Nursing Ethics

Nursing Ethics

Introduction to the Study of Ethics

Ethics is the exploration of moral thinking, where rational thought leads to making good decisions, even when faced with conflicting values. The development of our intellectual capacity and ethical reasoning has shaped human society throughout history, touching every aspect of life. Medical ethics, or bioethics, is a relatively recent field that delves into the moral and ethical aspects of research, technology, and decision-making within healthcare.

Understanding Ethics

Ethics isn’t just about distinguishing right from wrong or good from evil. It’s a process used by individuals to balance benefits and consequences, personal and shared values, and fundamental truths when confronted with moral dilemmas. Nursing Ethics follows the same principles.

What is an Ethical Dilemma?

An ethical dilemma arises when you’re forced to choose between equally unsatisfactory alternatives, leading to a distressing decision. Unlike situations with clear rules and guidelines, dilemmas are harder to resolve. They occur when no option leads to an acceptable outcome and any choice results in harm.

Consider this ethical dilemma:

You’re a parent with two children. One falls seriously ill and needs life-saving treatment. The only available treatment involves using the other child as a donor, putting both children at risk. You love them equally but must make a choice.

1. What makes this situation an ethical dilemma?
2. Faced with this dilemma, what decision will you make?

Historical Roots of Nursing Ethics

The origins of contemporary ethics trace back to early societies and their writings, influenced by classical philosophy, theology, and sociology.

The Pentateuch, the first five books of the Bible, contains some of the earliest moral principles. Early Christians turned these principles into the Mosaic Law, providing explicit guidance for living according to God’s law.

The Code of Hammurabi

King Hammurabi of Babylon (1800 B.C.) addressed complex moral and social issues by creating laws, known as The Code of Hammurabi. These laws extended beyond divine commandments and were the first expression of civil rights and liberties. They included protection for women and slaves, legal regulations, fixed service rates, and property rights, still relevant in modern legal systems.

Medical/Nursing Ethics

Nursing Ethics is rooted in professional codes of conduct, such as:

– The Greek Hippocratic Oath, which emphasizes doing good and avoiding harm.
– The Nightingale Pledge, a nursing-specific oath outlining duties and principles.
– The Nuremberg Code, applied to research ethics after Nazi Germany, protecting subjects in research and experimentation.

Classic Greek Philosophers

Plato (427-347 B.C.) laid the foundation for “virtue” theory, focusing on character and virtue over outcomes. Virtuous intent is essential, even if the result is not ideal.

Aristotle (384-322 B.C.) expanded Plato’s ideas, emphasizing intellectual development and moral virtue. He saw two aspects of virtue: intellectual virtue, governing thought, and moral virtue, shaped by intent and practical reason.

Early Christian Ethicists

St. Augustine (354-430 A.D.) adopted Christianity as an adult, emphasizing God’s grace as the solution to human weakness. He debated whether humans are inherently good or evil due to societal influence.

St. Thomas Aquinas (1224-1274 A.D.) believed laws exist to shape inherently good people, in line with Natural Law, stating that humans are fundamentally good as creations of a good God.

The Renaissance Thinkers

Hobbes (1588-1679) bridged the Middle Ages and the Renaissance, viewing law as functional rather than religious. He introduced egoism, where individuals work for self-interest but cooperate for prosperity.

Hume (1711-1776) was an empirical thinker, proposing moral sense theory, where individual moral sense determines right and wrong.

Kant (1724-1804) developed a principle-based ethic rooted in reason, valuing goodwill toward others and considering the good of the whole over individual needs.

Professional Codes of Ethics

Most professions have codes of ethics to guide practice. Nursing Ethics follows the American Nurses Association (ANA) Code, ensuring trustworthiness and competence.

Ethics Committees

Hospital ethics committees (HECs) assist healthcare professionals in resolving ethical dilemmas. While not binding, their recommendations offer guidance for patients, families, and staff facing ethical healthcare decisions.

Conclusion

Nursing Ethics, like ethics in general, stems from centuries of philosophical, theological, and sociological discourse. Moral thought and ethical reasoning are fundamental in making ethical decisions, addressing moral and social issues arising from ethical dilemmas.

Nursing Ethics References

Dilemma. (n.d.). In Merriam-Webster’s online dictionary. Retrieved August 26, 2008, from http://www.merriam-webster.com/dictionary/dilemma

Caplan, A.L, & McGee, G. (2004). An introduction to bioethics. American Journal of Bioethics. Retrieved July 30, 2008.

Law Research Services. (n.d.). The Code of Hammurabi (L. W. King, Trans.). Retrieved from http://www.lawresearchservices.com/admin/CodeHam.htm

Maricle, K. (1997). Ethics committee core curriculum−JCAHO: Patients rights and organizational ethics. Retrieved August 1, 2008, from http://wings.buffalo.edu/faculty/research/bioethics/man-jcah.html

Rae, S. B. (2000). Moral choices: An introduction to ethics (2^nded.). Grand Rapids, MI: Zondervan.