essay on nursing ethical principles

7 Main Ethical Principles in Nursing + Why They’re Important

Are you a nurse with a genuine desire to give the best care possible to patients and their families and to become a strong member of your nursing team? Maybe you are a nursing student eager to learn as much as possible to help you succeed in nursing. If so, the most important lesson you can learn is how to establish ethical nursing practices. There are several ways to demonstrate strong ethics, and knowing the main ethical principles of nursing is a great place to start. Perhaps you are wondering, "What are the 7 main ethical principles in nursing, and why they are important?” In this article, you will learn about ethical nursing principles and how they apply to you. As you continue reading, you will find an in-depth look at the 7 main ethical principles in nursing, why they’re important, and examples of how they are applied in the four main areas of nursing.

What Exactly Is An Ethical Principle In Nursing?

What is the source of ethical principles in nursing, 7 reasons why ethical principles are so important in nursing, how many ethical principles are there in nursing.

1. Accountability 2. Justice 3. Nonmaleficence 4. Autonomy 5. Beneficence 6. Fidelity 7. Veracity

Are There Any Conflicting Ethical Principles In Nursing?

What are the 7 main ethical principles in nursing and why they are important, 5 most common challenges you will face while applying the 7 ethical principles in nursing and how to overcome them, challenge #1: knowing where to draw the line between autonomy and beneficence, what is it:, how to overcome:, challenge #2: deciding whether to withhold information or be honest about a patient’s status or prognosis, challenge #3: supporting autonomy related to informed consent, challenge #4: keeping promises when your circumstances change, challenge #5: determining if nonmaleficence overrules a patient’s right to privacy, my final thoughts.

What is the Nursing Code of Ethics?

History of the nursing code of ethics.

• 4 Ethical Principles in Nursing

Nursing Code of Ethics Interpretive Statements

Making ethical decisions as a nurse, how nurses use the nursing code of ethics.

According to the American Nurses Association (ANA) , the nursing code of ethics is a guide for “carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.”

Ethics, in general, are the moral principles that dictate how a person will conduct themselves. Ethical values are essential for ALL healthcare workers, but ethical principles in nursing are particularly important given their role as caregivers.

There are 4 main principles that are part of the nursing code of ethics. They are:

• Autonomy in Nursing
• Beneficence in Nursing
• Non-maleficence

These principles are ideally what every nurse should be aware of in their daily nursing practice. While ethical principles are sometimes confusing and often taught briefly during undergraduate nursing -- they should be constants in nursing practice in order to provide the best, safest, and most humane care to all patients.

Interestingly, the nursing code of ethics is suggested to have been founded in 1893 and named the “Nightingale Pledge” after Florence Nightingale , the founder of modern nursing. As a modification of the Hippocratic Oath, taken by medical doctors, the Nightingale Pledge has been recited by nursing students at graduations with little changes since inception. 

The formal code of ethics was developed in the 1950s by the American Nurses Association (ANA) and has undergone numerous modifications since. The most significant recent change was in 2015 when 9 interpretative statements or provisions were added to the code of ethics to help guide nursing practice in a more definitive way. 

Many states include the ANA’s nursing code of ethics in their practice statements. Even though the code of ethics is primarily ethics-related, it also has legal implications. Given the importance of the code to the nursing profession, revisions continue on a regular basis.

4 Ethical Principles in Nursing 

1. autonomy .

Autonomy is recognizing each individual patient’s right to self-determination and decision-making. As patient advocates, it is imperative that nurses ensure that patients receive all medical information, education, and options in order to choose the option that is best for them. This includes all potential risks, benefits, and complications to make well-informed decisions. 

Once the patient has all the relevant information, the medical and nursing team can make a plan of care in compliance with the medical wishes of the patient. 

It is important that nurses support the patient in their medical wishes and ensure that the medical team is remembering those wishes. Sometimes, nurses will need to continue to advocate for a patient despite the wishes being verbalized because the medical team might not agree with those wishes.

Many factors may influence a patient's acceptance or refusal of medical treatment, such as culture, age, gender, sexual orientation, general health, and social support system.

2. Beneficence

Beneficence in nursing is acting for the good and welfare of others and including such attributes as kindness and charity. The American Nurses Association defines this as “actions guided by compassion.”

Justice is that there should be an element of fairness in all medical and nursing decisions and care. Nurses must care for all patients with the same level of fairness despite the individual's financial abilities, race, religion, gender, and/or sexual orientation. 

An example of this is when working at a free flu clinic or diabetes screening clinic. These are open to all individuals in the community regardless of the previously mentioned factors.

4. Nonmaleficence 

Nonmaleficence is to do no harm. This is the most well-known of the main principles of nursing ethics. More specifically, it is selecting interventions and care that will cause the least amount of harm to achieve a beneficial outcome

The principle of nonmaleficence ensures the safety of the patient and community in all care delivery. Nurses are also responsible for reporting treatment options that are causing significant harm to a patient, which may include suicidal or homicidal ideations. 

Revised in 2015 to include 9 provisions, the ANA’s nursing code of ethics now includes interpretative statements that can provide more specific guidance for nursing practice.

9 Provisions of the Nursing Code of Ethics 

Currently, the nurse’s code of ethics contains 9 main provisions:

• The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.
• The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.
• The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.
• The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.
• The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.
• The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.
• The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.
• The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.
• The profession of nursing, collectively through its professional organization, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

The aforementioned nine provisions were implemented to help guide nurses in ethical decision-making throughout their practice. 

Unfortunately, nurses are often unable to make complex ethical decisions based solely on the four principles and nine provisions. In these instances, it is important to consult the ethics committee before making any major decisions. Often, other resources are needed when making major ethical decisions.

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Knowing the nursing code of ethics is essential for nurses because it will help guide everyday practice and navigate the daily complexities of the healthcare profession. Nurses often use the four major ethical principles throughout a shift, even if not fully aware of them. 

This may include,

• Providing pain medication to a post-operative hip replacement
• Holding the hand of a dying patient who is alone
• Advocating for the patient that wants to end chemotherapy and enter hospice care

Nursing is consistently regarded as the most honest and ethical profession and practicing with the nursing code of ethics is essential to ensuring that patients and their families receive the care they have come to know and expect. Utilizing the ethical codes of justice, nonmaleficence, autonomy, and beneficence on a daily basis allows nurses to provide the safest and most compassionate care for their patients. 

What are the five codes of ethics in nursing? 

• The 5 nursing ethic codes are: nonmaleficence, beneficence, autonomy, justice, and privacy/confidentiality. 

What is the Professional Code of Ethics for Nurses?

• The Professional Code of Ethics for Nurses is the guiding outline for how nurses should behave ethically within their profession and how they should decide to act if they encounter barriers that prevent them from fulfilling their professional obligations. 

Why is the code of ethics important in nursing? 

• It can guide nurses’ professional behavior, provide a framework for decision-making when faced with challenges, and provide support and help prevent moral distress. 

What is the code of ethics in healthcare? 

• There is not one board ethical code for every healthcare professional, although it has been proposed. Instead, each branch of healthcare, from quality control to medical directors to physicians to nursing, has its own ethical codes. 

What is scholarly ethics in nursing? 

Find nursing programs.

Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

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Nursing Code of Ethics in Nursing

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Published: Mar 13, 2024

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Clarification of ethical principle of the beneficence in nursing care: an integrative review

Rozita cheraghi.

1 Medical Surgical Nursing Department, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

Leila Valizadeh

4 Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Vahid Zamanzadeh

5 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Hadi Hassankhani

2 Road Traffic Injury Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

Anahita Jafarzadeh

3 Student Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

Associated Data

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. All requests relating to data should be addressed to [email protected].

Ethics-based nursing practice can transform health care practices. As the biggest human capital in the health care system, nurses are obliged to follow ethical principles in this field. One of these ethical principles; is beneficence, which is considered the core of nursing care. This study aimed to investigate clarification of the principle of beneficence in nursing care and its related challenges.

