{"id":116,"date":"2021-08-24T19:35:30","date_gmt":"2021-08-24T19:35:30","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/6-2-basic-ethical-concepts\/"},"modified":"2025-02-18T18:43:02","modified_gmt":"2025-02-18T18:43:02","slug":"6-2-basic-ethical-concepts","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/6-2-basic-ethical-concepts\/","title":{"raw":"6.2 Basic Ethical Concepts","rendered":"6.2 Basic Ethical Concepts"},"content":{"raw":"The American Nurses Association (ANA) defines <strong>[pb_glossary id=\"409\"]morality[\/pb_glossary]<\/strong> as \u201cpersonal values, character, or conduct of individuals or groups within communities and societies,\u201d whereas <strong>[pb_glossary id=\"410\"]ethics[\/pb_glossary]<\/strong> is the formal study of morality from a wide range of perspectives.<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]\u00a0<\/sup>Ethical behavior is considered to be such an important aspect of nursing the ANA has designated <em>Ethics<\/em> as the first Standard of Professional Performance. The ANA Standards of Professional Performance are \"authoritative statements of the actions and behaviors that all registered nurses, regardless of role, population, specialty, and setting, are expected to perform competently.\" See the following box for the competencies associated with the ANA <em>Ethics<\/em> Standard of Professional Performance<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup>:\n<div class=\"textbox shaded\">\n\n<strong>Competencies of ANA's Ethics Standard of Professional Performance<\/strong><sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup>\n<ul>\n \t<li>Uses the <em>Code of Ethics for Nurses With Interpretive Statements<\/em> as a moral foundation to guide nursing practice and decision-making.<\/li>\n \t<li>Demonstrates that every person is worthy of nursing care through the provision of respectful, person-centered, compassionate care, regardless of personal history or characteristics (Beneficence).<\/li>\n \t<li>Advocates for health care consumer perspectives, preferences, and rights to informed decision-making and self-determination (Respect for autonomy).<\/li>\n \t<li>Demonstrates a primary commitment to the recipients of nursing and health care services in all settings and situations (Fidelity).<\/li>\n \t<li>Maintains therapeutic relationships and professional boundaries.<\/li>\n \t<li>Safeguards sensitive information within ethical, legal, and regulatory parameters (Nonmaleficence).<\/li>\n \t<li>Identifies ethics resources within the practice setting to assist and collaborate in addressing ethical issues.<\/li>\n \t<li>Integrates principles of social justice in all aspects of nursing practice (Justice).<\/li>\n \t<li>Refines ethical competence through continued professional education and personal self-development activities.<\/li>\n \t<li>Depicts one's professional nursing identity through demonstrated values and ethics, knowledge, leadership, and professional comportment.<\/li>\n \t<li>Engages in self-care and self-reflection practices to support and preserve personal health, well-being, and integrity.<\/li>\n \t<li>Contributes to the establishment and maintenance of an ethical environment that is conducive to safe, quality health care.<\/li>\n \t<li>Collaborates with other health professionals and the public to protect human rights, promote health diplomacy, enhance cultural sensitivity and congruence, and reduce health disparities.<\/li>\n \t<li>Represents the nursing perspective in clinic, institutional, community, or professional association ethics discussions.<\/li>\n<\/ul>\n<strong>Reflective Questions<\/strong>\n<ol>\n \t<li>What <em>Ethics<\/em> competencies have you already demonstrated during your nursing education?<\/li>\n \t<li>What <em>Ethics<\/em> competencies are you most interested in mastering?<\/li>\n \t<li>What questions do you have about the ANA\u2019s <em>Ethics<\/em> competencies?<\/li>\n<\/ol>\n<\/div>\nThe ANA's <em>Code of Ethics for Nurses With Interpretive Statements<\/em> is an ethical standard that guides nursing practice and ethical decision-making.<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]<\/sup> This section will review several basic ethical concepts related to the ANA's <em>Ethics<\/em> Standard of Professional Performance, such as values, morals, ethical theories, ethical principles, and the ANA <em>Code of Ethics for Nurses<\/em>.\n<h2>Values<\/h2>\n<strong>[pb_glossary id=\"411\"]Values[\/pb_glossary]<\/strong> are individual beliefs that motivate people to act one way or another and serve as guides for behavior considered \u201cright\u201d and \u201cwrong.\u201d People tend to adopt the values with which they were raised and believe those values are \u201cright\u201d because they are the values of their culture. Some personal values are considered sacred and moral imperatives based on an individual\u2019s religious beliefs.<sup>[footnote]Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a>[\/footnote]<\/sup> See Figure 6.1<sup>[footnote]\u201c<a href=\"https:\/\/pixabay.com\/de\/photos\/ethik-rechts-falsch-ethisch-moral-2991600\/\" target=\"_blank\" rel=\"noopener\">ethics-2991600_1920<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/de\/users\/tumisu-148124\/\" target=\"_blank\" rel=\"noopener\">Tumisu<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener\">CC0 1.0<\/a>[\/footnote]<\/sup> for an image depicting choosing right from wrong actions.\n\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"300\"]<img class=\"wp-image-110 size-medium\" title=\"\u201cethics-2991600_1920\u201d by Tumisu is licensed under CC0 1.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-300x212.jpg\" alt=\"Image showing a sign stating directions for right and wrong\" width=\"300\" height=\"212\"> Figure 6.1 Values[\/caption]\n\nIn addition to personal values, organizations also establish values. The American Nurses Association (ANA) Professional Nursing Model states that nursing is based on values such as caring, compassion, presence, trustworthiness, diversity, acceptance, and accountability. These values emerge from nursing practice beliefs, such as the importance of relationships, service, respect, willingness to bear witness, self-determination, and the pursuit of health.<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup> As a result of these traditional values and beliefs by nurses, Americans have ranked nursing as the most ethical and honest profession in Gallup polls since 1999, with the exception of 2001, when firefighters earned the honor after the attacks on September 11.<sup>[footnote]Gaines, K. (2021, January 19). <em>Nurses ranked most trusted profession 19 years in a row.<\/em> Nurse.org. <a href=\"https:\/\/nurse.org\/articles\/nursing-ranked-most-honest-profession\" target=\"_blank\" rel=\"noopener\">https:\/\/nurse.org\/articles\/nursing-ranked-most-honest-profession<\/a>\/[\/footnote]<\/sup>\n\nThe National League of Nursing (NLN) has also established four core values for nursing education: caring, integrity, diversity, and excellence<sup>[footnote]National League for Nursing. <em>Core values.<\/em> <a href=\"https:\/\/www.nln.org\/about\/about\/core-values\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nln.org\/about\/about\/core-values<\/a>[\/footnote]<\/sup>:\n<ul>\n \t<li style=\"font-weight: 400\"><strong>Caring:<\/strong> Promoting health, healing, and hope in response to the human condition.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Integrity:<\/strong> Respecting the dignity and moral wholeness of every person without conditions or limitations.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Diversity:<\/strong> Affirming the uniqueness of and differences among persons, ideas, values, and ethnicities.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Excellence:<\/strong> Cocreating and implementing transformative strategies with daring ingenuity.<\/li>\n<\/ul>\n<div class=\"textbox shaded \">\n<p class=\"video\">View the <a href=\"https:\/\/youtu.be\/SCjYaatMJuY\" target=\"_blank\" rel=\"noopener\">McCombs School of Business Values video on YouTube.<\/a><sup>[footnote]McCombs School of Business. (2018, December 18). <em>Values | Ethics defined<\/em>\u00a0[Video]. YouTube. All rights reserved. <a href=\"https:\/\/youtu.be\/SCjYaatMJuY\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/SCjYaatMJuY<\/a> [\/footnote]<\/sup><\/p>\n\n<\/div>\n<h2>Morals<\/h2>\n<strong>[pb_glossary id=\"412\"]Morals[\/pb_glossary] <\/strong>are the prevailing standards of behavior of a society that enable people to live cooperatively in groups. \u201cMoral\u201d refers to what societies sanction as right and acceptable. Most people tend to act morally and follow societal guidelines, and most laws are based on the morals of a society. Morality often requires that people sacrifice their own short-term interests for the benefit of society. People or entities that are indifferent to right and wrong are considered \u201camoral,\u201d while those who do evil acts are considered \u201cimmoral.\u201d<sup>[footnote]Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a>[\/footnote]<\/sup>\n<h2>Ethical Theories<\/h2>\nThere are two major types of ethical theories that guide values and moral behavior referred to as deontology and consequentialism.\n\n<strong>[pb_glossary id=\"413\"]Deontology[\/pb_glossary]<\/strong> is an ethical theory based on rules that distinguish right from wrong. See Figure 6.2<sup>[footnote]\u201c<a href=\"https:\/\/pixabay.com\/de\/illustrations\/ethik-wortwolke-kant-botschaft-947572\/\" target=\"_blank\" rel=\"noopener\">ethics-947572_1920<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/de\/users\/rdaconnect-1201591\/\" target=\"_blank\" rel=\"noopener\">rdaconnect a<\/a>t <a href=\"https:\/\/pixabay.com\/de\/\" target=\"_blank\" rel=\"noopener\">Pixabay.com<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener\">CC0 1.0<\/a>[\/footnote]<\/sup> for a word cloud illustration of deontology. Deontology is based on the word <em>deon<\/em> that refers to \u201cduty.\u201d It is associated with philosopher Immanuel Kant. Kant believed that ethical actions follow universal moral laws, such as, \u201cDon\u2019t lie. Don\u2019t steal. Don\u2019t cheat.\u201d<sup>[footnote]Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary)<\/em>. University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a>[\/footnote]<\/sup> Deontology is simple to apply because it just requires people to follow the rules and do their duty. It doesn\u2019t require weighing the costs and benefits of a situation, thus avoiding subjectivity and uncertainty.<sup>[footnote]Alexander, L., &amp; Moore, M. (2020, October 30). Deontological ethics. <em>Stanford Encyclopedia of Psychology.<\/em> <a href=\"https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/<\/a>[\/footnote],<\/sup><sup>[footnote]Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a>[\/footnote],<\/sup><sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup>\n\nThe nurse-client relationship is deontological in nature because it is based on the ethical principles of beneficence and maleficence that drive clinicians to \u201cdo good\u201d and \u201cavoid harm.\u201d<sup>[footnote]Mandal, J., Ponnambath, D. K., &amp; Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. <em>Tropical Parasitology, 6<\/em>(1), 5\u20137. <a href=\"https:\/\/doi.org\/10.4103\/2229-5070.175024\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.4103\/2229-5070.175024<\/a>[\/footnote]<\/sup> Ethical principles will be discussed further in this chapter.\n\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"304\"]<img class=\"wp-image-111 \" title=\"\u201cethics-947572_1920\u201d by rdaconnect at Pixabay.com is licensed under CC0 1.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-793x1024.jpg\" alt=\"Image showing a word cloud regarding deontology\" width=\"304\" height=\"393\"> Figure 6.2 Deontology[\/caption]\n\n<div class=\"textbox shaded \">\n<p class=\"video\">View the <a href=\"https:\/\/youtu.be\/wWZi-8Wji7M\" target=\"_blank\" rel=\"noopener\">McCombs School of Business Deontology video on YouTube.<\/a><sup>[footnote]McCombs School of Business. (2018, December 18). <em>Deontology | Ethics defined<\/em>\u00a0[Video]. YouTube. All rights reserved. <a href=\"https:\/\/youtu.be\/wWZi-8Wji7M\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/wWZi-8Wji7M<\/a> [\/footnote]<\/sup><\/p>\n\n<\/div>\n<strong>[pb_glossary id=\"414\"]Consequentialism[\/pb_glossary]<\/strong> is an ethical theory used to determine whether or not an action is right by the consequences of the action. See Figure 6.3<sup>[footnote]\u201c<a href=\"https:\/\/pixabay.com\/pt\/vectors\/saldo-%c3%a9tica-valores-certo-errado-6097898\/\" target=\"_blank\" rel=\"noopener\">balance-6097898_1280<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/pt\/users\/mohamed_hassan-5229782\/\" target=\"_blank\" rel=\"noopener\">mohamed_hassan<\/a>\u00a0is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener\">CC0 1.0<\/a>[\/footnote]<\/sup> for an illustration of weighing the consequences of an action in consequentialism. For example, most people agree that lying is wrong, but if telling a lie would help save a person\u2019s life, consequentialism says it\u2019s the right thing to do. One type of consequentialism is utilitarianism. <strong>[pb_glossary id=\"415\"]Utilitarianism[\/pb_glossary]<\/strong> determines whether or not actions are right based on their consequences with the standard being achieving the greatest good for the greatest number of people.