Nursing Ethical Principles and Virtues
Key Points
- Nursing ethics provides a moral base for daily professional action.
- Values are internal beliefs, while virtues are visible actions expressing those beliefs.
- Core principles include autonomy, justice, confidentiality, accountability, nonmaleficence, fidelity, beneficence, and veracity.
- Moral courage is acting on ethical duty even when personal or professional cost is possible.
Pathophysiology
Ethical failure in nursing care can produce direct patient harm through unsafe choices, rights violations, or trust erosion. Principles and virtues reduce this risk by structuring consistent, accountable decision-making under clinical pressure.
Classification
- Principle layer: Rules for right action (for example, autonomy and nonmaleficence).
- Virtue layer: Character-in-action (for example, integrity and moral courage).
- Accountability layer: Responsibility for decisions, actions, and consequences.
- Relationship layer: Trust-preserving behaviors in patient and team interactions.
Nursing Assessment
NCLEX Focus
Determine which ethical principle is most directly engaged before choosing a priority intervention.
- Assess decision context for autonomy, safety, and fairness conflicts.
- Assess whether information sharing protects confidentiality and veracity.
- Assess role-accountability expectations for the assigned intervention.
- Assess if patient vulnerability requires stronger beneficence safeguards.
- Assess whether ethical concern requires immediate escalation.
Nursing Interventions
- Protect patient decision rights through clear communication and consent support.
- Apply nonmaleficence by preventing avoidable harm in all care steps.
- Use beneficence to prioritize actions that produce meaningful patient benefit.
- Demonstrate fidelity by maintaining professional commitments and follow-through.
- Practice moral courage by reporting unsafe or unethical conduct promptly.
Integrity Gap
Knowing the ethical action but failing to act can still cause patient harm and professional risk.
Pharmacology
Ethical medication practice includes truthful counseling, consent-aware administration, confidentiality, and immediate accountability when errors or near misses occur.
Clinical Judgment Application
Clinical Scenario
A patient declines a recommended intervention after receiving explanation of risks and benefits.
Recognize Cues: Patient preference conflicts with team expectation. Analyze Cues: Autonomy and beneficence must be balanced without coercion. Prioritize Hypotheses: Respecting informed refusal while maintaining safety is the priority. Generate Solutions: Clarify understanding, document decision, and revise plan. Take Action: Implement a patient-aligned alternative care approach. Evaluate Outcomes: Safety and respect are preserved with ongoing reassessment.
Related Concepts
- patient-and-nurse-bill-of-rights-in-care - Operational rights framework tied to ethical principles.
- nursing-advocacy-in-professional-practice - Advocacy as applied ethical action.
- legal-regulation-of-nursing-practice-npa-and-sbon - Legal accountability context for ethical conduct.
Self-Check
- How does a virtue differ from a value in clinical nursing behavior?
- Which principle is most central when a competent patient refuses treatment?
- Why is moral courage essential to patient safety culture?