Ethical and Legal Principles in Nursing
Nursing practice is guided by ethical and legal principles, providing a framework that influences nurses’ goals, actions, and strategies in delivering patient care. Nurses often encounter dilemmas that necessitate ethical and legal considerations in their decision-making process. This blog explores the ethical and legal principles in nursing, as well as their applications in physical therapy and nursing education.
Legal and Ethical Principles in Nursing:
Nurses are obligated to adhere to ethical standards when caring for patients. The following are the key legal and ethical principles in nursing:
Autonomy:
Autonomy recognizes individuals’ rights to make decisions about their healthcare. Patients must be fully informed about their condition, treatment options, benefits, and risks. The law permits adult patients to refuse treatment, even if it’s deemed beneficial, unless it poses a threat to others’ well-being. Nurses should respect and support their patients’ wishes, considering factors such as general health, gender, culture, social status, sexual orientation, and age.
Justice:
The principle of justice requires nurses to treat all patients fairly and impartially, irrespective of their religion, socioeconomic status, sexual orientation, race, or gender. Providing unbiased medical care, as demonstrated in a screening clinic accessible to all individuals regardless of their circumstances, contributes to improved patient outcomes.
Beneficence:
Nurses are called to be compassionate and considerate in their care for patients, the community, and society. Providing optimal care involves setting aside personal feelings and addressing each patient’s unique perspectives, life circumstances, and experiences. Nurses act to benefit their patients, safeguard others’ rights, assist individuals with disabilities, prevent harm, rescue people from danger, and address issues that may lead to harm.
Non-maleficence:
The principle of non-maleficence requires nurses to avoid causing harm to their patients. It emphasizes harm prevention during healthcare delivery. In cases where patients are insufficiently informed about a procedure, nurses must act with utmost care to avoid any harm. This principle is especially crucial in making end-of-life decisions and managing pain.
Accountability:
Nurses are held accountable for their actions while caring for patients, accepting personal and professional consequences for their decisions. By prioritizing accountability, nurses strive to provide high-quality patient care and foster positive relationships with their patients.
Fidelity:
Fidelity calls for nurses to be loyal and committed to their patients, nurturing trust and fulfilling their responsibilities. However, nurses may face dilemmas when commitments clash with achieving the best outcome for the patient. Fidelity also entails safeguarding confidential information, including health records.
Veracity:
The principle of veracity necessitates honesty and openness in communication with patients, even if the information may cause distress. By being transparent, nurses foster a strong patient-nurse relationship, enabling patients to make informed decisions.
Legal Framework and Ethical Principles in Nursing:
Nursing law establishes legal boundaries in patient care, differentiating nursing actions from those of other healthcare practitioners, and maintaining professional standards. Legal practices in nursing are governed by laws, policies, licensure regulations, and more. Nurses’ skills and knowledge form the foundation for nursing practice.
Legal actions may be taken against nurses who fail to uphold the standards of practice. For example, a nurse who disregards a patient’s refusal and proceeds with physical contact may be liable for assault, tort, or battery. Informed consent must be obtained when a patient is capable of making decisions. Any harm or injury caused during patient care is considered a breach of the law.
Nurses and nursing students must abide by codes of ethics, employer procedures, protocols, and policies to avoid malpractice, negligence, or breach of patient confidentiality, which may lead to the revocation or reprimand of their licenses.
Legal and Ethical Principles in Nursing PT Information:
External factors, such as rules and regulations, influence nurses in providing optimal patient care. Physical therapists adhere to the practices outlined by the American Physical Therapy Association (APTA) to ensure the best care for patients. Members of the association include occupational therapists, psychologists, rheumatologists, pharmacists, and orthopedics.
Physical therapists follow the fiduciary (financial) principle when caring for patients, billing them based on Medicaid services methodology, regardless of their ability to pay. Nursing ethics aim to achieve a caring response in fulfilling the nursing role and its responsibilities.