<sup>[footnote]Alexander, L., &amp; Moore, M. (2020, October 30). Deontological ethics. <em>Stanford Encyclopedia of Psychology.<\/em> <a href=\"https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/<\/a>[\/footnote],[footnote]Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a>[\/footnote],<\/sup><sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote] <\/sup>For this reason, utilitarianism tends to be society-centered. When applying utilitarian ethics to health care resources, money, time, and clinician energy are considered finite resources that should be appropriately allocated to achieve the best health care for society.<sup>[footnote]Mandal, J., Ponnambath, D. K., &amp; Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. <em>Tropical Parasitology, 6<\/em>(1), 5\u20137. <a href=\"https:\/\/doi.org\/10.4103\/2229-5070.175024\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.4103\/2229-5070.175024<\/a>[\/footnote]<\/sup>\n\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"417\"]<img class=\"wp-image-112 \" title=\"\u201cbalance-6097898_1280\u201d by mohamed_hassan\u00a0is licensed under CC0 1.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-1024x694.png\" alt=\"Illustration showing justice scales with a checkmark in one side and an x in the other\" width=\"417\" height=\"283\"> Image 6.3 Consequentialism[\/caption]\n\nUtilitarianism can be complicated when accounting for values such as justice and individual rights. For example, assume a hospital has four clients whose lives depend upon receiving four organ transplant surgeries for a heart, lung, kidney, and liver. If a healthy person without health insurance or family support experiences a life-threatening accident and is considered brain dead but is kept alive on life-sustaining equipment in the ICU, the utilitarian framework might suggest the organs be harvested to save four lives at the expense of one life.<sup>[footnote]Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a>[\/footnote]<\/sup> This action could arguably produce the greatest good for the greatest number of people, but the deontological approach could argue this action would be unethical because it does not follow the rule of \u201cdo no harm.\u201d\n<div class=\"textbox shaded \">\n<p class=\"video\">Watch <a href=\"https:\/\/youtu.be\/51DZteag74A\" target=\"_blank\" rel=\"noopener\">McCombs School of Business Consequentialism video on YouTube.<\/a><sup>[footnote]McCombs School of Business. (2018, December 18). <em>Consequentialism | Ethics defined<\/em>\u00a0[Video]. YouTube. All rights reserved. <a href=\"https:\/\/youtu.be\/51DZteag74A\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/51DZteag74A<\/a> [\/footnote]<\/sup><\/p>\n\n<\/div>\n<div class=\"textbox shaded \">\n<p class=\"arrow\">Read more about <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4574465\/\" target=\"_blank\" rel=\"noopener\">Decision making on organ donation: The dilemmas of relatives of potential brain dead donors.<\/a><\/p>\n\n<\/div>\nInterestingly, deontological and utilitarian approaches to ethical issues may result in the same outcome, but the rationale for the outcome or decision is different because it is focused on duty (deontologic) versus consequences (utilitarian).\n\nSocieties and cultures have unique ethical frameworks that may be based upon either deontological or consequentialist ethical theory. Culturally derived deontological rules may apply to ethical issues in health care. For example, a traditional Chinese philosophy based on Confucianism results in a culturally acceptable practice of family members (rather than the client) receiving information from health care providers about life-threatening medical conditions and making treatment decisions. As a result, cancer diagnoses and end-of-life treatment options may not be disclosed to the client in an effort to alleviate the suffering that may arise from knowledge of their diagnosis. In this manner, a client\u2019s family and the health care provider may ethically prioritize a client\u2019s psychological well-being over their autonomy and self-determination.<sup>[footnote]Wang, H., Zhao, F., Wang, X., &amp; Chen, X. (2018). To tell or not: The Chinese doctors' dilemma on disclosure of a cancer diagnosis to the patient. <em>Iranian Journal of Public Health, 47<\/em>(11), 1773\u20131774. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30581799\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30581799<\/a>[\/footnote]<\/sup> However, in the United States, this ethical decision may conflict with HIPAA Privacy Rules and the ethical principle of client autonomy. As a result, a nurse providing client care in this type of situation may experience an ethical dilemma. Ethical dilemmas are further discussed in the \"<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/6-3-ethical-dilemmas\/\" target=\"_blank\" rel=\"noopener\">Ethical Dilemmas<\/a>\" section of this chapter.\n\nSee Table 6.2 comparing common ethical issues in health care viewed through the lens of deontological and consequential ethical frameworks.\n\nTable 6.2. Ethical Issues Through the Lens of Deontological or Consequential Ethical Frameworks\n<div align=\"left\">\n<table class=\"grid\">\n<tbody>\n<tr>\n<th class=\"shaded\" scope=\"col\"><strong>Ethical Issue<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Deontological View<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Consequential View<\/strong><\/th>\n<\/tr>\n<tr>\n<th scope=\"row\">Abortion<\/th>\n<td>Abortion is unacceptable based on the rule of preserving life.<\/td>\n<td>Abortion may be acceptable in cases of an unwanted pregnancy, rape, incest, or risk to the mother.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Bombing an area with known civilians<\/th>\n<td>Killing civilians is not acceptable due to the loss of innocent lives.<\/td>\n<td>The loss of innocent lives may be acceptable if the bombing stops a war that could result in significantly more deaths than the civilian casualties.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Stealing<\/th>\n<td>Taking something that is not yours is wrong.<\/td>\n<td>Taking something to redistribute resources to others in need may be acceptable.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Killing<\/th>\n<td>It is never acceptable to take another human being\u2019s life.<\/td>\n<td>It may be acceptable to take another human life in self-defense or to prevent additional harm they could cause others.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Euthanasia\/physician- assisted suicide<\/th>\n<td>It is never acceptable to assist another human to end their life prematurely.<\/td>\n<td>End-of-life care can be expensive and emotionally upsetting for family members. If a competent, capable adult wishes to end their life, medically supported options should be available.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Vaccines<\/th>\n<td>Vaccination is a personal choice based on religious practices or other beliefs.<\/td>\n<td>Recommended vaccines should be mandatory for everyone (without a medical contraindication) because of its greater good for all of society.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<h2>Ethical Principles and Obligations<\/h2>\n<strong>[pb_glossary id=\"416\"]Ethical principles[\/pb_glossary]<\/strong> are used to define nurses\u2019 moral duties and aid in ethical analysis and decision-making.<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup> Although there are many ethical principles that guide nursing practice, foundational ethical principles include autonomy (self-determination), beneficence (do good), nonmaleficence (do no harm), justice (fairness), fidelity (keep promises), and veracity (tell the truth).\n<h3>Autonomy<\/h3>\nThe ethical principle of <strong>[pb_glossary id=\"417\"]autonomy[\/pb_glossary]<\/strong> recognizes each individual\u2019s right to self-determination and decision-making based on their unique values, beliefs, and preferences. See Figure 6.4<sup>[footnote]\u201cAutonomy and Self-Determination.png\u201d by Meredith Pomietlo for <a href=\"https:\/\/www.cvtc.edu\/\" target=\"_blank\" rel=\"noopener\">Chippewa Valley Technical College<\/a>\u00a0is licensed under\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener\">CC BY 4.0<\/a>[\/footnote]<\/sup> for an illustration of autonomy. The American Nurses Association (ANA) defines autonomy as the \u201ccapacity to determine one\u2019s own actions through independent choice, including demonstration of competence.\u201d<sup>[footnote]American Nurses Association. (2021).<em> Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup> The nurse\u2019s primary ethical obligation is client autonomy.<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]<\/sup> Based on autonomy, clients have the right to refuse nursing care and medical treatment. An example of autonomy in health care is advance directives. Advance directives allow clients to specify health care decisions if they become incapacitated and unable to do so.\n\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"228\"]<img class=\"wp-image-113 \" title=\"\u201cAutonomy and Self-Determination.png\u201d by Meredith Pomietlo for Chippewa Valley Technical College\u00a0is licensed under\u00a0CC BY 4.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-838x1024.png\" alt=\"Image of fist icon with repeating text on the inside fist shape\" width=\"228\" height=\"279\"> Figure 6.4 Autonomy and Self-Determination[\/caption]\n\n<div class=\"textbox shaded \">\n<p class=\"arrow\">Read more about advance directives and determining capacity and competency in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/5-1-introduction\/\" target=\"_blank\" rel=\"noopener\">Legal Implications<\/a>\u201d chapter.<\/p>\n\n<\/div>\n<h4>Nurses as Advocates: Supporting Autonomy<\/h4>\nNurses have a responsibility to act in the interest of those under their care, referred to as advocacy. The American Nurses Association (ANA) defines advocacy as \u201cthe act or process of pleading for, supporting, or recommending a cause or course of action. Advocacy may be for persons (whether an individual, group, population, or society) or for an issue, such as potable water or global health.\u201d<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]<\/sup> See Figure 6.5<sup>[footnote]\u201cAdvocacy\u201d by Meredith Pomietlo for <a href=\"https:\/\/www.cvtc.edu\/\" target=\"_blank\" rel=\"noopener\">Chippewa Valley Technical College<\/a>\u00a0is licensed under\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener\">CC BY 4.0<\/a>[\/footnote]<\/sup> for an illustration of advocacy.\n\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"365\"]<img class=\"wp-image-114 \" title=\"\u201cAdvocacy\u201d by Meredith Pomietlo for Chippewa Valley Technical College\u00a0is licensed under\u00a0CC BY 4.0\u00a0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-1024x426.png\" alt=\"Image showing bullhorn shaped icon with text reading Advocacy coming out of it\" width=\"365\" height=\"152\"> Figure 6.5 Advocacy[\/caption]\n\n<strong>[pb_glossary id=\"418\"]Advocacy [\/pb_glossary]<\/strong> includes providing education regarding client rights, supporting autonomy and self-determination, and advocating for client preferences to health care team members and family members. Nurses do not make decisions for clients, but instead support them in making their own informed choices. At the core of making informed decisions is knowledge. Nurses serve an integral role in client education. Clarifying unclear information, translating medical terminology, and making referrals to other health care team members (within their scope of practice) ensures that clients have the information needed to make treatment decisions aligned with their personal values.\n\nAt times, nurses may find themselves in a position of supporting a client\u2019s decision they do not agree with and would not make for themselves or for the people they love. However, self-determination is a human right that honors the dignity and well-being of individuals. The nursing profession, rooted in caring relationships, demands that nurses have nonjudgmental attitudes and reflect \u201cunconditional positive regard\u201d for every client. Nurses must suspend personal judgement and beliefs when advocating for their clients\u2019 preferences and decision-making.<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup>\n<h3>Beneficence<\/h3>\n<strong>[pb_glossary id=\"419\"]Beneficence [\/pb_glossary] <\/strong>is defined by the ANA as \u201cthe bioethical principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit another or others, often going beyond what is required by law.