This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, and Scopus were searched using the keywords; “beneficence”, “ethic”, “nursing” and “care” in English and Persian in the time range of 2010 to 10 February, 2023. After applying inclusion criteria and assessing the articles using Bowling’s Quality Assessment Tool, finally, 16 papers were included from 984.

After reviewing and evaluating the qualified articles, the findings were classified into four main categories: (1) nature, (2) applicability, (3) Relevant and influential factors, and (4) challenges related to the ethical principle of beneficence in nursing care.

Based on the results of this review it seems that paying attention to clarification the principle of beneficence in nursing care can provide positive outcomes for patients to benefit from this principle and finally, it leads to increasing the well-being and health of patients, reducing their mortality rate, increasing satisfaction and maintaining the respect and human dignity of patients.

Today, nurses are considered the biggest human capital in the health care system [ 1 ]; so the care provided by them is one of the main components of services in this system [ 2 ]. Providing care based on ethics is one of the approaches in the nursing discipline that nursing ethics theorists have discussed [ 3 ]. An ethical nursing practice can transform healthcare practices [ 4 ]. Nursing ethics is considered an issue of bioethics, and a short time has passed since its formation [ 5 ]. Bioethics is the application of ethical theories and principles in ethical issues or healthcare dilemmas [ 6 ]. Therefore, understanding these principles and values is considered the first step in understanding ethics and its relationship with health care [ 7 ]. Good nursing care aims at the enhancement of the dignity of the human being in all dimensions and also succeeds to realize this intention in practice and it is considered dignity-enhancing care [ 8 ]. Hence, The nursing profession is considered a discipline with a health-oriented approach, which, focuses on the caring situations and helps people to adapt to their disease and improve their current performance capacity despite the disease [ 4 ].

The history of nursing shows that professional ethics, as a familiar concept in nursing, has been an inherent part of this profession since the early days, and it is internationally recognized as an essential part of nurses’ practice [ 9 ]. Four basic principles for bioethics were stated by Beauchamp and Childress, which are autonomy, justice, beneficence, and non-maleficence [ 10 ]. Ideally, these principles are the same ones that all nurses should be aware of in their practice and follow in caring for clients in order to provide the best, safest, and most humanistic care for all of them [ 11 ]. One of these basic principles is “beneficence” which is considered the basis of nursing and medical activities that performing such beneficial actions can encourage the motivation of good works [ 7 ]. It dares to say that the ethical principle of beneficence is an integral part of the mission of the nursing profession [ 12 ], which, according to a definition, implies doing positive things to help patients [ 7 ]. “Beneficence” is mentioned as a key component of bioethics and its outcome can help to receive the important and legitimate interests of the patient [ 13 ]. Although the concept of beneficence is widely used in medical sciences, it is not easy to define it precisely [ 14 ], and even few studies in health sciences have addressed the concept of beneficence [ 15 – 17 ]. In the nursing discipline, although professional ethics are well established, there is no real understanding of ethical principles [ 9 ], for this reason, several interpretations and definitions have been proposed [ 14 ]. Various definitions of beneficence have been presented in different kinds of literature, which consider this principle as the essence of ethics and doing “good” with mercy, kindness, generosity, and charity for patients [ 10 ]. Also, sometimes this principle is also mentioned in the meaning of doing good, kindness, and charity or any action that benefits others [ 14 ]. Singh & Ivory (2014) consider beneficence as the responsibility of healthcare experts to promote the well-being of patients through research and implementation of therapeutic interventions with the highest probability of positive patient outcomes [ 15 ]. In addition to these definitions, the principle of beneficence emphasizes the ethical commitment to the benefit, including protecting patients’ rights, preventing harm to them, and helping those at risk [ 18 ]. In another view, beneficence is interpreted as ensuring the provision of care with positive benefits and protecting patients, which plays a major role in all health care [ 19 ]. These views confirm the difficulty of implementing the principle of beneficence, which requires the definition of “what is good for the patient“ [ 20 ].

On the other hand; studies show that beneficence as an integral part of bioethics has always been beside other ethical principles, including autonomy, justice, and confidentiality, and therefore, there is a major challenge to balance the patient’s right to choose and the benevolent intention of the caregiver [ 21 ], and as mentioned, sometimes the care measures that guarantee beneficence may violate other ethical principles such as patient autonomy [ 22 ]. Of course, ethical conflicts are an integral part of nursing, because they try to fulfill their needs, goals, and efforts in the overall provision of nursing care [ 23 ], but despite this point of view, it should be said that nurses’ ethical commitment requires benefiting the patient by ignoring personal interests for the needs of the patients, their well-being and preferences [ 24 , 25 ]. It has been found that ethical dilemmas are sensitive to culture and context and reflects differences in culture, social attitudes, and legal principles [ 23 ], studies also emphasize that in order to beneficence in nursing care, they should pay attention to the cultural, social and ethical factors of patients [ 26 ].

What is obvious is that the basic issue in the principle of beneficence is the commitment to the benefit of patients in nursing care [ 27 ]. Although various studies have addressed this concept in a limited way, very few and scattered studies have focused on bioethics in nursing sciences and the principle of beneficence, and there is still no comprehensive and clear understanding of this concept as an ethical principle in providing nursing care. It should be noted that an integrative review study is a specific review method that summarizes empirical or theoretical studies that have already been conducted to provide a more comprehensive understanding of a specific phenomenon or healthcare problem [ 28 ]. Based on this, integrated reviews have the potential to expand the body of knowledge and create nursing science, knowledge, research, practice, and policies. In addition, these kinds of studies show the current state of knowledge in each discipline, help to develop theory, and have a direct application in the clinical fields and health policies [ 29 ]. Therefore, it seems that the results of this study can help clarify the concept of beneficence in nursing. Considering the importance of the principle of beneficence in nursing care and increasing patient satisfaction, we decided to review the studies conducted on this issue.

Study design

This study is an integrated review based on articles related to the ethical principle of beneficence, which was conducted to collect data from various studies on this concept. This integrative review was conducted using the Whittemore & Knafl method in 5 stages of review, including (a) problem identification, (b) searching the literature, (c) evaluating data from primary sources, (d) analyzing data, and (e) presenting the results, using of this method also increases the rigor of this study [ 29 – 31 ].

Search strategy

According to the Whittemore & Knafl method, a) in the first stage, the following question was set to answer the study’s aim: What is the ethical principle of beneficence in nursing care and its related challenges?

b) In the second stage, searching for articles was done by two researchers in the time range of 2010 to February 10, 2023. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, and Scopus were searched using the keywords; “beneficence,“ “ethic,“ “nursing,“ and “care” in English and Persian separately or combined using Boolean operators: AND and OR for papers that were published. The result of the initial and comprehensive search included 984 articles. After applying the inclusion criteria, including access to the full text of the article, writing in Persian and English, and the presence of keywords in the title and abstract of the article, finally, 968 were removed.

Eligibility criteria

c) In the third stage, to evaluate the data, two researchers reviewed the content of the studies to evaluate their quality using Bowling’s Quality Assessment Tool [ 32 ], so 4 articles were excluded by this tool, and then the results were compared. Finally, 16 articles were included in this study (Fig.  1 following the renewed PRISMA guideline) [ 33 ]. The Bowling tool consists of items that were used to check the structure of the methodology and present the results of the studies with a triple scale: yes, weak and unreported, which led to the elimination of weak and unreported articles.

PRISMA flow diagram

Data extraction

The key data extracted from the articles included: the authors’ profile, the publication’s year, the country of the study, the title and the methodology of the study, and also the main results that were extracted by the two researchers.

