics is a system of understanding determinations
and motivations based on an individual’s
perceptions of right and wrong. It is not determined
by strict rules or rigid guidelines, and although it is
relatively stable, it can change over time.
PROFESSIONAL ETHICS
1. The concept of professional ethics partly deals with
what a professional should or should not do in the
workplace.
2. Professional ethics is a set of standards adopted by
a professional community and it encompasses a
greater part of a professional’s life.
3. Professional codes of ethics regulate the manner in
which professionals conduct themselves while in the
workplace and include concepts such as professional
respect, avoidance of dishonesty or fraudulent
activity, such as plagiarism, and the professional
development of the individual. Another important
aspect is the enhancement of the profession and the
industry within which the professional works.
4. Nursing ethics is concerned with a professional
conduct and behaviour that helps a nurse to carry out
the nursing care in a manner that results in good to
the mankind and community.
5. A professional has more moral responsibilities than
those held by the population in general. This is
because professionals are capable of making
judgements and acting on informed decisions in
situations that the general public cannot, because
they have not received the relevant training. For
example, a layman could not be held responsible for
failing to act to save a car crash victim because he/she
does not have the relevant knowledge. In contrast, a
fully trained doctor (with the correct equipment)
would be capable of making the correct diagnosis and
carrying out the procedure and it is wrong if he/she
failed to help in this situation.
6. In the workplace, managers and supervisors should
set the standard for ethics by showing respect, being
honest, and promoting trust. If the management team
uses unethical forms of communication, the team and
business can fail.
7.
small businesses. Promoting ethics in the workplace
provides employees a sense of worth and trust that
can help the business and the employees succeed.
IMPORTANCE OF ETHICS IN NURSING
PROFESSION
Nursing ethics is a branch of ethics that deals with the
activities involved in the field of nursing.
Importance for the Nurses
 Ethics Provides Framed Ethical Principles to Do
Proper Nursing Care:  It helps to act as a guide for
the nurse and provides the code of conduct of
ethical behaviour.
 Ethics Protects the Nurse from All Legal and Ethical
Issues:  Every nurse is obligated to follow the ethical
principles and the code of ethics. As per the rules of
ethics, a nurse should abide by the rules and
regulations of nursing practice and hospital polices.
Since the nurse is in his/her ethical tract, it acts as a
shield and protects the nurse from getting trapped
into the medico-legal issues.
 Ethics Controls, Modifies, and Molds Good Ethical
Behaviour in the Nurse:  Following ethical principles
will help not only the nurse but also all health care
providers to modify and control their behaviour
towards patient care since all ethical principles are
grounded and framed to the benefit and protection
of the society. A nurse should strictly follow the
ethical principles of accountability and responsibility
in nursing care.
 Ethics Helps the Nurse to Attain Professional and
Personal Satisfaction:  A nurse should follow the
code of ethics and hospital policies.
 Ethical Values Help in Better Decision-making:  If
an institution or management has enforced a
standard and strong ethics, its principles will
definitely help in decision-making.
 Ethics Leads to Profits:  Both ethics and profits go
together. Without doubt, any management that
sticks to strong ethical principles will yield only
profit, since these principles work out only to
stabilize the unity.
Importance within the Horizons of the Nursing
Profession
The ethical principles in the nursing profession help in
the following:
1. Maintain a trustworthy relationship among the
health care team
2. Evaluate the performance of nursing care by
checking for any impaired practice, acceptance of any
forms of rewards, tokens, or goodies from the
patients or their relatives, and the maintenance of a
therapeutic relationship with patients.
3. Maintain confidentiality and ensure that the details
of the patients are recorded accurately and are kept
safe.
4. Not practice any illegal or criminal offense or allow
it in the nurse’s presence.
5. Maintain good morale.
6. Respect all cultural issues of the patient.
7. Use the power and potentiality to upgrade the
professional growth properly.
Nursing is not possible without ethics
Ethics in Nursing Profession
IMPORTANCE OF ETHICS IN NURSING
Ethics is important in the nursing profession for the
following reasons:
 Ethics is used to guide the professional behavior of
the nurses.
 It helps the teachers to identify what needs to be
taught for the nursing students.