\u201d<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only<\/a>\/[\/footnote]<\/sup> See Figure 6.6<sup>[footnote]\u201c<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Air_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg\" target=\"_blank\" rel=\"noopener\">Air_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg<\/a>\u201d by Senior Airman Tyler Placie is in the\u00a0<a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/pdm\/\" target=\"_blank\" rel=\"noopener\">Public Domain<\/a>[\/footnote]<\/sup> for an illustration of beneficence. Put simply, beneficence is acting for the good and welfare of others, guided by compassion. An example of beneficence in daily nursing care is when a nurse sits with a dying client and holds their hand to provide presence.\n\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"648\"]<img class=\"wp-image-2939 \" title=\"\u201cAir_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg\u201d by Senior Airman Tyler Placie is in the\u00a0Public Domain\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/Air_Force_special_operations_medical_team_saves_lives_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082-scaled-1.jpg\" alt=\"Photo showing an Air Force critical care nurse assisting a doctor in helping a child breathe\" width=\"648\" height=\"431\"> Figure 6.6 Beneficence[\/caption]\n\nNursing advocacy extends beyond direct client care to advocating for beneficence in communities. Vulnerable populations such as children, older adults, cultural minorities, and the homeless often benefit from nurse advocacy in promoting health equity. <strong>[pb_glossary id=\"421\"]Cultural humility[\/pb_glossary] <\/strong>is a humble and respectful attitude towards individuals of other cultures and an approach to learning about other cultures as a lifelong goal and process.[footnote]American Nurses Association. (2021).<em> Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote] Nurses, the largest segment of the health care community, have a powerful voice when addressing community beneficence issues, such as health disparities and social determinants of health, and can serve as the conduit for advocating for change.\n<h3>Nonmaleficence<\/h3>\n<strong>[pb_glossary id=\"420\"]Nonmaleficence[\/pb_glossary] <\/strong>is defined by the ANA as \u201cthe bioethical principle that specifies a duty to do no harm and balances avoidable harm with benefits of good achieved.\u201d<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]<\/sup> An example of doing no harm in nursing practice is reflected by nurses checking medication rights three times before administering medications. In this manner, medication errors can be avoided, and the duty to do no harm is met. Another example of nonmaleficence is when a nurse assists a client with a serious, life-threatening condition to participate in decision-making regarding their treatment plan. By balancing the potential harm with potential benefits of various treatment options, while also considering quality of life and comfort, the client can effectively make decisions based on their values and preferences.\n<h3>Justice<\/h3>\n<strong>[pb_glossary id=\"422\"]Justice[\/pb_glossary]<\/strong> is defined by the ANA as \u201ca moral obligation to act on the basis of equality and equity and a standard linked to fairness for all in society.\u201d<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup>\u00a0The principle of justice requires health care to be provided in a fair and equitable way. Nurses provide quality care for all individuals with the same level of fairness despite many characteristics, such as the individual's financial status, culture, religion, gender, or sexual orientation. Nurses have a social contract to \u201cprovide compassionate care that addresses the individual\u2019s needs for protection, advocacy, empowerment, optimization of health, prevention of illness and injury, alleviation of suffering, comfort, and well-being.\u201d<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup> An example of a nurse using the principle of justice in daily nursing practice is effective prioritization based on client needs.\n<div class=\"textbox shaded \">\n<p class=\"arrow\">Read more about prioritization models in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/2-1-introduction\/\" target=\"_blank\" rel=\"noopener\">Prioritization<\/a>\u201d chapter.<\/p>\n\n<\/div>\n<h3>Other Ethical Principles<\/h3>\nAdditional ethical principles commonly applied to health care include <strong>[pb_glossary id=\"423\"]fidelity[\/pb_glossary] <\/strong>(keeping promises) and <strong>[pb_glossary id=\"424\"]veracity[\/pb_glossary]<\/strong> (telling the truth). An example of fidelity in daily nursing practice is when a nurse tells a client, \u201cI will be back in an hour to check on your pain level.\u201d This promise is kept. An example of veracity in nursing practice is when a nurse honestly explains potentially uncomfortable side effects of prescribed medications. Determining how truthfulness will benefit the client and support their autonomy is dependent on a nurse\u2019s clinical judgment, self-reflection, knowledge of the client and their cultural beliefs, and other factors.<sup>[footnote]American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association.[\/footnote]<\/sup>\n\nA principle historically associated with health care is paternalism. <strong>[pb_glossary id=\"425\"]Paternalism[\/pb_glossary]<\/strong> is defined as the interference by the state or an individual with another person, defended by the claim that the person interfered with will be better off or protected from harm.<sup>[footnote]Dworkin, G. (2020, September 9). Paternalism. <em>Stanford Encyclopedia of Philosophy<\/em>. <a href=\"https:\/\/plato.stanford.edu\/entries\/paternalism\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plato.stanford.edu\/entries\/paternalism\/<\/a>[\/footnote]<\/sup> Paternalism is the basis for legislation related to drug enforcement and compulsory wearing of seatbelts.\n\nIn health care, paternalism has been used as rationale for performing treatment based on what the provider believes is in the client\u2019s best interest. In some situations, paternalism may be appropriate for individuals who are unable to comprehend information in a way that supports their informed decision-making, but it must be used cautiously to ensure vulnerable individuals are not misused and their autonomy is not violated.\n\nNurses may find themselves acting paternalistically when performing nursing care to ensure client health and safety. For example, repositioning clients to prevent skin breakdown is a preventative intervention commonly declined by clients when they prefer a specific position for comfort. In this situation, the nurse should explain the benefits of the preventative intervention and the risks if the intervention is not completed. If the client continues to decline the intervention despite receiving this information, the nurse should document the education provided and the client\u2019s decision to decline the intervention. The process of reeducating the client and reminding them of the importance of the preventative intervention should be continued at regular intervals and documented.\n<h3>Care-Based Ethics<\/h3>\nNurses use a client-centered, care-based ethical approach to client care that focuses on the specific circumstances of each situation. This approach aligns with nursing concepts such as caring, holism, and a nurse-client relationship rooted in dignity and respect through virtues such as kindness and compassion.<sup>[footnote]Fry, S. T. (1989). The role of caring in a theory of nursing ethics. <em>Hypatia, 4<\/em>(2), 87-103. <a href=\"https:\/\/doi.org\/10.1111\/j.1527-2001.1989.tb00575.x\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1111\/j.1527-2001.1989.tb00575.x<\/a>[\/footnote],[footnote]Taylor, C. (1993). Nursing ethics: The role of caring. <em>Awhonn's Clinical Issues in Perinatal and Women's Health Nursing, 4<\/em>(4), 552-560. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8220369\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/8220369\/<\/a>[\/footnote]<\/sup> This care-based approach to ethics uses a holistic, individualized analysis of situations rather than the prescriptive application of ethical principles to define ethical nursing practice. This care-based approach asserts that ethical issues cannot be handled deductively by applying concrete and prefabricated rules, but instead require social processes that respect the multidimensionality of problems.<sup>[footnote]Schuchter, P., &amp; Heller, A. (2018). The care dialog: The \"ethics of care\" approach and its importance for clinical ethics consultation. <em>Medicine, Health Care, and Philosophy, 21<\/em>(1), 51\u201362. <a href=\"https:\/\/doi.org\/10.1007\/s11019-017-9784-z\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/s11019-017-9784-z<\/a>[\/footnote]<\/sup> Frameworks for resolving ethical situations are discussed in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/6-3-ethical-dilemmas\/\" target=\"_blank\" rel=\"noopener\">Ethical Dilemmas<\/a>\u201d section of this chapter.\n<h2>Nursing Code of Ethics<\/h2>\nMany professions and institutions have their own set of ethical principles, referred to as a <strong>[pb_glossary id=\"426\"]code of ethics[\/pb_glossary]<\/strong>, designed to govern decision-making and assist individuals to distinguish right from wrong. The American Nurses Association (ANA) provides a framework for ethical nursing care and guides nurses during decision-making in its formal document titled <em>Code of Ethics for Nurses With Interpretive Statements (Nursing Code of Ethics)<\/em>. The <em>Nursing Code of Ethics<\/em> serves the following purposes<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]<\/sup>:\n<ul>\n \t<li style=\"font-weight: 400\">It is a succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively.<\/li>\n \t<li style=\"font-weight: 400\">It is the profession\u2019s nonnegotiable ethical standard.<\/li>\n \t<li style=\"font-weight: 400\">It is an expression of nursing\u2019s own understanding of its commitment to society.<\/li>\n<\/ul>\nThe preface of the ANA\u2019s <em>Nursing Code of Ethics<\/em> states, \u201cIndividuals who become nurses are expected to adhere to the ideals and moral norms of the profession and also to embrace them as a part of what it means to be a nurse. The ethical tradition of nursing is self-reflective, enduring, and distinctive. A code of ethics makes explicit the primary goals, values, and obligations of the profession.\u201d<sup>[footnote]American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a>[\/footnote]<\/sup>\n\nThe <em>Nursing Code of Ethics<\/em> contains nine provisions. Each provision contains several clarifying or \u201cinterpretive\u201d statements. Read a summary of the nine provisions in the following box.\n<div class=\"textbox shaded \">\n\n<strong>Nine Provisions of the ANA <em>Nursing Code of Ethics<\/em><\/strong>\n<ul>\n \t<li style=\"font-weight: 400\"><strong>Provision 1:<\/strong> The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 2:<\/strong> The nurse\u2019s primary commitment is to the client, whether an individual, family, group, community, or population.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 3:<\/strong> The nurse promotes, advocates for, and protects the rights, health, and safety of the client.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 4:<\/strong> The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 5:<\/strong> 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.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 6:<\/strong> 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.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 7:<\/strong> 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.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 8<\/strong>: The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.<\/li>\n \t<li style=\"font-weight: 400\"><strong>Provision 9:<\/strong> The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.<\/li>\n<\/ul>\n<\/div>\n<div class=\"textbox shaded \">\n<p class=\"arrow\">Read the free, online full version of the <a href=\"https:\/\/www.nursingworld.org\/coe-view-only\" target=\"_blank\" rel=\"noopener\"><em>ANA's Code of Ethics for Nurses With Interpretive Statements.<\/em><\/a><\/p>\n\n<\/div>\nIn addition to the <em>Nursing Code of Ethics,<\/em> the ANA established the Center for Ethics and Human Rights to help nurses navigate ethical conflicts and life-and-death decisions common to everyday nursing practice.\n<div class=\"textbox shaded \">\n<p class=\"arrow\">Read more about the <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/\" target=\"_blank\" rel=\"noopener\">ANA Center for Ethics and Human Rights<\/a>.<\/p>\n\n<\/div>\n<h3>Specialty Organization Code of Ethics<\/h3>\nMany specialty nursing organizations have additional codes of ethics to guide nurses practicing in settings such as the emergency department, home care, or hospice care. These documents are unique to the specialty discipline but mirror the statements from the ANA\u2019s <em>Nursing Code of Ethics.<\/em> View examples of ethical statements of specialty nursing organizations using the information in the following box.