Data synthesis

Data charts were designed independently by two researchers and they were evaluated. The data chart was updated in a continuous process. Then, the extracted data were analyzed and interpreted. The data analysis process was initiated when the final 16 papers for inclusion were determined and had been verified by all three authors. First, a data extraction sheet were created to document the required information for each review, including the five methodological stages. So, each review was analyzed individually by two researchers separately. All of the data gathered in the data extraction sheets was read by the same two researchers, who reached a consensus on selecting pertinent and significant items for each stage. Then, the similarities and differences among the reviews with regard to each methodological stage were examined throughout the data analysis process. Finally, conclusion drawing and verification were performed by all three authors to ensure that all 16 reviews were thoroughly assessed in terms of methodological stages and that the results described matched the research questions of this present study.

Quality appraisal

Whittemore and Knafl (2005) state that assessing the quality of the included evidence is not essential in a supplementary review [ 30 ]. All studies meeting the inclusion criteria, regardless of their methodological quality, were retained in the review to examine all evidence of the factors that influenced the nursing role implementation in practice settings.

According to the framework of review and selection of articles, 16 articles were selected from 984 articles. All articles included in this study were in English, including quantitative (n = 2) and qualitative (n = 14) studies.

After reviewing and evaluating the qualified articles, the findings were classified into four main categories as follows: (1) nature, (2) applicability, (3) Relevant and influential factors, and (4) challenges related to the ethical principle of beneficence in nursing care (Table  1 ).

Main categories and sub-categories extract from the review of selected articles

The present study investigated the ethical principle of beneficence in nursing care and its related challenges in different studies. This integrated review identified four main categories (nature, applicability, relevant and influential factors, and challenges) and twenty-six sub-categories. It is obvious that the ethical principle of beneficence is an integral part of the nursing code, also called the “moral heart of the nursing profession,“ so a nurse should provide nursing care only with the goal to provide benefit to the client [ 16 ]. It is on this basis in nursing ethics, beneficence is considered a moral commitment that is worthy and generous [ 43 ]. Despite the role of this ethical principle in nursing care, the Lack of acquaintance with the definition of the beneficence concept is considered an important challenge [ 36 ]. What is observed in the reviewed studies; “doing good” is considered beneficial [ 12 , 20 , 22 , 26 , 34 , 35 , 36 , 37 ]. The difficulty of implementing this ethical principle; requires a clear definition of “what is good for a patient“ [ 20 ]. This definition has been expressed in different forms in different studies, including doing good [ 12 , 20 , 22 , 26 , 34 , 35 , 36 , 37 ], maximum positive benefits for patients [ 16 , 20 , 22 , 24 , 34 , 36 , 37 , 38 ], best care [ 16 , 23 , 34 , 35 , 37 ], the core of care [ 20 ], and ethical commitment to the benefit for patients [ 39 ].

The patient’s best interest must be the center of ethical decision-making at all times [ 44 ], so healthcare workers have to provide more patient-centered care to include attention to patient priorities and preferences [ 12 ]. It is on this basis that in every context or every part of society, people should be encouraged to do good acts and benevolence, and their work and actions, both professional and personal, should benefit the people of the whole society [ 45 ]. The outcome of this good action will be providing maximum positive benefits for the patients and achieving the best care for them [ 34 , 35 , 46 ], which will ultimately improve their health and general well-being [ 45 , 46 ] because the core of ethical care is the pursuit of moral attitude and goodness [ 47 ].

A beneficent act promotes the betterment and welfare of patients, and nurses should deliver professional care to enhance the recovery of patients. As Beauchamp and Childress (2013) mentioned this principle is positive beneficence and break it down into three components: to prevent evil or harm; to remove evil or harm; and to do or promote good [ 48 , 49 , 50 ]. Also, beneficence considers the balancing of the benefits of treatment against the risks and costs; so, the healthcare professional should act in a way that benefits the patient [ 51 ], and Edwards (2009) states that beneficence is about promoting the well-being of those with whom we interact [ 52 ]. In most cases, the principle of beneficence and non-maleficence mean together [ 12 , 16 , 22 , 26 , 34 , 35 , 36 , 37 , 38 , 40 , 44 ], because non-maleficence prevents harming the patient but rather seeks to improve people’s well-being and health [ 20 ]. In fact, avoiding any useless intervention and any action that may lead to irreparable harm (such as death) to the patient; is interpreted as non-maleficence. As mentioned, beneficence and non-maleficence are often two sides of the same coin and are discussed together, as the former involves doing good acts that benefit others, and the latter involves avoiding actions that harm oneself or others. Having these two principles together, conflicts between the care team and the patient’s families are inevitable [ 53 ]. Although both of these principles are important, the duty of non-maleficence is considered a stronger commitment in health care [ 54 ], and the principle of beneficence requires that “good” be done, and “harmful” actions for patients be avoided [ 10 ]. It may be said that the distinction between these two important ethical principles lies in the fact that beneficence is an ethical commitment to take positive steps to help patients and not merely to prevent harm [ 55 ].

Recent research shows that healthcare institutions and organizations that have a benevolent ethical atmosphere may achieve better clinical results, improve patient and family satisfaction, and reduce patient mortality [ 56 ]. The importance of these two principles, as the main values of nursing, always influences their behavior to direct their actions for the benefit of patients [ 36 ]. Nevertheless, nurses should understand that benevolent actions may not always be a benefit to patients [ 57 ] and sometimes conflict with preserving the ethical principle of autonomy [ 16 , 22 , 25 , 26 , 34 , 37 , 38 , 39 ]. Per Ross’s ethical principles, all human beings should follow before the factors such as the benefit or utility of outcomes and results, like justice-fair distribution of benefits, risks, and costs [ 58 ].

Since the professional duty to respect the rights of patients and their autonomy in decision-making is considered a universally accepted norm [ 57 ], it may be said that nowhere in ethical decision-making situations; the contradiction is not as obvious as when the principles of beneficence and autonomy collide [ 46 ]. However, in all clinical decision-making situations, novice and experienced nurses must consider the patient’s right to autonomy and consider their nursing care beneficial for the patient’s health outcomes [ 59 ]. To achieve this level of care, nurses should expand the scope of ethical principles of beneficence, autonomy and, patient Advocacy in patient care [ 22 ].

The principle of beneficence makes it necessary to provide equitable care based on need and equally without discrimination for all patients [ 53 ], so when nurses are required to make decisions that negate the patient’s autonomy, these decisions should be considered as complying with the principle of benefit for them [ 59 ]. When beneficence and autonomy are in conflict and coercion is necessary for beneficence, the healthcare team needs a way to resolve this dichotomy and retain their self-esteem, in these cases, they may experience cognitive dissonance, a phenomenon that defines the mental tension arising when conflicting attitudes are held or when behaviors are incompatible with certain attitudes [ 60 ]. So, ignoring the principle of patient autonomy is considered a very serious issue, but it can be considered when there are real reasons to maximize beneficence and as long as it is consistent with the patient’s values [ 46 , 61 ]. Therefore, a nurse can only prioritize beneficence over the principle of client autonomy when there is a good reason that the client’s respect will be preserved and she/he will really benefit from this approach [ 16 , 39 ]. Nevertheless, sometimes nurses report that they experience ethical dilemmas in ethical principles; in these cases, it is recommended that nurses decide on the best care option for patients; consider their needs and preferences [ 25 ]. The beneficence can include patient autonomy because “the best interests of patients are closely related to their preferences,“ which is one of the main duties of the health team towards all patients [ 62 ]. However, beneficence is defined as ‘the principle of doing good and providing care to others’ by Berglund(2007) [ 63 ].On the other hand; respecting the needs, values, and preferences of the patient and their family are at the core of nursing care, and nurses should be aware of these needs by documenting the life history of the patients because the needs and interests of patients are formed based on religious, cultural and social issues [ 16 , 26 , 41 , 64 ]. This attention to values in care protects and defends the client and ensures that the best decisions are made in the best way [ 64 ].

