Everyone enters the nursing profession with the intention of providing safe, compassionate, and ethical care. Most license issues don’t stem from bad intentions but from split-second decisions made under pressure, fatigue, or unclear guidance. Ethical principles in nursing aren’t just theories from nursing school; they are practical tools that guide real-time decisions at the bedside and help protect both your patients and your nursing license.
This article reviews the ethical principles you should understand and regularly reflect on so you can practice confidently and avoid putting your hard-earned license at risk.
What Is Nursing Ethics?
Ethics is the formal, systematic study of moral beliefs. Nursing ethics is a specialized branch of ethics that focuses on moral situations specific to nursing practice and patient care.
Two Types of Ethical Theories
Two main ethical theories guide ethical decision-making in nursing:
- Teleological Theory (Consequentialism)
This theory focuses on the outcomes or consequences of an action. An action is considered ethical if it produces the greatest good. - Deontological Theory
This theory holds that ethical standards and duties exist independently of outcomes. Actions are considered right or wrong based on principles, not consequences.
As nurses, we often have a duty to act based on the most relevant ethical principle in a given situation.
11 Ethical Principles in Nursing You Must Know
Below are the most common ethical principles nurses should be familiar with:
1. Autonomy
Derived from the Greek words autos (self) and nomos (law), autonomy refers to a person’s right to make their own decisions. In nursing, it includes respecting patients’ choices, privacy, and independence (free from coercion).
2. Beneficence
Beneficence is the duty to do good and actively promote the well-being of patients through kindness, compassion, and care.
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3. Confidentiality
Confidentiality relates to a patient’s right to privacy. Information shared by a patient should not be disclosed unless it benefits the patient or there is a serious threat to public safety.
4. Double Effect
This principle may justify actions that have both good and harmful effects, as long as all four conditions are met:
- The action itself is morally good or neutral
- The intention is to achieve a good effect, not a harmful one
- The good effect is not achieved through the harmful effect
- There is a proportionate balance of good over harm
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5. Fidelity
Fidelity means keeping promises and being faithful to commitments explicitly and implicitly. If you tell a patient you’ll return in 10 minutes, do your best to follow through.
6. Justice
Justice means treating similar cases similarly. Distributive justice refers to fair distribution of resources based on factors such as:
- Equality
- Individual need
- Effort
- Societal contribution
- Legal entitlement
Retributive justice relates to fair punishment when wrongdoing occurs.
7. Nonmaleficence
Nonmaleficence is the duty to do no harm and to prevent harm (from your patients) whenever possible. While closely related to beneficence, it is often considered the more binding obligation.
8. Paternalism
Paternalism involves limiting a patient’s autonomy when doing so is believed to be in the patient’s best interest: For example, preventing harm when a patient lacks decision-making capacity.
9. Respect for Persons
This principle goes beyond acknowledging autonomy. It involves actively supporting patients so they can understand their options and make informed choices.
10. Sanctity of Life
This principle holds that life is the highest good and should be protected, regardless of judgments about the quality of life.
11. Veracity
Veracity is the obligation to tell the truth. In modern clinical practice, the legal and ethical responsibility for truthful disclosure lies with the clinician. Failing to disclose risks or ensure informed consent can lead to professional liability.
Ethical Challenges in Nursing Practice
While ethical principles guide nursing practice, applying them in real-world settings can be challenging.
1. Professional and Clinical Responsibility
According to the ANA Code of Ethics, nurses must balance:
- Patient protection and advocacy
- Prevention of illness versus relief of suffering
- Treating illness while addressing the human response to illness
2. Decision-Making Conflicts
Ethical challenges often arise during care decisions, including:
- Supporting patients who struggle to express their values
- Applying abstract ethical principles to complex, real-life situations
3. Structural and Bureaucratic Conflict
Nurses may experience conflict when:
- Organizational policies limit their advocacy role
- Authority and decision-making boundaries cause tension among healthcare team members
4. Communication and Interdisciplinary Issues
Ethical practice suffers when:
- Nurses are not treated as valued members of the healthcare team
- There is no clear framework for communicating ethical concerns
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Wrapping Up: Ethical Principles in Nursing
Ethics exists in every profession for a reason. As a nurse, keeping these principles in mind helps guide your daily practice, protect your patients, and safeguard your license.
You worked hard to earn your nursing license; don’t risk losing it by overlooking ethical responsibilities. When in doubt, pause, reflect, and choose the path that prioritizes ethical care and patient trust.
References for further reading:
- Brunner & Suddarth’s Medical-Surgical Nursing
- Sciencedirect: Nursing Ethics
- American Nurses Association