\n<div class=\"textbox shaded \">\n\n<strong>Sample Ethical Statements of Selected Specialty Nursing Organizations<\/strong>\n<p class=\"arrow\"><a href=\"https:\/\/www.midwife.org\/acnm\/files\/ACNMLibraryData\/UPLOADFILENAME\/000000000293\/Code-of-Ethics-w-Explanatory-Statements-June-2015.pdf\" target=\"_blank\" rel=\"noopener\">American College of Nurse-Midwives<\/a><\/p>\n<p class=\"arrow\"><a href=\"http:\/\/nann.org\/about\/code-of-ethics\" target=\"_blank\" rel=\"noopener\">National Association of Neonatal Nurses<\/a><\/p>\n\n<\/div>","rendered":"<p>The American Nurses Association (ANA) defines <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_409\">morality<\/a><\/strong> as \u201cpersonal values, character, or conduct of individuals or groups within communities and societies,\u201d whereas <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_410\">ethics<\/a><\/strong> is the formal study of morality from a wide range of perspectives.<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-1\" href=\"#footnote-116-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a>\u00a0<\/sup>Ethical behavior is considered to be such an important aspect of nursing the ANA has designated <em>Ethics<\/em> as the first Standard of Professional Performance. The ANA Standards of Professional Performance are &#8220;authoritative statements of the actions and behaviors that all registered nurses, regardless of role, population, specialty, and setting, are expected to perform competently.&#8221; See the following box for the competencies associated with the ANA <em>Ethics<\/em> Standard of Professional Performance<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-2\" href=\"#footnote-116-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/sup>:<\/p>\n<div class=\"textbox shaded\">\n<p><strong>Competencies of ANA&#8217;s Ethics Standard of Professional Performance<\/strong><sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-3\" href=\"#footnote-116-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/sup><\/p>\n<ul>\n<li>Uses the <em>Code of Ethics for Nurses With Interpretive Statements<\/em> as a moral foundation to guide nursing practice and decision-making.<\/li>\n<li>Demonstrates that every person is worthy of nursing care through the provision of respectful, person-centered, compassionate care, regardless of personal history or characteristics (Beneficence).<\/li>\n<li>Advocates for health care consumer perspectives, preferences, and rights to informed decision-making and self-determination (Respect for autonomy).<\/li>\n<li>Demonstrates a primary commitment to the recipients of nursing and health care services in all settings and situations (Fidelity).<\/li>\n<li>Maintains therapeutic relationships and professional boundaries.<\/li>\n<li>Safeguards sensitive information within ethical, legal, and regulatory parameters (Nonmaleficence).<\/li>\n<li>Identifies ethics resources within the practice setting to assist and collaborate in addressing ethical issues.<\/li>\n<li>Integrates principles of social justice in all aspects of nursing practice (Justice).<\/li>\n<li>Refines ethical competence through continued professional education and personal self-development activities.<\/li>\n<li>Depicts one&#8217;s professional nursing identity through demonstrated values and ethics, knowledge, leadership, and professional comportment.<\/li>\n<li>Engages in self-care and self-reflection practices to support and preserve personal health, well-being, and integrity.<\/li>\n<li>Contributes to the establishment and maintenance of an ethical environment that is conducive to safe, quality health care.<\/li>\n<li>Collaborates with other health professionals and the public to protect human rights, promote health diplomacy, enhance cultural sensitivity and congruence, and reduce health disparities.<\/li>\n<li>Represents the nursing perspective in clinic, institutional, community, or professional association ethics discussions.<\/li>\n<\/ul>\n<p><strong>Reflective Questions<\/strong><\/p>\n<ol>\n<li>What <em>Ethics<\/em> competencies have you already demonstrated during your nursing education?<\/li>\n<li>What <em>Ethics<\/em> competencies are you most interested in mastering?<\/li>\n<li>What questions do you have about the ANA\u2019s <em>Ethics<\/em> competencies?<\/li>\n<\/ol>\n<\/div>\n<p>The ANA&#8217;s <em>Code of Ethics for Nurses With Interpretive Statements<\/em> is an ethical standard that guides nursing practice and ethical decision-making.<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-4\" href=\"#footnote-116-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/sup> This section will review several basic ethical concepts related to the ANA&#8217;s <em>Ethics<\/em> Standard of Professional Performance, such as values, morals, ethical theories, ethical principles, and the ANA <em>Code of Ethics for Nurses<\/em>.<\/p>\n<h2>Values<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_411\">Values<\/a><\/strong> are individual beliefs that motivate people to act one way or another and serve as guides for behavior considered \u201cright\u201d and \u201cwrong.\u201d People tend to adopt the values with which they were raised and believe those values are \u201cright\u201d because they are the values of their culture. Some personal values are considered sacred and moral imperatives based on an individual\u2019s religious beliefs.<sup><a class=\"footnote\" title=\"Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https:\/\/ethicsunwrapped.utexas.edu\/glossary\" id=\"return-footnote-116-5\" href=\"#footnote-116-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a><\/sup> See Figure 6.1<sup><a class=\"footnote\" title=\"\u201cethics-2991600_1920\u201d by Tumisu is licensed under CC0 1.0\" id=\"return-footnote-116-6\" href=\"#footnote-116-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><\/sup> for an image depicting choosing right from wrong actions.<\/p>\n<figure id=\"attachment_114\" aria-describedby=\"caption-attachment-114\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-110 size-medium\" title=\"\u201cethics-2991600_1920\u201d by Tumisu is licensed under CC0 1.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-300x212.jpg\" alt=\"Image showing a sign stating directions for right and wrong\" width=\"300\" height=\"212\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-300x212.jpg 300w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-1024x724.jpg 1024w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-768x543.jpg 768w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-1536x1086.jpg 1536w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-65x46.jpg 65w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-225x159.jpg 225w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920-350x247.jpg 350w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2021\/08\/ethics-2991600_1920.jpg 1920w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-114\" class=\"wp-caption-text\">Figure 6.1 Values<\/figcaption><\/figure>\n<p>In addition to personal values, organizations also establish values. The American Nurses Association (ANA) Professional Nursing Model states that nursing is based on values such as caring, compassion, presence, trustworthiness, diversity, acceptance, and accountability. These values emerge from nursing practice beliefs, such as the importance of relationships, service, respect, willingness to bear witness, self-determination, and the pursuit of health.<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-7\" href=\"#footnote-116-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a><\/sup> As a result of these traditional values and beliefs by nurses, Americans have ranked nursing as the most ethical and honest profession in Gallup polls since 1999, with the exception of 2001, when firefighters earned the honor after the attacks on September 11.<sup><a class=\"footnote\" title=\"Gaines, K. (2021, January 19). Nurses ranked most trusted profession 19 years in a row. Nurse.org. https:\/\/nurse.org\/articles\/nursing-ranked-most-honest-profession\/\" id=\"return-footnote-116-8\" href=\"#footnote-116-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/sup><\/p>\n<p>The National League of Nursing (NLN) has also established four core values for nursing education: caring, integrity, diversity, and excellence<sup><a class=\"footnote\" title=\"National League for Nursing. Core values. https:\/\/www.nln.org\/about\/about\/core-values\" id=\"return-footnote-116-9\" href=\"#footnote-116-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><\/sup>:<\/p>\n<ul>\n<li style=\"font-weight: 400\"><strong>Caring:<\/strong> Promoting health, healing, and hope in response to the human condition.<\/li>\n<li style=\"font-weight: 400\"><strong>Integrity:<\/strong> Respecting the dignity and moral wholeness of every person without conditions or limitations.<\/li>\n<li style=\"font-weight: 400\"><strong>Diversity:<\/strong> Affirming the uniqueness of and differences among persons, ideas, values, and ethnicities.<\/li>\n<li style=\"font-weight: 400\"><strong>Excellence:<\/strong> Cocreating and implementing transformative strategies with daring ingenuity.<\/li>\n<\/ul>\n<div class=\"textbox shaded\">\n<p class=\"video\">View the <a href=\"https:\/\/youtu.be\/SCjYaatMJuY\" target=\"_blank\" rel=\"noopener\">McCombs School of Business Values video on YouTube.<\/a><sup><a class=\"footnote\" title=\"McCombs School of Business. (2018, December 18). Values | Ethics defined\u00a0[Video]. YouTube. All rights reserved. https:\/\/youtu.be\/SCjYaatMJuY\" id=\"return-footnote-116-10\" href=\"#footnote-116-10\" aria-label=\"Footnote 10\"><sup class=\"footnote\">[10]<\/sup><\/a><\/sup><\/p>\n<\/div>\n<h2>Morals<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_412\">Morals<\/a> <\/strong>are the prevailing standards of behavior of a society that enable people to live cooperatively in groups. \u201cMoral\u201d refers to what societies sanction as right and acceptable. Most people tend to act morally and follow societal guidelines, and most laws are based on the morals of a society. Morality often requires that people sacrifice their own short-term interests for the benefit of society. People or entities that are indifferent to right and wrong are considered \u201camoral,\u201d while those who do evil acts are considered \u201cimmoral.\u201d<sup><a class=\"footnote\" title=\"Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https:\/\/ethicsunwrapped.utexas.edu\/glossary\" id=\"return-footnote-116-11\" href=\"#footnote-116-11\" aria-label=\"Footnote 11\"><sup class=\"footnote\">[11]<\/sup><\/a><\/sup><\/p>\n<h2>Ethical Theories<\/h2>\n<p>There are two major types of ethical theories that guide values and moral behavior referred to as deontology and consequentialism.<\/p>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_413\">Deontology<\/a><\/strong> is an ethical theory based on rules that distinguish right from wrong. See Figure 6.2<sup><a class=\"footnote\" title=\"\u201cethics-947572_1920\u201d by rdaconnect at Pixabay.com is licensed under CC0 1.0\" id=\"return-footnote-116-12\" href=\"#footnote-116-12\" aria-label=\"Footnote 12\"><sup class=\"footnote\">[12]<\/sup><\/a><\/sup> for a word cloud illustration of deontology. Deontology is based on the word <em>deon<\/em> that refers to \u201cduty.\u201d It is associated with philosopher Immanuel Kant. Kant believed that ethical actions follow universal moral laws, such as, \u201cDon\u2019t lie. Don\u2019t steal. Don\u2019t cheat.\u201d<sup><a class=\"footnote\" title=\"Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https:\/\/ethicsunwrapped.utexas.edu\/glossary\" id=\"return-footnote-116-13\" href=\"#footnote-116-13\" aria-label=\"Footnote 13\"><sup class=\"footnote\">[13]<\/sup><\/a><\/sup> Deontology is simple to apply because it just requires people to follow the rules and do their duty. It doesn\u2019t require weighing the costs and benefits of a situation, thus avoiding subjectivity and uncertainty.<sup><a class=\"footnote\" title=\"Alexander, L., &amp; Moore, M. (2020, October 30). Deontological ethics. Stanford Encyclopedia of Psychology. https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/\" id=\"return-footnote-116-14\" href=\"#footnote-116-14\" aria-label=\"Footnote 14\"><sup class=\"footnote\">[14]<\/sup><\/a>,<\/sup><sup><a class=\"footnote\" title=\"Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https:\/\/ethicsunwrapped.utexas.edu\/glossary\" id=\"return-footnote-116-15\" href=\"#footnote-116-15\" aria-label=\"Footnote 15\"><sup class=\"footnote\">[15]<\/sup><\/a>,<\/sup><sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-16\" href=\"#footnote-116-16\" aria-label=\"Footnote 16\"><sup class=\"footnote\">[16]<\/sup><\/a><\/sup><\/p>\n<p>The nurse-client relationship is deontological in nature because it is based on the ethical principles of beneficence and maleficence that drive clinicians to \u201cdo good\u201d and \u201cavoid harm.\u201d<sup><a class=\"footnote\" title=\"Mandal, J., Ponnambath, D. K., &amp; Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. Tropical Parasitology, 6(1), 5\u20137. https:\/\/doi.org\/10.4103\/2229-5070.175024\" id=\"return-footnote-116-17\" href=\"#footnote-116-17\" aria-label=\"Footnote 17\"><sup class=\"footnote\">[17]<\/sup><\/a><\/sup> Ethical principles will be discussed further in this chapter.