A concern to promote beneficence may be expressed in traditional medical ethics by paternalism, where the health professional makes a decision based upon a perspective of acting in the patient’s best interests. However, some believed that this approach acts against person-centered values found in nursing ethics [ 65 ]. By the way, health care balances the ethical principles of beneficence and justice, and the best possible care for patients with equitable care is presented for the entire population using limited resources in the most efficient way [ 35 ]. It should also be considered that the principle of justice provides a key link between the importance of health for individuals and the responsibilities of promoting the health of society [ 66 ]. Indeed, it is optimal to both respect choice and protects from harmful choice, but sometimes this is not possible [ 49 ]. However, any choices for the patient may sometimes create a conflict between justice and beneficence [ 34 ]. Some researchers consider the attention to beneficence before justice, although the principle based on justice is based on profit, which is reflected in the health system [ 66 ]. However, the priorities of health care should be focused on distributive justice, which means that decisions should be made in such a way that, according to the amount of cost; will provide care to patients that is beneficial for a large number of patients and focus on achieving the greatest benefit for a large number of them [ 35 ]. According to the studies, most ethical theories have accepted various aspects of beneficence and consider it as a basis for creating the most benefit for all patients [ 19 ].

The attention and focus of the principle of beneficence in nursing management are also on providing safe, effective, timely, efficient, fair, and patient-centered care combined with accuracy, kindness, and staff collaboration [ 37 ]. In such ethical climates, nursing staff is supported by managers in decisions- making For the benefit of patients [ 67 ]. With this point of view, the ethical principle of beneficence will undoubtedly be an integral part of the mission of the nursing profession to reduce the pain and suffering of patients [ 68 ]. Achieving this requires nurses to be equipped with ethical knowledge and insight [ 16 ], and the responsibility of nurses as an ethical commitment for increasing patient’s trust and their families, so that the beneficence applicability will reduce their pain and suffering, especially in end-of-life and palliative care [ 41 ].

All patients should be treated with dignity and protected from any possible harm, it is the professional’s moral obligation, to not cause harm [ 69 , 70 ]. Thus, beneficence and non-maleficence are connected to the patient’s rights, and the safety of care that guarantees care free of danger or risk of injury [ 71 ]. Each care program and treatment should provide absolute benefit to the patient, and the nurse’s essential responsibility is to ensure the individual’s safety. As a result, the nurse considers all of the care practices that will be beneficial to the patient before implementing them [ 72 , 73 ], and in accordance with these principles, they revealed that they valued patient safety, sought to avoid risk and harm, and sought to help cope, regardless of illness or functional impairment [ 74 ]. When medical errors are not reported, the principle of beneficence is threatened, as non-reporting prevents other healthcare professionals from accessing relevant information and avoiding similar errors. Ethics and patient safety are intertwined, so, a lack of honesty in communication and a lack of commitment to finding solutions to adverse events is both disrespectful to beneficence and non-maleficence principles, and it compromises patient safety [ 75 ].

Truth-telling to the patient as an issue of communication and trust is considered as the applicability of beneficence, which nurses should combine with the patient’s autonomy and balance in their care. As a result, the goal of Truth-telling in health care will be achieving treatment that is effective and based on the patient’s interest [ 26 , 44 , 46 ], and support [ 16 ]. In this way, healthcare workers should pay attention to the cultural, social, and ethical differences of patients [ 16 , 26 ].

In general, it should be noted that the main guideline in ethical judgment about different choices, especially in cases of conflict and dilemmas, is to refer to beneficence, which includes a kind of rational profit in terms of cost-effectiveness regarding the results of the intervention and outcomes for the patient [ 53 ].

Studies show that although nurses have good knowledge about nursing ethics, most are not familiar with the principle of beneficence in nursing care and what is good for the patient and for her/his benefit [ 34 , 42 ]. However, health promotion programs, policies, research, and access to health care have the principle of beneficence at their core [ 20 ]. Therefore, considering the importance of the principle of beneficence in nursing care; it is necessary to carry out appropriate studies with the approach of the beneficence concept and different aspects of this important ethical principle.

The ethical principle of beneficence is considered an important issue and one of the primary values in nursing care, and this is while the results of the present study clarify different aspects of this principle. Lack of acquainted with the definition of the beneficence concept in nursing care is an important challenge that makes it necessary to conduct more studies focusing on the analysis of the concept of the beneficence and developing appropriate instruments in different nursing wards and fields for its measure and application. It seems that conducting clarification of the approach of the principle of beneficence in nursing care can provide positive outcomes for patients to benefit from this principle.

On the other hand, paying attention to the applicability obtained from studies that focus on reducing and predicting pain, fair distribution of resources and care, performing evidence-based care, not harming the patient, telling the truth in the correct situation, performing palliative and ending life care and finally the patient’s safety in nursing care leads to increasing the well-being and health of patients, reducing their mortality and preserving human respect and dignity. Promoting a dignified life by observing the principle of beneficence for patients in nursing care, and paying attention to the principles of autonomy and justice, will ultimately increase patients’ satisfaction. Therefore, it is suggested that more studies should be done focusing on identifying the exact dimensions of the concept of beneficence, developing an appropriate instrument to measure this concept in nursing care, and providing adequate training in this direction.

Limitations

The limitations of this study include: not searching for articles in languages other than English and Persian, so our search strategies may have under-represented studies in other languages, such as Spanish and Portuguese.

Acknowledgements

Considering that the present study was an integrated review study and the results of other researchers’ studies have been used, the research team would like to express their gratitude to all whose studies were used in this study.

Authors’ contributions

RCH: study design, data collection and search, analysis and interpretation, drafting of the manuscript; LV: concept design, data collection, analysis and interpretation, drafting of the manuscript; VZ: review and critical revision of the manuscript; HH: supervision of the review and critical revision of the final manuscript, checking the translation and for grammar. AJ: data collection and search. All authors read and approved the final manuscript.

No funds were used to conduct this study.

Data availability

Declarations.

The author(s) declared no potential conflicts of interest with respect concerning the research, authorship, and/or publication of this article.

Ethical approval was not required to conduct this review.

Not applicable.

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Nursing Code of Ethics: The Ultimate Guide to Ethical Challenges

#i',$content, -1); --> table of contents a brief history of the nursing code of ethics code of ethics in nursing as basics of professional behavior the importance of studying the code of ethics for nurses main principles of the american nurses association code of ethics code of ethics nursing: 9 provisions a nurse must adhere to how can code of ethics for nursing help shape good nurses in conclusion all healthcare professionals must adhere to ethical standards. however, for nurses, keeping ethical principles is of paramount importance. according to statistics, nurses in a hospital spend about 60% of their time communicating with patients. this percentage is even higher in intensive care units in hospices and nursing homes. so, adhering to ethical standards is critical to doing a quality job. equally important is knowing how to deal with ethical dilemmas and solve related problems. the american nurses association (ana) has developed a nursing code of ethics. this is not just a set of rules but a support system that makes nurses’ jobs easier and their decisions more informed. it lays down the basic moral principles of healthcare. a brief history of the nursing code of ethics.

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Florence Nightingale, one of the most famous nurses in history, laid down the fundamental principles of the nursing code of ethics in the 19th century. She also established the groundwork for contemporary healthcare practices. Later, in the 50s of the 20th century, the American Nurses Association (ANA) unified these principles.

The Code of Ethics has undergone many revisions and additions. The last major revision passed in 2015, and a new one is scheduled for 2025. Changes are planned to adapt the regulation to modern challenges. However, the basics of the code of ethics, which include autonomy, beneficence, justice, and nonmaleficence, will remain unchanged.

Code of Ethics in Nursing as Basics of Professional Behavior

For more than 20 years, nursing has been the most moral profession in the United States, according to surveys. The code of ethics for nursing is one of the reasons for this high rating. This is the foundation of professional behavior, a set of principles and standards that define ethical obligations to clients, their families, colleagues, and society. The code should not be confused with job descriptions. The latter represents more technical and procedural work norms; the code, in turn, determines the general atmosphere of the working processes.

Many of the principles are self-evident norms of working behavior, and their observance simplifies the job and helps the patients feel safe. A person who feels cared for is better able to share their concerns and problems, which can be critical in determining successful treatment. Besides, it leads to better adherence to medical prescriptions after discharge, which has a beneficial effect on the number of remissions and results in the long term.

