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=                           Nursing ethics                           =
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                            Introduction
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Nursing ethics is a branch of applied ethics that concerns itself with
activities in the field of nursing. Nursing ethics shares many
principles with medical ethics, such as beneficence, non-maleficence
and respect for autonomy. It can be distinguished by its emphasis on
relationships, human dignity and collaborative care.


                       Development of subject
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The nature of nursing means that nursing ethics tends to examine the
ethics of caring rather than 'curing' by exploring the everyday
interaction between the nurse and the person in care. Early work to
define ethics in nursing focused more on the virtues that would make a
good nurse, which historically included loyalty to the physician,
rather than the focus being on nurse's conduct in relation to the
person in the nurse's care. In recent times, the ethics of nursing has
also shifted more towards the nurse's obligation to respect the human
rights and dignity of the patient and this is reflected in a number of
professional codes for nurses, such as in the latest code from the
International Council of Nurses.


                         Distinctive nature
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Although much of nursing ethics can appear similar to medical ethics,
there are some factors that differentiate it. Breier-Mackie suggests
that nurses' focus on care and nurture, rather than cure of illness,
results in a distinctive ethics. Furthermore, nursing ethics
emphasizes the ethics of everyday practice rather than moral dilemmas.
Nursing ethics is more concerned with developing the caring
relationship than broader principles, such as beneficence and justice.
For example, a concern to promote beneficence may be expressed in
traditional medical ethics by the exercise of paternalism, where the
health professional makes a decision based upon a perspective of
acting in the patient's best interests. However, it is argued by some
that this approach acts against person-centred values found in nursing
ethics.

The distinction can be examined from different theoretical angles.
Despite the move toward more deontological themes by some, there
continues to be an interest in virtue ethics in nursing ethics and
some support for an ethic of care. This is considered by its advocates
to emphasise relationships over abstract principles and therefore to
reflect the caring relationship in nursing more accurately than other
ethical views. Themes that emphasize the dignity of the patient by
promoting a respectful and caring attitude from nurses are also
commonly seen.


                   Some themes in nursing ethics
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Nurses seek to defend the dignity of those in their care. Being able
to respond to the vulnerability of patients in a way that provides
dignifying care is a key concept in the field.

In terms of standard ethical theory, respecting dignity can also be
aligned with having a respect for people and their autonomous choices.
People are then enabled to make decisions about their own treatment.
Amongst other things this grounds the practice of informed consent
that should be respected by the nurse, although much of the debate
lies in the discussion of cases where people are unable to make
choices about their own treatment due to being incapacitated or having
a mental illness that affects their judgement. A suggested way to
maintain autonomy is for the person to write an advance directive,
outlining how they wish to be treated in the event of their inability
to make an informed choice, thus avoiding unwarranted paternalism.

Another theme is confidentiality and this is an important principle in
many nursing ethical codes. This is where information about the person
is only shared with others after permission of the person, unless it
is felt that the information must be shared to comply with a higher
duty such as preserving life. Related to information giving is the
debate relating to truth telling in interactions with the person in
care. There is a balance between people having the information
required to make an autonomous decision and, on the other hand, not
being unnecessarily distressed by the truth. Generally the balance is
in favour of truth telling due to respect for autonomy, but sometimes
people will ask not to be told, or may lack the capacity to understand
the implications. Finally, the role of empirical ethics has become
prominent in recent years.

By giving consideration to the themes above, the nurse can endeavour
to practice in an ethical way. This key outcome in nursing practice is
sometimes challenged by resource, policy or environmental constraints
in the practice area, which can lead to moral distress.


                Awards for nursing ethics excellence
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* The National Nursing Ethics Conference (NNEC) awards an annual
Nursing Ethics Leadership Award
* Massachusetts Nursing Association (MNA) offers an Image of the
Professional Nurse Award
* American Nursing Association Massachusetts offers an annual Living
Legends in Massachusetts Nursing Award


                              See also
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*Bullying in nursing
*Clinical governance
*Patient advocacy
*Philosophy of healthcare


                           External links
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*[https://www.surrey.ac.uk/fhms/research/centres/ICE/index.htm
International Care Ethics Observatory, University of Surrey, UK]
*[https://web.archive.org/web/20030826152601/http://web.amnesty.org/library/Inde
x/engACT750021997
'Nurses and Human Rights'] from Amnesty International
*[http://journals.sagepub.com/home/nej 'Nursing Ethics'] a prominent
journal in the field
*[http://onlineprograms.widener.edu/nursing/rn-to-bsn/resource/nursing-code-of-e
thics
Understanding the Nursing Code of Ethics, Widener University]


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