APPROACHES

IN
PROFESSIONA
L NURSING
ETHICS
IVAN B. DOROJA BSN4
INTENDED LEARNING OUTCOME

At the end of the discussion, the student will be able to:

1. Explain the nursing ethics and integrate them in clinical practice.

2. Identify the approaches in professional nursing ethics in ethical
decision making when given an ethical issue.
3. Integrate basic understanding and application of the approaches of
professional nursing ethics in the nursing profession.
 01
Nursing Ethics
Meaning and Purpose
NURSING ETHICS
▣ Nursing ethics is concerned with the principles and right conduct as
they apply to the nursing profession. It reinforces the nurses’ ideals and
motives in order to maximize the affectivity of their service.
▣ Determine how a person or group of people will act or behave in
specific situations. Strong ethics are vital to nursing, as moral dilemmas
can frequently arise while attending to patients. Nurses and other
healthcare professionals must recognize these ethical problems when
they occur and apply the profession’s ethics and core values in their
judgment and decision making.
▣ The American Nurses Association’s nursing code of ethics serves as a
guide for nurses to practice with competence and integrity. People’s
own set of ethics and morals influence their actions and decision-
making, as well as how they perceive the consequences of those
actions. In healthcare, ethics allow nurses and other professionals to
identify moral dilemmas and apply good judgment to their decisions.
▣ The first world countries experiencing phenomenal medical and
technological advances in nursing witness and study the ethical and
moral issues brought about by these changes in the practice of the
nursing profession. They are aware of the evolution of ethics in the
nursing practice into a new professional ethics for three reasons.
▣ (1) The changing philosophy of healthcare with its
increasing emphasis on the principle of personal
autonomy.
▣ (2) The changing philosophy of nursing with its
emphasis on patient-oriented care; and
▣ (3) The evolution of nursing as profession distinct
from medicine.
 Approaches to
02 Nursing Ethics
APPROACHES TO NURSING ETHICS
▣ Since nurses’ work mainly focuses on patients, ethics in nursing offers a
framework to help them ensure the safety of patients and their fellow
healthcare providers. The nationally accepted guide is the
Code of Ethics for Nurses with Interpretive Statements, or The Code,
issued by the American Nurses Association.
▣ This approaches help nurses work through difficult situations and
provide them with a moral compass to do their jobs fairly. At the same
time, these guidelines promote high levels of care and attention.
THREE MAJOR APPROACHES IN THE STUDY OF
NURSING ETHICS
DEONTOLOGICAL
APPROACH
01 Upholds the use of universal code and principle when making ethical decisions
in nursing practice.
ETHICAL SKEPTICISM
02 APPROACH
Follows the principle of relativity in which ethical standards are considered not
universal.

03 UTILITARIANISM APPROACH
The practical approach to nursing in which the ethical standards are
based on the assessment of the costs and benefits of nursing action.
Deontological Approach
▣ Duty Oriented Theory or Duty based ethics
▣ The basic rightness or wrongness of an act depends on the intrinsic
natures rather than upon the situation or its consequences.
▣ Deontological ethics are based on duties and rights and respect
individuals as ends in themselves. It places value on the intentions of
the individual (rather than the outcomes of any action) and focuses on
rules, obligations and duties.
▣ This is in direct contrast with consequentialism.
Example:
A cancer patients are quite often advised to undergo a course of
chemotherapy or radiotherapy.
ETHICAL SKEPTICISM
▣ Skepticism is how an individual realizes to whom to disclose certain
things. Accepting the nature and power of emotions and habits is the
key that allows an individual to overlook the facts over a thing that
feels right
▣ Skepticism refers to doubt about the truth of moral judgments. Moral
skepticism can range from dogmatic beliefs that morality is not
knowable or whether morality exists to practical applications of
skepticism to morally complicated questions.
▣ Skepticist views claims that moral knowledge is not possible.
Utilitarianism Approach
▣ An act is good if it maximizes the greatest amount of good.
▣ Utilitarianism adopts a teleological approach to ethics and claims that
actions are to be judged by their consequences.
▣ Utilitarianism has important implications for how we should think
about leading an ethical life. Because utilitarianism weighs the well-
being of everyone equally, it implies that we should make helping
others a very significant part of our lives.
▣ Utility: The Greatest Happiness Principle actions are right in proportion
as they tend to promote happiness, wrong as they tend to produce the
reverse the happiness.
JEREMY BENTHAM(1748-1832)

▣ Father of Modern Utilitarianism

▣ It was he who made the utilitarian
principle serve as the basis for a unified
and comprehensive ethical system that
applies, in theory at least, to every area of
life
▣ Never before had a complete detailed
system of ethics been so consistently
constructed from a single fundamental
ethical principle.
BENTHAM’S “ACT” UTILITARIANISM
▣ The principle of utility is the principle which approves or
disapproves of every action, according to the tendency which it
appears to augment or diminish the happiness of the party whose
interest is in question.
▣ Jeremy Bentham figured that laws should be useful not merely reflect
the status quo; and that while he believed that men inevitably pursue
pleasure and avoid pain.
▣ Bentham supposed that the whole of morality could be derived from
“enlightened self-interest” and that a person who always acted with a
view to his own maximum satisfaction in the long run would always act
rightly.
JOHN STUART MILL (1806-73)
▣ Successor as the leader of the utilitarians
and the most influential british thinker of
the 19th century.
▣ Mill sought to show that utilitarianism is
compatible with moral rules and
principles relating to justice, honesty, and
truthfulness by arguing that utilitarians
should not attempt to calculate before
each action whether that particular action
will maximize utility.
 ACT and RULE UTILITARIANISM
ACT UTILITARIANISM
▣ Looks at the consequences of each individual act and calculate utility
each time the act is performed.

RULE UTILITARIANISM
▣ Looks at the consequences of having everyone follow a particular rule
and calculates the overall utility of accepting or rejecting the rule.
EXAMPLE:
A prominent and much loved leader has been rushed to the hospital,
grievously wounded by an assassin’s bullet. He needs a heart and lung
transplant immediately to survive. No suitable donors are available, but
there is a homeless person in the Emergency Room who is being kept
alive on a respirator, who probably has only few days to live, and who is
a perfect donor. Without the transplant the leader will die; the homeless
person will die in a Few days anyway. Security at the hospital is very
well controlled. The transplant team could hasten the death of the
homeless person and carry out the transplant without the public ever
knowing that they killed the homeless person for his organ. WHAT
SHOULD THEY DO?
THANK
YOU!