Textbook of Medical-Surgical Nursing 3e

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Chapter 2   Thoughtful practice

CHART 2-2

Common ethical principles

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.

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 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 Non-maleficence). Confidentiality

Ethics and related matters Nursing codes in Australia and New Zealand

CHART 2-3

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.