 It can be used to prevent a nurse from practicing if
his/her conduct is poor and clearly below the
standards set by the code.
 It can be used to protect a nurse who is falsely
accused of doing something wrong.
 It can also be used as a guide for direction when
legal action must be taken in a lawsuit.
NURSING ETHICS
Nursing ethics provides the professional standards for
nursing activities, which help to protect not only the
nurse but also the patient. In 1973, the International
Council for Nurses (ICN) adopted the code of ethics and
implemented a rule that all nurses must follow this
code. The main objectives of the code of ethics as
described by the ICN are as follows:
 Promote health and well-being
 Prevent illnesses and complications
 Restore the health and alleviate the suffering of the
patient without any complications
A nurse should maintain the dignity of the nursing
profession in any situation and should not be influenced
by the social status of the patient or money and get
involved in corruption. This is possible only by following
nursing ethics.
CODE OF ETHICS
The code of ethics states the kind of conduct expected
from the members of a profession and the
responsibilities of its members towards those whom
they serve, their co-workers, the profession and the
society as a whole. It would be easier in decision-making
if the member understands what the wrong or right
behaviour in different situations is.
 The ICN Code of Ethics gives a general description of
the following:
1. What a nurse does
2. How nursing service should be given
3. To whom service is given
Nursing Branches Involving Ethical Issues
Ethical issues are involved in the following branches in
nursing:
1. Nursing research
2. Nursing education
3. Nursing administration
4. Nursing management
5. Intensive care unit
6. Operation theatre/surgical nursing
7. Medical nursing
8. Community health nursing
9. Child health nursing/Pediatrics
10. Mental health nursing/Psychiatric Nursing
11. Maternity nursing
ETHICAL THEORIES
Each moral theory holds a specific approach in how to
handle life’s decisions. Throughout history, a few moral
theories have surfaced and have been analyzed for their
strengths and weaknesses. A moral theory often shapes
a person’s attitude toward others, belief system and life
choices.
UTILITARIANISM
Utilitarianism is a moral theory that implements fair
choices in an effort to ensure the least amount of harm
is done to all parties involved. The utilitarianism
approach requires that you decide what course of
action needs to be done and evaluate the outcomes of
each action. By focusing on the outcome of each action,
utilitarianism demands that you decide on what course
of action based on the benefits or harm of the actions
without regard to the cost of the action.
For example, Julie walks into a hostage situation. There are 20
hostages and she is told that if she shots one hostage, she will
save the lives of the other 19. Utilitarianism would support
Julie’s killing of one of the hostages because the other 19 lives
are a greater benefit, regardless of the fact that the cost
would be one person’s life.
DEONTOLOGY
Deontology focuses on the consequences of your
actions and believes that when faced with life choices,
you should operate according to responsibility and
obligations. A deontologist believes that morality is a
responsibility for everyone as well as a duty.
For example, if a man steals three loaves of bread and a
gallon of milk to feed his family, it would be supported by
deontology because of the moral responsibility and
obligations of the man to care for his family.
Sometimes deontologists are unable to determine
certain courses of action as moral or not. A coffee shop
owner who requires his employees to dress in black
cannot be identified with the deontology theory simply
because the requirement is the owner’s preference and
whatever governs such preference is neither moral nor
immoral.
DEONTOLOGY
Deontological ethics, or deontology, is the normative
ethical theory that the morality of an action should be
based on whether that action itself is right or wrong
under a series of rules, rather than based on the
consequences of the action.
It is sometimes described as responsibility,
commitment, or rule-based ethics.
A moral obligation may arise from an external or
internal source, such as a set of rules inherent to the
universe (ethical naturalism), religious law, or a set of
personal or cultural values (any of which may be in
conflict with personal desires).
TELEOGY
teleological ethics, (teleological from Greek telos,
“end”; logos, “science”), theory of morality that derives
duty or moral obligation from what is good or desirable
as an end to be achieved. Also known as
consequentialist ethics, it is opposed to deontological
ethics (from the Greek deon, “duty”), which holds that
the basic standards for an action’s being morally right
are independent of the good or evil generated.
