Ethical Issues in Nursing: Explanations & Solutions (2023)

Ethical Issues in Nursing: Explanations & Solutions (1)

Ethical issues happen when choices need to be made, the answers may not be clear and the options are not ideal. The result could be declines in the quality of patient care; problematic clinical relationships; and moral distress, which is defined as knowing the right thing to do but not being allowed or able to do it. Nurse managers, in particular, are susceptible to ethical issues in nursing and moral distress because of their leadership and mentoring roles. Nurses and other medical staff look to nurse managers for appropriate and ethical decisions.

Before stepping into a role as a nurse manager, registered nurses (RNs) should understand the role ethical decision-making plays in the day-to-day work. Through Duquesne University’s Master of Science in Nursing program, students explore the foundations of ethical management and leadership from professors with real-world experience. The coursework not only covers the fundamentals of ethical nursing but delves deep into controversial case studies, giving students the chance to examine alternative viewpoints and develop reasoning skills.

(Video) Ethical Issues

For nurse managers, ethical decision-making stems from the American Nurses Association Code of Ethics, which was developed as a guideline for nursing responsibilities “in a manner consistent with quality in nursing care and the ethical obligations of the profession.” Nurse managers help solve ethical issues in nursing through using their leadership qualities to implement the Code of Ethics in their daily lives.

Nurses’ Code of Ethics

ANA adopted its first Code of Ethics in 1950. Since then, it has undergone several revisions to offset advances and changes in research, technology, law and overall challenges in nursing. The guidelines are divided into nine provisions that cover topics that include human dignity, confidentiality, moral virtue and healthcare as a right. ANA said that each of the provisions covers topics important to the challenges of nursing in the 21st century.

“The code is particularly useful in today’s healthcare environment because it reiterates the fundamental values and commitments of the nurse, identifies the boundaries of duty and loyalty and describes the duties of the nurse that extend beyond individual patient encounters,” ANA said in a statement.

Daily, nurse managers face a barrage of decisions and must maintain ethical fortitude to ensure the health, safety and well-being of their patients and staff. They actively work toward resolving ethical issues in nursing that they find in their workplace.

Examples of Ethical Dilemmas in Nursing

The ANA Code of Ethics provides a standard by which nurse managers can assess ethical issues in nursing. However, the way it addresses ethical dilemmas can vary in different situations. One ethical dilemma that can occur in healthcare facilities is when nurses themselves are not properly equipped to complete their duties. Nurses who notice their coworker’s lack of knowledge face an ethical dilemma of whether they should bring the issue to their nurse manager. To help curb this ethical dilemma, nurse managers can work hard to educate their nurses regarding the Code of Ethics as well as educate them regarding the Code of Ethics for their specific medical facility. Nurse managers can also provide regular trainings for their nurses regarding recurring issues.

One example of a common ethical dilemma nurses deal with is establishing boundaries with patients. Nurses and nurse managers devote their careers to helping patients receive the care they need, so it can often be difficult to establish professional boundaries. Patients should not rely on nurses beyond their professional capacity and should not develop romantic relationships with them or offer them gifts. Nurse managers can intervene in situations where ethical and professional boundaries are crossed by either patients or nurses.

(Video) Nursing Ethics: Understanding Ethics in Nursing

Another ethical issue in nursing pertains to patient privacy. Nurses and nurse managers have access to a patient’s records and medical history and cannot ethically or legally release that information to anyone besides the patient. Nurses should have the best interest of patients in mind, understanding that they need to protect their privacy and medical data.

Common Ethical Situations for Nurse Managers and Nursing Ethics Examples

Even though nursing is a fast-paced job with new challenges daily, many nurse managers report facing similar ethical dilemmas. A recent study found that the most frequently occurring and stressful ethical situations are protecting patients’ rights, staffing, advanced care planning and decision-making. Exacerbating the problem is the large number of inexperienced nurses entering the field, many who have never faced ethical issues in nursing. Such challenges make experienced nurse managers all the more critical to daily healthcare needs nationwide.

