Question

Give examples of how the major principles of health care ethics (autonomy, beneficence, nonmaleficence, justice, and fidelity) are incorporated into your daily nursing practice.

Answer 1

Ethics in nursing are based upon the American Nurses association(ANA,2001) which includes ANA Code of Ethics for Nurses with interpretive statements. These ethics must ensure advocacy for the patient, dedication to duty and honesty between patients and healthcare professionals. The major principles of healthcare ethics are fundamental to nursing includes: Autonomy, beneficence, nonmaleficence, justice and fidelity.

1. Autonomy: Autonomy is derived from words auto which means self and nomos means rule, governance or law. Thus autonomy means ability to self-rule and make independent decisions. In nursing it implies as obtaining informed consent of patients for treatment; accepting patient’s refusal of treatment;diagnosis, and treatment options to patients which are kept confidential. In case of communicable diseases or acts of violence which can harm others, patients lose their basic rights to self determination (autonomy). Autonomy must ensure the patients welfare and respects their decisions.
2. Beneficence: Beneficence principle in nursing practice is based upon the acts of mercy and kindness. In nursing practice implies that nurses take actions to benefit patients to aid their well being. The example includes subtle lifting side rails on the patients bed to prevent falls, taking time to make phone calls for a frail elderly patient and or othe subtle actions.

1. Nonmaleficence: Nonmaleficence literally means “do not harm” i.e. prevent any injury or damage to patient. It is based upon Hippocrates’ oath . In nursing practice it includes avoiding negligent care, making decisions regarding withholding or withdrawing of a treatment (which might include any extraordinary treatment as well).

1. Justice: Justice in nursing practice is measured in terms of fairness, equality, need and any of the criterions subject to justice decision. In nursing practice most often it refers to the distribution of scarce healthcare resources. Most of the time difficult resource allocations decisions are based on attempts to answer questions regarding who has a right to health care and who will pay for healthcare costs.
2. Fidelity: Fidelity basically means trust and faithfulness it also include dedication advocacy and fairness to patients. For example: A patient requests to keep confidential his terminal ailments to his family (distant or close). In view of his family might try keeping him alive in any of agonizing circumstances. In this case the nurse must ensure confidentiality of the patient’s reports but still support his/her family.