An Introduction to

Ethics and the Law

A Perspective for Nurses

Chapter 1

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 Nurses must have knowledge of ethics and
the law, as this is important to the practice
of nursing. This knowledge includes
How ethics in nursing has evolved over the
past century.

The role of nurses as professionals.

Introduction
How ethical reasoning and shifting societal
values influence and shape the law.

The complex ethical and legal challenges

that nurses face in their practice.

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 Watch
https://www.youtube.com/watch?v=6wQWkKQ0ZMg
Introduction
to Ethics

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LEARNING OUTCOMES
1. Understanding the intersection between nursing
and ethics
2. Describe the connection between theories of
The Good Life and Ethics
3. Discuss the relationship between Ethics and
Religion / Ethics and Human Nature

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 Evolution of Ethics in Nursing
(1 of 2)
Early 20th Century
• Florence Nightingale 1860
• Emphasis on character, virtues, moral conduct
• Advocacy for specific patients
• Institutional focus on safe care.
• Recognition of the moral foundation of care and the influence of caring on healing

Early 21st Century

• Additional focus on addressing complex ethical challenges and professional behaviour
• Strong advocacy role for individual clients, families and broader health care system
• Professional regulation including established standards, legal and ethical frameworks
• Development of Nursing theory and knowledge regarding an ethic of care

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 Evolution of Ethics in Nursing (2 of 2)

Early 20th Century

• Limited recognition of the importance of family

• Early recognition of the importance of environment, poverty etc.
• Deference to authority. Loyalty to physician and superiors
• Passive, expectation to follow orders and rules

Early 21st Century

• Person and Family Centred Care

• Strong emphasis on social justice, respect for differences and the values and beliefs
of others
• An autonomous profession, a collaborative, respectful member of the health care
team
• Focus on critical thinking with an evidence informed approach to care. Assertive,
respectfully challenge plans that are ineffective or harmful

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 Nurses the Law and Ethics
Professions Including Nursing…

Have an obligation to serve the public interest and the common

good

Possess a unique body of knowledge

Have multiple accountabilities

Are trusted to engage in decisions that influence and shape public

policy, law, and societal norms

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Why Should Nurses Study Ethics? (1 of 2)

Morality and care is at the heart of nursing theory and practice

Care is a moral imperative for nurses who as moral agents are

accountable for knowing what is right and wrong in their practice

To ensure awareness of and identification of the ethical issues at a

client, leadership, organizational and system level

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Why Should Nurses Study Ethics? (2 of 2)

Clarify and justify

actions
To support a position
or perspective on a
complex issue Understand the moral
context of the values
and beliefs of self and
To ensure a shared others
language, knowledge
and understanding of
the issues
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 Moral Justification

Nurses Must Understand and Have Knowledge of:

Ethical Theories  Their Meaning for Nurses:

• Ethical Theory and principles and the influence of values on

ethical decision-making

Available Resources that Guide Ethical Practice

• The CNA Code of Ethics for Registered Nurses

• Ethical Decision-Making Models and processes
• Ethics Committees

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Why Must Nurses Know the Law?
• Failure to understand professional responsibilities and standards
places nurses at risk of disciplinary or legal action

• Complex situations can arise before laws, such as Medical

Assistance in Dying, are made to address them

• Nurses have legal obligations to their patients

• Nurses have legal rights that must be protected

• The law holds nurses to a high standard that is regulated through

professional self-governing bodies

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 Legal Knowledge

The Canadian Legal System:

• The court systems

• The journey to legislation
• Canada Health Act, Charter of Rights and Freedoms
• The Nurse’s Legal Accountabilities, including:
Professional Competence, Misconduct, and
Malpractice

The Regulation of the Nursing Profession:

• Legal and Organizational Structure of Nursing Bodies

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Complex Ethical and Legal Issues (1 of
3)

Nurses Face Many Challenges in their Practice Including:

• Informed Consent  Rights and Obligations
• Challenges with Children and the Mentally Ill

• Complexity at the End of Life  The Ethical and Legal Challenges

• Medical Assistance in Dying
• Organ Donation

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Complex Ethical and Legal Issues (2 of 3)

• Ethical and Legal Issues Related to Advancing Science and

Technology, including:

• Genetics, Genomics and Gene Editing

• Stem Cell Technologies
• Reproductive Technologies

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 Complex Ethical and Legal Issues (3 of
3)

• Including those • Violence in the

most vulnerable; Workplace
Indigenous • Occupational
Safeguarding People, LGBTQ2 Perspectives Health and Safety
Patient communities, on the Rights • Collective
Rights children and of Nurses
seniors Bargaining
• Person Centred • Healthy Work
Care Environments

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 The Intersection of Ethics
and the Law

Respect for autonomy • Dilemmas arise when autonomy and

led to legislation the law conflict with what health
regarding consent, professionals think would be in the
capacity and privacy. person’s best interests.

Respect for individual

rights, compassion • Some believe this conflicts with the
and well-being led to principle of sanctity of life.
Medical Assistance in • Raises issue of conscientious objection.
Dying.

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 A strong understanding of ethics and the law
assists nurses in meeting high standards of
care and in making and defending their
choices.

Nurses are then able to:

• Defend and protect patients’ rights
Summary • Promote compassionate care
• Enhance the dignity and autonomy of
their clients
• Understand their rights and
responsibilities within a challenging and
complex health care environment.

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 Chapter 1: Critical Thinking Discussion
Points Review Questions
1. What informed your decision to become a professional nurse?

2. Identify what personal values you think you share with the nursing profession.

3. Describe an ethical dilemma you have experienced in your life or as a student or nurse. What position
did you take, and why? Did your personal values help you address this issue?

4. Before you became a nursing student, were you expecting to discover that there are significant ethical
and legal challenges associated with the nursing profession?

5. Describe an encounter that you or your family have had with the health care system. Examine you or
your family’s experience with the health care system. Was this a positive experience or a negative
experience? What factors influenced this perspective? What changes would you make to this experience?

6. In your opinion, what is the most significant legal issues that nurses may encounter? What do you think
are the two most significant ethical issues that a nurse may face?

7. If you were a patient or client today, what would you expect from the nurses caring for you? If a member
of your family were a patient or client today, what would be your expectations? As a nurse or a nursing
student, do you meet these expectations?

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