Quimson, Cedriel S.

BSN 4-B
TASK 1. ASSESSING YOUR UNDERSTANDING
Instructions: Using the table below, provide a more inclusive explanation of the common ethical
principles. Fill-in reflection and experience which are necessary to understand many of the
ethical principles in the context of health care and nursing practice. (see rubrics for scoring)
Ethical Principle Example in Nursing Practice
Autonomy Clinical autonomy is the power, freedom, and
carefulness of medical caretakers to make
decisions about patient consideration.
For example:
 Administer prn pain medication. 
 Raise the head of bed when a patient is
short of breath. 
 Seek out the physical therapist to
discuss advancing ambulation.
 Initiate a teaching plan for a caregiver
at home who does not understand when
or how to interpret the patient's
symptoms.
 Give some advice when the patient or
patient’s relatives does not know when
to decide to administer a medication.
Respect for Others Regard is a fundamental part of a high-
performance association. It assists with
establishing a healthy environment in which
patients feel really cared on as people, and
individuals from medical care groups are
engaged, collaborative and focused on service.
 Close the door when you help him dress
or use the bathroom.
 Knock before opening a closed door.
 Don’t discuss confidential information
with other people, even family
members, without his permission.
 Listen to understand.
 Keep your promises.
 Be encouraging.
 Connect with others.
 Express gratitude.
 Share information.
Beneficence This is the center guideline of doing great and
patient advocacy. To have compassion, make
positive moves to help other people and finish
with the willingness to do great. Nurses focus
on guaranteeing that their patients get the best
treatment to accomplish ideal outcomes.

An example of beneficence:

If a nursing home patient falls and fractures his

hip, a nurse should provide him pain
medication as quickly as possible.
Nonmaleficence The first principle, no maleficence, or do no
harm, is directly tied to the nurse's duty to
protect the patient's safety. Born out of the
Hippocratic Oath, this principle dictates that
we do not cause injury to our patients.
Example:
 Nurses must be able to appraise the risk
to the individual use interventions
 treatments to minimize risk and
maximize benefits.
 Stopping a medication that is causing
harmful side effects or discontinuing a
treatment strategy that is not effective
and may be harmful.

Other example: (Situational)

If an incompetent, or chemically impaired,

health care practitioner is taking care of
patients, a nurse should report the abuse to
protect the patient. This principle stands for
many things, including dedication, loyalty,
truthfulness, advocacy and fairness to patients.
Fidelity Fidelity in nursing implies that medical
caretakers should be dedicated to the
guarantees they made as experts to give skilled,
quality consideration to their patients. At the
point when medical caretakers care for a
gathering of patients, care should be given
impartially, decently and fairly to every person.
 For example:
When an older patient with intact cognitive
function is diagnosed with a terminal illness
and he or she doesn't want to share that
information with immediate family, it can
create an ethical dilemma.
 Don't share any healthcare information
without the patient's consent.
 Consult with other interdisciplinary
team members, such as case managers,
social workers, and clergy,
Veracity Refers to the ethics of telling the truth and is
one guide of the conduct of medical
practitioners. While this principle is not a
law, violation of ethical principles, including
veracity, will result in a loss of credibility and
respect with other professionals and patients
alike. 

For example:

If a patient was starting chemotherapy and

asked about the side effects, a nurse practicing
veracity would be honest about the side effects
they could expect with chemotherapy.
Confidentiality Privacy in the clinical setting alludes to "the
standard of keeping secure and secret from
others, data given by or about a person
throughout an professional relationship. It is
the right of each patient, even in the afterlife.

For example:

A psychologist can disclose information about

a patient who talks about suicide or reveals
their intent to harm someone.

Other examples:
 Not responding to any telephone or
email inquiries about patients unless the
inquiring person states a unique
identifier for the patient such as a secret
code number or word.
Justice Justice implies being impartial and reasonable.
Nurses settling on impartial clinical choices
exhibit this, whether it identifies with restricted
assets or new medicines paying little heed to
financial status, nationality, sexual direction

For example:

it is not fair if a patient cannot make payments

and the institution has to pay for the treatments
already given for the patient’s benefit.
Paternalism Paternalistic practices, wherein providers
confer a treatment or service upon a person or
persons without their consent, ostensibly by
reason of their limited autonomy or diminished
capacity, are widespread in healthcare and in
societies around the world.

For example:

A physician refuses to perform a requested

permanent sterilization because of his or her
judgment that it would not be in the sexually
active, twenty-year-old requester’s best
interests in the long run. Or a physician
declines to participate in assisted suicide in a
jurisdiction where it is legal because he or she
does not believe it would be in that patient’s
best interest.
Utilitarianism Utilitarianism is a moral theory that focuses on
the overall balance of positive and negative
effects of a healthcare professional's actions;
all actions are considered on the basis of
consequences, not on the basis of fundamental
moral rules and principles or with regard to
character trait.

