The Ethical Theory and Conceptual Principles in Understanding Nursing

Introduction

Zerwekh and Claborn (2009) describe nurses as healthcare professions who are motivated by science, have technical skills and are caring. Arguably, the nursing profession is among the most taxing in the healthcare industry. This can be attributed to the fact that nurses, more than other healthcare practitioners, are expected to show high levels of professional values and behaviors since they interact with patients more often than other players in the health care industry. As such, having professional values is very important to nurses since it can help them better the health of their patients and to a large extent, help prolong the lives of those in medical need.

With this in mind, nursing can be defined by the practices, values and attitudes that are expected from professional nurses. Similarly, these practices values and attitudes can be used to define nursing. As such, it may be argued that nursing as a profession is a reflection of the ethical theories that govern this practice and interchangeably, ethical theories in nursing reflect the essence of nursing. This is called a mirror perspective of nursing whereby two concepts (nursing and nursing theory) reflect each other. This paper shall set out to argue that ethical theories in nursing best reflect the practices, conducts and attitudes that constitute to nursing. An example of such theory shall be offered and a discussion on how it describes/mirrors nursing shall be provided. This shall aim at elaborating how this theory and its principles define nursing.

A mirrored perspective of nursing: Theory application

According to the Royal College of Nursing (2004), all professional healthcare practitioners should be able to make decisive and accurate judgments in regard to the assessment, diagnosis, evaluation and prescription processes involved in healthcare delivery. In addition, professionalism in nursing is all about having adequate knowledge on the techniques and criterions used to asses the needs of the patients, and determining the best course of action to be taken to come up with a viable solution that meet the immediate needs of the patients.

Throughout history, people have been using their reasoning to determine what is right or wrong in different circumstances and in justifying why it is so. This criterion is the basic foundation of normative ethics. In most cases, health care professionals encounter highly complex issues while dealing with their patients or the health care system at large. Handling such issues requires a strong theoretic foundation based on knowledge and skills that can be applied, so as to generate solutions that benefit both the patient (in terms of quality treatment) and the organization as regarding to the management of risks and preservation of life (Ashcroft, Dawson & Draper, 2007). With this in mind, it can be argued that ethical theories in nursing mirror the practices, conduct and attitudes that nurses are expected to have so as to perform efficiently.

Similarly, to be recognized as a professional, one must understand the foundation of the field of practice. In other words, a health care professional is expected to fully understand the nuts and bolts that hold the health care system together. In nursing, this foundation is rooted in theories that try to explain how nurses should behave and practice.

Ethics in the healthcare business is not simply doing what we consider to be right. As mentioned earlier, issues encountered in this sector are often exceedingly complex and assuming that there is a one-shoe-fits-all approach to dealing with these issues is an outrageous fallacy. To make matters worse, the society and other health care professions also have their inflexible ethical expectations. To this end, it is not only logical, but also wise for a healthcare practitioner to have a strong foundation and a deeper insight in the theories and principles of ethics if they are to act professionally in regard to execution of tasks and decision-making processes (Ashcroft, Dawson & Draper, 2007).

Ethics and Nursing: A Brief Overview

There are various documented theories that can be used to describe nursing. You may be questioning the relationship between these theory and nursing. Well, the answer is that professional conduct in nursing cannot be standardized without implementing a solid ethical foundation. This is evidenced by the fact that a lack of ethical standards forwarded by different theories leaves an individual with no other choice but to make decisions devoid of a solid structure to support those decisions (Morrison & Monagle, 2009). Without these theories, a practitioner would therefore lack the ability to defend his/her actions whenever the need arises. In addition, you would not be adequately equipped to deal with the issues that are inherent in today’s health care sector (Royal College of Nursing, 2004). As such, understanding the ethical theories that apply in health care delivery is not only pivotal, but also a necessity in today’s dynamic, and aggressive working environment.