<\/p>\n<figure id=\"attachment_114\" aria-describedby=\"caption-attachment-114\" style=\"width: 304px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-111\" title=\"\u201cethics-947572_1920\u201d by rdaconnect at Pixabay.com is licensed under CC0 1.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-793x1024.jpg\" alt=\"Image showing a word cloud regarding deontology\" width=\"304\" height=\"393\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-793x1024.jpg 793w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-232x300.jpg 232w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-768x992.jpg 768w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-1190x1536.jpg 1190w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-65x84.jpg 65w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-225x291.jpg 225w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920-350x452.jpg 350w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/ethics-947572_1920.jpg 1487w\" sizes=\"auto, (max-width: 304px) 100vw, 304px\" \/><figcaption id=\"caption-attachment-114\" class=\"wp-caption-text\">Figure 6.2 Deontology<\/figcaption><\/figure>\n<div class=\"textbox shaded\">\n<p class=\"video\">View the <a href=\"https:\/\/youtu.be\/wWZi-8Wji7M\" target=\"_blank\" rel=\"noopener\">McCombs School of Business Deontology video on YouTube.<\/a><sup><a class=\"footnote\" title=\"McCombs School of Business. (2018, December 18). Deontology | Ethics defined\u00a0[Video]. YouTube. All rights reserved. https:\/\/youtu.be\/wWZi-8Wji7M\" id=\"return-footnote-116-18\" href=\"#footnote-116-18\" aria-label=\"Footnote 18\"><sup class=\"footnote\">[18]<\/sup><\/a><\/sup><\/p>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_414\">Consequentialism<\/a><\/strong> is an ethical theory used to determine whether or not an action is right by the consequences of the action. See Figure 6.3<sup><a class=\"footnote\" title=\"\u201cbalance-6097898_1280\u201d by mohamed_hassan\u00a0is licensed under CC0 1.0\" id=\"return-footnote-116-19\" href=\"#footnote-116-19\" aria-label=\"Footnote 19\"><sup class=\"footnote\">[19]<\/sup><\/a><\/sup> for an illustration of weighing the consequences of an action in consequentialism. For example, most people agree that lying is wrong, but if telling a lie would help save a person\u2019s life, consequentialism says it\u2019s the right thing to do. One type of consequentialism is utilitarianism. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_415\">Utilitarianism<\/a><\/strong> determines whether or not actions are right based on their consequences with the standard being achieving the greatest good for the greatest number of people.<sup><a class=\"footnote\" title=\"Alexander, L., &amp; Moore, M. (2020, October 30). Deontological ethics. Stanford Encyclopedia of Psychology. https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/\" id=\"return-footnote-116-20\" href=\"#footnote-116-20\" aria-label=\"Footnote 20\"><sup class=\"footnote\">[20]<\/sup><\/a>,<a class=\"footnote\" title=\"Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https:\/\/ethicsunwrapped.utexas.edu\/glossary\" id=\"return-footnote-116-21\" href=\"#footnote-116-21\" aria-label=\"Footnote 21\"><sup class=\"footnote\">[21]<\/sup><\/a>,<\/sup><sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-22\" href=\"#footnote-116-22\" aria-label=\"Footnote 22\"><sup class=\"footnote\">[22]<\/sup><\/a> <\/sup>For this reason, utilitarianism tends to be society-centered. When applying utilitarian ethics to health care resources, money, time, and clinician energy are considered finite resources that should be appropriately allocated to achieve the best health care for society.<sup><a class=\"footnote\" title=\"Mandal, J., Ponnambath, D. K., &amp; Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. Tropical Parasitology, 6(1), 5\u20137. https:\/\/doi.org\/10.4103\/2229-5070.175024\" id=\"return-footnote-116-23\" href=\"#footnote-116-23\" aria-label=\"Footnote 23\"><sup class=\"footnote\">[23]<\/sup><\/a><\/sup><\/p>\n<figure id=\"attachment_114\" aria-describedby=\"caption-attachment-114\" style=\"width: 417px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-112\" title=\"\u201cbalance-6097898_1280\u201d by mohamed_hassan\u00a0is licensed under CC0 1.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-1024x694.png\" alt=\"Illustration showing justice scales with a checkmark in one side and an x in the other\" width=\"417\" height=\"283\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-1024x694.png 1024w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-300x203.png 300w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-768x520.png 768w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-1536x1041.png 1536w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-65x44.png 65w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-225x152.png 225w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898-350x237.png 350w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/balance-6097898.png 1920w\" sizes=\"auto, (max-width: 417px) 100vw, 417px\" \/><figcaption id=\"caption-attachment-114\" class=\"wp-caption-text\">Image 6.3 Consequentialism<\/figcaption><\/figure>\n<p>Utilitarianism can be complicated when accounting for values such as justice and individual rights. For example, assume a hospital has four clients whose lives depend upon receiving four organ transplant surgeries for a heart, lung, kidney, and liver. If a healthy person without health insurance or family support experiences a life-threatening accident and is considered brain dead but is kept alive on life-sustaining equipment in the ICU, the utilitarian framework might suggest the organs be harvested to save four lives at the expense of one life.<sup><a class=\"footnote\" title=\"Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https:\/\/ethicsunwrapped.utexas.edu\/glossary\" id=\"return-footnote-116-24\" href=\"#footnote-116-24\" aria-label=\"Footnote 24\"><sup class=\"footnote\">[24]<\/sup><\/a><\/sup> This action could arguably produce the greatest good for the greatest number of people, but the deontological approach could argue this action would be unethical because it does not follow the rule of \u201cdo no harm.\u201d<\/p>\n<div class=\"textbox shaded\">\n<p class=\"video\">Watch <a href=\"https:\/\/youtu.be\/51DZteag74A\" target=\"_blank\" rel=\"noopener\">McCombs School of Business Consequentialism video on YouTube.<\/a><sup><a class=\"footnote\" title=\"McCombs School of Business. (2018, December 18). Consequentialism | Ethics defined\u00a0[Video]. YouTube. All rights reserved. https:\/\/youtu.be\/51DZteag74A\" id=\"return-footnote-116-25\" href=\"#footnote-116-25\" aria-label=\"Footnote 25\"><sup class=\"footnote\">[25]<\/sup><\/a><\/sup><\/p>\n<\/div>\n<div class=\"textbox shaded\">\n<p class=\"arrow\">Read more about <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4574465\/\" target=\"_blank\" rel=\"noopener\">Decision making on organ donation: The dilemmas of relatives of potential brain dead donors.<\/a><\/p>\n<\/div>\n<p>Interestingly, deontological and utilitarian approaches to ethical issues may result in the same outcome, but the rationale for the outcome or decision is different because it is focused on duty (deontologic) versus consequences (utilitarian).<\/p>\n<p>Societies and cultures have unique ethical frameworks that may be based upon either deontological or consequentialist ethical theory. Culturally derived deontological rules may apply to ethical issues in health care. For example, a traditional Chinese philosophy based on Confucianism results in a culturally acceptable practice of family members (rather than the client) receiving information from health care providers about life-threatening medical conditions and making treatment decisions. As a result, cancer diagnoses and end-of-life treatment options may not be disclosed to the client in an effort to alleviate the suffering that may arise from knowledge of their diagnosis. In this manner, a client\u2019s family and the health care provider may ethically prioritize a client\u2019s psychological well-being over their autonomy and self-determination.<sup><a class=\"footnote\" title=\"Wang, H., Zhao, F., Wang, X., &amp; Chen, X. (2018). To tell or not: The Chinese doctors' dilemma on disclosure of a cancer diagnosis to the patient. Iranian Journal of Public Health, 47(11), 1773\u20131774. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30581799\" id=\"return-footnote-116-26\" href=\"#footnote-116-26\" aria-label=\"Footnote 26\"><sup class=\"footnote\">[26]<\/sup><\/a><\/sup> However, in the United States, this ethical decision may conflict with HIPAA Privacy Rules and the ethical principle of client autonomy. As a result, a nurse providing client care in this type of situation may experience an ethical dilemma. Ethical dilemmas are further discussed in the &#8220;<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/6-3-ethical-dilemmas\/\" target=\"_blank\" rel=\"noopener\">Ethical Dilemmas<\/a>&#8221; section of this chapter.<\/p>\n<p>See Table 6.2 comparing common ethical issues in health care viewed through the lens of deontological and consequential ethical frameworks.<\/p>\n<p>Table 6.2. Ethical Issues Through the Lens of Deontological or Consequential Ethical Frameworks<\/p>\n<div style=\"text-align: left;\">\n<table class=\"grid\">\n<tbody>\n<tr>\n<th class=\"shaded\" scope=\"col\"><strong>Ethical Issue<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Deontological View<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Consequential View<\/strong><\/th>\n<\/tr>\n<tr>\n<th scope=\"row\">Abortion<\/th>\n<td>Abortion is unacceptable based on the rule of preserving life.<\/td>\n<td>Abortion may be acceptable in cases of an unwanted pregnancy, rape, incest, or risk to the mother.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Bombing an area with known civilians<\/th>\n<td>Killing civilians is not acceptable due to the loss of innocent lives.<\/td>\n<td>The loss of innocent lives may be acceptable if the bombing stops a war that could result in significantly more deaths than the civilian casualties.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Stealing<\/th>\n<td>Taking something that is not yours is wrong.<\/td>\n<td>Taking something to redistribute resources to others in need may be acceptable.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Killing<\/th>\n<td>It is never acceptable to take another human being\u2019s life.<\/td>\n<td>It may be acceptable to take another human life in self-defense or to prevent additional harm they could cause others.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Euthanasia\/physician- assisted suicide<\/th>\n<td>It is never acceptable to assist another human to end their life prematurely.<\/td>\n<td>End-of-life care can be expensive and emotionally upsetting for family members. If a competent, capable adult wishes to end their life, medically supported options should be available.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Vaccines<\/th>\n<td>Vaccination is a personal choice based on religious practices or other beliefs.<\/td>\n<td>Recommended vaccines should be mandatory for everyone (without a medical contraindication) because of its greater good for all of society.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<h2>Ethical Principles and Obligations<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_416\">Ethical principles<\/a><\/strong> are used to define nurses\u2019 moral duties and aid in ethical analysis and decision-making.<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-27\" href=\"#footnote-116-27\" aria-label=\"Footnote 27\"><sup class=\"footnote\">[27]<\/sup><\/a><\/sup> Although there are many ethical principles that guide nursing practice, foundational ethical principles include autonomy (self-determination), beneficence (do good), nonmaleficence (do no harm), justice (fairness), fidelity (keep promises), and veracity (tell the truth).<\/p>\n<h3>Autonomy<\/h3>\n<p>The ethical principle of <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_417\">autonomy<\/a><\/strong> recognizes each individual\u2019s right to self-determination and decision-making based on their unique values, beliefs, and preferences. See Figure 6.4<sup><a class=\"footnote\" title=\"\u201cAutonomy and Self-Determination.png\u201d by Meredith Pomietlo for Chippewa Valley Technical College\u00a0is licensed under\u00a0CC BY 4.0\" id=\"return-footnote-116-28\" href=\"#footnote-116-28\" aria-label=\"Footnote 28\"><sup class=\"footnote\">[28]<\/sup><\/a><\/sup> for an illustration of autonomy. The American Nurses Association (ANA) defines autonomy as the \u201ccapacity to determine one\u2019s own actions through independent choice, including demonstration of competence.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-29\" href=\"#footnote-116-29\" aria-label=\"Footnote 29\"><sup class=\"footnote\">[29]<\/sup><\/a><\/sup> The nurse\u2019s primary ethical obligation is client autonomy.