The following are some other examples of common ethical situations that nurse managers face:

  • Honesty vs. withholding information. Family members may want to withhold medical information from sick patients to protect their emotions. However, patients have the right to know about their medical conditions. Deciding how to share this information, especially if it goes against the family’s beliefs, can be a touchy situation. ANA advocates for truth telling, or veracity, as a key factor in nurse-patient relationships.
  • Science vs. spirituality. Healthcare, which is science-based and results driven, can impede religious or personal beliefs. Some religions restrict medical interventions and lifesaving techniques. Nurses focus on providing medical care to reduce suffering and to allow patients to concentrate on self-care. For patients or their families with strong religious or spiritual convictions, the focus may be on adhering to a strict set of guidelines. The ANA Code of Ethics states that nurses should respect the “unique differences of the patient,” including “lifestyle, value system, and religious beliefs.” However, respect for the belief “does not imply that the nurse condones those beliefs or practices on a personal level.”
  • Healthcare needs vs. resource allocation. The rising cost of healthcare is increasingly putting nurse managers at odds with budgeting constraints and patient needs. A large number of medical facilities have scarce resources, which puts patients at risk for not getting the care they need. These resources range from medical equipment to healthcare staff. Research suggests that nurse leaders must include staff in the budgeting process so that they can better understand the needs and demands.
  • Autonomy vs. beneficence. Nurses are required to administer prescribed medicine, but patients, at the same time, can refuse them. Patient autonomy can go against medical directives, despite clearly defined needs. Patients have a right to refuse all medical care. ANA highlights that it is important for nurses and nurse managers to understand patient backgrounds and individual circumstances to inform the patient of the medical necessity. ANA explains: “Using ethical principles to arrive at a solution should be done in an atmosphere of caring, respect, openness, and honesty. This process should be based on a sound ethical, decision-making model, using the best evidence-based-practice guidelines available.”

How to Deal With Ethical Dilemmas in Nursing

Nurses undergo many years of education and clinical training before they can become certified nurses, and yet, dealing with real ethical issues in nursing can be far more complex than solving hypothetical issues in textbooks. Nurses can learn how to deal with ethical dilemmas in the workplace through gaining experience and interacting with patients over time. Although nurses have great levels of empathy, it can benefit them to establish professional boundaries with each of their patients at the outset of their careers. Whenever nurses struggle to identify whether something is ethical, they can review the ANA Code of Ethics.

Nurses can also benefit by surrounding themselves with well-seasoned nurses as well as experienced nurse managers. They can rely on the guidance of nurse managers when it comes to situations they may not know how to address. Nurse managers can cultivate educational environments, in which they regularly discuss ethical issues with the nurses in their units. By having open dialogues about ethical issues, nurses can learn from the mistakes others have made and learn how to approach ethical issues and challenges.

(Video) Ethical Issues in Nursing Part 1

Help Avoid Ethical Dilemmas in Nursing

The Duquesne University School of Nursing’s MSN program integrates ethical problem-solving and decision-making to help MSN graduates explore and address ethical issues. Students in each of Duquesne University’s MSN tracks — Adult-Gerontology Acute Care Nurse Practitioner, Family (Individual Across the Lifespan) Nurse Practitioner, Psychiatric-Mental Health Nurse Practitioner, Executive Nurse Leadership and Health Care Management, Forensic Nursing and Nursing Education and Faculty Role — learn how ethics and problem-solving play distinct roles in nursing.

U.S. News & World Report ranked Duquesne University’s online MSN program among the Best Online Graduate Nursing Programs in 2017. If you are interested in advancing your career as a nurse manager, explore how Duquesne University’s Master of Science in Nursing program can help you pursue your professional goals and help you avoid ethical issues in nursing.

Recommended Readings

Family Nurse Practitioners and Professional Liability Insurance

Importance of Nurse Manager Resilience

Using Escape Rooms for Nurse Education


American Nurses Association, View the Code of Ethics for Nurses

(Video) Nursing Profession and Ethics - Fundamentals of Nursing Principles | @Level Up RN

Houston Chronicle, “Legal & Ethical Issues That Health Care Professionals Face”

Lippincott Solutions, Best Practices for Ethical Nursing Leadership

Medical Records Info, Top 10 Most Prevalent Ethical Issues in Nursing

National Center for Biotechnology Information, “Ethical Problems in Nursing Management —A Cross-Sectional Survey About Solving Problems”

NurseChoice, “4 Common Nursing Ethics Dilemmas”


What are the 7 major ethical issues in nursing practice? ›

The ethical principles that nurses must adhere to are the principles of justice, beneficence, nonmaleficence, accountability, fidelity, autonomy, and veracity.

