Mark E Borden MD | What Are the 7 Ethical Principles in Nursing?
Nursing is a profession that extends beyond clinical
competence, involving ethical responsibilities to patients, colleagues, and
society. Nurses often face moral dilemmas that require them to carefully navigate
complex situations, ensuring their decisions align with both ethical standards
and patient needs. To help guide decision-making in these situations, the
nursing profession relies on seven core ethical principles. These
principles—autonomy, beneficence, non-maleficence, justice, fidelity, veracity,
and accountability—serve as the foundation of ethical nursing practice, helping
nurses provide compassionate, fair, and responsible care to all patients.
1. Autonomy
The principle of autonomy is central to nursing ethics,
emphasizing the importance of respecting patients’ rights to make their own
decisions. Autonomy is about acknowledging and supporting a patient's capacity
to make informed choices regarding their health, treatment, and personal
well-being. Nurses are responsible for ensuring that patients receive all the
necessary information to make these decisions, including understanding the
benefits, risks, and alternatives of proposed treatments. Mark E Borden MD
However, autonomy can present ethical challenges, particularly
when patients make decisions that conflict with medical advice or when they are
not fully competent to make their own choices. In such cases, nurses must
navigate these situations by balancing respect for the patient’s autonomy with
other ethical principles, such as beneficence and non-maleficence, which
prioritize the patient’s overall well-being.
2. Beneficence
Beneficence refers to the ethical obligation to act in the
best interests of the patient and promote their well-being. Nurses practice beneficence
by providing compassionate care, which can range from administering medications
to alleviate pain, to offering emotional support during difficult times. This
principle demands that nurses always act in ways that benefit the patient,
including advocating for their needs within the healthcare system and ensuring
that the patient’s physical and emotional health is prioritized.
However, beneficence is not just about doing good—it also
requires nurses to consider the long-term impact of their actions. This may
involve making difficult decisions about what kind of care is appropriate,
especially when aggressive interventions may do more harm than good.
3. Non-Maleficence
Often summarized as “do no harm,” non-maleficence is the
ethical principle that guides nurses to avoid causing injury, suffering, or any
form of harm to their patients. Non-maleficence often goes hand-in-hand with
beneficence, but while beneficence focuses on the positive actions nurses can
take, non-maleficence focuses on the obligation to avoid harm.
In practice, non-maleficence requires nurses to evaluate the
potential risks and benefits of treatments, ensuring that the chosen course of
action minimizes harm. For example, if a patient is considering a surgical
procedure, the nurse must help the patient understand not only the potential
benefits but also the risks, ensuring the patient can make an informed
decision. Nurses must always be mindful of avoiding harm in all aspects of
care, from administering medications to safeguarding patient privacy.
4. Justice
The principle of justice focuses on fairness in the
distribution of healthcare resources and services. It calls for equitable
treatment of all patients, regardless of their background, financial status, or
social position. Justice requires nurses to ensure that every patient receives
access to the same level of care, even in the face of systemic barriers such as
healthcare inequities or resource limitations.
Nurses advocate for justice by working to identify and
correct disparities in patient care. This can mean pushing for equitable access
to treatments, resources, and health information, especially for vulnerable or
marginalized populations. Nurses also support justice by collaborating with
other healthcare professionals and policymakers to promote fairness in the
delivery of healthcare on a broader scale. Mark Borden MD
5. Fidelity
Fidelity is the ethical principle that emphasizes loyalty
and the fulfillment of promises. It speaks to the nurse’s responsibility to
remain trustworthy, dependable, and loyal to the patient’s interests. Fidelity
means keeping promises to patients, families, and colleagues and maintaining
professional standards of care.
One of the most important aspects of fidelity is
confidentiality. Patients must feel confident that the information they share
with nurses will remain private and secure unless disclosure is required to
prevent harm. By keeping patient information confidential and maintaining
transparency in their interactions, nurses build trust, which is the cornerstone
of the nurse-patient relationship.
6. Veracity
Veracity refers to the ethical principle of truthfulness.
Nurses must provide accurate and complete information to patients, ensuring
that patients are fully informed about their condition, treatment options, and
prognosis. Veracity builds trust and fosters informed consent, a crucial
component of patient autonomy.
In practice, veracity can be challenging, especially when
conveying difficult or upsetting news. Nurses may struggle with how to share
the truth in a way that is both compassionate and clear. Despite these
challenges, nurses are ethically obligated to prioritize honesty and
transparency, ensuring that patients can make fully informed decisions about
their care.
7. Accountability
Accountability is the ethical principle that holds nurses
responsible for their actions, decisions, and the outcomes of patient care.
Nurses are accountable to patients, colleagues, and the nursing profession,
ensuring that their conduct aligns with the highest ethical and professional
standards.
In practice, accountability means that nurses must take
ownership of their decisions and be willing to address any mistakes or errors
in judgment. This includes reporting errors when they occur, adhering to
protocols, and continuously engaging in self-reflection and professional
development. By taking responsibility for their actions, nurses uphold the
integrity of the profession and ensure the best possible outcomes for patients.
Conclusion
The seven ethical principles in nursing—autonomy,
beneficence, non-maleficence, justice, fidelity, veracity, and
accountability—provide a moral framework that guides nurses in delivering
ethical, compassionate, and equitable care. These principles help nurses
navigate the complexities of patient care, ensuring that each decision is
grounded in respect, fairness, and a commitment to doing what is right for the
patient. By adhering to these ethical principles, nurses not only protect their
patients' rights but also strengthen the trust that is essential to effective
nursing practice.
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