Chapter 22: Ethics and Values in Nursing Practice

Ethics and Values in Nursing Practice emphasizes the critical role of values—deeply held personal beliefs—and the process of value clarification in navigating complex clinical situations where patient and provider perspectives may differ. The discussion covers the field of bioethics and details the fundamental principles guiding ethical decision-making in health care: autonomy (respecting patient independence and consent), beneficence (taking positive action to benefit others), nonmaleficence (the commitment to avoid harm), justice (fairness in resource allocation), and fidelity (keeping promises). The American Nurses Association (ANA) Code of Ethics is explored as a collective statement of professional standards, highlighting core duties such as advocacy, responsibility, accountability, and the legal and ethical mandates of confidentiality under HIPAA. Several theoretical frameworks are analyzed to help nurses interpret ethical problems, including deontology (which defines rightness based on adherence to rules), utilitarianism (which focuses on consequences and the greatest good), casuistry (case-based reasoning), feminist ethics (addressing power imbalances), and the ethics of care (prioritizing relationships and context). The chapter also differentiates between ethical dilemmas, where two justifiable actions conflict, and moral distress, where a nurse knows the right action but is prevented from taking it. To aid in resolution, a systematic seven-step approach to processing ethical problems is outlined, similar to the nursing process. Finally, the text addresses contemporary ethical issues such as the privacy risks associated with social media, the subjective nature of quality of life, challenges in end-of-life care, and the systemic ethical concerns regarding access to affordable health care.