Moral commitment guides physical therapists in delivering quality healthcare services, collaborating with colleagues, and earning public trust. The APTA instills professional and ethical behavior among its members through various publications and core documents. Understanding the scope of rules, ethical codes, and laws helps physical therapists make sound decisions.
Ethical and Legal Principles in Nursing Education:
The National League for Nursing (NLN) addresses ethical issues concerning violence, privacy, and dishonesty in nursing education. The NLN provides ethical principles that serve as a guide in nursing education. Ethical practice in nursing education is anchored in integrity, diversity, excellence, and caring.
The diversity principle encourages nurse educators to appreciate the uniqueness of each learner and employ varied learning approaches to accommodate individual needs. Equal treatment must be extended to all learners, regardless of age, gender, race, ethnicity, or religion. Integrity involves treating students with respect, dignity, and professionalism both inside and outside the classroom.
Nurse educators must also show respect and care towards their students to achieve positive outcomes. Promoting excellence involves fostering a culture of innovation and research. However, legal action may be taken if a nurse educator fails to supervise students in a clinical setting, leading to patient harm, or if they act against a student accused of unethical practices. Additionally, if a patient suffers injury or harm due to a student’s inadequate training, legal repercussions may arise.
Ethical and Legal Issues in Nursing:
Nurses frequently encounter ethical dilemmas while providing patient care. Some of these issues include patients’ refusal of treatment due to personal or cultural beliefs, discomfort with treatment, and making life-or-death decisions. Many legal and ethical issues in nursing can result in severe consequences, such as the loss of licensure, termination of employment, or even incarceration. The following are key legal and ethical issues in nursing:
1. Negligence:
Negligence refers to carelessness or deviation from the standard patient care practices, whether intentional or unintentional. Nurses may be held liable for negligence if it leads to serious errors, such as administering the wrong medication or failing to communicate crucial information.
2. Defamation:
Defamation involves making false statements about a patient that can harm their reputation, such as spreading untrue claims about a patient on social media.
3. Confidentiality:
Nurses are bound by the code of ethics to maintain the privacy and confidentiality of a patient’s health records. Disclosing patient information to unauthorized individuals can lead to legal consequences.
4. Battery:
Battery occurs when nurses engage in physical contact or harassment with patients without their knowledge or consent. Nurses should always seek permission from patients before any physical contact, and they must respect the patients’ right to refuse treatment or physical contact.
5. Mandatory Reporting:
Nurse practitioners have both a legal and moral duty to report neglect, abuse, epidemics, infectious diseases, and any unsafe practices by colleagues that could harm patients.
6. Informed Consent:
Before performing any medical procedure, nurses must obtain full consent from the patient. Patients should be fully informed about the benefits and risks of the procedure or treatment. If the patient is unable to comprehend the implications, the nurse should inform the patient’s close family, who can provide consent on their behalf.
7. Patients’ Beliefs:
Before conducting any medical procedure, nurses should be sensitive to a patient’s religious and cultural beliefs. The nurse must communicate the relevant procedure and make adjustments if it conflicts with the patient’s religious or cultural values.
Ethical Decision-Making in Nursing:
Nurses face ethical dilemmas in healthcare, necessitating strong decision-making skills. The advancement of medical technology has contributed to more complex challenges. Ethical decision-making is the framework that guides nurses in making choices while evaluating the potential impacts of their actions.
By adhering to ethical principles, nurses can ensure compassionate and safe patient care. Understanding ethical principles, codes of ethics, legal obligations, and nursing laws is crucial for effective nursing practice. For instance, supporting a patient who chooses to discontinue cancer treatment and opt for hospice care demonstrates a nurse’s commitment to the code of ethics in nursing.
Conclusion:
Ethical and legal principles in nursing play a critical role in guiding nurses’ decision-making processes while providing patient care. Issues such as patients’ refusal of treatment and life-or-death decisions require careful consideration within the boundaries of ethical principles, laws, and legal obligations. Understanding these underlying principles is essential for nursing practice and patient well-being.