How can nurses solve ethical issues? ›

Experts contacted for this article suggested several strategies organizations can implement to address ethical issues and reduce nurses' and other clinicians' moral distress:
  1. Support the nursing code of ethics. ...
  2. Offer ongoing education. ...
  3. Create an environment where nurses can speak up. ...
  4. Bring different disciplines together.
3 Mar 2014

What are the solution for ethical issues? ›

5 Steps for Resolving Ethics Issues
  • Cut the Ethical Issues Off at Their Root.
  • Create An Environment of Trust.
  • Institute a Formal Code of Conduct and Reporting System.
  • Go Beyond The Law.
  • Punish and Reward Accordingly.
6 Jul 2018

What are the biggest issues facing nurses today? ›

Read on to learn about some of the challenges nurses may face today.
  • Inadequate Staffing. Being short-staffed for brief periods of time is common in most professions, and in many of those situations, it is a minor inconvenience. ...
  • Stress. ...
  • Safety on the Job. ...
  • Workplace Violence. ...
  • Improving Self-Care.
5 Jul 2022

What are the 10 nursing ethical values? ›

The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency.

Why are ethical issues important in nursing? ›

The nursing code of ethics helps caregivers consider patient needs from several viewpoints and maintain a safe recovery environment. Ethical guidelines remind caregivers to treat all people equitably and individually, while protecting the privacy rights of patients in ways that may not seem overtly obvious.

What are the five main ethical issues? ›

Unethical accounting, harassment, health and safety, technology, privacy, social media, and discrimination are the five primary types of ethical issues in the workplace.

What are the three most important solutions that can help solve any ethical issue? ›

In ethical decision making there are three basic principles that can be used for resolution of problem. These three principles are that of intuitionism, moral idealism and utilitarianism.

How can we overcome ethical issues in healthcare? ›

7 Tips for Nurses Dealing with Ethical Dilemmas
  1. Understand the Uniqueness of the Dilemma. ...
  2. Refer to the Code of Ethics. ...
  3. Seek Ethics Education. ...
  4. Speak Up. ...
  5. Seek Perspective. ...
  6. Reach Out to Professional Organizations/Associations. ...
  7. Seek Counseling.
20 Jun 2018

How can nurses improve ethical practices? ›

Organize an ethics committee or identify ethical champions in everyday life. Develop ethics-friendly policies and procedures. Provide continuing education and training in ethical decision making. Promote open discussions among staff nurses and managers regarding ethical patient care.

What is the first step when solving an ethical issue? ›

identify an ethical situation and the ethical issues involved in it. This is the first step. Further steps involved in solving an ethical dilemma: The main elements of the situation are identified and analyzed.

What are the six steps to resolving ethical dilemmas? ›

Understanding Ethics
  1. Know the Facts. Before tackling an ethical issue, clearly define the nature of the challenge. ...
  2. Identify the Required Information. You don't know what you don't know. ...
  3. List the Concerns. ...
  4. Develop Possible Resolutions. ...
  5. Evaluate the Resolutions. ...
  6. Recommend an Action.
2 Mar 2020

What are the three biggest issues in healthcare today? ›

5 Current Issues in Health Care and What Administrators Can Do
  • The High Cost of Health Care. The problem: Perhaps the most pressing issue in health care currently is the high cost of care. ...
  • The Concerns of Health Equity. ...
  • The Promise (and Pitfalls) of Technology. ...
  • The Move Toward Value-Based Care. ...
  • The Growing Provider Shortage.
23 Oct 2022

What are the issues nurses are facing in the workplace? ›

Nurses' schedules are demanding and working over 40 hours a week is not uncommon. Over time, this can leave nurses feeling drained. Stress and exhaustion (both mental and physical) can present as secondary challenges in nursing, leading to the potential for costly medical mistakes.

What are the most common nursing errors? ›

Here are a few of the most common nursing mistakes:
  • Forgetting to turn on the bed alarm for a patient at high risk for falls.
  • Incorrectly programming an IV pump resulting in underdosing or overdosing.
  • Failing to report a change in a patient's condition.
  • Medication errors.
  • Inaccurate documentation.
10 Mar 2021

What are the 6 C's of nursing? ›

The 6Cs of nursing are:
  • Care.
  • Compassion.
  • Competence.
  • Communication.
  • Courage.
  • Commitment.

What is the most important ethical principle in nursing? ›

Autonomy is essential in all aspects of nursing practice. This vital ethical nursing principle goes hand-in-hand with the principle of accountability. The following are a few reasons why autonomy is important in nursing practice. Autonomy helps nurses strengthen their critical thinking and decision-making skills.

