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Chapter: Medical Surgical Nursing: Critical Thinking,Ethical Decision Making, and the Nursing Process

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Common Ethical Principles - Nursing Process

The following common ethical principles may be used to validate moral claims.

Common Ethical Principles

 

The following common ethical principles may be used to validate moral claims.

 

Autonomy

 

This word is derived from the Greek words autos (“self ”) and nomos (“rule” or “law”), and therefore refers to self-rule. In contemporary dis-course it has broad meanings, including individual rights, privacy, and choice. Autonomy entails the ability to make a choice free from exter-nal constraints.

 

Beneficence

 

Beneficence is the duty to do good and the active promotion of benev-olent acts (eg, goodness, kindness, charity). It may also include the in-junction not to inflict harm (see nonmaleficence).

 

Confidentiality

 

Confidentiality relates to the concept of privacy. Information ob-tained from an individual will not be disclosed to another unless it will benefit the person or there is a direct threat to the social good.

 

Double Effect

 

This is a principle that may morally justify some actions that produce both good and evil effects.

All four of the following criteria must be fulfilled:

•      The action itself is good or morally neutral.

•      The agent sincerely intends the good and not the evil effect (the evil effect may be foreseen but is not intended).

•      The good effect is not achieved by means of the evil effect.

•      There is proportionate or favorable balance of good over evil.

Fidelity

 

Fidelity is promise keeping; the duty to be faithful to one’s commit-ments. It includes both explicit and implicit promises to another person.

 

Justice

 

From a broad perspective, justice states that like cases should be treated alike. A more restricted version of justice is distributive justice, which refers to the distribution of social benefits and burdens based on various criteria that may include the following:

 

Equality

Individual need

Individual effort

Societal contribution

Individual merit

Legal entitlement

 

Retributive justice is concerned with the distribution of punishment.

 

Nonmaleficence

 

This is the duty not to inflict harm as well as to prevent and remove harm. Nonmaleficence may be included within the principle of benef-icence, in which case nonmaleficence would be more binding.

 

Paternalism

 

Paternalism is the intentional limitation of another’s autonomy, jus-tified by an appeal to beneficence or the welfare or needs of another. Under this principle, the prevention of evils or harm takes precedence over any potential evils caused by interference with the individual’s autonomy or liberty.

 

Respect for Persons

 

Respect for persons is frequently used synonymously with autonomy. However, it goes beyond accepting the notion or attitude that people have autonomous choice, to treating others in such a way that enables them to make the choice.

 

Sanctity of Life

 

This is the perspective that life is the highest good. Therefore, all forms of life, including mere biologic existence, should take precedence over external criteria for judging quality of life.

 

Veracity

 

Veracity is the obligation to tell the truth and not to lie or deceive others.

 

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