ETHICAL AND LEGAL ISSUES

Ethics: also called moral philosophy, the discipline concerned with what is morally good and
bad and morally right and wrong. The term is also applied to any system or theory of moral
values or principles.
Ethics are the principles that guide us to make a positive impact through our decisions and
actions. Ethics play an important role not only in our personal lives but also in business. ...
Ethics is what guides us to tell the truth, keep our promises, or help someone in need.

Ethics are the principles that guide us to make a positive impact through our decisions and
actions. Ethics play an important role not only in our personal lives but also in business. ...
Ethics is what guides us to tell the truth, keep our promises, or help someone in need.

Morality: the term ‘moral’ tends to refer to the norms of conduct, which individuals and groups
uphold and adhere to. The violation of a moral rule by an individual may, for example, elicit
disapproval in the form of mistrust, hostility by the group.

Moral values: values are closely related to the meaning of life. A value is an effective
disposition towards a person, an object or an idea and represents the way of life. Values relate to
our identity and we find our values through specific experiences and from our association with
other people
Ethics and the Law: Ethics is not synonymous with law although law and ethics sometimes
overlap, eg when the law requires a nurse to provide a patient with sufficient information to
enable the patient to make an informed decision on proposed treatment. At times, judgements of
law and ethics are dichotomous eg when a distinction is made between taking a patient off a
respirator and not putting the patient on a respirator in the first place
The concepts of ethics and the law both serve as guides to action and both have social sanctions
and functions. Laws are promulgated to maintain order in society and to establish minimum
standards of social conduct. Ethics on the other hand may make a demand on an individual,
which may conflict with or even violate the demands of the law. Ethics is regarded as higher that
the law and often serves as a source of judgement of the law itself. At the level of everyday
decision making, disregard for the law may result in punishment, whereas disregard for ethical
norms does not carry the same force.

What is ethics and its importance? (Discuss)

Nursing is a caring and inherently moral enterprise, and nursing practice is characterized by its
long noteworthy moral tradition
 The nursing profession’s concern for ethics in nursing practice was expressed more than a
century ago when the Nightingale pledge was introduced as an oath for nurses completing their
training
Nursing ethics is a social ethics because it is based on an enduring ideal of service, which is not
confined to bedside nursing.

Caring and nursing ethics: Caring is the cornerstone of all nursing that is moral and centered
on the wellbeing of patients. Caring is a commitment that entails respect for all persons. Caring
means that patients matter as persons

Bioethics and Biomedical ethics: Bioethics is the study of the moral and social implications of
techniques resulting from advances in the biological sciences. Bioethics has emerged partly
because of the vulnerability of patients and the extremely intimate relationship between patients
and health professionals, together with the undesirable degree of power, which health
professionals hold over patients. It is especially important because humans are used as subjects
of medical research and because of the growing threat of malpractice suits. In practice, bioethics
has come to be practically interchangeable with medical ethics or biomedical ethics.

Nurse Practice Act: Read Nurses Act Chapter 257 of the Laws of Kenya 2012

Ethical and legal issues: Nurse Practice Act, Malpractice Vs Negligence, misdemeanor, Good Samaritan Law,
Liability Protection/Insurance.

Felony: Ethical Principles: Nursing code of ethics, autonomy, advocacy, accountability, patient’s rights,

Ethical decision making: Duty-based, Utilitarianism. Specific ethical issues related to nursing: Informed consent,
Bio-ethical concerns: Concerns about conception- genetic/reproductive issues, concerns about death – end of
life/palliative care.

Malpractice Vs Negligence
In simple terms, medical negligence is a mistake that resulted in causing a patient unintended
harm. Medical malpractice, on the other hand, is when a medical professional knowingly
didn't follow through with the proper standard of care.
Misdemeanor Vs Felony
 A crime can either be classified as a misdemeanor or a felony, depending on how serious the
offense is. Misdemeanors are less serious than felonies and carry lighter penalties. Felonies,
on the other hand, come with at least a year (and sometimes decades or even a lifetime) in prison.

Good Samaritan Law

A responder can never be forced to put himself or herself in danger to aid another person. -The
responder is not legally liable for the death, disfigurement or disability of the victim, as long as
the responder acted rationally, in good faith, and in accordance with their level of training.

Four key elements in good samaritan laws are:

 Permission of ill/injured person when possible.
 Care given in appropriate (non-reckless) manner.
 Person covered by good samaritan laws was NOT the one who caused an accident.
 Care was being given because it was an emergency situation and trained help had yet to arrive.