What are the 7 standards of nursing? ›

  • American Nurses Association (ANA)
  • ANA Standards of Practice.
  • Standard 1. Assessment. ...
  • Standard 2. Diagnosis. ...
  • Standard 3. Outcome Identification. ...
  • Standard 4. Planning. ...
  • Standard 5. Implementation. ...
  • Standard 6. Evaluation.

What is the purpose of ethical issues? ›

They promote the aims of research, such as expanding knowledge. They support the values required for collaborative work, such as mutual respect and fairness. This is essential because scientific research depends on collaboration between researchers and groups.

What is the importance of knowing ethical issues concerns in healthcare? ›

Ethics within healthcare are important because workers must recognize healthcare dilemmas, make good judgments and decisions based on their values while keeping within the laws that govern them.

Why is it important to know ethical issues? ›

It is important to adhere to ethical principles in order to protect the dignity, rights and welfare of research participants. As such, all research involving human beings should be reviewed by an ethics committee to ensure that the appropriate ethical standards are being upheld.

What are the 2 biggest ethical issues in health care? ›

5 Ethical Issues in Healthcare
  • Do-Not-Resuscitate Orders. ...
  • Doctor and Patient Confidentiality. ...
  • Malpractice and Negligence. ...
  • Access to Care. ...
  • Physician-Assisted Suicide.

What is the most common ethical issue? ›

Harassment and discrimination are arguably the largest ethical issues that impact business owners today. Should harassment or discrimination take place in the workplace, the result could be catastrophic for your organization both financially and reputationally.

What are the 10 ethical issues? ›

The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1) Patients' Rights, (2) Equity of resources, (3) Confidentiality of the patients, (4) Patient Safety, (5) Conflict of Interests, (6) Ethics of privatization, (7) Informed Consent, (8) Dealing with the opposite sex, (9) ...

What are the 3 basic types of ethical issues? ›

There are three main types of ethical issues: Utilitarian, Deontological, and Virtue. Utilitarian ethics focus on the consequences of an action, while deontological ethics focus on the act itself. Virtue ethics focuses on the character of the person acting.

What are the three important ethical issues? ›

Results: The major ethical issues in conducting research are: a) Informed consent, b) Beneficence- Do not harm c) Respect for anonymity and confidentiality d) Respect for privacy.

What are the 4 steps for solving ethical dilemmas? ›

A rudimentary framework for how managers engage in the decision making process contains four steps.
  1. 1) Identify the problem.
  2. 2) Generate alternatives.
  3. 3) Decide on a course of action.
  4. 4) Implement.

What are the 4 approaches to solving ethical dilemmas? ›

The four approaches are: The principle approach, in which decisions are made according to a principle such as the Ten Commandments or the Golden Rule The consequence approach, in which decisions are made according to their likely outcomes The virtue/character approach, in which decisions are made according to the ...

How can you avoid ethical issues in your nursing care? ›

To help curb this ethical dilemma, nurse managers can work hard to educate their nurses regarding the Code of Ethics as well as educate them regarding the Code of Ethics for their specific medical facility. Nurse managers can also provide regular trainings for their nurses regarding recurring issues.

What are some possible solutions for healthcare? ›

Accessibility to Health Care: 5 Potential Solutions
  • Expand Insurance to Cover Health Care Costs. ...
  • Extend Telehealth Services. ...
  • Invest in Mobile Clinics. ...
  • Educate the Public About Multiple Health Care Sites. ...
  • Improve Cultural Responsiveness.

How can healthcare ethics be improved? ›

Seek community and stakeholder input in decision-making; Collaborate with other community resources to make progress on community needs; Communicating expectations that behaviors and actions are based on the organization's code of ethics, values and ethical standards of practice.

How do nurses maintain integrity and ethics? ›

Be honest.

Integrity in nursing practice (and life in general) means being honest. You must be honest with yourself and others. If you make a mistake, own it and learn from it. Don't risk being dishonest simply because you think others don't want to hear the truth.

