186 Unit 3 CURRENTSOCIAL ANDEMOTIONALCONCERNS
behalf of clients such as laws permitting people to be
detained after treatment is completed when there is a
potential of future risk of violence.
Ethical Decision-Making
The American Nurses Association (ANA) has pub-
lished a Code or Ethics for Nursesto guide choices
about ethical actions (Box 9-5). Models for ethical
decision-making include gathering information, clar-
ifying values, identifying options, identifying legal
considerations and practical restraints, building con-
sensus for the decision reached, and reviewing and
analyzing the decision to determine what was learned
(Kennedy-Swartz, 2000).
SELF-AWARENESS ISSUES
All nurses have beliefs about what is
right or wrong and good or bad. That is, they have val-
ues just like all other people. Being a member of the
nursing profession, however, presumes a duty to
clients and families under the nurse’s care: a duty to
protect rights, to be an advocate, and to act in the
client’s best interests even if that duty is in conflict
with the nurse’s personal values and beliefs. The nurse
is obligated to engage in self-awareness by identifying
clearly and examining his or her own values and be-
liefs so that they do not become confused with or over-
shadow the client’s. For example, if a client is grieving
over her decision to have an abortion, the nurse must
be able to provide support to her even though the
nurse may be opposed to abortion. If the nurse cannot
do that, then he or she should talk to colleagues to find
someone who can meet that client’s needs.Points to Consider When Confronting
Ethical Dilemmas- Talk to colleagues or seek professional super-
vision. Usually the nurse does not need to
resolve an ethical dilemma alone. - Spend time thinking about ethical issues,
and determine what your values and beliefs
are regarding situations before they occur. - Be willing to discuss ethical concerns with
colleagues or managers. Being silent is
condoning the behavior.
➤ KEY POINTS
- Clients can be involuntarily hospitalized if
they present an imminent danger of harm to
themselves or others. - The Patient’s Bill of Rights includes the
right to receive and refuse treatment, to be
Box 9-5
➤ AMERICANNURSESASSOCIATIONCODE OFETHICS FORNURSES
- The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity,
worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, per-
sonal attributes, or the nature of health problems. - The nurse’s primary commitment is to the patient, whether an individual, family, group, or community.
- The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
- The nurse is responsible and accountable for individual nursing practice and determines the appropriate del-
egation of tasks consistent with the nurse’s obligation to provide optimum patient care. - The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety,
to maintain competence, and to continue personal and professional growth. - The nurse participates in establishing, maintaining, and improving health care environments and conditions
of employment conducive to the provision of quality health care and consistent with the values of the profes-
sion through individual and collective action. - The nurse participates in the advancement of the profession through contributions to practice, education,
administration, and knowledge development. - The nurse collaborates with other health professionals and the public in promoting community, national, and
international efforts to meet health needs. - The profession of nursing, as represented by associations and their members, is responsible for articulating
nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.
American Nurses Publishing, 2001