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1

Moral & Ethical Concerns
A situation that has potentially undesirable
outcomes for a patient that requires application
of ethical principles.

1. The promotion & protection of people’s
genuine wellbeing & welfare (including
their interests in not suffering
unnecessarily)
2. Responding justly to the genuine needs &
significant interests of different people
3. Determining & justifying what constitutes
right & wrong conduct in a given situatio

2

ICN Code of Ethics
- 4 principal elements

1. Nurses and people
2. Nurses and practice
3. Nurses and the profession
4. Nurses and co-workers

3

1. Nurses and people

 The nurse’s primary responsibility is to the person
requiring care

4

2. Nurses and practice

 Nurse assumes responsibility and accountability for
their own practice

5

3. Nurses and the profession

 Actively engage with and contribute to the profession

6

4. Nurses and co-workers

 Sustains a collaborative and respectful relationship
with co-worker

7

These 5 ethical principles in the Code of Ethics allow moral
decisions in healthcare to be judged as appropriate or
not. Remember your first year ethics lectures:

Justice
Autonomy
Non-maleficence
Beneficence
Veracity

8

JUSTICE

 Based on the concept of fairness
 Fair allocation of health resources
 Considers the point of view of the least
fortunate members of society
 All people should be treated equally
unless there is justification for unequal
treatment

9

Autonomy

 The principal of autonomy = respect for the self
determination (or the choice) of the individual
 The principal of autonomy applies even if we
disagree with the individual’s choice or the
choice they make is not in their best interests
 The principle of autonomy does not apply if the
person is not competent to decide for themselves
 The principal of autonomy does not apply if the
individual’s choice impacts the moral interests of
others

10

Non-maleficence

The duty to “do no harm”
▪ Physical
▪ Psychological
▪ Spiritual
▪ Social
 Non-maleficence includes avoiding actual harm and
avoiding the risk of harm
 Ask, “Will this treatment cause more harm than
good?”

11

Beneficence

 The obligation to act for the benefit of others
 To promote welfare and well being, and
prevent harm
▪ Providing benefits
▪ Balancing benefits and harm
 Sometimes beneficence (or prevention of
harm) overrides autonomy or the person’s
ability to choose
▪ This is called paternalism

12

VERACITY

 Truthfulness
 Neither lying or deceiving
▪ Intentional lying
▪ Non-disclosure
▪ Partial disclosure
 It can be difficult to decide how much truth
to tell

13

Examples of dilemmas in
the clinical environment

 Moral boundaries of being ‘in relationship’
with patients
 How to help a patient/family when the
‘system’ appears to be against them
 How to help if colleagues are breaching
standards of care with patients
 Where to get help with nurse’s own moral
distress