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POLYTECHNIC COLLEGE OF DAVAO DEL SUR INC.

Personality Development 5

CAREER ORIENTATION

FINAL PAPER

NURSING ETHICS

Submitted to:

Harold Cris D. Aleria

Submitted by:

Lacbungan, Hannah

Guerrero, Issa Belle

Ambang, Norainie

Colita, Pryll
INTRODUCTION

Ethics is a branch of philosophy concerned with determining right and wrong in relation to people’s

decision and actions. This simple definition serves to demonstrate the inherent difficulty in applying ethics to

the realities of daily life.

Ethics is evident when values such as right and wrong (or good and bad) are introduced. The word

‘should’ is also an indicator of ethical thinking, as it provides a view on the right way to act. It is therefore,

possible to recognize ethical statements by their morally evaluative component.

For example, the statement “It is wrong to deceive a friend deliberately” requires consideration such

as: Who is making this assertion and in what context? Is the statement supported by objective evidence or

is it a matter of personal opinion? Are any individual values and beliefs influencing the speaker?

Our own ethical claims demand a similar degree of critical reflection. The process can be demanding

but without it the temptation is to resort to basic, ill conceived assertions such as: “I think that’s terrible”, which

lack foundation, or to retain an instinctive, and not always reasonable view of right and wrong based solely

on social, cultural and/or religious circumstances.

When faced with an ethical dilemma, that is, when a difficult choice has to be made between two or

more alternatives, especially equally undesirable ones, it is essential that those wishing to make an ethically

appropriate choice engage in a process of ethical analysis, This may require the identification of the ethical

aspects of the situation, the related ethical concepts and ethical questions raised and a consideration of the

ethically justifiable options.

Ethics is concerned with what is just and not, although agreeing what is right can be challenging. An

understanding of ethics is essential to the delivery of skilled professional care. It is vital that nurses appreciate

the value of ethics in their work. Ethics is relevant to clinical, practice-based issues and affects all areas of
the professional nursing role. To apply ethics effectively, nurses must develop reasoning skills and

understand the concepts and principles that assist ethical analysis.

PHILOSOPHICAL FACTORS THAT INFLUENCE THE NURSING PRACTICE

In the field of nursing, several philosophical values or factors can affect on how a nurse acts or

renders care to a particular patient. This can be either factors coming from both the nurse and the patient.

These include the culture, religion, spiritual belief and ethical principles an individual has. For example, a

patient immediately needs to have a blood transfusion or else he will die. However, the patient’s religion is

Jehovah’s Witness and it is strictly prohibited by their religion to undergo such a procedure. Instinctively, the

nurse’s primary duty is to preserve the life of the patient but because of this ethical dilemma, the nurse has

to respect the decision of the patient and his beliefs even though it might cost the patient’s life.

Another such dilemma can be in the case of a DNR or Do Not Resuscitate. This is a special situation

wherein the patient or his/her immediate family member decides to stop all health services given to the patient

and allow the patient to have a natural death to finally end his suffering. Again, this contradicts not only the

nurses’ but also the doctors’ sole purpose which is to preserve life. But because of the legal agreement the

patient or his immediate family signed, healthcare professionals have no other choice but to abide by it.

One more factor which is common in third world countries like the Philippines is in the case of the

patient being unable to afford healthcare services. Yes, certain governments provide free healthcare services

but this does not encompass all kinds of healthcare needs. Patients have no choice but to leave the hospital

if they can’t afford the bill though they can request for a promissory note. But still, what if the patient really

has nothing for himself? Would it be possible for a nurse or any other healthcare professional give financial

aid to the patient? The sad answer is no. As per hospital policy, nurses or any healthcare professionals are
not allowed to give financial support to any patient. What might seem right for a nurse’s ethical and moral

standard can be wrong to other people’s own ethical thinking.

Lastly, certain countries prohibit people especially healthcare professionals to follow the Good

Samaritan Law. This law which is taken from the Holy Bible allows a certain individual to help other people

who are in immediate need of help especially those who had an accident. In the Philippines, healthcare

professionals including nurses who have attended the Basic Life Support training have the authority to apply

CPR or first aid to people who had an accident either on the streets or inside establishments. Of course, this

follows the basic principle and duty of a nurse which is to preserve life. However, in countries like Saudi

Arabia, doing this can mean criminal liability to the particular nurse or healthcare professional. It is your duty

to preserve life yet the government prohibits you from acting as such even if your intentions were good. One

single scratch, scrape or injury that you can inflict to that person in need will make you accountable for it even

if you saved that person’s life in the process. This is where the ethical dilemma comes in. Would you risk

yourself for the benefit of other people? We all have our own choices, ethical and moral principles. The only

problem is that you cannot tell if these principles are right or wrong.
PERSONAL THOUGHTS ON THE DIFFERENT ETHICAL DILEMMAS

Us humans have found ways for us to preserve our species throughout history. We have invented

technology to make our lives better and easier. We made laws for us to abide and to protect our sovereignty.