The Importance of Studying the Code of Ethics for Nurses

Competent and polite communication with clients is no less important than the ability to perform standard care procedures. In such a case, ethical awareness is just as much a part of professionalism. The code of ethics for nurses is an indispensable guide to becoming a good healthcare professional with well-developed communication skills. It is not just a course to take in nursing school but one of the fundamentals of quality care improvement.

The importance of code of ethics in nursing cannot be overemphasized. Knowing and successfully applying this code ensures a personalized approach to every patient and improving their outcomes. In addition, the study of nursing ethical considerations forms a common standard of behavior for all workers, which helps find answers to complex ethical issues. This enhances the standard of medical care and boosts trust in the field.

Main Principles of the American Nurses Association Code of Ethics

The American Nurses Association Code of Ethics defines the 4 main ethical principles when working with patients.

• Autonomy in Nursing means people have the right to freedom of choice in treatment wherever possible. Nurses should respect patients’ views and support them in making informed decisions about their health.
• Beneficence in Nursing implies that nurses should do their best to improve patients’ health, morale, and quality of life, focusing their interests first rather than the specialist’s personal opinion.
• The Justice principle suggests that nurses should treat each person equally. They should give each patient the necessary attention and distribute their care fairly without preference or bias.
• The Non-maleficence principle of health care means that the nurse must ensure that the patient’s health and morale are not harmed. The cardinal rule of medicine should guide every action: “The main thing is not to harm.”

Adherence to these principles helps maintain the high quality of healthcare delivery and prevent wrong ethical decisions.

Code of Ethics Nursing: 9 Provisions a Nurse Must Adhere To

In addition to adhering to the 4 core principles of the ANA’s Code, it is important to be aware of what are the 9 Code of Ethics for Nurses. There are nine main provisions to follow for successful performance and professional development. Briefly, each of the provisions can be described as follows:

• A nurse must respect the dignity of every person and treat the individual with compassion.
• The nurse’s primary focus should be on the patient. The patient refers to a single person, family, or social group.
• The nurse should advocate and promote the patient’s right to quality health care.
• The nurse must provide care according to all regulations and capabilities to provide the best care.
• The nurse is accountable to patients and self by being an example of health promotion and professional growth.
• Through their efforts, the nurses shall promote an ethical environment and improve working conditions and healthcare.
• The nurse in any position shall promote the profession and enhance its public status.
• The nurse should cooperate with fellow healthcare and social professionals to enhance service quality and minimize health disparities.
• The nurses themselves and collectively, through their organization, should shape and develop nursing values and integrate them into the overall healthcare system.

Provision 9 of the regulation is worth mentioning separately, as it has a broad interpretation. In general, this provision of the Code of Ethics Nursing means that workers should organize groups and meet in committees. These meetings unite nurses to fight more effectively for social justice and improve national health policy in the country.

How Can Code of Ethics for Nursing Help Shape Good Nurses

Knowledge of theory, the ability to perform procedures, and the capability to meet people’s needs in care are the primary skills needed to becoming a nurse . Internships and lectures help hone specialized skills. Regarding patient communication and related soft skills, a significant part of being a nurse is having an excellent knowledge of the code of ethics in nursing and the ability to apply its principles to practice.

Knowing nursing ethics helps maintain high standards of the profession and moral principles in work. This increases trust and respect for the profession. A set of ethical rules is a reliable guide to navigating specialists in complex ethical dilemmas. These rules help resolve problems based on justice, fairness, and respect for human dignity. The study of ethical principles helps healthcare workers develop themselves. Through self-reflection and understanding of patients’ needs, the overall level of care delivery increases.

In Conclusion

The Nursing Code of Ethics, in its current form, has helped nurses worldwide maintain high ethical standards in patient care for over 70 years. This regulation has made the nursing profession one of the most respected in society. Learning the code of ethics is a crucial part of becoming every nurse. It is essential to realize this and not treat this manual as just another nursing training course. Knowing and following these rules will help you become better for yourself, your patients, and your community.

Ethical Theory, Framework, and Principles in Nursing Practice Essay

The Family Nurse Practitioner specialty prioritizes care for pregnant women, newborns, children, adolescents, and adults in family-centered care. In their practice, family nurse practitioners (FNP) often become involved in situations where ethical concerns and issues take a significant part. One of the ethical concerns FNPs face in modern conditions is racial disparities in care for pregnant women from minorities and rising fatalities during childbirth in this population segment. Addressing the ethical concern requires the implementation of different ethical theories, frameworks, and principles in nursing practice. This essay will explain which ethical theory, framework, and principles I will use in my nursing practice to address the ethical concern of racial disparities in care for pregnant women.

Firstly, there are several ethical theories, and not every theory can be successfully applied to nursing practice. Furthermore, theories use different approaches to the issue of discrimination and racial disparities. One of the primary ethical theories of deontology, which prioritizes an individual’s obligation to duty, is often applied in nursing practice. Furthermore, the patient-centered deontology theory is often opposed to the society-centered utilitarian theory, which prioritizes the consequences of an action and justifies the means (Chukwuneke and Ezenwugo, 2022). The Kantian imperative of deontology encourages people to treat others with humanity and emphasizes “sameness” in people, which will help address racial disparities in care (Barnard and Turnbull, 2019, p.23). Thus, in my nursing practice, I plan to use guidance from Kantian ethical theory founded on deontology ethics to address the issue of discrimination and treat all patients equally with respect.

Furthermore, I plan to use the ICN Code of Ethics for Nurses as an ethical framework in my practice. The code provides valuable knowledge about the ethical values and responsibilities of nurses. The code addresses the issue of racial disparities by requiring nurses to provide culturally appropriate care with respect to human rights without prejudice (International Council of Nurses, 2021). In addition, the code encourages nurses to practice non-discrimination in relation to culturally diverse colleagues and educate people about relevant social issues (International Council of Nurses, 2021). Thus, utilizing the approach from the framework will help me promote non-discrimination in my practice and educate other people about the reasons for rising fatalities in childbirth in minorities.

Lastly, two ethical principles of nursing practice will support my advanced nursing practice in addressing the ethical concern of racial disparities in care for pregnant women. Firstly, the principle of justice requires nursing professionals to be fair in the distribution of care and equally respect all patients. Furthermore, the social justice and equality principle promotes equal access to healthcare (McDermott-Levy et al., 2018). Next, the second primary ethical principle for addressing the issue is beneficence. While the justice principle requires nurses to treat all patients equally, personal kindness encouraged by beneficence can further improve the situation. According to Stamps (2021), addressing bias in nursing students requires recalling the beneficence principle. Thus, the ethical issue of racial discrimination in nursing can be solved by eliminating unconscious bias with the promotion of the beneficence principle.

In conclusion, this essay explored which theories, frameworks, and principles I will use in my practice as an FNP to address the issue of racial disparities in care for pregnant women from minorities. The Kantian deontology theory will guide me in always treating patients equally and prioritizing my duties. Furthermore, using the ICN Code of Ethics for Nurses as the ethical framework will improve my approach toward culturally diverse patients and colleagues. Lastly, ethical principles of justice and beneficence will provide the foundation for my development as a kind and compassionate nursing professional who treats all patients equally.

Barnard, R. T., & Turnbull, D. J. (2019). Discrimination and social justice: Questions of diversity, plurality, representativeness, measurability, and doublespeak . The International Journal of Interdisciplinary Civic and Political Studies, 14 (2), 21-34. Web.

Chukwuneke, F., & Ezenwugo, A. C. (2022). Deontology vs. utilitarianism: Understanding the basis for the moral theories in medicine . International Journal of Medicine and Health Development, 27 (1), 19-23. Web.

International Council of Nurses. (2021). The ICN code of ethics for nurses. Web.

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice . Nursing Outlook, 66 (5), 473-481. Web.