Liability Protection/Insurance.

Liability insurance refers to an insurance product that provides an insured party

with protection against claims resulting from injuries and damage. Components of liability
liability insurance: bodily injury, property damage and uninsured/under-insured motorists
coverage.

Codes of Ethics
Common guidelines which are used by nurses for making ethical decisions are contained in
various codes and pledges. Like other professional codes of ethics, nursing codes contain rules
and moral standards applicable to nursing conduct.
While some codes address specific issues and are not confined to matters of etiquette and broad
statements, most do not give guidance on conduct in specific situations. Nursing codes not only
guide members of the profession but also serve as a declaration to the public they serve
Established professions like the nursing profession tend to express explicitly the moral standards
which guide their professional conduct. Professions consequently rely on the integrity of their
members to carry out their work in the best interests of those whom they serve. In practice, then,
while codes of ethics have limitations and cannot provide answers to day-to-day moral
dilemmas, they do provide a framework of general rights, duties, values and policies that govern
professional practice.
The nature and scope of Ethics
Ethics is a specialized field of study which deals with the dynamics of deciding what is right and
what is wrong. It can be approached from three different perspectives:
 Descriptive ethics: consists of factual descriptions of conduct or moral beliefs that are
often found in research studies and undertaken by anthropologists, historians, sociologists
and psychologists. They are merely concerned with stating what the actual beliefs of a
person or a group are. It does not pass judgement on moral conducts or beliefs. It merely
describes what certain people believe to be right or wrong without judging these beliefs.
While they can be applied to moral issues, it is not a formal branch of ethics.
 Analytical ethics or meta-ethics: The study of moral judgement is the domain of the
professional ethicist. Is a field of study in which philosophers ask and attempt to answer
questions about the meaning of words like ‘right’ and ‘wrong’ or ‘good and ‘bad’ eg does
it mean to say that mercy killing is wrong. Is concerned with theories of ethics and
analyses questions such as ‘why be good?’ or ‘what do we mean when we say a particular
value is good or right?’ These questions are important because they provide critique on
ethics. They consider the connection between human conduct and morality or between
ethical beliefs and the facts of the real world, and the relationship between the various
theoretical principles on ethics and human conduct
 Normative ethics: Here the concern is not merely with what someone thinks is right but
what in fact is right. The focus is therefore on the justification of a particular moral belief.
The study of ethics in the field of nursing and health care is primarily centered on
normative ethics. It is generally divided into norms of value and norms of obligation.
Norms of value deal with what is ‘good or evil’ on people. Early nursing ethics was
concerned with virtue, within the domain of norms of value. The emphasis in nursing
today has shifted from the moral character of nurses to the ethical duties and obligations
of nurses. Norms of obligations are concerned with what is the ‘right’ and what is the
‘wrong’ thing to do.

Basic ethical theories and principles

Traditional ethical theories
 Consequentialism or teleology (Utilitarian moral theories): Egoism, utilitarianism,
limited consequentialism
Holds that the rightness or wrongness of an action is solely dependent on the result the action
produces
 Non-consequentialism or deontology (formalist theories): it is the good intention to do
one’s moral duty which determines whether an action is morally praiseworthy
 Ethical principles in nursing and healthcare

 The principle of Autonomy and informed consent

 The principles of non-maleficence and beneficence
 The principle of justice
Moral rules derived from major principles:
 Veracity and fidelity derived from the principle of autonomy- telling the truth
 Confidentiality and privacy- aspect of fidelity is the confidentiality of information about
patients

Rights and responsibilities

Basic human rights in healthcare context:
 The right to treatment
 The right to know the right information
 The right to confidentiality and privacy
Moral rights of patients:
 To decide what may be done to their bodies
 To receive information to enable to make the informed decision
 To know the effects of treatment
 To accept, refuse or stop treatment
Rights of patients:
 Emergency medical treatment
 Information regarding one’s condition
 Give informed consent for treatment
 Participate in decision-making regarding one’s health
 Be informed when participating in research
 Privacy
 Access to health records
 Submit complaints regarding health services
 Be treated with respect
Professional rights of nurses
Nurses have the right to freely and openly advocate for themselves and their patients,
without fear of retribution. Nurses have the right to fair compensation for their work, consistent
with their knowledge, experience and professional responsibilities.