Teleological theories differ on the nature of the end that
actions ought to promote. Eudaemonist theories
(Greek eudaimonia, “happiness”), which hold that ethics
consists in some function or activity appropriate to man
as a human being, tend to emphasize the cultivation
of virtue or excellence in the agent as the end of all
action. These could be the classical virtues—courage,
temperance, justice, and wisdom—that promoted the
Greek ideal of man as the “rational animal”; or the
theological virtues—faith, hope, and love—that
distinguished the Christian ideal of man as a being
created in the image of God.
VIRTUE
Virtue is very distinct from other ethic theories in that it
looks at a person’s individual character, not necessarily
his actions. When observing an unethical position, the
virtue theory considers the person's reputation and
purpose for committing the act. If a high school student
is temperate, modest, witty and intelligent and
plagiarized on a class writing assignment, the virtue
theory would analyze the student's past personality
traits and interpersonal skills in order to determine
whether the student is truly guilty.
Relativism
Relativism is a theory that deems your moral obligations
and beliefs to be based on the individual environment.
For example, in American culture cannibalism is
considered taboo, while in other cultures the act of
consuming other human flesh is accepted as a sacrifice
or ritual. Relativism determines morals and ethics
according to the society that is being observed.
Relativism argues that every society and culture
believes differently and thus, each culture must be
evaluated according to its particular cultural patterns
and influences.
BIOETHICAL ISSUES
Medical technology has mushroomed, providing an
ever-increasing array of diagnostic and interventional
modalities that can diagnose and treat illnesses that
were believed to be lethal only a few years ago.
Bioethics represents a particular branch of ethics within
the field of health care.
Bioethics affects all the health professionals who seek
knowledge to improve their skills; at times, they are
trapped in legal and ethical issues and their minds are in
an ethical dilemma regarding taking any decisions
concerning the ethical issues involved in the bioethics.
Therefore, it is important for a nurse to learn and
practice bioethical issues and management.
DEFINITIONS
 It is a branch of science that deals with the ethical
and moral implications of new biological discoveries
and biomedical advances.
 It is a branch of ethics, philosophy, and social
commentary that discusses the life sciences and
their potential impact on society.
 It deals with the study of value judgements
pertaining to human actions in the fields of biology
and biotechnology.
 It is a study of the moral and ethical choices that
scientists and doctors face in medical research and
in the treatment of patients.
 It is a branch of science that explores the moral and
ethical questions surrounding life, health, science,
medicine and environment.
  It is a study of right and wrong in biomedical
advances and activities such as genetic engineering,
organ transplantation and the care of terminally ill.
The hidden part of the ice can be revealed only when
diagnoses are made, that is, through in-depth
understanding of the bioethical principles and
awareness of such issues.
PURPOSE AND SCOPE
The purpose and scope of bioethics are as follows:
1. To reveal the hidden bioethical issues, for example,
abortion, surrogate mother, euthanasia.
2. To measure the safety limits of any bioethical issue.
3. To create a new ethical law based on the bioethical
issues.
4. To solve the bioethical issues and dilemmas that
arise in health care.
5. To evaluate the range of bioethical ethical issues
involved while performing any patient care as mild,
moderate or severe, because it is important to
analyze whether the depth of the issue is simple or
complex. It is better to safeguard the nurse and the
patient at the earliest, that is, at the simple or mild
stage of the issue.
6. To do any research on humans, it is important to
analyze whether at any time during the research
process, any injury or harm might be caused to the
individual or to the society.
NURSE CODE OF ETHICS
Nursing Branches Involving Ethical Issues
Ethical issues are involved in the ff branches in nursing:
 Nursing research
 Nursing education
 Nursing administration
 Nursing management
 Intensive care unit
 Operation theatre/surgical nursing
 Medical nursing
 Community health nursing
 Child health nursing
 Mental health nursing
 Maternity nursing
 Nursing procedures
The code of ethics states the kind of conduct expected
from the members of a profession and the
responsibilities of its members towards those whom
they serve, their co-workers, the profession and the
society as a whole.
The ICN Code of Ethics gives a gen description of the ff:
1. What a nurse does: the fourfold responsibility of
promoting health, preventing illness, restoring health
and alleviating suffering.
2. How nursing service should be given: unrestricted
by the considerations of nationality, race, creed,
color, age, sex, politics or social status; coordinated
with related groups.
