By

Dr. Myra C. Britiller

 ETHICS

Came from the Greek word
ethos which means moral
duty

Refers to a standard to
examine and understand
moral life
 ETHICS

Studies how people
make judgement in
regard to right or
wrong
 Ethics

About making choices that
are best for the individual or
society at certain times and
in particular situations and
then evaluating such choices
and outcomes
 
Ethicist Joseph Fletcher differentiates morality
from ethics:
“Morality is what you believe is right and good
while ethics is the critical reflection about
morality from ethics and rational analysis
about it.”
 Professional Ethics

Branch of moral science
concerned with the
obligations that a
member of the profession
owes to the public.
 Health Care Ethics

Division of ethics that
relates to human health

Resides in the realm

human values, morals,
customs, personal beliefs,
and faith
 Bioethics

Specific domain of ethics
that focuses on moral
issues in the field of
health care
Systematic study of
human behavior in the
field of life science and
health care in the light of
moral values and
principles
 Nursing Ethics

Reinforces the nurse’s
ideals and motives in order
to maximize the affectivity
of their service
 Nursing Ethics

by Johnston:
“examination of all
ethical and bio-ethical
issues from the
prospective of nursing
theory and nursing
ethics”
 Nursing Ethics
By Vercoe, et. al.

The fields of nursing ethics
be focused on the needs
and experiences of
practicing nurses, the
exploration of its meaning
and that of ethical practice
in terms of the perception
of these nurses
 Universal Principles of
Biomedical Ethics

In health care delivery, basic ethical
principles assist the health
professionals to determine right or
wrong in regard to value issues
involving the pursuit of health,
alleviation of suffering, and assisting
patients towards peaceful death
 Universal Principles of
Biomedical Ethics

Autonomy
Veracity
Beneficence
Nonmaleficence
Justice
 Autonomy

Comes from the Greek
work autos meaning self
and nomos meaning
governance.
 Autonomy
Involves self-

determination and
freedom to choose and
implement one’s decision,
free from deceit, duress,
constraint or coercion.

Informed Consent
 Veracity

The patient has the responsibility to
provide, to the best of his knowledge,
accurate and complete information
about his complaints, past illness,
previous hospitalizations, medications
being taken, allergies, religious
restrictions, and other matters relevant
to his health
 Veracity

Benevolent Deception
The practitioner himself
intentionally withholds
information according
to his judgement when
such revelation would
do more harm to an
emotionally unstable or
depressed person.
 
Promotes doing acts of kindness and
mercy that directly benefit the patient.
Acts that promote health of the patient,
prevent illness or complications,
alleviate suffering and assist towards
peaceful death if inevitable comes.

 Nonmaleficence
Do no harm

Not assisting in or performing abortion
Not assisting persons to commit suicide
Not performing euthanasia
Not willfully subjecting patients to
experimental drugs whose potential harm may
be greater than the expected benefit
Not harming a person’s reputation by revealing
confidential information

 Justice

In health care, justice refers to the right
to demand to be treated justly, fairly
and equally
Responsibilities of a
Professional Nurse

 Responsibilities of the
Nurse to the Patient
The primary

responsibility of the nurse
to the patient is to give
him the kind or care his
condition needs
regardless of his race,
creed, color, nationality
or status.
 Responsibilities of the
Nurse to the Patient

The patient’s care shall
be based on needs, the
physician’s orders, and
the ailment; and shall
involve the patient and
his family so that he or
any of the family can
participate in his care.
Confidentiality of Information

Privileged communication
Given based on trust
Patients and family are expected to
give the necessary information so that
proper diagnosis and treat could be
made
Confidentiality of Information

The patient and family are entitled to
know information or facts within the
limits determined by the physician.
If the patient insists on knowing what
his/her diagnosis is, the nurse may
only repeat what the doctor wishes to
disclose.
Confidentiality of Information

Any information gathered by the nurse
during the course of caring for the
patient should always be treated
confidential.
This duty extends even after the
patient’s death.
 Confidential Information may
only be Revealed when:

Claim for hospitalization, insurance
benefits
Medico-legal
Patient is ill of communicable disease
Revelation to other members of the
health if information is relevant to his
care
Nurses Responsibilities
in Research
on Human Subjects