<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-30\" href=\"#footnote-116-30\" aria-label=\"Footnote 30\"><sup class=\"footnote\">[30]<\/sup><\/a><\/sup> Based on autonomy, clients have the right to refuse nursing care and medical treatment. An example of autonomy in health care is advance directives. Advance directives allow clients to specify health care decisions if they become incapacitated and unable to do so.<\/p>\n<figure id=\"attachment_114\" aria-describedby=\"caption-attachment-114\" style=\"width: 228px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-113\" title=\"\u201cAutonomy and Self-Determination.png\u201d by Meredith Pomietlo for Chippewa Valley Technical College\u00a0is licensed under\u00a0CC BY 4.0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-838x1024.png\" alt=\"Image of fist icon with repeating text on the inside fist shape\" width=\"228\" height=\"279\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-838x1024.png 838w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-246x300.png 246w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-768x938.png 768w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-1257x1536.png 1257w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-1677x2048.png 1677w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-65x79.png 65w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-225x275.png 225w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination-350x428.png 350w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Autonomy-and-Self-Determination.png 1715w\" sizes=\"auto, (max-width: 228px) 100vw, 228px\" \/><figcaption id=\"caption-attachment-114\" class=\"wp-caption-text\">Figure 6.4 Autonomy and Self-Determination<\/figcaption><\/figure>\n<div class=\"textbox shaded\">\n<p class=\"arrow\">Read more about advance directives and determining capacity and competency in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/5-1-introduction\/\" target=\"_blank\" rel=\"noopener\">Legal Implications<\/a>\u201d chapter.<\/p>\n<\/div>\n<h4>Nurses as Advocates: Supporting Autonomy<\/h4>\n<p>Nurses have a responsibility to act in the interest of those under their care, referred to as advocacy. The American Nurses Association (ANA) defines advocacy as \u201cthe act or process of pleading for, supporting, or recommending a cause or course of action. Advocacy may be for persons (whether an individual, group, population, or society) or for an issue, such as potable water or global health.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-31\" href=\"#footnote-116-31\" aria-label=\"Footnote 31\"><sup class=\"footnote\">[31]<\/sup><\/a><\/sup> See Figure 6.5<sup><a class=\"footnote\" title=\"\u201cAdvocacy\u201d by Meredith Pomietlo for Chippewa Valley Technical College\u00a0is licensed under\u00a0CC BY 4.0\" id=\"return-footnote-116-32\" href=\"#footnote-116-32\" aria-label=\"Footnote 32\"><sup class=\"footnote\">[32]<\/sup><\/a><\/sup> for an illustration of advocacy.<\/p>\n<figure id=\"attachment_114\" aria-describedby=\"caption-attachment-114\" style=\"width: 365px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-114\" title=\"\u201cAdvocacy\u201d by Meredith Pomietlo for Chippewa Valley Technical College\u00a0is licensed under\u00a0CC BY 4.0\u00a0\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-1024x426.png\" alt=\"Image showing bullhorn shaped icon with text reading Advocacy coming out of it\" width=\"365\" height=\"152\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-1024x426.png 1024w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-300x125.png 300w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-768x320.png 768w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-1536x639.png 1536w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-2048x852.png 2048w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-65x27.png 65w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-225x94.png 225w, https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-content\/uploads\/sites\/225\/2025\/02\/Advocacy-350x146.png 350w\" sizes=\"auto, (max-width: 365px) 100vw, 365px\" \/><figcaption id=\"caption-attachment-114\" class=\"wp-caption-text\">Figure 6.5 Advocacy<\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_418\">Advocacy <\/a><\/strong> includes providing education regarding client rights, supporting autonomy and self-determination, and advocating for client preferences to health care team members and family members. Nurses do not make decisions for clients, but instead support them in making their own informed choices. At the core of making informed decisions is knowledge. Nurses serve an integral role in client education. Clarifying unclear information, translating medical terminology, and making referrals to other health care team members (within their scope of practice) ensures that clients have the information needed to make treatment decisions aligned with their personal values.<\/p>\n<p>At times, nurses may find themselves in a position of supporting a client\u2019s decision they do not agree with and would not make for themselves or for the people they love. However, self-determination is a human right that honors the dignity and well-being of individuals. The nursing profession, rooted in caring relationships, demands that nurses have nonjudgmental attitudes and reflect \u201cunconditional positive regard\u201d for every client. Nurses must suspend personal judgement and beliefs when advocating for their clients\u2019 preferences and decision-making.<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-33\" href=\"#footnote-116-33\" aria-label=\"Footnote 33\"><sup class=\"footnote\">[33]<\/sup><\/a><\/sup><\/p>\n<h3>Beneficence<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_419\">Beneficence <\/a> <\/strong>is defined by the ANA as \u201cthe bioethical principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit another or others, often going beyond what is required by law.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-34\" href=\"#footnote-116-34\" aria-label=\"Footnote 34\"><sup class=\"footnote\">[34]<\/sup><\/a><\/sup> See Figure 6.6<sup><a class=\"footnote\" title=\"\u201cAir_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg\u201d by Senior Airman Tyler Placie is in the\u00a0Public Domain\" id=\"return-footnote-116-35\" href=\"#footnote-116-35\" aria-label=\"Footnote 35\"><sup class=\"footnote\">[35]<\/sup><\/a><\/sup> for an illustration of beneficence. Put simply, beneficence is acting for the good and welfare of others, guided by compassion. An example of beneficence in daily nursing care is when a nurse sits with a dying client and holds their hand to provide presence.<\/p>\n<figure id=\"attachment_114\" aria-describedby=\"caption-attachment-114\" style=\"width: 648px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2939\" title=\"\u201cAir_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg\u201d by Senior Airman Tyler Placie is in the\u00a0Public Domain\" src=\"https:\/\/pressbooks.ccconline.org\/accphysicalgeology\/wp-content\/uploads\/sites\/225\/2025\/02\/Air_Force_special_operations_medical_team_saves_lives_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082-scaled-1.jpg\" alt=\"Photo showing an Air Force critical care nurse assisting a doctor in helping a child breathe\" width=\"648\" height=\"431\" \/><figcaption id=\"caption-attachment-114\" class=\"wp-caption-text\">Figure 6.6 Beneficence<\/figcaption><\/figure>\n<p>Nursing advocacy extends beyond direct client care to advocating for beneficence in communities. Vulnerable populations such as children, older adults, cultural minorities, and the homeless often benefit from nurse advocacy in promoting health equity. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_421\">Cultural humility<\/a> <\/strong>is a humble and respectful attitude towards individuals of other cultures and an approach to learning about other cultures as a lifelong goal and process.<a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-36\" href=\"#footnote-116-36\" aria-label=\"Footnote 36\"><sup class=\"footnote\">[36]<\/sup><\/a> Nurses, the largest segment of the health care community, have a powerful voice when addressing community beneficence issues, such as health disparities and social determinants of health, and can serve as the conduit for advocating for change.<\/p>\n<h3>Nonmaleficence<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_420\">Nonmaleficence<\/a> <\/strong>is defined by the ANA as \u201cthe bioethical principle that specifies a duty to do no harm and balances avoidable harm with benefits of good achieved.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-37\" href=\"#footnote-116-37\" aria-label=\"Footnote 37\"><sup class=\"footnote\">[37]<\/sup><\/a><\/sup> An example of doing no harm in nursing practice is reflected by nurses checking medication rights three times before administering medications. In this manner, medication errors can be avoided, and the duty to do no harm is met. Another example of nonmaleficence is when a nurse assists a client with a serious, life-threatening condition to participate in decision-making regarding their treatment plan. By balancing the potential harm with potential benefits of various treatment options, while also considering quality of life and comfort, the client can effectively make decisions based on their values and preferences.<\/p>\n<h3>Justice<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_422\">Justice<\/a><\/strong> is defined by the ANA as \u201ca moral obligation to act on the basis of equality and equity and a standard linked to fairness for all in society.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-38\" href=\"#footnote-116-38\" aria-label=\"Footnote 38\"><sup class=\"footnote\">[38]<\/sup><\/a><\/sup>\u00a0The principle of justice requires health care to be provided in a fair and equitable way. Nurses provide quality care for all individuals with the same level of fairness despite many characteristics, such as the individual&#8217;s financial status, culture, religion, gender, or sexual orientation. Nurses have a social contract to \u201cprovide compassionate care that addresses the individual\u2019s needs for protection, advocacy, empowerment, optimization of health, prevention of illness and injury, alleviation of suffering, comfort, and well-being.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-39\" href=\"#footnote-116-39\" aria-label=\"Footnote 39\"><sup class=\"footnote\">[39]<\/sup><\/a><\/sup> An example of a nurse using the principle of justice in daily nursing practice is effective prioritization based on client needs.<\/p>\n<div class=\"textbox shaded\">\n<p class=\"arrow\">Read more about prioritization models in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/2-1-introduction\/\" target=\"_blank\" rel=\"noopener\">Prioritization<\/a>\u201d chapter.<\/p>\n<\/div>\n<h3>Other Ethical Principles<\/h3>\n<p>Additional ethical principles commonly applied to health care include <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_423\">fidelity<\/a> <\/strong>(keeping promises) and <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_424\">veracity<\/a><\/strong> (telling the truth). An example of fidelity in daily nursing practice is when a nurse tells a client, \u201cI will be back in an hour to check on your pain level.\u201d This promise is kept. An example of veracity in nursing practice is when a nurse honestly explains potentially uncomfortable side effects of prescribed medications. Determining how truthfulness will benefit the client and support their autonomy is dependent on a nurse\u2019s clinical judgment, self-reflection, knowledge of the client and their cultural beliefs, and other factors.<sup><a class=\"footnote\" title=\"American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.\" id=\"return-footnote-116-40\" href=\"#footnote-116-40\" aria-label=\"Footnote 40\"><sup class=\"footnote\">[40]<\/sup><\/a><\/sup><\/p>\n<p>A principle historically associated with health care is paternalism. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_425\">Paternalism<\/a><\/strong> is defined as the interference by the state or an individual with another person, defended by the claim that the person interfered with will be better off or protected from harm.<sup><a class=\"footnote\" title=\"Dworkin, G. (2020, September 9). Paternalism. Stanford Encyclopedia of Philosophy. https:\/\/plato.stanford.edu\/entries\/paternalism\/\" id=\"return-footnote-116-41\" href=\"#footnote-116-41\" aria-label=\"Footnote 41\"><sup class=\"footnote\">[41]<\/sup><\/a><\/sup> Paternalism is the basis for legislation related to drug enforcement and compulsory wearing of seatbelts.<\/p>\n<p>In health care, paternalism has been used as rationale for performing treatment based on what the provider believes is in the client\u2019s best interest. In some situations, paternalism may be appropriate for individuals who are unable to comprehend information in a way that supports their informed decision-making, but it must be used cautiously to ensure vulnerable individuals are not misused and their autonomy is not violated.