3. To whom service is given: the individual, the family
and the community.
The body of the code is made up of five sections.
Nurses and People. This code is concerned with a
nurse’s actions towards the people. Here, the term
“people” refers to the patients for whom care is
provided. A nurse’s responsibilities based on the ethics
are as follows:
1. Hold the personal information of patients in
confidence and use judgement in sharing this
information.
2. Provide nursing care with prime responsibility for
those who need care.
3. Provide care for patients without considering their
caste, creed, etc. and give respect to their values,
customs, and spiritual beliefs.
Nurses and Practice. A nurse should adopt standard
nursing practices while providing nursing care and
should maintain the highest quality possible within the
reality of the specific situation. The following are the
principles stated in this code with respect to a nurse’s
practice:
1. Have a personal interest in updating his/her
knowledge and should ensure it by continual learning.
2. Always provide evidence-based care with the help
of continuous research activities.
3. Apply the scientific principles specific for each
nursing procedure as learnt and modify, verify the
same, and act according to the hospital practices.
4. Never ignore any patient while on duty.
5. Should not commit any malpractice or be negligent
while working.
6. Avoid absenteeism in working hours.
7. Be physically, mentally, and socially alert at all
times during practice.
8. Accept and delegate the responsibilities with
proper judgement and expert guidance.
9. Always maintain standards throughout the life of
nursing practice.
Nurses and Society. This code reflects on the
responsibilities of a nurse towards the society and
states the following:
1. Educate the public and create awareness about the
various health problems as and when needed.
2. Initiate and support activities to meet the health
and social needs of the public.
3. Act as an initiator, supervisor and supporter of any
health program implemented for the benefit of the
society.
4. Inform the higher authorities in time about any
abnormalities or contagious diseases noticed during
nursing care.
Nurses and Co-workers. Nursing is always a teamwork.
An individual can never provide complete care. He/she
needs the support and guidance of the co-workers. This
code aims to do the following:
1. Create “espirit de corps” among the workers.
2. Have a positive and healthy relationship with the
co-workers.
3. Maintain dignity and give respect to the co-workers
at all levels.
4. Safeguard patients and co-workers by taking
appropriate actions, especially in case of accidents,
disasters, bioterrorism, bomb explosions, etc.
Nurses and the Profession. Nursing has its own
scientific background and its own nursing foundation.
This is why it is called as the nursing profession. It has
its own professional bodies and associations, they
provide training on the policies and procedures involved
in the nursing profession and implement updated
standard principles of nursing practices, which all the
nurses should abide by and follow. This code reflects on
the responsibilities of a nurse towards their profession
as follows:
1. Be active and alert at all times as a nurse plays a
major role in caring for the patient. Use professional
knowledge in the administration of nursing care.
2. Update the standards of practice and improve the
quality of care through research activities.
3. Provide care equally to all categories of people, and
establish good and healthy social and economic
working conditions.
4. Adopt high qualities of nursing care through all
stages of his/her nursing practice, that is, novice,
practitioner and expert.
5. Be an active member in a nursing organization.
International Code of Nursing Ethics
The ICNE states the following:
 The fundamental responsibility of a nurse is to
conserve life and to promote health. Every nurse is a
teacher of health by example.
 A nurse must be adequately prepared to practice
nursing and be willing to continue to learn new
ideas by reading and attending meetings.
 A nurse must learn to respect authority.
 A nurse must carry out the doctor’s orders
accurately and sustain confidence in the doctor and
all members of the health team.
 A nurse should report any unusual condition or
symptom to the doctor or the nurse in charge.
 The religious beliefs of a patient should be
respected.
 All information given to a nurse should be held in
confidence.
 When a patient requires continued nursing care, the
nurse must remain with the patient until adequate
relief is available.
 A nurse has the obligation to give conscientious
service and, in return, is entitled to just
remuneration.
 A patient should always be called by his full name.
 Punctuality is very important for a nurse.
 Obedience is very important in observing rules and
regulations.
 Every nurse must have respect for authority and for
rules and regulations.
 Manpower, money and material supplies should be
blended fairly as per the hospital needs to meet the
demands of the patients. Any inequality in
manpower, money and material will affect not only
the nursing care but also the entire management
process in the hospital.