 Nurses Responsibilities in Research
on Human Subjects

The Helsinky Declaration of 1964 issued guidelines on
medical research.
 In 1975 it differentiated two major types of research:
that which is essentially therapeutic and that which is
directed toward developing scientific knowledge and
has no therapeutic value for the subjects
Nurses Responsibilities in Research
on Human Subjects

The declaration emphasizes that the
research subjects must be informed
when a clinical or non-clinical study
will be of no personal benefit to them to
avoid any suspicion to the contrary.
 ANA Human Rights Guidelines for
Nurses in Clinical and other Research

1. Employment in Settings where research is
conducted
2. Vigilant protection of human subject’s rights
3. Scope of application
4. Supporting accrual of knowledge
5. Informed consent
6. Representation on human rights
 Basic Human Rights of
Research Subjects

1. Right to informed consent
2. The right to refuse and/or withdraw from
participation
3. Right to privacy
4. Right to confidentiality or anonymity of data
5. Right to protected from harm
 Living Wills and
Advanced Directives

Health-care policy forms to patients being
admitted
The patient designates a health care
representative, usually a member of the
family, a friend, or a family physician to
make decisions for him or her when he/she
is unable, due to physical or mental
incapacity, to make his/her health care
decision
 Living Wills and
Advanced Directives

Includes decisions to accept or refuse
any treatment, service or procedure
used to diagnose or treat his/her
physical or mental condition and
decisions to provide, withhold or
withdraw life-sustaining measures.
 Living Wills and
Advanced Directives

Signed by patient
Witnessed by two other persons
 Declare the patient signed the will
 Of sound mind
 Free of duress or undue influence
 18 years old and above
 Not designated as the person’s health care
representative or alternate
Attached to the chart
Has a force of law
 Nurses and People

Values, customs
and spiritual beliefs
held by individuals
are to be respected.
 Nurses and People

The nurse’s holds in
strict confidence
personal information
required in the
process of giving
nursing care. She/he
uses discriminative
judgement in the
sharing time.
 Nurses and Practice

The nurse is accountable for her/his
own nursing practice. She/he is
responsible for his/her personal and
professional growth and development.
The nurse maintains or modifies
standards of practice within the reality
of any given situation. Quality care is
her/his goal.
 Nurses and Practice

The nurse is the advocate of the patient of the
patient. She/he takes appropriate steps to
safeguard the patient’s rights and privileges.
The nurse is aware that her/his nursing
actions have professional, ethical, moral, and
legal dimensions. She/he strives to perform
her/his work in the best interest of all
concerned.
The nurse observes personal and professional
decorum at all times
 Nurses and Co-workers

The nurse maintains collaborative working
relationship with her/his co-workers and
other members of the health team.
The nurse recognizes her/his capabilities
and limitations in accepting responsibilities
and those of her/his co-workers hen
delegating responsibilities to them.
 Nurses and Society

The nurse is a contributing member of
society. She/he assumes responsibilities
inherent in being a member and citizen of
the community/society in which she/he
lives/work.
She/he recognizes the need for change
and initiates, participates and supports
activities to meet the health and social
needs of the people.
THE NURSING CODE
OF ETHICS

 THE NURSING CODE
OF ETHICS

The code of ethics is a formal statement of a
group’s ideals and values
 It is a set of ethical principles that:
Is shared by members of the group
Reflects their moral judgement over time
Serves as a standard for their professional
actions
 Purposes:

 Inform the public about the minimum standards of the
profession and help them understand professional
nursing conduct
 Provide a sign of the profession’s commitment to the
public it serves
 Outline the major ethical considerations of the
profession
 Provide ethical standards for ethical behaviour
 Guide the profession in self regulation
 Remind nurses of the special; responsibility they assume
when caring for the sick
Responsibility and Accountability for
the Practice of Professional Nursing

 Professional Negligence

Refers to the commission
or omission of an act,
pursuant to a duty, that a
reasonably prudent
person in the same or
similar circumstance
would or would not do,
and acting or the non-
acting of which is the
proximate cause of injury
to another person or his
property
 Specific Examples of Negligence
1.