<\/p>\n<p>Nurses may find themselves acting paternalistically when performing nursing care to ensure client health and safety. For example, repositioning clients to prevent skin breakdown is a preventative intervention commonly declined by clients when they prefer a specific position for comfort. In this situation, the nurse should explain the benefits of the preventative intervention and the risks if the intervention is not completed. If the client continues to decline the intervention despite receiving this information, the nurse should document the education provided and the client\u2019s decision to decline the intervention. The process of reeducating the client and reminding them of the importance of the preventative intervention should be continued at regular intervals and documented.<\/p>\n<h3>Care-Based Ethics<\/h3>\n<p>Nurses use a client-centered, care-based ethical approach to client care that focuses on the specific circumstances of each situation. This approach aligns with nursing concepts such as caring, holism, and a nurse-client relationship rooted in dignity and respect through virtues such as kindness and compassion.<sup><a class=\"footnote\" title=\"Fry, S. T. (1989). The role of caring in a theory of nursing ethics. Hypatia, 4(2), 87-103. https:\/\/doi.org\/10.1111\/j.1527-2001.1989.tb00575.x\" id=\"return-footnote-116-42\" href=\"#footnote-116-42\" aria-label=\"Footnote 42\"><sup class=\"footnote\">[42]<\/sup><\/a>,<a class=\"footnote\" title=\"Taylor, C. (1993). Nursing ethics: The role of caring. Awhonn's Clinical Issues in Perinatal and Women's Health Nursing, 4(4), 552-560. https:\/\/pubmed.ncbi.nlm.nih.gov\/8220369\/\" id=\"return-footnote-116-43\" href=\"#footnote-116-43\" aria-label=\"Footnote 43\"><sup class=\"footnote\">[43]<\/sup><\/a><\/sup> This care-based approach to ethics uses a holistic, individualized analysis of situations rather than the prescriptive application of ethical principles to define ethical nursing practice. This care-based approach asserts that ethical issues cannot be handled deductively by applying concrete and prefabricated rules, but instead require social processes that respect the multidimensionality of problems.<sup><a class=\"footnote\" title=\"Schuchter, P., &amp; Heller, A. (2018). The care dialog: The &quot;ethics of care&quot; approach and its importance for clinical ethics consultation. Medicine, Health Care, and Philosophy, 21(1), 51\u201362. https:\/\/doi.org\/10.1007\/s11019-017-9784-z\" id=\"return-footnote-116-44\" href=\"#footnote-116-44\" aria-label=\"Footnote 44\"><sup class=\"footnote\">[44]<\/sup><\/a><\/sup> Frameworks for resolving ethical situations are discussed in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/6-3-ethical-dilemmas\/\" target=\"_blank\" rel=\"noopener\">Ethical Dilemmas<\/a>\u201d section of this chapter.<\/p>\n<h2>Nursing Code of Ethics<\/h2>\n<p>Many professions and institutions have their own set of ethical principles, referred to as a <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_116_426\">code of ethics<\/a><\/strong>, designed to govern decision-making and assist individuals to distinguish right from wrong. The American Nurses Association (ANA) provides a framework for ethical nursing care and guides nurses during decision-making in its formal document titled <em>Code of Ethics for Nurses With Interpretive Statements (Nursing Code of Ethics)<\/em>. The <em>Nursing Code of Ethics<\/em> serves the following purposes<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-45\" href=\"#footnote-116-45\" aria-label=\"Footnote 45\"><sup class=\"footnote\">[45]<\/sup><\/a><\/sup>:<\/p>\n<ul>\n<li style=\"font-weight: 400\">It is a succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively.<\/li>\n<li style=\"font-weight: 400\">It is the profession\u2019s nonnegotiable ethical standard.<\/li>\n<li style=\"font-weight: 400\">It is an expression of nursing\u2019s own understanding of its commitment to society.<\/li>\n<\/ul>\n<p>The preface of the ANA\u2019s <em>Nursing Code of Ethics<\/em> states, \u201cIndividuals who become nurses are expected to adhere to the ideals and moral norms of the profession and also to embrace them as a part of what it means to be a nurse. The ethical tradition of nursing is self-reflective, enduring, and distinctive. A code of ethics makes explicit the primary goals, values, and obligations of the profession.\u201d<sup><a class=\"footnote\" title=\"American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" id=\"return-footnote-116-46\" href=\"#footnote-116-46\" aria-label=\"Footnote 46\"><sup class=\"footnote\">[46]<\/sup><\/a><\/sup><\/p>\n<p>The <em>Nursing Code of Ethics<\/em> contains nine provisions. Each provision contains several clarifying or \u201cinterpretive\u201d statements. Read a summary of the nine provisions in the following box.<\/p>\n<div class=\"textbox shaded\">\n<p><strong>Nine Provisions of the ANA <em>Nursing Code of Ethics<\/em><\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400\"><strong>Provision 1:<\/strong> The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 2:<\/strong> The nurse\u2019s primary commitment is to the client, whether an individual, family, group, community, or population.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 3:<\/strong> The nurse promotes, advocates for, and protects the rights, health, and safety of the client.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 4:<\/strong> The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 5:<\/strong> 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.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 6:<\/strong> 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.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 7:<\/strong> 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.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 8<\/strong>: The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.<\/li>\n<li style=\"font-weight: 400\"><strong>Provision 9:<\/strong> The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.<\/li>\n<\/ul>\n<\/div>\n<div class=\"textbox shaded\">\n<p class=\"arrow\">Read the free, online full version of the <a href=\"https:\/\/www.nursingworld.org\/coe-view-only\" target=\"_blank\" rel=\"noopener\"><em>ANA&#8217;s Code of Ethics for Nurses With Interpretive Statements.<\/em><\/a><\/p>\n<\/div>\n<p>In addition to the <em>Nursing Code of Ethics,<\/em> the ANA established the Center for Ethics and Human Rights to help nurses navigate ethical conflicts and life-and-death decisions common to everyday nursing practice.<\/p>\n<div class=\"textbox shaded\">\n<p class=\"arrow\">Read more about the <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/\" target=\"_blank\" rel=\"noopener\">ANA Center for Ethics and Human Rights<\/a>.<\/p>\n<\/div>\n<h3>Specialty Organization Code of Ethics<\/h3>\n<p>Many specialty nursing organizations have additional codes of ethics to guide nurses practicing in settings such as the emergency department, home care, or hospice care. These documents are unique to the specialty discipline but mirror the statements from the ANA\u2019s <em>Nursing Code of Ethics.<\/em> View examples of ethical statements of specialty nursing organizations using the information in the following box.<\/p>\n<div class=\"textbox shaded\">\n<p><strong>Sample Ethical Statements of Selected Specialty Nursing Organizations<\/strong><\/p>\n<p class=\"arrow\"><a href=\"https:\/\/www.midwife.org\/acnm\/files\/ACNMLibraryData\/UPLOADFILENAME\/000000000293\/Code-of-Ethics-w-Explanatory-Statements-June-2015.pdf\" target=\"_blank\" rel=\"noopener\">American College of Nurse-Midwives<\/a><\/p>\n<p class=\"arrow\"><a href=\"http:\/\/nann.org\/about\/code-of-ethics\" target=\"_blank\" rel=\"noopener\">National Association of Neonatal Nurses<\/a><\/p>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-116-1\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-116-2\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-116-3\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-116-4\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-116-5\">Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a> <a href=\"#return-footnote-116-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-116-6\">\u201c<a href=\"https:\/\/pixabay.com\/de\/photos\/ethik-rechts-falsch-ethisch-moral-2991600\/\" target=\"_blank\" rel=\"noopener\">ethics-2991600_1920<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/de\/users\/tumisu-148124\/\" target=\"_blank\" rel=\"noopener\">Tumisu<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener\">CC0 1.0<\/a> <a href=\"#return-footnote-116-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-116-7\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-116-8\">Gaines, K. (2021, January 19). <em>Nurses ranked most trusted profession 19 years in a row.<\/em> Nurse.org. <a href=\"https:\/\/nurse.org\/articles\/nursing-ranked-most-honest-profession\" target=\"_blank\" rel=\"noopener\">https:\/\/nurse.org\/articles\/nursing-ranked-most-honest-profession<\/a>\/ <a href=\"#return-footnote-116-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-116-9\">National League for Nursing. <em>Core values.<\/em> <a href=\"https:\/\/www.nln.org\/about\/about\/core-values\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nln.org\/about\/about\/core-values<\/a> <a href=\"#return-footnote-116-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><li id=\"footnote-116-10\">McCombs School of Business. (2018, December 18). <em>Values | Ethics defined<\/em>\u00a0[Video]. YouTube. All rights reserved. <a href=\"https:\/\/youtu.be\/SCjYaatMJuY\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/SCjYaatMJuY<\/a>  <a href=\"#return-footnote-116-10\" class=\"return-footnote\" aria-label=\"Return to footnote 10\">&crarr;<\/a><\/li><li id=\"footnote-116-11\">Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a> <a href=\"#return-footnote-116-11\" class=\"return-footnote\" aria-label=\"Return to footnote 11\">&crarr;<\/a><\/li><li id=\"footnote-116-12\">\u201c<a href=\"https:\/\/pixabay.com\/de\/illustrations\/ethik-wortwolke-kant-botschaft-947572\/\" target=\"_blank\" rel=\"noopener\">ethics-947572_1920<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/de\/users\/rdaconnect-1201591\/\" target=\"_blank\" rel=\"noopener\">rdaconnect a<\/a>t <a href=\"https:\/\/pixabay.com\/de\/\" target=\"_blank\" rel=\"noopener\">Pixabay.com<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener\">CC0 1.0<\/a> <a href=\"#return-footnote-116-12\" class=\"return-footnote\" aria-label=\"Return to footnote 12\">&crarr;<\/a><\/li><li id=\"footnote-116-13\">Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary)<\/em>. University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a> <a href=\"#return-footnote-116-13\" class=\"return-footnote\" aria-label=\"Return to footnote 13\">&crarr;<\/a><\/li><li id=\"footnote-116-14\">Alexander, L., &amp; Moore, M. (2020, October 30). Deontological ethics. <em>Stanford Encyclopedia of Psychology.<\/em> <a href=\"https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/<\/a> <a href=\"#return-footnote-116-14\" class=\"return-footnote\" aria-label=\"Return to footnote 14\">&crarr;<\/a><\/li><li id=\"footnote-116-15\">Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a> <a href=\"#return-footnote-116-15\" class=\"return-footnote\" aria-label=\"Return to footnote 15\">&crarr;<\/a><\/li><li id=\"footnote-116-16\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-16\" class=\"return-footnote\" aria-label=\"Return to footnote 16\">&crarr;<\/a><\/li><li id=\"footnote-116-17\">Mandal, J., Ponnambath, D. K., &amp; Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. <em>Tropical Parasitology, 6<\/em>(1), 5\u20137. <a href=\"https:\/\/doi.org\/10.4103\/2229-5070.175024\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.4103\/2229-5070.175024<\/a> <a href=\"#return-footnote-116-17\" class=\"return-footnote\" aria-label=\"Return to footnote 17\">&crarr;<\/a><\/li><li id=\"footnote-116-18\">McCombs School of Business. (2018, December 18). <em>Deontology | Ethics defined<\/em>\u00a0[Video]. YouTube. All rights reserved. <a href=\"https:\/\/youtu.be\/wWZi-8Wji7M\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/wWZi-8Wji7M<\/a>  <a href=\"#return-footnote-116-18\" class=\"return-footnote\" aria-label=\"Return to footnote 18\">&crarr;<\/a><\/li><li id=\"footnote-116-19\">\u201c<a href=\"https:\/\/pixabay.com\/pt\/vectors\/saldo-%c3%a9tica-valores-certo-errado-6097898\/\" target=\"_blank\" rel=\"noopener\">balance-6097898_1280<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/pt\/users\/mohamed_hassan-5229782\/\" target=\"_blank\" rel=\"noopener\">mohamed_hassan<\/a>\u00a0is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener\">CC0 1.0<\/a> <a href=\"#return-footnote-116-19\" class=\"return-footnote\" aria-label=\"Return to footnote 19\">&crarr;<\/a><\/li><li id=\"footnote-116-20\">Alexander, L., &amp; Moore, M. (2020, October 30). Deontological ethics. <em>Stanford Encyclopedia of Psychology.