NR 222 Week 2 Key Ethical Principles of Nursing

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Chamberlain University

NR-222 Health & Wellness

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Key Ethical Principles of Nursing

Nursing ethics represents the framework of moral values and professional standards that guide nurses in their daily practice. These principles help ensure that nurses provide safe, compassionate, and respectful care while protecting patients’ rights and dignity. Ethical guidelines not only shape professional accountability but also strengthen trust between healthcare providers and patients. The following sections outline the fundamental ethical principles of nursing, supported with examples that highlight their practical application in clinical settings.

Non-Maleficence

Non-maleficence refers to the duty of healthcare professionals to “do no harm.” Nurses are expected to perform their responsibilities with competence and vigilance to prevent injury, suffering, or unnecessary risk to patients. They are also ethically obligated to report unsafe practices, suspected abuse, or impaired colleagues to protect patient welfare.

Example: If a nurse notices a colleague administering incorrect medication doses due to impairment, they must promptly report the concern to prevent patient harm and ensure corrective action.

Beneficence

The principle of beneficence emphasizes acting for the good of the patient. Nurses are called to advocate for patient needs and promote their overall well-being. This includes supporting patients in making informed choices and providing care that maximizes benefits while minimizing risks.

Example: If a patient hesitates to ask questions about a surgical procedure, the nurse should step in to clarify the information, ensuring that the patient feels confident and supported in making an informed decision.

Autonomy

Autonomy underscores patients’ right to make independent decisions about their healthcare. Nurses must respect patients’ wishes, even when those choices differ from the provider’s recommendations, as long as they do not place the patient at severe risk. Respect for autonomy also involves honoring legal documents such as living wills or advance directives.

Example: In accordance with the Patient Self-Determination Act of 1990, nurses must respect a patient’s advance directive that specifies preferences for life-sustaining treatments.

Justice

Justice refers to fairness, equality, and impartiality in delivering healthcare. Nurses must ensure that care is distributed without favoritism, prejudice, or discrimination. This principle becomes particularly challenging when resources are limited, requiring ethical decision-making to balance fairness with necessity.

Example: When free medical procedures, such as corrective surgeries, are available to only a small number of patients, nurses and providers must develop fair criteria to determine who should receive the treatment.

Fidelity

Fidelity highlights loyalty, faithfulness, and honesty in the nurse–patient relationship. Nurses are responsible for maintaining confidentiality, being truthful when appropriate, and fostering trust. Patients rely on nurses to uphold promises and commitments, even in difficult situations.

Example: If a patient requests that their medical diagnosis not be disclosed to family members, the nurse must respect and uphold the patient’s confidentiality, unless disclosure is legally mandated.

Paternalism

Paternalism occurs when a healthcare provider makes decisions on behalf of a patient, believing it to be in the patient’s best interest. While it may be well-intentioned, paternalism can conflict with autonomy if not carefully balanced. Nurses must ensure that paternalistic actions are guided by beneficence and respect for the patient’s values.

Example: A patient undergoing chemotherapy may doubt whether to continue due to harsh side effects. While the nurse may advise continuation based on the potential benefits, the patient’s autonomy must remain central to the decision-making process.

Principles of Totality and Integrity

This principle highlights the importance of holistic care, considering the patient as a whole rather than focusing only on disease or symptoms. Nurses must recognize the interconnectedness of physical, psychological, social, and spiritual aspects of health when planning care.

Example: Before developing a treatment plan, nurses should assess not only a patient’s medical needs but also their emotional support systems, family dynamics, and cultural values to ensure a comprehensive approach.

Table of Ethical Principles in Nursing

Ethical Principle	Definition	Example
Non-Maleficence	Avoiding harm and ensuring competence in care delivery.	Reporting an impaired or incompetent healthcare provider to safeguard patient safety.
Beneficence	Acting in ways that promote the patient’s best interests and well-being.	Advocating for a patient who feels hesitant to ask questions about a treatment procedure.
Autonomy	Respecting the patient’s right to self-determination in healthcare decisions.	Honoring advance directives under the Patient Self-Determination Act of 1990.
Justice	Ensuring fairness and equality in the distribution of healthcare resources.	Determining fair allocation of limited surgeries in low-income communities.
Fidelity	Demonstrating loyalty, honesty, and confidentiality in patient care.	Respecting a patient’s wish to keep a diagnosis private from family members.
Paternalism	Making decisions for the patient with the intent of protecting their interests.	Advising continuation of chemotherapy while respecting the patient’s right to make the decision.
Principles of Totality & Integrity	Addressing the patient’s holistic needs—physical, emotional, and social.	Considering a patient’s overall well-being before designing a care plan.

References

American Nurses Association. (n.d.). Code of ethics for nurses with interpretive statements. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

NR 222 Week 2 Key Ethical Principles of Nursing

Butts, J. B., & Rich, K. L. (2022). Nursing ethics: Across the curriculum and into practice (6th ed.). Jones & Bartlett Learning.