Stamps, D. C. (2021). Nursing leadership must confront implicit bias as a barrier to diversity in health care today . Nurse Leader, 19 (6), 630-638. Web.

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• Is Abortion Moral From Kantian Standpoint?
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Common Ethical Dilemmas in Nursing and their Solutions

Healthcare professionals, including nurses, face ethical dilemmas fairly regularly. Most of the dilemmas are usually serious and very stressful because when faced with a dilemma, a nurse must make a decision, which is easier said than done.

As a nursing student, you might be assigned to write an essay where you identify, analyze, and resolve an ethical dilemma. We have noticed over the years that many students struggle with writing an ethical dilemma nursing essay. If that sounds like you, read this post that comprehensively explores ethical dilemmas in nursing, including their examples and solutions.

In most cases, essays about ethical dilemmas in nursing take the reflective essay approach, where you reflect on real, researched, or imagined clinical scenario or encounter. It could be during your placement, clinical rotations, or shadowing experiences. As you do so, you will borrow from various ethical theories and decision-making models.

If you could use some help, our experienced online nursing essay writers can help you get a bespoke ethical dilemma essay at an affordable fee.

Let's get started with the basics to more advanced concepts.

What is an Ethical Dilemma in Nursing?

An ethical dilemma is a scenario where it is not easy to decide one way or another. Nurses are faced with ethical dilemmas almost every day. They have to make serious and difficult decisions fairly regularly. The decisions can sometimes mean life or death. Therefore, as a student nurse, it is vital to learn about ethical dilemmas nurses face, how to identify them, and how to solve them correctly.

When facing an ethical dilemma, you should always follow the nursing code of ethics . This is because most dilemmas can be solved by following the nursing code of ethics. The nursing code of ethics is a bunch of rules nurses has to follow to provide quality, safe, and unquestionable care to those who need it.

While most dilemmas can be solved by following the code of ethics in nursing, some dilemmas cannot be solved in this manner. The reason is that the nursing code does not guide every ethical dilemma or situation.

If faced with a situation that makes it difficult for you to follow the nursing code of ethics, you should use your judgment to weigh the pros and cons of both decisions to make the right decision.

Examples of ethical dilemmas nurses face regularly include: how to deal with a non-compliant patient, how to deal with a patient that is refusing treatment, and whether to disclose confidential information to help a patient.

Ethical Dilemma Versus Moral Dilemma

The terms ethical and moral are often used interchangeably in speech. However, the two terms do not always mean the same thing. For example, there is a slight difference between ethical and moral dilemmas.

An ethical dilemma involves two morally correct choices, but one is slightly more ethically problematic than the other. In contrast, a moral dilemma is a situation with two morally correct choices, but neither is preferable. For the moral dilemmas, the nurses know the right action yet might be limited to acting by forces outside their control.

As a nurse, you are more likely to face ethical dilemmas than moral dilemmas. Because ethical dilemmas are anticipated, a code of conduct has been created to help you always make the right decision.

Reasons Nurses Face Ethical Dilemmas in Healthcare

There are many reasons why nurses face ethical dilemmas frequently when providing care to patients. The following are the eight main ones:

• Inadequate staffing. When a healthcare facility has fewer staff than it needs to function optimally, nurses sometimes must make a tough decision. They have to decide whether to work longer to care for patients or to prioritize their mental and physical health and work only as much as possible.
• Incompetent peers. As a registered nurse, you will have a big dilemma if you notice a colleague showing incompetence. You will have to choose one of two options – to ignore your colleague's incompetence because they are a friend and they probably will not do it again, or report your colleague to a supervisor to ensure high standards are maintained. This is an ethical dilemma since the former is more ethically problematic than the latter.
• Religious/cultural beliefs. Your religious or cultural beliefs may present an ethical dilemma as a practicing nurse. For instance, you might be given a nursing assignment that contradicts your religious beliefs, e.g., you are asked to clean up the private parts of a male patient after a procedure as a Muslim female nurse (this is forbidden according to Islam). It is easy to see how this situation would present an ethical dilemma.
• Patient refusing treatment. There are occasionally situations when patients refuse treatment. As a nurse, you know what is best for the patient. However, you also know that they have the right to make their own decision. So when a patient refuses treatment, this will always present you with an ethical dilemma – do you insist and look for ways to ensure they get the treatment or grant them their wish?
• Artificial nutrition and hydration. Some patients and older adults do not want to be fed or hydrated using a tube. This presents a huge ethical dilemma for nurses. This is because nurses are trained to care for people who need it. Therefore, they feel bad about it when they see the need to provide artificial nutrition and hydration and get stopped because of a patient's wishes. They feel so bad because they know there is something they can do, yet they are asked not to do it.
• Providing futile care. Being asked by a patient's family to continue providing care despite a patient's continued decline is one of the biggest ethical dilemmas nurses face. This is especially true for critical care nurses. Being trained medical staff, they can see when it is not in a patient's best interest to continue receiving aggressive interventions. However, most of the time, patient families don't want to give up on their loved ones. Therefore, they insist that interventions continue presenting nurses with a big ethical dilemma.
• Opioid crisis. The opioid crisis across the United States presents nurses with several ethical dilemmas. For example, many nurses do not want to give patients opioid pain medications, especially when they believe they risk getting addicted. Now imagine knowing that a patient can benefit from a medication yet at the same time feeling like it could lead to them getting addicted to it
• Anti-vaccine stance. Nurses who do not mind vaccines face a dilemma whenever they interact with those against vaccines. This is because, on the one hand, they know they have to provide care to everyone without discrimination. Yet, on the other hand, they know that people against vaccines pose a serious public health hazard.

Identifying Ethical Dilemmas in Nursing

As evident in the section above, ethical dilemmas can arise virtually anywhere in the nursing world. It is up to you as a nurse to identify dilemmas when they arise and deal with them as expected by the ANA code of conduct. In this section, we are going to focus on how to identify ethical dilemmas in nursing.

Here are the main indicators of ethical dilemmas in nursing.

• Harm potential. When you face a healthcare situation that has the potential to impact a patient negatively, you are most likely facing an ethical dilemma. If it were so easy to spare the patient from the negative impact, the situation wouldn't be a dilemma because this is the option you would take.
• Conflict of interests. When you face a healthcare situation with a conflict of interests between you and the patient or you and the case management team, it is likely an ethical dilemma.
• Uncertainty. This is perhaps one of the biggest indicators of ethical dilemmas and dilemmas. When you face a healthcare situation in which you are unsure what to decide, you are most likely facing an ethical dilemma. Nurses are trained to judge situations and make decisions quickly. When you cannot do these things as a nurse, something is holding you back, and the situation is likely a dilemma.
• Cautiousness. When you face a healthcare situation in which you are cautious about the outcome of the options you can take, you are most likely facing an ethical dilemma. People are cautious when making ethical dilemma decisions because they do not want to see negative consequences (if any) caused by their decision(s).
• Delay. When you have a decision to make at work and keep delaying the decision-making, you are most likely facing an ethical dilemma. People delay making ethical dilemma decisions because they fear the consequences.

Principles of Nursing Ethics

Principles of nursing ethics were formulated to help nurses consistently make the right decisions when faced with ethical situations. There are many principles of nursing ethics, but the main ones are non-maleficence, beneficence, autonomy, and justice. These are the ones that are always integrated into nursing training programs to help nurses make the right decisions whenever they are faced with difficult situations.

1. Nonmaleficence

Nonmaleficence is probably the most well-known ethical principle in the healthcare world. It applies to nurses, doctors, and other medical professionals.

This principle teaches nurses that it is their responsibility to provide care, treatment options, and/or case management in a manner that does not harm the patient. When you internalize this principle as a nurse, you will always choose to provide care and treat patients safely.

Non-maleficence is an important part of providing patients with safe and quality care. Exercising this principle means doing everything possible as a nurse to provide care while ensuring the highest degree of patient safety.

An excellent example of non-maleficence in nursing practice is withholding the administration of a powerful medication until you get confirmation on whether a patient is allergic to it or not. Another example of maleficence in nursing practice is discontinuing medication when you notice signs of adverse reactions.

