The term ethics is derived from the Greek word "ethos" meaning "character"
and is defined as "moral principles that govern a person's or group's behavior".
Nursing ethics first appeared in textbooks in the late 19th century. Isabel
Hampton Robb, the founder of modern nursing theory, authored one of the first
texts on nursing ethics. Nursing ethics initially encompassed
virtues that were
desired in a nurse. At the time, these virtues included physician loyalty,
commitment to high moral character and obedience. As the nursing profession
evolved, nurses gradually embraced patient advocacy. As patient advocates,
nurses work as part of an interdisciplinary team to provide patient care.
Nursing ethics have kept pace with the advancement of the nursing profession
to include a patient-centered focus, rather than a physician-centered focus.
Nursing ethics differ from medical ethics because of their focus on caring,
rather than curing.
Ethics in Nursing Practice
Ethics are important to the nursing profession. They guide nurses in their practice
on a daily basis. They help nurses distinguish between right and wrong when the correct
path is unclear. Ethical dilemmas may arise out of patient care situations or interactions
with co-workers. At times, nurses may be asked to do things by other health care providers
or employers that are out of their comfort zone. Ethics can also come into play when a
nurse is off-duty. Nurses may find themselves in a position to make an ethical choice to
provide care to a stranger should they come upon a car wreck or should a fellow airplane
passenger experience a heart attack. A nurse may not be legally bound to provide care,
but may have an ethical obligation to help. These situations are times when nurses must
employ their personal and professional ethical decision making skills to determine how
they should respond.
Nurses may find it necessary to employ ethical decision making as part of the nursing
process throughout the day. To aid in ethical decision making, many hospitals have an
ethics board. The ethics board is a committee of health care providers who help to
resolve ethical issues that arise in hospitals. Nurses can use the ethics board as
a resource if they are faced with a situation that calls their personal morals into
question. Nurses can also employ ethical reflection techniques. Ethical reflection
aids nurses in identifying personal biases and reinforces moral foundations. Nurses
who use ethical reflection may be better prepared while encountering ethical dilemmas
on a day to day basis.
Nursing students learn about ethics during the course of their nursing education. Depending
on the school, student nurses can choose to earn a minor or certificate in ethics. Graduate
nursing students may choose to write a thesis or dissertation on an ethical component of
nursing practice. Students with additional education in ethics will be knowledgeable about
different ethical theories including virtue ethics, ethics of care and deontological ethics.
Nurses who are knowledgeable about ethical theories may be better prepared for ethical nursing
practice as they will have a more thorough knowledge of which ethical approach will be most
appropriate in a given situation.
Professional Organizations and Nursing Ethics
National and international nursing organizations provide ethical guidelines for nurses.
Two of the largest nursing organizations, the International Council of Nurses and American
Nurses Association provide a code of ethics for nurses. Ethical guidelines are also
provided by the State Boards of Nursing. While professional ethical codes vary, common
themes include confidentiality, dignity and respect. When ethical guidelines are breached
there is a potential for criminal or civil liability depending on the situation. Nurses
may also be sanctioned by the State Board of Nursing or be fired by their employer for a
breach of ethics.
Ethical nursing practice is enhanced through collaborative discussion at conferences and
conventions. The Ethics of Caring collaboration has been stimulating ethical discussions
and providing ethical education for nurses and other healthcare providers since 1993. The
Ethics in Caring Annual Conference is a multi-disciplinary symposium in the Los Angeles area.
Conference attendees can meet with healthcare providers from across the country and share
ethical issues, ideas and dilemmas.
Nursing ethics will remain an important aspect of the nursing profession. Ethical dilemmas
will continue to be encountered by nurses in the course of their careers. Current ethical
hot topics in nursing include assisting in abortions, flu-shot requirements for nurses and
end-of-life issues. Nurses should be familiar with the ethics of the nursing profession,
but also be comfortable with their own ethical code. Nurses who can find agreement between
personal and professional ethics will be most successful at maintaining their integrity and
moral character. Nurses who are comfortable with their morals and let ethics guide their
decisions will be well equipped to provide patient care.