<\/em> <a href=\"https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plato.stanford.edu\/entries\/ethics-deontological\/<\/a> <a href=\"#return-footnote-116-20\" class=\"return-footnote\" aria-label=\"Return to footnote 20\">&crarr;<\/a><\/li><li id=\"footnote-116-21\">Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a> <a href=\"#return-footnote-116-21\" class=\"return-footnote\" aria-label=\"Return to footnote 21\">&crarr;<\/a><\/li><li id=\"footnote-116-22\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-22\" class=\"return-footnote\" aria-label=\"Return to footnote 22\">&crarr;<\/a><\/li><li id=\"footnote-116-23\">Mandal, J., Ponnambath, D. K., &amp; Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. <em>Tropical Parasitology, 6<\/em>(1), 5\u20137. <a href=\"https:\/\/doi.org\/10.4103\/2229-5070.175024\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.4103\/2229-5070.175024<\/a> <a href=\"#return-footnote-116-23\" class=\"return-footnote\" aria-label=\"Return to footnote 23\">&crarr;<\/a><\/li><li id=\"footnote-116-24\">Ethics Unwrapped - McCombs School of Business. (n.d.). <em>Ethics defined (a glossary).<\/em> University of Texas at Austin. <a href=\"https:\/\/ethicsunwrapped.utexas.edu\/glossary\" target=\"_blank\" rel=\"noopener\">https:\/\/ethicsunwrapped.utexas.edu\/glossary<\/a> <a href=\"#return-footnote-116-24\" class=\"return-footnote\" aria-label=\"Return to footnote 24\">&crarr;<\/a><\/li><li id=\"footnote-116-25\">McCombs School of Business. (2018, December 18). <em>Consequentialism | Ethics defined<\/em>\u00a0[Video]. YouTube. All rights reserved. <a href=\"https:\/\/youtu.be\/51DZteag74A\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/51DZteag74A<\/a>  <a href=\"#return-footnote-116-25\" class=\"return-footnote\" aria-label=\"Return to footnote 25\">&crarr;<\/a><\/li><li id=\"footnote-116-26\">Wang, H., Zhao, F., Wang, X., &amp; Chen, X. (2018). To tell or not: The Chinese doctors' dilemma on disclosure of a cancer diagnosis to the patient. <em>Iranian Journal of Public Health, 47<\/em>(11), 1773\u20131774. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30581799\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30581799<\/a> <a href=\"#return-footnote-116-26\" class=\"return-footnote\" aria-label=\"Return to footnote 26\">&crarr;<\/a><\/li><li id=\"footnote-116-27\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-27\" class=\"return-footnote\" aria-label=\"Return to footnote 27\">&crarr;<\/a><\/li><li id=\"footnote-116-28\">\u201cAutonomy and Self-Determination.png\u201d by Meredith Pomietlo for <a href=\"https:\/\/www.cvtc.edu\/\" target=\"_blank\" rel=\"noopener\">Chippewa Valley Technical College<\/a>\u00a0is licensed under\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener\">CC BY 4.0<\/a> <a href=\"#return-footnote-116-28\" class=\"return-footnote\" aria-label=\"Return to footnote 28\">&crarr;<\/a><\/li><li id=\"footnote-116-29\">American Nurses Association. (2021).<em> Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-29\" class=\"return-footnote\" aria-label=\"Return to footnote 29\">&crarr;<\/a><\/li><li id=\"footnote-116-30\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-30\" class=\"return-footnote\" aria-label=\"Return to footnote 30\">&crarr;<\/a><\/li><li id=\"footnote-116-31\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-31\" class=\"return-footnote\" aria-label=\"Return to footnote 31\">&crarr;<\/a><\/li><li id=\"footnote-116-32\">\u201cAdvocacy\u201d by Meredith Pomietlo for <a href=\"https:\/\/www.cvtc.edu\/\" target=\"_blank\" rel=\"noopener\">Chippewa Valley Technical College<\/a>\u00a0is licensed under\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener\">CC BY 4.0<\/a> <a href=\"#return-footnote-116-32\" class=\"return-footnote\" aria-label=\"Return to footnote 32\">&crarr;<\/a><\/li><li id=\"footnote-116-33\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-33\" class=\"return-footnote\" aria-label=\"Return to footnote 33\">&crarr;<\/a><\/li><li id=\"footnote-116-34\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only<\/a>\/ <a href=\"#return-footnote-116-34\" class=\"return-footnote\" aria-label=\"Return to footnote 34\">&crarr;<\/a><\/li><li id=\"footnote-116-35\">\u201c<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Air_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg\" target=\"_blank\" rel=\"noopener\">Air_Force_special_operations_medical_team_saves_lives,_helps_shape_future_of_Afghan_medicine_111010-F-QW942-082.jpg<\/a>\u201d by Senior Airman Tyler Placie is in the\u00a0<a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/pdm\/\" target=\"_blank\" rel=\"noopener\">Public Domain<\/a> <a href=\"#return-footnote-116-35\" class=\"return-footnote\" aria-label=\"Return to footnote 35\">&crarr;<\/a><\/li><li id=\"footnote-116-36\">American Nurses Association. (2021).<em> Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-36\" class=\"return-footnote\" aria-label=\"Return to footnote 36\">&crarr;<\/a><\/li><li id=\"footnote-116-37\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-37\" class=\"return-footnote\" aria-label=\"Return to footnote 37\">&crarr;<\/a><\/li><li id=\"footnote-116-38\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-38\" class=\"return-footnote\" aria-label=\"Return to footnote 38\">&crarr;<\/a><\/li><li id=\"footnote-116-39\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-39\" class=\"return-footnote\" aria-label=\"Return to footnote 39\">&crarr;<\/a><\/li><li id=\"footnote-116-40\">American Nurses Association. (2021). <em>Nursing: Scope and standards of practice<\/em> (4th ed.). American Nurses Association. <a href=\"#return-footnote-116-40\" class=\"return-footnote\" aria-label=\"Return to footnote 40\">&crarr;<\/a><\/li><li id=\"footnote-116-41\">Dworkin, G. (2020, September 9). Paternalism. <em>Stanford Encyclopedia of Philosophy<\/em>. <a href=\"https:\/\/plato.stanford.edu\/entries\/paternalism\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plato.stanford.edu\/entries\/paternalism\/<\/a> <a href=\"#return-footnote-116-41\" class=\"return-footnote\" aria-label=\"Return to footnote 41\">&crarr;<\/a><\/li><li id=\"footnote-116-42\">Fry, S. T. (1989). The role of caring in a theory of nursing ethics. <em>Hypatia, 4<\/em>(2), 87-103. <a href=\"https:\/\/doi.org\/10.1111\/j.1527-2001.1989.tb00575.x\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1111\/j.1527-2001.1989.tb00575.x<\/a> <a href=\"#return-footnote-116-42\" class=\"return-footnote\" aria-label=\"Return to footnote 42\">&crarr;<\/a><\/li><li id=\"footnote-116-43\">Taylor, C. (1993). Nursing ethics: The role of caring. <em>Awhonn's Clinical Issues in Perinatal and Women's Health Nursing, 4<\/em>(4), 552-560. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8220369\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/8220369\/<\/a> <a href=\"#return-footnote-116-43\" class=\"return-footnote\" aria-label=\"Return to footnote 43\">&crarr;<\/a><\/li><li id=\"footnote-116-44\">Schuchter, P., &amp; Heller, A. (2018). The care dialog: The \"ethics of care\" approach and its importance for clinical ethics consultation. <em>Medicine, Health Care, and Philosophy, 21<\/em>(1), 51\u201362. <a href=\"https:\/\/doi.org\/10.1007\/s11019-017-9784-z\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/s11019-017-9784-z<\/a> <a href=\"#return-footnote-116-44\" class=\"return-footnote\" aria-label=\"Return to footnote 44\">&crarr;<\/a><\/li><li id=\"footnote-116-45\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-45\" class=\"return-footnote\" aria-label=\"Return to footnote 45\">&crarr;<\/a><\/li><li id=\"footnote-116-46\">American Nurses Association. (2015). <em>Code of ethics for nurses with interpretive statements.<\/em> American Nurses Association. <a href=\"https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.nursingworld.org\/practice-policy\/nursing-excellence\/ethics\/code-of-ethics-for-nurses\/coe-view-only\/<\/a> <a href=\"#return-footnote-116-46\" class=\"return-footnote\" aria-label=\"Return to footnote 46\">&crarr;<\/a><\/li><\/ol><\/div><div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_116_409\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_409\"><div tabindex=\"-1\"><p>Personal values, character, or conduct of individuals or groups within communities and societies.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_410\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_410\"><div tabindex=\"-1\"><p>The formal study of morality from a wide range of perspectives.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_411\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_411\"><div tabindex=\"-1\"><p>Individual beliefs that motivate people to act one way or another and serve as a guide for behavior.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_412\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_412\"><div tabindex=\"-1\"><p>The prevailing standards of behavior of a society that enable people to live cooperatively in groups.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_413\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_413\"><div tabindex=\"-1\"><p>An ethical theory based on rules that distinguish right from wrong.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_414\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_414\"><div tabindex=\"-1\"><p>An ethical theory that judges whether or not an action is right by the consequences of the action.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_415\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_415\"><div tabindex=\"-1\"><p>A type of consequentialism is utilitarianism that judges actions by their consequences with the standard of achieving the greatest good for the greatest number of people.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_416\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_416\"><div tabindex=\"-1\"><p>Principles used to define nurses\u2019 moral duties and aid in ethical analysis and decision-making.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_417\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_417\"><div tabindex=\"-1\"><p>The capacity to determine one\u2019s own actions through independent choice, including demonstration of competence.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_418\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_418\"><div tabindex=\"-1\"><p>The act or process of pleading for, supporting, or recommending a cause or course of action.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_419\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_419\"><div tabindex=\"-1\"><p>The bioethical principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit another or others, often going beyond what is required by law.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_421\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_421\"><div tabindex=\"-1\"><p>Humble and respectful attitude towards individuals of other cultures and an approach to learning about other cultures as a lifelong goal and process.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_420\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_420\"><div tabindex=\"-1\"><p>The bioethical principle that specifies a duty to do no harm and balances avoidable harm with benefits of good achieved.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_422\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_422\"><div tabindex=\"-1\"><p>A moral obligation to act on the basis of equality and equity and a standard linked to fairness for all in society.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_423\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_423\"><div tabindex=\"-1\"><p>An ethical principle meaning keeping promises.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_424\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_424\"><div tabindex=\"-1\"><p>An ethical principle meaning telling the truth.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_425\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_425\"><div tabindex=\"-1\"><p>The interference by the state or an individual with another person, defended by the claim that the person interfered with will be better off or protected from harm.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_116_426\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_116_426\"><div tabindex=\"-1\"><p>A set of ethical principles established by a profession that is designed to govern decision-making and assist individuals to distinguish right from wrong.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":32,"menu_order":2,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-116","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":107,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/116","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/users\/32"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/116\/revisions"}],"predecessor-version":[{"id":555,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/116\/revisions\/555"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/parts\/107"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/116\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/media?parent=116"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapter-type?post=116"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/contributor?post=116"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/license?post=116"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}