Virtue Ethics Theory

This theory as defined by Melia (2004) argues that we should find a solution for humanity and then work towards achieving that solution. It focuses on finding perfection and excellence in all we do. It therefore proposes that as human beings, we should work towards developing ourselves to excellence by using the best of our ability. The questions in this theory include: What kind of an individual should I become? Or how can we live together in harmony? Devettere (2009) contends that this theory is very influential in formulating professional code of ethics in nursing. Virtues are described as desirable moral qualities. According to Melia (2004), this theory was founded on the tenets that everyone is innately virtuous but there is need for development and nurturing before a person can exhibit a virtuous character. This sentiment is further supported by Loewy and Springer (2004), who defines virtue elitism as a state in which a person who has been nurturing virtues becomes virtuous after long practice.

Perception of Leadership and education according to the virtue ethics theory

Personal values and beliefs are of immense importance to an individual since they dictate what a person judges to be of importance or worth in their lives. Pandey and Singh (2008, p.310) define personal values as “the deepest beliefs and sentiments we subscribe to”, and state that values have a direct bearing on a person’s success and accomplishments in life. A person’s core values are also central to their leadership abilities. It therefore makes sense for a person to be aware of their personal values.

Clark (2008) theorizes that an understanding of one’s values and beliefs can result in excellence in leadership. This perspective of leadership is greatly emphasized by the virtue ethics theory, which aims at enhancing a practitioners ability to develop, apply and maintain desirable (virtuous practices) and values. As such, it can be deduced that a successful leader is a virtuous person. Similarly, a virtuous person can be viewed as a successful leader according to this theory.

For example, Greenhalgh (2007), states that virtue ethics enable practitioners to balance their obligations more efficiently. For example, there are some treatments such as chemotherapy, which are harmful to the patients but beneficial in the long-run. A professional practitioner equipped with the knowledge of virtue ethics can effectively communicate the harms as well as the benefits of such treatments to the patient and get consent to administer the treatment. As such, the virtue ethics theory in itself is educative since understanding it equips practitioners with adequate knowledge on how to behave and handle health care situations and patients.

In addition, if the patient views the practitioner as a virtuous person, their confidence in the services provided increases. Also, caregivers who have practical wisdom (a virtue) are able to find viable solutions and work towards attaining them. As such, people who have practical wisdom can consult each other and come up with appropriate remedies to different issues. Over the years, healthcare organizations have used such people to form ethics committees which help in determining ethical courses of actions and resolving conflicts (Ashcroft, Dawson & Draper, 2007). Such progress has been made possible through the understanding of what the virtue ethics theory entails. This theory focuses on educating practitioners on practical wisdom. Practical wisdom is the ability of a practitioner to critically analyze different situations that demand a different approach other than the prescribed procedures.

On the same note, Loewy and Springer (2004) contend that a virtuous person (one having practical wisdom) can effectively decide on which theory to apply so as to solve an issue. This is important in leaders who are expected to make the right decisions and justify the same. Take a physician for example; their primary duty is to cater for the needs of their patients. However, this is not their only obligation they have other duties such as recruiting, training and firing employees, as well as conducting scientific studies and managerial duties. All these roles are handled differently and different theories can be used to diffuse them.

On a different note, education is broadly defined as a learning process through which people acquire knowledge and skills necessary to handle situations in the real world. Similarly, the virtue ethics theory views education as a process through which desirable values and practices are learnt over time. The end result of education is elitism, in which a practitioner applies the virtues imparted through educational and social experiences in practice. An individual who has knowledge of the professional socialization process recommended in this theory is more likely to select and apply the theories that ethically examines and solves current problem.

Professionalism also calls for cooperation among individual professionals. In the health industry, cooperation is mandatory since health care professionals are often required to work in interdisciplinary collaborative environments (Ashcroft, Dawson & Draper, 2007). For this reason, inter-professional collaboration is necessary for better patient-centered care to be achieved. Dumont (2010, p. 65) asserts that nurses and other medical professionals should be taught skills that “involve knowledge of the various professions and the needs of patients and their close relatives, as well as the competencies and attitudes that foster collaboration between professionals”.

