Nursing ethics
Nursing ethics is the discipline of
evaluating the merits, risks, and social concerns of activities in the field of
nursing. There are many defined codes of ethics for nurses .
Nursing ethics shares many principles
with other branches of health care ethics, such as beneficence and
non-maleficence, but also has a number of distinctions .
Nursing ethics is a branch of applied
ethics that concerns itself with activities in the field of nursing .
Nursing ethics respect for autonomy .
It can be distinguished by its emphasis on relationships , human dignity and collaborative care .
Human rights and Nursing practice
Ethics has been an integral part of
Nursing practice from the earliest foundations of modern Nursing in the late
nineteenth century. This has always entailed a respect for human rights of the
persons in their care. However, early attempts to define ethics in Nursing were
focused more on the virtues of the nurses themselves, rather than looking at
how the rights of the patient or client might be promoted in particular. In the
modern era, the ethics of Nursing has shifted more toward the promotion of
these rights and the duties of the nurse .
According
to the Universal Declaration of Human Rights, fundamental human rightsare
violated when, among other things .
1 - A
certain race, creed, or group is denied recognition as a person .
2 - Men
and women are not treated as equal .
3 - Different
racial or religious groups are not treated as equal .
4 - Life,
liberty or security of person is threatened .
5 - A
person is sold as or used as a slave .
6 - Cruel,
inhuman or degrading punishment is used on a person - such as torture or
execution .
7 - Victims
of abuse are denied an effective judicial remedy .
8 - Punishments
are dealt arbitrarily or unilaterally, without a proper and fair trial
9 - Arbitrary
interference into personal, or private lives by agents of the state .
10 - Citizens
are forbidden to leave or return to their country .
11 - Freedom
of speech or religion is denied .
12 - The
right to join a trade union is denied .
13 - Education
is denied .
Human Rights in Islam
1 - Security of Life and Property .
2 - The Protection of Honor .
3 - Sanctity and Security of Private Life .
4 - The Security of Personal Freedom .
5 - Right to Protest Against Tyranny .
6 - Freedom of Expression .
7 - Freedom of Association .
8 - Protection of Religious Sentiments .
9 - Protection from Arbitrary Imprisonment .
10 - The Rights to Basic Necessities of Life .
11 - Equality Before Law .
12 - Rulers Not Above the Law .
13 - The Right to Participate in the Affairs of the
State .
Distinctive nature
Although historically much of Nursing
ethics has been derived from medical ethics, there are some factors that
differentiate it from this. The key difference is that paternalism, which is
often a key feature in theories of medical ethics, is generally not compatible
with Nursing ethics . This is because Nursing theory seeks a collaborative
relationship with the person in their care. It therefore emphasises autonomy of
the person being nursed over paternalistic practice where the health
professional seeks to do what they believe to be in the person's or society's
best interests. Codes of conduct for nurses tend to be written in the ethical
framework of deontology and are therefore based on the rights of the patient
and the duties of the nurse rather than on utilitarian concerns of the
consequences justifying the action .
Development of subject
The nature of nursing means that
nursing ethics tends to examine the ethics of caring rather than 'curing' by
exploring the relationship between the nurse and the person in care . Early
work to define ethics in nursing focused more on the virtues that would make a
good nurse, rather than looking at what conduct is necessary to respect the
person in the nurse's care. However, recently, the ethics of nursing has also
shifted more towards the nurse's obligation to respect the human rights of the
patient and this is reflected in a number of professional codes for nurses . For
example, this is made explicit in the latest code from the International
Council of Nurses .
Distinctive nature
Although much of nursing ethics can appear
similar to medical ethics, there are some factors that differentiate it.
Generally, the focus of nursing ethics is more on developing a caring
relationship than concerns about broader principles, such as beneficence and
justice . For example, a concern to promote beneficence may be expressed in
traditional medical ethics by the exercise of paternalism, where the health
professional makes a decision based upon a perspective of acting in the
patient's best interests. However, it is argued by some that this approach acts
against important values found in nursing ethics . Nursing theory seeks a
collaborative relationship with the person in care. Brier-Mackie suggests that
nurses' focus on care and nurture rather than cure of illness results in a
distinctive ethics. Also, themes that emphasize respect for the dignity of the
patient by promoting choice and control over their environment are commonly
seen.
The distinction can be examined from
different theoretical angles. Despite the move toward more deontological themes
by some, there continues to be an interest in virtue ethics in nursing ethics
and some support for an ethic of care . This is considered by its advocates to
emphasise relationships over abstract principles and therefore to reflect the
caring relationship in nursing more accurately than other ethical views .
Common themes in Nursing ethics
Nurses seek to defend the dignity of
those in their care . In terms of standard ethical theory, this is aligned with
having a respect for people and their autonomous choices. People are then
enabled to make decisions about their own treatment. Amongst other things this
grounds the practice of informed consent that should be respected by the nurse .
Although much of the debate lies in the discussion of cases where people are
unable to make choices about their own treatment due to being incapacitated or
having a mental illness that affects their judgement. A way to maintain
autonomy is for the person to write an advance directive, outlining how they
wish to be treated in the event of them not being able to make an informed
choice, thus avoiding unwarranted paternalism.
Another theme is confidentiality and
this is an important principle in many nursing ethical codes . This is where information
about the person is only shared with others after permission of the person ,
unless it is felt that the information must be shared to comply with a higher
duty such as preserving life .
Also related to information giving is
the debate relating to truth telling in interactions with the person in care .
There is a balance between people having the information required to make an
autonomous decision and , on the other hand , not being unnecessarily
distressed by the truth . Generally the balance is in favour of truth telling
due to respect for autonomy , but sometimes people will ask not to be told , or
may lack the capacity to understand the implications .
By observing the principles above, the
nurse can act in a way that respects the dignity of the individual in their
care, although this key outcome in nursing practice is sometimes challenged by
resource , policy or environmental constraints in the practice area .
More so, the nurse's role is one of
advocate for the interests of the people in their care. In terms of ethical
theory, this means having a respect for the autonomy of the person to make
decisions about their own treatment and be provided with information available
in order to do this. So the principle of informed consent, where a person
understands fully the implications of having or refusing a treatment, is one
which is held in the nurse's mind when suggesting treatment options. (Rumbold
1999) This principle is not absolute as people are sometimes unable to make
choices about their own treatment due to being incapacitated or having a mental
illness that affects their judgement. This means that the nurse has to weigh
their duty of care against the autonomy of the person in care .
Other common themes are that of truth
telling in interactions with the person in care. This, however, also has to be
weighed against any unnecessary harm that may be caused by divulging the
information. Confidentiality is also an important principle in many Nursing
ethical codes. This is where information about the person is only shared with
others after permission of the person, unless it is felt that the information
must be shared to comply with a higher duty such as preserving life - Rumbold
1999 .
Nurses are interested in the quality
of life of the people in their care. In medical ethics theories, this can be
measured by QALYs. However, this is highly controversial as it is very
difficult to measure the quality of someone else's life lively and this can be
particularly difficult if the person in care is unable to communicate their
need , such as when they are unconscious or in a vegetative state .
.jpg)
0 التعليقات:
إرسال تعليق