This paper will discuss the theories of ethics as they are applied to quality healthcare and the preservation of the principles of confidentiality based on trust existing between patient and nurse. These ethical values are patterned from the Hippocratic oath which is used as the standard of care for physicians and were adopted by Florence Nightengale, founder of the modern nursing practice. The basic ethical values are commitment to patient, respect for human dignity, and patient’s right to privacy.
Ethics are defined as a system of moral principles, the study of values relating to human conduct, and a person’s judgment of what is right or wrong. The Nursing Code of Ethics requires that we, as nurses, provide quality health services to our patients while protecting their right to human dignity and privacy or confidentiality. Ethics are viewed as a way of deciphering between right and wrong and using moral reasoning to make decisions. Is it right to cheat on a test or falsify documents as long as no one knows? Moral reasoning may be affected by our childhood experiences and training or religious beliefs. We use personal values to make decisions and solve dilemmas such as “what should I do if my baby is sick and needs me at home, but there is a shortage of staff at work and I’m needed there too”. Maternal values say that you should remain with your child, but work ethics say that you should go to work. We often are required to make a choice of two unfavorable alternatives. This presents a stressful situation for the nurse who usually must act promptly and be able to defend her decision if requested.
B. IMPORTANCE OF ETHICAL THEORY AND EXAMPLES -The two types of ethical theories used most often in solving ethical dilemmas are utilitarianism and deontology. Using the system of utilitarianism, also called situation ethics, the nurse will make decisions according to the situation and determine if her decision will create greater happiness for more people than any other alternative. Often she will make comparisons of risks to benefits in any given case. This could probably be successfully used in the case of a patient who had several treatment alternatives and one or more had greater risks but more benefits. This would not be beneficial in the instant case study because the patient does not desire any treatments and only wants privacy and confidentiality. Therefore, unless the nurse could discuss with her the benefits of treatment and have her recognize the benefits of discussing the treatment plans with her husband, this decision making process would not be effective.
The theory of deontology is a system of decision making based on moral rules and unchanging principles. It is based on duty and obligation and does not change according to the situation but remains steadfast in its emphasis on moral obligation to patients.
Other theories of ethics used in nursing practice are consequentialism, ethics of care, and virtue ethics. In consequentialism, we make moral judgments according to the outcome or consequences and believe that it is morally right if it has a favorable outcome. In ethics of care, we consider the importance of caring to build good relationships and friendships. Virtue ethics promotes the character of the nurse and says that nurses should be truthful and honest in their relationship with patients.
The basic principles and concepts of medical ethics are autonomy, beneficence, nonmaleficense, justice, fidelity, veracity and confidentiality. The principle of autonomy means respecting the individual’s right to make her own decision. The patient has the right to make her own decision even though the medical staff may disagree. Autonomy is acceptable except when the patient has a contagious disease and treatment is required by law. In the present case study, the patient is seeking autonomy in making her own decision about her refusal of treatment and seeks privacy and confidentiality in her...