How can nurses improve their integrity? ›

How to practice integrity in nursing
  1. Focus on honest communication. ...
  2. Treat others with respect. ...
  3. Uphold ethical standards. ...
  4. Hold yourself and others accountable. ...
  5. Follow through with your commitments.
18 Aug 2021

How do you deal with an unethical situation and examples? ›

Dealing with Unethical Behavior in the Workplace: What to Do
  1. Don't Take Action without Evidence. Before you do anything, you need to make sure you know the facts. ...
  2. Follow Company Procedure. ...
  3. When the Issue Goes Beyond Being Unethical. ...
  4. Consider Going Elsewhere.
3 Oct 2016

How do you make good ethical decisions? ›

A Framework for Ethical Decision Making
  1. Identify the Ethical Issues.
  2. Get the Facts.
  3. Evaluate Alternative Actions.
  4. Choose an Option for Action and Test It.
  5. Implement Your Decision and Reflect on the Outcome.
5 Nov 2021

How do you solve unethical issues in the workplace? ›

How to Promote Ethical Behavior in the Workplace:
  1. Establish straightforward guidelines. You should develop an easily understood yet comprehensive code of conduct that outlines company expectations for ethical behavior at work. ...
  2. Promote knowledge. ...
  3. Provide tools. ...
  4. Be proactive. ...
  5. Employ data monitoring. ...
  6. Foster ethical behavior.

What is the most important step in ethical decision-making? ›

Step 1: Define the problem

The most significant step in any decision-making process is to determine why a decision is called for and identify the desired outcome(s).

What are the 9 strategies for making ethical decisions? ›

Nine Basic Steps to Personal Ethical Decision Making
  • Practice ethical behavior actively. ...
  • Beware of "new" ethics programs. ...
  • Define the ethical problem when it arises. ...
  • Formulate alternatives. ...
  • Evaluate the alternatives. ...
  • Seek additional assistance, as appropriate. ...
  • Choose the best ethical alternative.

What are 8 strategies for resolving conflict? ›

  • Understand the situation. Few situations are exactly as they seem or as presented to you by others. ...
  • Acknowledge the problem. ...
  • Be patient and take your time. ...
  • Avoid using coercion and intimidation. ...
  • Focus on the problem, not the individual. ...
  • Establish guidelines. ...
  • Keep the communication open. ...
  • Act decisively.
1 Oct 2021

What are the 7 basic ethical principles? ›

WHAT ARE THE 7 MAIN ETHICAL PRINCIPLES IN NURSING AND WHY THEY ARE IMPORTANT? There are seven primary ethical principles of nursing: accountability, justice, nonmaleficence, autonomy, beneficence, fidelity, and veracity.

What are the 7 principles of ethical decision making? ›

In brief these are: 1) modify human practices when possible; 2) justify the need for control; 3) have clear and achievable outcome-based objectives; 4) cause the least harm to animals; 5) consider community values and scientific information; 6) include long-term systematic management; and 7) base control on the ...

What are the top 5 ethical issues in healthcare? ›

5 Ethical Issues in Healthcare
  • Do-Not-Resuscitate Orders. ...
  • Doctor and Patient Confidentiality. ...
  • Malpractice and Negligence. ...
  • Access to Care. ...
  • Physician-Assisted Suicide.

What are the 9 code of ethics for nurses? ›

What Are The 7 Ethical Principles On Which The Nursing Code Of Ethics Is Based? The 7 ethical principles the Nursing Code of Ethics is based upon include beneficence, nonmaleficence, justice, accountability, autonomy, fidelity, and veracity.

What are the 4 main ethical principles in nursing? ›

Nurses are advocates for patients and must find a balance while delivering patient care. There are four main principles of ethics: autonomy, beneficence, justice, and non-maleficence. Each patient has the right to make their own decisions based on their own beliefs and values. [4].

What are the 4 key values for deciding ethical issues? ›

The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and justice, are defined and explained.

What are the 8 guiding principles of healthcare ethics? ›

The final Washington e-Health Code of Ethics sets forth guiding principles under eight main headings: candor; honesty; quality; informed consent; privacy; professionalism in online health care; responsible partnering; and accountability.

What are the 8 ethical standards? ›

This analysis focuses on whether and how the statements in these eight codes specify core moral norms (Autonomy, Beneficence, Non-Maleficence, and Justice), core behavioral norms (Veracity, Privacy, Confidentiality, and Fidelity), and other norms that are empirically derived from the code statements.

What are the 6 nursing ethics? ›

Utilizing the ethical principles of autonomy, beneficence, nonmaleficence, fidelity, justice, and paternalism as outlined by the American Nurses Association (ANA) provides us with a firm foundation for ethical decision making.

What is an example of ethics in nursing? ›

The nurses do not influence the patient's choice. Examples of nurses demonstrating this include obtaining informed consent from the patient for treatment, accepting the situation when a patient refuses a medication, and maintaining confidentiality.


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