NCM 21O - COMMUNITY HEALTH NURSING
Ethical Considerations 🧑⚕️ DESIATA, LYRIZZA
Ethical Considerations In CHN THE PHN/ CHN LIKE ANY OTHER NURSING
FIELD, IS INHERENTLY ETHICAL IN NATURE. THE
FOLLOWING ARE THE ETHICAL PRINCIPLES
WHAT IS ETHICS?
● Ethicos (Greek word)
OUTLINED IN THE NURSES’ CODE OF ETHICS:
– Custom or Character (1) Values, customs, and spiritual beliefs held
● It is the science that deals with the by individuals shall be respected.
morality of human conduct. (2) Individual freedom to make rational and
● It is the term for various ways of unconstrained decisions shall be respected.
understanding and examining the moral (3)Personal information acquired in the
life of the person process of giving nursing care shall be held in
● It is a branch of philosophy concerned strict confidence
with judgements about right and wrong; (4) Human life is inviolable.
goodness and badness. It also covers - Should not be derogated at any time or
related concepts such as virtue, vice, infringed (overstepped or trespassed) on in
duty and obligation any way and must be fully respected and
defended.
(5) Quality and excellence in the care of the
ETHICOLEGAL ASPECTS OF NURSING
patients are the goals of nursing practice.
PRACTICE IN THE COMMUNITY
(6) Accurate documentation of actions and
● It is guided by a number of legal and
outcomes of delivered care is the hallmark.
ethical principles centered on the
(7) Registered Nurses are the advocates of the
welfare of clients and protection of their
patients: they shall take appropriate steps to
rights
safeguard their rights and privileges
● Professional practice is legal if the
- Respect the Patients’ Bill of Rights in the
practitioner works in accordance with
delivery of care
the law
- Provide clients or families with pertinent
information except those which may be
ETHICAL PRACTICE IS CHARACTERIZED BY
deemed harmful to their wellbeing
THREE MAJOR PRINCIPLE - Uphold patient’s rights
(1) Respect for Autonomy (8) Registered Nurses are aware that their
- the ability to decide, adequate actions have professional, ethical, moral and
information, intellectual competence legal dimensions. They strive to perform their
(2) Beneficence work in the interest of all concerned.
- acts of mercy and charity, to apply (9) The Registered Nurse is in solidarity with
measures for the benefit of the sick other members of the healthcare team in
- maximize the good, minimize harm working for the patient’s best interest.
(3) Justice (10) The Registered Nurse maintains collegial
- fairness, must be treated equally and collaborative working relationships with
colleagues and other health care providers.
(11) The preservation of life, respect for human
rights, and promotion of a healthy
environment shall be a commitment of a
Registered Nurse.
(12) The establishment of linkages with the ETHICAL APPROACHES TO PUBLIC HEALTH
public in promoting local, national, and PRECAUTIONARY PRINCIPLE
international efforts to meet health and social ● Or the Principle of Forecaring
needs of the people as a contributing member ○ one uses foresight and preparation
of society is a noble concern of a Registered ● It is aligned with the principle of “first do no
Nurse. harm” (nonmaleficence) and the adage
(13) Maintenance of loyalty to the nursing “better safe than sorry”.
profession and preservation of its integrity are ● When an activity raises threats of harm to the
ideal. environment or human health, precautionary
(14) Compliance with the by-laws of the measures should be taken
accredited professional organization (PNA), KANTIAN ETHICS (DEONTOLOGY)
and other professional organizations of which ● All rational persons are autonomous, ends-in
the Registered Nurse is a member is a lofty themselves (means doesn’t depend on
duty. anything else; a rational person is bound by
- Be a member of an accredited an unconditional moral requirement to treat
professional nursing organization humanity) and worthy of dignity and respect.
(15) Commitment to continual learning and ● Autonomy has been the central idea of this
active participation in the development and principle. It is focused on the individual rights
growth of the profession are commendable and informed consent
obligations. ● In public health, the nurse must balance the
- Strictly adhere to nursing standards right of individuals and the right of the
(16) Contribution to the improvement of the community or population. Like, considering
socio-economic conditions and general your appropriate actions when the person
welfare of nurses through appropriate has a stigmatizing communicable disease
legislation is a practice and a visionary mission. that may jeopardize the health of other
- Be assertive in the implementation of labor people
and work standards UTILITARIANISM PRINCIPLE
● Principle of Utilitarianism
● “The greatest good for the greatest number”
● It emphasize a population-focus care
● Widely use in public health
● How resources will be distributed among
citizenry, to decide how expenditure or use of
resources can achieve the greatest good for
the greatest number of people.
COMMUNITARIAN ETHICS
● The focus is the community rather than the
individual
● Florence Nightingale is an example of
communitarian-minded
● Nurses have an important role in bringing the
populations and communities together to
work together for a common humanitarian
good.
SOCIAL JUSTICE DUTY TO PROVIDE CARE
● Is related to the fair distribution of benefits ● In accepting their professional nursing role,
and burdens of members of society nurses make a contract or covenant with the
● Public health and social justice involve public to provide certain services. There are
important ethical decisions on how members only a few situations in which nurses are
of societies choose to distribute their ethically permitted to refuse to care for
resources and provide for the well-being of certain patients like if the nurse is pregnant or
their fellow citizens it places the nurse in danger or at risk.
VIRTUE ETHICS: JUSTICE AND GENEROSITY PRINCIPLE OF INFORMED CONSENT
● Justice involves giving others what is due to ● This right and responsibility is exercised by
them freely and voluntarily consenting or refusing
● Generosity is giving people from a source consent to recommended medical
that is somehow personal. procedure based on sufficient knowledge of
● Nurses can use the ladder of charity to the benefits, burdens and risks involved.
determine what type of giving she will utilize ● The ability to give informed consent depends
keeping her eyes focused on the top of the on the following:
ladder which is self-reliance or taking a. Adequate disclosure of information
responsibility in one’s own health. b. Freedom of choice
“The greatest level of charity is to support an c. Comprehension of information
impoverished fellow by giving them a gift or loan, d. Capacity to make decisions
or entering into a partnership with them, or giving ACCOUNTABILITY IN CHN
them a job, in order to strengthen their hand until ● Nurses should be accountable for their own
they no longer need to ask others for help,” practice. It means they are answerable to
Moses Maimonides (Laws of Charity) one’s self and others for one’s own actions.
AUTONOMY ● The application of the principle indicates on
● Right of individuals to determine their own how a nurse morally provides health services
fates and live their lives the way they choose, so as to provide maximized total net health of
as long as they do not interfere with the rights the population.
of others. BENEFICENCE
● Respect for person, freedom of choice, right ● No harm should be done to anyone and
to refuse, etc. nurses should contribute to their welfare and
PRIVACY/ CONFIDENTIALITY growth.
● The nurse safeguards the patient’s right to Example:
privacy. - Measuring the benefits and costs of the
● The need for health care does not justify alternative approaches to a problem
unwanted intrusion into patient’s life. - Deciding on how to distribute health
● Associated with the right to privacy, the nurse program funds
has a duty to maintain confidentiality of
patient’s information.
● To provide quality care relevant data should
be shared to members of the healthcare
team who have a need to know.
● Only information pertinent to a patient’s
treatment and welfare is disclosed and only
those directly involved with the patient’s
care. However, this is not absolute and may
be modified in order to protect the patient
and other people and in circumstances of
mandatory disclosure for public health
reasons.