When a nurse lacks this principle, it can result in dire consequences for patients. More specifically, a lack of nonmaleficence can lead to reduced patient safety. And, of course, this can mean patient injury or even death. Patient injury or death resulting from lack of nonmaleficence can cause mental trauma, job loss, and even legal consequences.

Therefore, it is imperative to internalize and adhere to this nursing principle.

2. Beneficence

Beneficence is another important nursing principle. This principle is characterized by charity and kindness. It is basically all about ensuring your actions are guided by compassion and maximum consideration of the welfare of those you serve.

While some people choose to pursue nursing for the money or job security, most people in nursing are in it out of their love for serving others. Therefore, this beneficence principle is almost always naturally ingrained in the minds of most nurses.

The best way to apply this nursing ethical principle is to always act in the patient's best interest regardless of the circumstances. Practicing this principle regularly will ensure the patient is always cared for in the best way possible. You will also automatically improve positive patient outcomes.

An excellent example of beneficence in nursing practice is offering to sit with a patient to console them after giving them bad news about their situation. Another superb example of beneficence is drawing curtains to protect a patient's and his family's privacy when exchanging final goodbyes.

Lack of beneficence can result in poor nurse-patient relationships and reduced patient safety. When a patient realizes you are not kind or acting in their best interest, they will not be very interested in showing you kindness or respect. This can result in poor nurse-patient relationships and adverse patient outcomes.

As mentioned above, a lack of beneficence can also lead to reduced patient safety. When you don't act in the patient's best interest, it can lead to safety issues such as failure to record vital info, failure to use protective measures when providing care, and medication errors.

It is easy to see how following this principle can make it easier for nurses to provide quality care and make more ethical decisions.

3. Autonomy

Autonomy is a fundamental nursing ethical principle. It recognizes the right of the patient to make their own decisions. Nurses must never forget this right to avoid imposing their will or self-interest on the patient. 

Of course, there is a right way to recognize patients' independence and ability to make their own decisions. This right way involves offering the patient all the necessary information to make the best decisions. This information includes available treatment options and the pros and cons of each option.

Once a nurse has offered a patient all the correct information, they have to respect whatever decisions the patient makes, even if they disagree.

Autonomy is essential in nursing practice because it helps nurses adhere to the patient's wishes. It is also important because it passes responsibility for some major care decisions to the patient they will affect the most.

A good example of autonomy is when a nurse agrees to respect a patient's choice not to get treatment, even if they believe the treatment benefits the patient. Another excellent example of autonomy is a nurse respecting a patient's wish to be seen or attended to by a nurse of the same sex for religious reasons.

When a nurse doesn't practice this ethical principle, they can make decisions that make patients feel disrespected. They can also make decisions that can lead to a breakdown of the nurse-patient relationship. Thus, it is always essential to have this ethical principle in mind.

Justice is a fundamental ethical principle. It is all about nurses showing fairness in the way they provide care. Nurses must provide quality care to patients regardless of their appearance, age, financial history, religious preference, race, and gender.

Even when faced with a situation that involves healthcare for a convicted murderer or any other criminal, a nurse must still offer the best care they can provide.

This nursing ethical principle is crucial because it ensures fairness and equity in nursing. In other words, it provides patients care regardless of who they are. This usually has the effect of making patients feel valued. This, in turn, usually has the effect of enhancing patient outcomes.

A good example of justice in nursing practice is providing care to a known anti-vaccine campaigner when they get COVID or any other vaccine-preventable illness. This is justice and fairness because it allows the person to become well again without considering the negative influence of vaccine use.

A nurse lacking this ethical principle can act in ways that make a patient feel rejected, leading to adverse patient outcomes. It can also lead to unfair prioritization in care provision, resulting in dire consequences for the patient.

By following the nursing ethical principles discussed above and adhering to the ANA code of conduct, you can handle different ethical dilemmas correctly and without serious negative consequences.

Examples of Ethical Dilemmas in Healthcare

Understanding some ethical dilemma scenarios you can write an essay about as a nursing student is essential. Remember, there is never a right or wrong answer; in the same way, there is no small or big ethical issue. As long as it impacts healthcare, it falls within nursing practice or medical ethics.

The following are some of the most common ethical dilemmas in nursing.

1. Pro-choice versus pro-life.

The pro-choice versus pro-life dilemma is common in nursing. For example, when a patient wishes to have an abortion because they do not want a baby, yet a nurse is pro-life because of religious beliefs, it becomes a big dilemma.

SOLUTION : Respect the wishes of the patient.

2. Religious beliefs versus science.

This dilemma is common in nursing practice. For example, it can occur when a patient refuses a specific procedure or treatment because of religious beliefs, yet a nurse knows what science says is best in the situation.

SOLUTION : Respect patient autonomy and do as they wish.

3. Beneficence versus autonomy.

As a nurse, you must practice beneficence (kindness and charity). You are also required to respect the patient's autonomy. Now imagine you have been ordered to give a patient medication to ease pain and suffering, yet they insist on not taking it to stay awake and spend their last minutes with their loved ones. This presents a great beneficence vs. autonomy dilemma.

SOLUTION : Obey the patient's wishes as long as they are conscious and can make their own decisions

4. Anti-vaccine stance.

As a nurse, you must follow exactly what the guardian wants for a child unless it is required by law to do otherwise. Now imagine a situation where a parent refuses to let their child get vaccinated, yet you know at the back of your mind that vaccines benefit children. You know what you must do, yet a guardian insists you must not do it. This is a significant ethical dilemma.

SOLUTION : Obey the guardian's wishes for their child.

5. Withholding information versus being honest.

Nurses are ethically expected to be open and transparent with patients. However, there are cases when you may feel as a nurse that explaining the gravity of a situation to a patient will worsen their stress and anxiety. You may, therefore, think it is more appropriate to withhold some information from them. This presents a big dilemma.

SOLUTION: Always be honest, especially when the situation is complex. Patients deserve to know the truth.

6. Limited resources versus healthcare needs.

Nurses occasionally face situations where their resources are not optimal for the people they serve. Remember the COVID-ventilator issue? Doctors and nurses had to decide whom to give ventilators initially at the start of the pandemic when there were not enough ventilators.

SOLUTION: When the resources are limited, choosing patients based on severity is recommended.

7. Questionable orders.

Doctors and other medical professionals are not perfect. They make mistakes from time to time. Therefore, you will have a big dilemma when a doctor prescribes treatment, and you feel it is not the best treatment in the back of your mind. Do you fulfill the doctor's order or intercede and question it?

SOLUTION: When you feel something wrong is about to happen, you should speak up to protect the patient's interest.

How to Address Ethical Dilemmas in Nursing

The best way to address ethical dilemmas is to internalize and follow the nursing ethical principles and the ANA code of conduct. However, not everyone constantly has the time and energy to review nursing ethical principles and the ANA code of conduct.

For this reason, we have shared the tips below to help you correctly address ethical dilemmas in nursing.

1. A Problem Shared Is a Problem Halved

When you feel uneasy about an ethical situation, you should share it with a trusted colleague or a supervisor. Communicating the problem with someone else invites a fresh perspective to the problem and increases the likelihood of arriving at a better decision.

2. Internalize Patient Autonomy

Remembering and recognizing patient autonomy or the right to make their own decisions is always important. It doesn't matter what you think is best for a patient – what they want is what you should do as long as it is legal and within your nursing responsibilities. Of course, you should present the patient with all the information they need to decide. So if you ever have to grapple with an ethical situation that makes you feel like ignoring patient autonomy, you shouldn't do it. You should choose the option that ensures patient autonomy.

3. Respect the Right to Privacy

Every patient has a right to privacy. This means you should treat their information as confidential and only to be shared with them or with persons they approve. It is not in your place to share patient information, especially when it is sensitive. You can only share info when given consent. Therefore, if you ever have a dilemma about sharing information, remember to respect the right to privacy and ask for consent to share info if you think it is necessary.

