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A cheerful nurse in blue scrubs takes notes on a clipboard while engaging with an elderly patient in a clinic room, signifying a caring and professional nurse-patient interaction.

Why Ethics in Nursing Matters

3 min readApril, 25 2023

Registered nurses routinely encounter issues that may have ethical implications. Nurses work with patients whose lives may be at stake. It’s a nurse’s job to follow protocol and best practices while treating the patient as an individual with their own wishes and preferences for care. These decisions may warrant discussion with the larger care team, or they may require swift action in a moment of crisis. Understanding ethics and the consequences of their actions can help a nurse make the best decision when it isn’t always apparent.

What Is the Nursing Code of Ethics?

The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements (Code of Ethics) has been a guide and reference for registered nurses since its development in the 1950s. It serves as a moral compass to promote high levels of care, an ethical standard for those entering the nursing profession, and a commitment to society affirming the responsibilities of the registered nurse.

The Code of Ethics has been revised over time to reflect technological advances, societal changes, and the expansion of the nursing practice. Every day, nurses draw upon ethical nursing principles to make patient care decisions. That’s one reason that for over two decades, nurses have led Gallup’s annual ranking of professions for high honesty and ethics.

Four Ethical Principles in Nursing

The Code’s provisions require that a registered nurse advocate for patients by providing safe care with compassion and a commitment to the patient’s primary interest. Ethical principles of nursing include looking beyond the bedside to individual self-regard and human rights while striving to maintain health care advancement and social justice.

Developing an ethical awareness can ensure quality care. Nursing ethical principles can be broadly categorized into four major ethical nursing principles:

  1. Autonomy: The right to self-determination. Autonomy in nursing means providing adequate information to allow patients to make their own decisions based on their beliefs and values, even if they aren’t the ones the nurse chooses. Autonomy also relates to only providing nursing care within the scope of practice defined by state and organizational rules. Examples of autonomy in nursing include administering PRN medications or assigning nursing duties based on levels of competence.
  2. Beneficence: The promotion of good. Beneficence in nursing relates to ensuring that the patient's best interest is considered, regardless of the nurse's personal opinion. Examples of beneficence in nursing include providing comfort to a dying patient or assisting with tasks a patient cannot perform independently.
  3. Justice: Fairness or an equal distribution of benefits. Justice in nursing relates to impartiality regarding a patient's age, ethnicity, economic status, religion, or sexual orientation. Examples of justice in nursing include impartiality when assigning clinical or prioritizing patient care.
  4. Nonmaleficence: The avoidance or minimization of harm. Nonmaleficence in nursing requires the provision of safe, effective, high-quality care. Examples of nonmaleficence in nursing include holding a medication due to adverse reactions or taking steps to ensure a safe work environment.

Ethical Decision Making in Nursing

A cheerful nurse in blue scrubs takes notes on a clipboard while engaging with an elderly patient in a clinic room, signifying a caring and professional nurse-patient interaction.

A health care organization’s support of ethical principles unifies its nursing practices and settings. Registered nurses are trusted with a range of responsibilities in various roles in clinical practice, education, leadership, or research. The nurse may be required to make decisions beneficial to the patient, nursing student, employee, or organization.

If a nursing action ignores a patient's preference or conflicts with ethical principles, the registered nurse may be acting unethically. Emphasizing ethical principles in nursing will increase decision-making confidence across any nursing practice. Performing nursing care according to the Code of Ethics may require the registered nurse to risk adverse personal outcomes such as employer or peer backlash, but it ensures that the focus remains on the patient. Registered nurses are faced with difficult decisions each day that may affect the lives of others. A foundation based in ethics helps ensure those decisions are the best route forward.

Trust in the nursing profession by individuals and society isn’t to be taken lightly. Increasing ethical awareness in nursing can help ensure that the nursing profession maintains that trust, supports nursing colleagues, and continues to develop the future of nursing.

Explore our continuing education materials on ethics and nursing including articles, books, webinars and the Code of Ethics.


Images sourced from Getty Images

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