It is only by gaining inter-professional education that stipulates professional roles and responsibilities that health care givers can perform optimally in the field. The virtue ethics theory seeks to foster this collaborative relationship among members in the health care industry. As such, education is viewed as a tool used to nurture collaboration. Similarly, collaboration can only be nurtured through education in this theory. Evidence of this is in the assumption forwarded by this theory, which states that collaboration can only be realized through the learning process of professional socialization.

Biomedical Principles Emanating From Virtue Ethics Theory

The four core ethical principles used in healthcare delivery have their roots in the virtue ethics theory (Greenhalgh, 2007). They include beneficence, non maleficence, justice and autonomy. These principles provide practitioners with an avenue through which they can learn and improve on their leadership traits. Beneficence refers to the caregiver’s responsibility to extend kindness/goodness to their patients. This principle dictates that healthcare practitioners have the responsibility to keep the patient’s interest before their own by ensuring that they get the most benefit from all health care related practices (Greenhalgh, 2007). The second principle of non maleficence states that health care practitioners should avoid doing harm to others. This principle sets out to protect patients from practices that may put them at risk or at harms ways in a health care setting (Devettere, 2009).

The third principle of justice suggests that health care practitioners should treat their patients fairly, equitably and lawfully without malice or discrimination. The final principle is that of autonomy, which refers to the ability to make decisions for oneself without external or emotional influences. This principle holds that people should always respect the decisions made by others and that making decisions for other people without their permission is wrong or in ethical terms; paternalism. These four principles show virtuous characteristics that should be inherent in all health care practitioners. Not only do they protect the patients from harm and unfair health care practices, but they help the practitioners act in an ethically and legally acceptable manner (Loewy & Springer, 2004).

Conclusion

Evidently, the twenty-first century comes with various health care ethical challenges to individuals, society and organizations that participate in this sector. As such, a deeper understanding of the ethical theories that govern this sector is not only logical, but also necessary if ethical conduct is to prevail. From this discussion, it is clear that nursing can be described by the virtue ethics theory. This has been attributed to the fact that this theory plays a pivotal role in creating appropriate responses for the challenges that are inherent of this sector. As a result, a detailed review of this theory has been provided and scenarios in which the theory mirrors nursing provided.

While not all theories have been discussed, it is clear that having a foundation of ethical theory is critical in ensuring that quality services are offered to various stakeholders. In addition, knowledge of these theories helps health care practitioners make correct decisions, and provide adequate support for their decisions. By applying these theories and their principles, professionals in the health care sector will be able to do their work more efficiently, all the while minimizing the chances of gross misconduct and harmful practices that may eventually cost them their careers.

References

Ashcroft, R., Dawson, A., & Draper, H. (2007). Principles of health care ethics. New York: John Wiley and Sons.

Clark L. (2008). Clinical leadership: Values, beliefs and vision. Nursing Management, 15(7): 30-35.

Devettere, R. (2009). Practical decision making in health care ethics: cases and concepts. USA: Georgetown University Press.

Dumont, S. (2010). Implementing an Interfaculty Series of Courses on Interprofessional Collaboration in Prelicensure Health Science Curriculums. Education for Health, 23(1).

Greenhalgh, T. (2007). Primary health care: theory and practice. Boston: John Wiley and Sons.

Loewy, E., & Springer, R. (2004). Textbook of health care ethics. New York: Springer.

Melia, K. (2004). Health care ethics: lessons from intensive care. New York: SAGE.

Morrison, E., & Monagle, J. (2009). Health care ethics: critical issues for the 21st century. California: Jones & Bartlett Learning.

Pandey, S. & Singh, M. (2008). Women Empowerment and Personal Values as Predictors of Reproductive Health. Journal of the Indian Academy of Applied Psychology, 34(2): 309-316.

Royal College of Nursing. (2004). Defining Nursing. Web.

Zerwekh, G. J. & Claborn, C. (2009). Nursing Today: Transition and Trends. Sydney: Elsevier Health Sciences.

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