Chapter 2
Thoughtful practice
21
Common ethical principles
The following common ethical principles may be used to
validate moral claims.
Autonomy
This word is derived from the Greek words autos (‘self’) and
nomos (‘rule’ or ‘law’), and therefore refers to self-rule. In
contemporary discourse it has broad meanings, including
individual rights, privacy and choice. Autonomy entails the
ability to make a choice free from external constraints.
Beneficence
Beneficence is the duty to do good and the active promotion
of benevolent acts (eg, goodness, kindness, charity).
It may also include the injunction not to inflict harm (see
Non-maleficence).
Confidentiality
Confidentiality relates to the concept of privacy. Information
obtained from an individual will not be disclosed to another
unless it will benefit the person or there is a direct threat to
the social good.
Double effect
The double effect principle may morally justify some actions
that produce both good and evil effects.
All four of the following criteria must be fulfilled:
1. The action itself is good or morally neutral.
2. The agent sincerely intends the good and not the evil effect
(the evil effect may be foreseen but is not intended).
3. The good effect is not achieved by means of the evil effect.
4. There is proportionate or favourable balance of good over
evil.
Fidelity
Fidelity is promise keeping; the duty to be faithful to one’s
commitments. It includes both explicit and implicit promises
to another person.
Justice
From a broad perspective, justice states that like cases
should be treated alike. A more restricted version of justice
is distributive justice, which refers to the distribution of social
benefits and burdens based on various criteria that may include
the following:
Equality
Individual need
Individual effort
Societal contribution
Individual merit
Legal entitlement.
Retributive justice is concerned with the distribution of
punishment.
Non-maleficence
Non-maleficence is the duty not to inflict harm as well as
to prevent and remove harm. It may be included within the
principle of beneficence, in which case non-maleficence would
be more binding.
Paternalism
Paternalism is the intentional limitation of another’s autonomy,
justified by an appeal to beneficence or the welfare or needs
of another. Under this principle, the prevention of evils or harm
takes precedence over any potential evils caused by interference
with the individual’s autonomy or liberty.
Respect for people
Respect for people is frequently used synonymously with
autonomy. However, it goes beyond accepting the notion or
attitude that people have autonomous choice, to treating others
in such a way that enables them to make choices.
Sanctity of life
The sanctity of life principle proposes that life is the highest
good. Therefore, all forms of life, including mere biological
existence, should take precedence over external criteria for
judging quality of life.
Veracity
Veracity is the obligation to tell the truth and not to lie or
deceive others.
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Ethics and related matters
Nursing codes in Australia and New Zealand
Code of Ethics for Nurses in Australia
1. Nurses value quality nursing care for all people.
2. Nurses value respect and kindness for self and others.
3. Nurses value the diversity of people.
4. Nurses value access to quality nursing and healthcare for all
people.
5. Nurses value informed decision making.
6. Nurses value a culture of safety in nursing and healthcare.
7. Nurses value ethical management of information.
8. Nurses value a socially, economically and ecologically
sustainable environment promoting health and well-being.
Code of Conduct for Nurses in New Zealand
PRINCIPLE 1 Respect the dignity and individuality of health
consumers.
PRINCIPLE 2 Respect the cultural needs and values of health
consumers.
PRINCIPLE 3 Work in partnership with health consumers to
promote and protect their well-being.
PRINCIPLE 4 Maintain health consumer trust by providing safe
and competent care.
PRINCIPLE 5 Respect health consumers’ privacy and
confidentiality.
PRINCIPLE 6 Work respectfully with colleagues to best meet
health consumers’ needs.
PRINCIPLE 7 Act with integrity to justify health consumers’
trust.
PRINCIPLE 8 Maintain public trust and confidence in the
nursing profession.
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