IMPLICATION OF ETHICS IN
COMMUNITY HEALTH NURSING PRACTICE

Definitions of Ethics:

Values or standards that govern the behavior of groups and determine the rightness and wrongness of actions.

A set of moral principles or values; a theory or system of moral values.

Community Health Ethics:

Medical ethics that deal with values, choices, and personal moral behavior.

Basic values that Guide Decision-Making

There are 03 basic human values are considered key to guiding decision making in the provider - client relationship.

1. Self-determination:

Or individual autonomy is a person’s exercise of the capacity to shape and pursue personal plans for life. It is instrumentally valued because self-judgment about a person’s goals and choices is conducive to an individual’s sense of well being.

2. Wellbeing:

Is a state of positive health. Although all therapeutic interventions by health care professionals are intended to improve client’s health and promote wellbeing, well intended interventions sometimes fall short if they are in conflict with clients’ preferences and needs.

3. Equity:

Means being treated equally or fairly. In other words, different people have different needs in health care, but all must be served equally and adequately. So all individual should have same access to health care according to benefits or needs, when any one follows equity.

Ethical Decision Making in Community Health Nursing

The key values self determination, well-being, and equity influence nursing practice in many ways.

The value of self-determination has implication for how community health nurses;

1. Respect the choices of clients

2. Protect privacy

3. Provide for informed consent

4. Protect diminished capacity for self determination

The value of wellbeing has implication for how community health nurses;

1. Reduce/ prevent harm and provide benefits to client populations

2. Measure the effectiveness of nursing services

3. Balance the cost of services against real client benefits

The value of equity has implication for community health nursing in terms of its priorities for;

1. Broadly distributing health goods, which are macro-allocation issues

2. Deciding which populations will obtain available health goods and services which are micro-allocation issues

Decision based on one value mean that this value often will conflict with other values. Therefore Community health nurses should balance these values that may even conflict with their own personal values or values of nursing profession. CHN always use value clarification techniques in ethical decision making process to promote client’s wellbeing without reducing their self determination or ignoring equity.

ETHICAL PRINCIPLES

Seven basic ethical principles guide community health nurses in making ethical decisions regarding clients’ care; which are discussed as follow.

1) Respect:

It refers to treating people as a unique, equal, and responsible moral agent. This principle emphasizes people’s importance as members of the community and of the health services team.

It includes treating clients as equals on the health team and holding them and their views in high regard.

Application: to acknowledge community clients as valued participants in shaping their own and the community’s health outcomes.

2) Autonomy:

It means freedom of choice and the exercise of people’s rights. Individualism and self determination are dominant values underlying this principle.

Application: nurses’ promote individuals’ & groups’ rights to and their involvement in decision making. When applying this principle, nurses should make certain that clients are fully informed and that decisions are deliberate.

3) Beneficence:

It means doing good or benefiting others. It is the promotion of good or taking action to ensure positive outcomes on behalf of clients.

Application: Actively promote best interests and wellbeing of community clients. For example a) developing health program for senior citizen that ensures equal access to all needy people in the community. b) supporting programs to encourage preschool immunizations.

4) Nonmaleficence:

Avoiding or preventing harm to others as a consequence of person’s own choices and actions. It involves taking steps to avoid negative consequences.

Application: encouraging physicians to prescribe drugs with the fewest side effects, promoting legislation to protect the environment from pollutants emitted from gasoline even if it raises prices, and lobbying for lower speed limits or gun control to save lives.

5) Justice:

This principle refers to treating people fairly. It mean the fair distribution of both benefits and costs among society’s members.

Application:

1) decisions about equal access to health care,

2) equitable distribution of services to rural as well as urban population,

3) not limiting amount or quality of services because of income level, and

4) fair distribution of resources.

6) Veracity:

This principle refers to telling the truth. Community clients deserve to be given accurate information in a timely manner. To withhold information or not tell the truth can be hurtful as well as disrespectful act of nurse towards clients. Truth-telling treats clients as equals, expands the opportunity for greater client involvement, and provides needed information for decisions.

7) Fidelity:

It means keeping promises. People deserve to count on commitments being met. This principle involves the issues of trust and trustworthiness. Nurses who follow through on what they have said earn their clients’ respect and trust. Fidelity influences the quality of nurse’s relationship with clients, who then are more likely share information, leading to improved decisions.

Implication of Ethics in of Community Health Nursing | POST RN BSN NURSING RESOURCES