And because of such freedom, we are all allowed to believe in different ideologies in all walks of life. Through

all of these we have our own identities such as culture and philosophy. We have come a long way from the

primitives we once were. However, this kind of freedom comes with a certain price. Misunderstanding,

miscommunication and a constant struggle on what belief is right or wrong. Religion for example plays a vital

role in our society especially in the field of nursing. A Roman Catholic mother requests for an immediate

baptism of her stillborn child from the attending nurse however the nurse’s own belief does not allow her to

perform such thing. A Jehovah’s Witness needs blood but his religion forbids the process of blood transfusion.

If I were given the chance to save such a life, then I would do everything that I could but because of such

beliefs and even laws, then it will hinder me from doing so. Saving a life never has been this complicated.
REVIEW OF RELATED LITERATURE

FOREIGN LITERATURE

Transcultural nursing is an essential aspect of healthcare today. The ever increasing multicultural

population in different countries poses a significant challenge to nurses providing individualize and holistic

care to the patients. This requires the nurses to recognize and appreciate cultural differences in healthcare

values, beliefs and customs. Nurses must acquire the necessary knowledge and skills in cultural competency.

Culturally competent nursing care helps ensure patient satisfaction and positive outcomes. Transcultural

nursing shows how professional nursing interacts with the concept of culture.

According to Madeleine Leininger, transcultural nursing is a substantive area of study and practice

that focuses on the comparative cultural values of caring, the belief and practices of individuals or groups of

similar or different cultures.

Nurses need to be aware of and sensitive to the cultural needs of clients. The practice of nursing

today demands that the nurse identify and meet the cultural needs of diverse groups, understand the social

and cultural reality of the client, family, and community, develop expertise to implement culturally acceptable

strategies to provide nursing care, and identify and use resources acceptable to the client (Andrews and

Boyle, 2002).
LOCAL LITERATURE

According to RA 9439, it shall be unlawful for any hospital or medical clinic in the country to detain

or to otherwise cause, directly or indirectly, the detention of patients who have fully or partially recovered or

have been adequately attended to or who may have died, for reasons of nonpayment in part or in full of

hospital bills or medical expenses.

Patients who have fully or partially recovered and who already wish to leave the hospital or medical

clinic but are financially incapable to settle, in part or in full, their hospitalization expenses, including

professional fees and medicines, shall be allowed to leave the hospital or medical clinic, with a right to

demand the issuance of the corresponding medical certificate and other pertinent papers required for the

release of the patient from the hospital or medical clinic upon the execution of a promissory note covering

the unpaid obligation. The promissory note shall be secured by either a mortgage or by a guarantee of a co-

maker, who will be jointly and severally liable with the patient for the unpaid obligation. In the case of a

deceased patient, the corresponding death certificate and other documents required for interment and other

purposes shall be released to any of his surviving relatives requesting for the same: Provided, however, that

patients who stayed in private rooms shall not be covered by this Act.
REFERENCES

 Chaloner C (2007) An introduction to ethics in nursing. Nursing Standard. 21, 32, 42-46.

 REPUBLIC ACT NO. 9439. (n.d.). Retrieved from

https://lawphil.net/statutes/repacts/ra2007/ra_9439_2007.html

 Murphy SC. Mapping the literature of transcultural nursing. J Med Libr Assoc 2006 Apr;94(2 Suppl):

143-51.

 Leninger M. Culture Care Theory: A Major Contribution to Advance Transcultural Nursing Knowledge

and Practices. Journal of Transcultural Nursing, Vol. 13 No. 3, July 2002: 189 - 192.

 Leininger M. Transcultural nursing: Concepts, theories, research, and practice. Columbus, OH:

McGraw-Hill College Custom Series; 1995.

 Andrews MM, Boyle JS. Transcultural concepts in nursing care. J Transcult Nurs. 2002 Jul; 13(3):178-

80.

 George Julia B. Nursing theories: The base of professional nursing practice. 5th edition,2002. Norwalk,

CN: Appleton and Lange.