For example:
Assume a hospital has four people whose lives
depend upon receiving organ transplants: a
heart, lungs, a kidney, and a liver. If a healthy
person wanders into the hospital, his organs
could be harvested to save four lives at the
 expense of one life. This would arguably
produce the greatest good for the greatest
number. But few would consider it an
acceptable course of action, let alone the most
ethical one.

Privacy Nurses have ethical and legal obligations to

protect the privacy of people requiring and
receiving care. This encompasses treating as
confidential information gained in the course
of the relationship between those persons and
nurses and restricting the use of the
information gathered for professional purposes
only.

For example:
Prevents physicians from disclosing
information shared with them by a patient in
the course of a physician–patient
Deontology Deontological ethics are based on duties and
rights and respect individuals as ends in
themselves. It places value on the intentions of
the individual and focuses on rules, obligations
and duties.

For example:

Cancer patients are quite often advised to

undergo a course of chemotherapy or
radiotherapy. Both treatments involve some
harmful side effects, but the benefits should
outweigh the harm caused by the treatment.

Principalism Principalism aims to provide a framework to

help those working in medicine both to identify
moral problems and to make decisions about
what to do.

Classic examples are problems of paternalism

where physicians seek to provide health
benefits by overriding a patient's autonomous
choice.
TASK 2. APPLYING YOUR KNOWLEDGE
Instructions: Briefly answer the following discussion questions. (see rubrics for scoring)
Scenario: Ralfa is in the hospital. She is a 47-year-old woman who has metastatic breast cancer
and does not want her family to know that she is at the end-of-life and is dying. Ralfa has low
energy, and her fatigue level now taxes her coping mechanisms, which are normally excellent;
she does not feel that she can deal with her family’s grief. Ralfa’s daughter has been discharged
from the Air Force and is returning home from an overseas deployment. The family has planned
a surprise party for Ralfa in the hospital when her daughter arrives back home and has invited
many of her friends and family members. Ralfa’s nurse is conflicted because she practices
under the principle of utilitarianism and is aware of her patient’s desire for privacy as well as
the party planned by the family. Ralfa does not know about the party and her family does not
know about her prognosis.
Discussion Questions
1. Define and state the limitations of utilitarianism, privacy, and veracity

A limitation of utilitarianism is that it tends to create a black-and-white construct of morality.

Utilitarianism also cannot predict with certainty whether the consequences of our actions will be
good or bad the results of our actions happen in the future. While the limits of privacy, it is
contended, are set by the desires of the patients or, where these are not known, by reference to
those whose right and need to know identify with the consideration of the patient. Lastly,
Veracity can be violated by either deliberately lying or also by withholding all or part of the
truth or communicating it in such a way that the other person is misled. Veracity is one of the
basic moral and ethical principles in society. It is entrenched in medical ethics and in nurses'
ethical codes.

2. What would a person of utilitarian thought do in this case?

As a nurse that is practicing under utilitarianism I will respect the desire for privacy and
confidentiality of my patient. I will respect her decision to not tell her relative about her severe
condition, but as her nurse I will also trrelative about her severe condition, but as her nurse I
will also try to convince her if she agrees to inform her relative when she’s ready about her
situation to avoid regrets and conflicts but it is still her decision whether to tell it or not.

3.What about the unwritten nurse-patient agreement as it relates to beneficence?

The unwritten social contract between patient and physician requires that medical professionals
still attempt to inform the patient of the potential consequences of proceeding against medical
advice so When disagreements arise between a healthcare provider and a patient, the health care
provider must explain the reasons for their recommendations, allowing the patient to make a
more informed decision.

4.How does this pose a conflict for a nurse practicing the ethical principle of utilitarianism?

- A nurse practicing this ethic may feel uneasy because utilitarianism considers the overall costs
and benefits of the use of the medication and compares it to the overall costs and benefits of
other possible options. But there is high chance of possibility to choose what’s right and
appropriate for his/her patient’s sake.

5. Are your values regarding veracity stronger or weaker than your desire to cause no harm to
Ralfa’s feelings (nonmaleficence)?

It is stronger since as a nurse who is also practicing utilitarianism and confidentiality of the
patient it will be so hard to tell the truth to her family and to tell her about the surprise that her
family is planning. So it is really important to decide what you tell and do in this case since you
might violate some other ethics applied in this situation you should stick to your principle.

TASK 3. CASE ANALYSIS

Instructions: Briefly answer the following discussion questions. (see rubrics for scoring)

Scenario: Over the past several weeks, you have noticed that your closest friend, Rafaela, has
been erratic and has been making poor patient-care decisions. On two separate occasions, you
quietly intervened and “fixed” his errors. You have also noticed that he volunteers to give pain
medications to other nurses’ patients, and you see him standing very close to other nurses when
they remove controlled substances from the medication distribution center. Today you watched
him go to the center immediately after another colleague and then saw him go into the men’s
room. Within about20 minutes his behavior had changed completely. You suspect that he may be
taking controlled substances. You and Rafaela have been friends for more than 20 years. You
grew up together and went to nursing school together. You realize that if you approach him, you
may jeopardize this close friendship that means a great deal to you.

Using the MORAL ethical decision-making model, devise a plan to resolve this dilemma.