Failure to report observations to attending physicians
2. Failure to exercise the degree of diligence which the
circumstance of the particular case demands
3. Mistaken identity
4. Wrong medicine, wrong concentration, wrong route,
wrong dose
5. Defects in the equipment such as stretchers and
wheelchairs may lead to falls thus injuring patients
6. Failure due to family assistance
7. Administration of medicine without a doctor’s
prescription
 The Doctrine of Res Ipsa Loquitur

Three conditions are required to establish a defendant’s
negligence without proving specific conduct:
1. That the injury was of such nature that it would
normally occur unless there was a negligent act on
the part someone
2. That the injury was caused by an agency within
control of the defendant
3. That the plaintiff himself did not engage in any
manner that would tend to bring about the injury
 Malpractice

Implies the idea of
improper or unskillful
care of a patient by a
nurse
Denotes stepping
beyond one’s authority
with serious
consequences
 Doctrine of Force Majeure

An irresistible force, one that is unforeseen or
inevitable
Floods
Fire
Earthquake
Accidents
Habitual tardiness due to heavy traffic is not
excused
 Doctrine of Respondeat Superior

“let the master answer for the acts of the
subordinates”
Liability is expanded to include the master as
well as the employee and not a shift of liability
from the subordinate to the master
Private duty nurses are liable for their own
negligent actions
 Incompetence

The lack of ability, legal
qualifications or fitness
to discharge the
required duty
Liability of Nurses for the
Work of Nursing Aides

 Liability of Nurses for the
Work of Nursing Aides

Nursing aides perform selected nursing
activities under the direct supervision of nurses
Nurses are enjoined to supervise their
subordinates and see to it that they perform
only those which they have been taught to do
and those which they are capable of doing
Liability of Nurses for the
Work of Nursing Students

 Liability of Nurses for the
Work of Nursing Students

1. Nursing students should always be under the
supervision of their CI.
2. They should be given assignments that are at
their level of training, experience, and
competency.
3. They should be advised to seek guidance
especially if they are performing a procedure
for the first time.
 Liability of Nurses for the
Work of Nursing Students

4. They should be oriented to the policies of the
nursing unit where they are assigned.
5. Their performance should be assessed frequently
to determine their strengths and weaknesses.
6. Frequent conferences with the student will reveal
their problems which they may want to bring to the
attention of their instructors or vice versa.
Discussion of these problems will iron out doubts
and possible solutions that may be provided.
 Liability of Nurses for the
Work of Nursing Students

However, it is emphasized that although
nursing students are not employees of the
hospital they are entrusted with the
responsibility of providing supervised nursing
care to the patient. The patients can expect that
the care given by these students will be in a
manner consistent with that which a
reasonably prudent person will give.
 Liability of Nurses for the
Work of Nursing Students

Both the clinical instructor and the staff nurse
in the clinical area where the nursing students
are assigned should coordinate in assessing the
competence of nursing students before they are
allowed to give care to patients so that the risk
of injury to the same will be avoided.
RA 9173

 RA 9173

Change in the Philippine Nursing Act
of 2002 from RA 7164, The Philippine
Nursing Act of 1998, taken from the
Implementing Rules and Regulations of
RA 9173
 Composition of the
Board Nursing

The Board is now composed of a
Chairman and six (6) members instead
of a Chairman and four (4) members
 Submissions of Names

Submission of names of qualified
nominees by the Accredited
Professional Organization (APO) to the
Commission, three (3) nominees per
vacancy, not later than three months
before the vacancy
Licensure Examination and
Registration

Dates of examination
Age of examinees
 Ratings

Number of times an examinee may
take the licensure examination has been
deleted
Examination shall be taken within two
(2) years after the last failed
examination
Revocation and Suspension
of Certificate of Registration

Rules and Regulations
Code of Ethics
Code of Technical Standards, for
Nursing practice, and policies of the
Board and of the Commission
 Nursing Education

Added: requirement for inactive nurses
returning to practice
Qualifications of Faculty
Qualifications of the Dean of the
College of Nursing
 Nursing Practice

Duties and Responsibilities of the
Nurse
Qualification of Nursing
Service Administrators

Priority in Appointment
Health Human Resource Production
and Utilizations
Penal and Miscellaneous Provision
Prepare for the
PRELIMS
