7 Ethical Principles in Nursing

All nurses, regardless of practice area, make decisions in the course of their daily duties that require ethical consideration. But as any nurse will tell you, these decisions can weigh heavily on a person’s shoulders. A core set of ethical principles in nursing offers a solid foundation that nurses can rely on to help them make sound decisions. Such ethical principles likely contribute to the fact that, historically, Americans trust nurses more than any other profession, according to Gallup’s annual Honesty and Ethics poll.

Principles of Ethics in Nursing: Background

Ethics refers to how people think and conduct themselves in terms of right and wrong. The concept of nursing ethics began to develop in the late 19th century. At the time, ethics in nursing referred to certain character traits like obedience, physician loyalty, and high moral character.

As the world and the healthcare industry evolves, so too must nursing ethics themselves. Nurses face increasingly complex human rights and ethical issues. In response, the American Nurses Association developed its Code of Ethics for Nurses, which serves as the standard by which all nurses should practice. It acts as a social contract between nurses and the general public, helping people understand the commitment all nurses make to providing safe, evidence-based, high-quality care.

Each member of the profession adheres to a set of core ethical principles in nursing. The nursing code of ethics helps nurses make good judgment calls, provide high-quality care, and support patients and their loved ones emotionally, physically, and mentally. It also helps keep a nurse’s license in good standing. Let’s take a deeper look at each of the ethics in nursing.

What Are the 7 Ethical Principles in Nursing?

1. Accountability
2. Justice
3. Nonmaleficence
4. Autonomy
5. Beneficence
6. Fidelity
7. Veracity

1. Accountability

Accountability is chief among the ethical principles in nursing. Each nurse must be responsible for his or her own choices and actions in the course of patient care. Nurses who hold themselves accountable often provide higher-quality patient care. They are more likely to build stronger relationships with patients, thanks to increased trust. Accountable nurses adhere to their scope of practice and, in many cases, are greatly appreciated by their colleagues and patients.

2. Justice

Justice plays a significant part in the nursing code of ethics. Every nurse has a responsibility to make care decisions that are based only on the facts, not on other factors like the patient’s

• Age
• Ethnicity
• Religion
• Socioeconomic status
• Sexual orientation

To uphold the justice ethical principle, nurses should act as fair and impartial care givers, which can help patients feel more valued. Treating each patient fairly, regardless of their circumstances, is essential for helping patients accept and participate in their own care; this, in turn, often leads to better patient outcomes.

3. Nonmaleficence

You’ve likely already heard of this ethical principle, which is to do no harm. According to the National Library of Medicine, nursing nonmaleficence echoes exactly that. Nurses have a critical responsibility to prevent further harm from coming to all their patients. Each nurse must take action to prevent harm. Nonmaleficence in nursing is essential to safe, effective patient care that is delivered to the best of a nurse’s ability.

4. Autonomy

While nurses are guided by best medical practices and standards of care, they must also support patient autonomy. This means that patients who can make decisions for themselves must be allowed to do so, even if their decisions go against nursing or medical expertise. Nurses must advocate for patient autonomy as long as patients are capable of exercising this right.

5. Beneficence

Beneficence in nursing can be defined as the charity and kindness nurses offer to other people, which is demonstrated by their actions in the medical setting. Beneficence means that nurses perform actions intended to benefit others; they act with the patient’s best interests in mind. In order to act with beneficence in nursing, each nurse must approach each patient as a unique individual with their own life circumstances, opinions, and experiences. Beneficence also means that nurses must put aside their own personal feelings to provide care to the best of their abilities.

6. Fidelity

People want to know they can count on nurses, no matter what. The fidelity ethical principle can best be described by keeping your word to patients. Nurses should be honest and loyal to each patient, as this helps the nurse gain trust and fulfill their professional commitment. Without fidelity, more trusting relationships cannot be formed, which leads to less positive patient outcomes and less trust in professional relationships.

7. Veracity

Working in healthcare is challenging for many reasons, and in some cases, nurses must communicate unpleasant information to a patient. Veracity in nursing is the ethical principle of being completely open and honest with patients, even if the truth causes distress. While being completely truthful can be daunting, especially in certain patient care circumstances, veracity in nursing is important for establishing trust and strengthening the nurse-patient relationship. Veracity also helps patients become more autonomous, making decisions for their care based on all relevant, factual information.

Nursing Ethical Principles in Practice

In order to learn how to put each of these nursing ethical principles to good use, most nursing programs include ethics as part of their curriculum. Ethical principles in nursing may be presented as an individual class, or the topic may be rolled into another course, such as professionalism in nursing practice. To reinforce the importance of the subject matter, questions about nursing ethics often appear on the NCLEX exam.

Ethical principles in nursing help guide nurses’ daily practice, even if a nurse isn’t directly aware of it. You’ve probably already encountered these ethical principles, even if you didn’t know it at the time. Check out these real-world examples of ethical principles in nursing:

• Accountability: If you mix up medications when drawing them up, you take accountability by discarding them and pulling new vials rather than administering them to the patient.
• Justice: When you know a patient needs extra assistance because of a disability or economic hardship, you go out of your way to advocate for their needs to be met.
• Nonmaleficence: Even if you know a patient, you perform the rights of medication administration before giving them their evening medicines.
• Autonomy: If a patient makes a care decision that goes against your judgment as a clinician, you respect their decision because you value their autonomy.
• Beneficence: When your patient is undergoing a care plan change that could have negative side effects, you help them understand the pros and cons so they can choose the treatment with the most benefit for them.
• Fidelity: If you promise a patient that you won’t tell their family about a procedure they’re having, you keep that promise because you value their trust.
• Veracity: When you have bad news to share with a patient, you explain the situation with truth and empathy. Being truthful, even when you’re talking about an unwanted outcome, reinforces trust and helps patients make autonomous decisions.

Use Your Ethical Principles in Nursing at a Job That Works for You

Whether you are looking for your first job in nursing or are a seasoned professional, ethical principles can help you better serve your patients. Looking for more career pointers? Sign up for IntelyCare’s nursing newsletter to inspire your next moves.