4. Transparency is Key

You should always be open and honest with patients. Doing this will help you to avoid many ethical situations. It will also make it easy for you to make ethical decisions. Therefore, whenever necessary, please share all the information you can share with patients to help them understand what is happening. Share with them the pros and cons of every treatment or management option. Let them be fully aware of the benefits and risks of everything.

5. Ask Yourself What Is in The Best Interest of the Patient

Whenever you need to make an ethical decision, in addition to all your other considerations, you should ask yourself what is in the patient's best interest. Asking yourself this question will help you act in a way that ensures the patient's best interests are taken into account. It will also force you to involve the patient in decision-making to know what they want or wish for. You can never go wrong by acting in a patient's best interest.

6. Stay Up-To-Date with Ethical Guidelines

Ethical guidelines change regularly. Therefore, to ensure you are always making the right ethical decisions, you should stay up to date with ethical guidelines (both professional guidelines and institution-specific guidelines). It is not always easy to do this, but you can subscribe to nursing blogs that discuss ethical guidelines. This will ensure you always have the latest information you need to make good ethical decisions. You can also stay up to date by enrolling in at least one online ethical nursing training program or course. This will help you to refresh your ethical principles knowledge and to be aware of the latest ethical issues in nursing.

7. Always Do Something as Soon as You Can

When faced with an ethical situation, never do anything and hope the situation will resolve itself. Always do something as soon as possible. This will ensure either the issue is solved or starts getting solved. When you ignore an ethical situation, it has the risk of snowballing and becoming a much bigger issue down the line. Therefore, please do something about an issue whenever you can do it quickly.

8. Negotiating Never Hurts Anybody

One of the best things you can do when facing a nursing ethical dilemma is to negotiate with the parties involved. When you do this respectfully and fairly, you can easily resolve most ethical situations. For example, if a patient refuses a specific treatment for religious reasons, you can convince them to accept it using various persuasion techniques. Of course, you should respect the patient's decision if they insist on a certain stance or position.

9. Talk to Somebody Higher Up

As a nurse, some ethical decisions are not yours; they are above your pay grade. In such a case, they should be referred to somebody higher up, e.g., the nurse manager or the nurse supervisor. Because the manager or supervisor is usually more experienced, they are often in a much better position to handle ethical decisions and teach you what to do when faced with the same situation again.

Consequences of Failing to Address Ethical Dilemmas in Nursing Properly

When you fail to address ethical dilemmas in nursing correctly, there are often negative consequences. The most common negative consequences nurses have to deal with include the following:

1. Loss of License

When you are faced with an ethical decision, you must make sure you act in the way expected of you according to the nursing code of conduct. Failure to act in the manner that is expected of you in the nursing code of conduct can lead to loss of licensure. This is especially true when your decision in an ethical situation is an egregious violation of the nursing code of conduct or the ethical principles of nursing. Therefore, when faced with an ethical decision, it is best to consider the options carefully and to act in the way that is expected of you.

2. Legal Issues

You could face legal issues when you fail to adequately address certain ethical dilemmas in nursing. As a nurse, you have specific responsibilities. You are also expected to adhere to the nursing code of conduct. If you fail to address ethical issues correctly, e.g., you leak confidential information about a celebrity patient for money to the public, you could face legal issues, including a lawsuit and/or criminal charges. Hence it is crucial to think long and hard about some ethical issues before deciding what to do.

3. Job Suspension or Termination

Most hospitals have a code of conduct that nurses and other healthcare professionals must sign when hired. They expect nurses to follow the code to the letter. Most hospitals also expect nurses to follow the ANA code of conduct and to always adhere to the ethical principles of nursing. So when faced with an ethical situation and failing to act correctly, you could end up before the ethics committee of your hospital, and they could recommend your suspension or the termination of your job contract.

4. Stress and Burnout

Ethical situations can cause a lot of stress and mental burnout. They can make it almost impossible for you to continue operating normally. When you ignore them or make the wrong decision, you can potentially make them worse. This can lead to even more stress and even physical burnout. Consequently, it is important to make the right decisions quickly when faced with ethical problems or issues.

5. Negative Patient Outcomes

The worse thing that could happen if you don't address ethical issues correctly is an adverse patient outcome, such as patient deterioration, patient injury, or death. It is always painful for nurses to realize or discover that their decisions caused an adverse patient outcome. It can lead to stress, loss of self-confidence, and so on. Of course, an adverse patient outcome can also lead to legal issues, job suspension, and job loss. So it is best to make the correct decision whenever faced with an ethical dilemma.

Takeaway about Ethical Dilemmas in Nursing Practice

Nursing training is all-rounded in anticipation of all the issues a trained nurse would experience in typical clinical settings. Learning about ethical dilemmas and how to solve them can be a stepping stone toward excellence as a nurse or medical/healthcare practitioner. You will be dealing with many ethical dilemmas in the workplace and an experience on how to solve them can always help you avert adverse situations.

Related Readings:

• List of hot controversial topics for nursing issue papers

If you have an ethical dilemma assignment, paper, essay, or coursework troubling you, you should hire a nursing writer from NurseMyGrade to help you. We are a team of professional nursing writers offering assignment help and coursework help for busy nursing students and nurses worldwide.

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Personal Code of Ethics what is it

This essay about crafting a personal code of ethics explores the core principles that guide the author’s daily actions and decisions: honesty, fairness, compassion, and responsibility. It discusses how these values are applied in real-life situations, often presenting challenges when principles appear to conflict, such as balancing honesty with compassion. The essay also emphasizes the importance of personal accountability and environmental stewardship, reflecting a broader sense of responsibility. Through continual self-reflection and adaptation to new experiences, the author highlights how a personal ethical code serves as a moral compass, providing a foundation for integrity and purposeful living. This narrative illustrates the dynamic nature of ethical codes and their role in guiding personal growth and decision-making.

How it works

Creating a personal code of ethics is akin to drafting a blueprint for one’s moral architecture. It’s a self-crafted guide that encompasses the values and principles I strive to uphold, regardless of external pressures or fleeting trends. This personal ethical framework is not just theoretical but a practical set of standards that inform my decisions and shape my interactions within various aspects of life.

At the heart of my ethical code are the principles of honesty, fairness, and compassion.

Honesty for me means more than just not lying. It involves being authentic and transparent in my intentions and communications, ensuring that my actions align with my words. Fairness is another pillar, guiding me to treat everyone with equity and without prejudice, recognizing that fairness often requires adjusting the balance to accommodate unequal starting points in life. Compassion extends beyond empathy; it compels me to actively seek out ways to alleviate the suffering of others, whether through direct help or advocacy.

The application of these principles is not without its challenges. Real-world scenarios often present complex situations where these ideals might seem to be in conflict. For instance, being honest in providing feedback might risk hurting someone’s feelings, challenging the balance between honesty and compassion. In such dilemmas, I strive to find a resolution that remains true to my core values while considering the broader context and potential consequences of my actions.

My ethical code also emphasizes responsibility, both in personal accountability and in environmental stewardship. I believe that taking responsibility for one’s actions is fundamental to ethical conduct. This includes acknowledging when I’m wrong and making amends where possible. Environmental stewardship, on the other hand, reflects a broader responsibility to the planet. It influences my choices, from minimizing waste to supporting sustainable practices and policies.

Staying true to this ethical code requires constant vigilance and reflection. It involves regularly evaluating my choices and actions to ensure they align with these principles. This ongoing process helps me grow and adapt my code as I learn and as the world changes around me. It’s a dynamic process, one that evolves as I encounter new experiences and insights.

In crafting and adhering to my personal code of ethics, I have developed a framework that not only guides my daily decisions but also shapes my aspirations and dreams. It helps me navigate through life’s challenges and opportunities with a sense of integrity and purpose. More importantly, it serves as a compass in times of moral uncertainty, helping me make choices that I can stand behind confidently.

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