Question

consider this: A common idea in health care is that if you are drawn to health care as a profession, you are inherently guided by an inner compass that is composed of a strong moral framework. Why is this a dangerous assumption?

Answer 1

Ethics are not optional in medicine: they are an essential and integral part of health care. A common ethical code for everybody involved in health care. It is potentially valuable and is to be welcomed, but the role and limitations of such a code need to be recognised.

Ethical behavior is not the display of one’s moral rectitude in times of crisis. It is the day-to-day expression of one’s commitment to other persons and the ways in which human beings relate to one another in their daily interactions.

An ethical code cannot provide the answer to specific ethical problems. Rather than dictating particular actions a code should describe the ethical environment for the delivery of health care and reflect its character and general approach. An ethical code should not try to make subjective aspects of care more objective or separate value from practical situations: it is in the nature of the work of professions that there remains individual responsibility for ethical practice. If challenged, ethical codes cannot explain why moral judgments should be made or give a firm justification for making those judgments; considered, individual moral judgments themselves are more basic and require no more profound reference.

Ethical codes can give shape and structure to our moral environment and summarise our ethical position while leaving ethical responsibility with the individual practitioner. Looked at in this way, individual variation and personal issues can be taken into account. An ethical code can facilitate the discussion of ethical issues in difficult cases, and distinctive ethical positions can be established and argued, leading to broader and more secure moral conclusions. An ethical code can describe the ethical attitudes that are shared by healthcare workers, and in this it can be immensely valuable and influential. But what it cannot do is provide the certain answers for the many ethical problems encountered in the course of medical practice.

Health care ethics ("medical" ethics or "bioethics"), at its simplest, is a set of moral principles, beliefs and values that guide us in making choices about medical care. At the core of health care ethics is our sense of right and wrong and our beliefs about rights we possess and duties we owe others.

Ethics, encountered in management, law, politics, media and medical field and that is one of the concept that is difficult to conduct precise definition, has always been an important part of healthcare service provision from past to present. Ethical perspective is needed in protecting and promoting human health in uncertain, high degree of difficulty and risky situations due to the nature of healthcare services.

Ethics is a set of values that is proposing to humans things to do or should not do. These values can be examined in four groups as manners homework, virtues, principles and interest of society. A Code of Ethics is an attempt to define basic rules, or principles for determining what constitutes "good" or "right" behavior. In other words, to determine what we ought to do next.

Ethics is”

• The discipline of dealing with what is good and bad, and with moral duty and obligation
• A set of moral principles or values
• The principles of conduct governing an individual or group

Provisions of the Code of Ethics for Nurses

1. The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
2. The nurse’s primary commitment is to the patient, whether an individual, family, group, or community.
3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
4. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.
5. The nurse owes the same duty to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
6. The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.
7. The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
8. The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.
9. The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.

Ethical Challenges
As a nurse, you may be caring for a patient with a terminal disease whose current plan of care seems futile; with endless painful treatments and procedures. The patient’s provider may view following the plan as an ethical responsibility to employ every technique that may possibly cure the patient’s problem. The provider may have a research interest in the treatment plan, or a professional interest in the outcome of prolonging life. The patient’s family may feel a responsibility to prolong the patient’s life. The most important perspective, the PATIENT’s, may be drowned out by all these conflicting perspectives. In some situations, the healthcare professional’s ethical responsibility is clear. The healthcare professional is obliged to advocate for the patient. Yet:

• What if the patient is unsure about what he wants?
• What if the patient is misinformed – can you educate the patient without persuading to your point of view or disrespecting his cultural values?
• What are the consequences for you if you advocate for the patient in opposition with the views of the provider and the patient’s family?

“Think About It” situations may not have one complete right answer that applies to every situation. Your professional role is to face, and not ignore, ethical challenges, to raise questions, and to identify resources that can facilitate ethical outcomes.
In some situations there may be more than one ethical course of action. However, the patient’s rights to choice, dignity, privacy, and safe care ALWAYS take priority

Healthcare organizations establish formal ethics committees to provide consultation on situations in which ethical issues have arisen. At the unit level, some clinicians have found it helpful to convene their own unit-based debriefing sessions in which staff members discuss specific patient situations. In one intensive care setting, clinicians implemented monthly debriefing meetings. Sessions include bioethicists, social workers, and chaplains, in addition to clinical personnel.

Ethical Principles
Four basic principles form the basis of moral thought in healthcare:

• Autonomy - Respect the uniqueness and dignity of each person, self, and others.
• Nonmaleficence - Prevent harm and removal of harmful conditions.
• Beneficence - Act to remove harm or promote benefit.
• Justice - Treat individuals equally.

A code of ethics identifies what colleagues should expect of each other within a profession and what the public should expect from the professional. A code of ethics is hallmark of a profession.