Which nursing action incorporates the ethical principle of Nonmaleficence?

According to the American Nurses Association (ANA), the nursing code of ethics is a guide for “carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.” Ethics, in general, are the moral principles that dictate how a person will conduct themselves. Ethical values are essential for ALL healthcare workers, but ethical principles in nursing are particularly important given their role as caregivers.

There are 4 main principles that are part of the nursing code of ethics. They are,

1. Autonomy
2. Beneficence
3. Justice
4. Non-maleficence

These principles are ideally what every nurse should be aware of in their daily nursing practice. While ethical principles are sometimes confusing and often taught briefly during undergraduate nursing -- they should be constants in nursing practice in order to provide the best, safest, and most humane care to all patients.

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History of the Nursing Code of Ethics

Interestingly, the nursing code of ethics is suggested to have been founded in 1893 and named the “Nightingale Pledge” after Florence Nightingale, the founder of modern nursing. As a modification of the Hippocratic Oath, taken by medical doctors, the Nightingale Pledge has been recited by nursing students at graduations with little changes since inception. 

The formal code of ethics was developed in the 1950s by the American Nurses Association (ANA) and has undergone numerous modifications since. The most significant recent change was in 2015 when 9 interpretative statements or provisions were added to the code of ethics to help guide nursing practice in a more definitive way. 

Many states include the ANA’s nursing code of ethics in their practice statements. Even though the code of ethics is primarily ethics-related, it also has legal implications. Given the importance of the code to the nursing profession, revisions continue on a regular basis.

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4 Principles of Ethics for Nurses

1. Autonomy 

Autonomy is recognizing each individual patient’s right to self-determination and decision-making. As patient advocates, it is imperative that nurses ensure that patients receive all medical information, education, and options in order to choose the option that is best for them. This includes all potential risks, benefits, and complications to make well-informed decisions. 

Once the patient has all the relevant information, the medical and nursing team can make a plan of care in compliance with the medical wishes of the patient. 

It is important that nurses support the patient in their medical wishes and ensure that the medical team is remembering those wishes. Sometimes, nurses will need to continue to advocate for a patient despite the wishes being verbalized because the medical team might not agree with those wishes.

Many factors may influence a patient's acceptance or refusal of medical treatment, such as culture, age, gender, sexual orientation, general health, and social support system.

2. Beneficence

Beneficence is acting for the good and welfare of others and including such attributes as kindness and charity. The American Nurses Association defines this as “actions guided by compassion.”

3. Justice

Justice is that there should be an element of fairness in all medical and nursing decisions and care. Nurses must care for all patients with the same level of fairness despite the individual's financial abilities, race, religion, gender, and/or sexual orientation. 

An example of this is when working at a free flu clinic or diabetes screening clinic. These are open to all individuals in the community regardless of the previously mentioned factors.

4. Nonmaleficence 

Nonmaleficence is to do no harm. This is the most well-known of the main principles of nursing ethics. More specifically, it is selecting interventions and care that will cause the least amount of harm to achieve a beneficial outcome

The principle of nonmaleficence ensures the safety of the patient and community in all care delivery. Nurses are also responsible to report treatment options that are causing significant harm to a patient which may include suicidal or homicidal ideations. 

Nursing Code of Ethics Interpretive Statements

Revised in 2015 to include 9 provisions, the ANA’s nursing code of ethics now includes interpretative statements that can provide more specific guidance for nursing practice.

9 Provisions of the Nursing Code of Ethics 

Currently, the nurse’s code of ethics contains 9 main provisions:

1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.
2. The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.
3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.
4. The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.
5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.
6. The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.
7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

   What is the ethical principle of Nonmaleficence?

   Nonmaleficence. The principle of nonmaleficence holds that there is an obligation not to inflict harm on others. It is closely associated with the maxim primum non nocere (first do no harm).

   What is Maleficence during nursing care?

   The doctor's actions will only prolong his dying. The physician is guilty of maleficence, since the actions provide no benefit or good effect but do inflict intentional harm.

   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 principles of beneficence and Nonmaleficence?

   The “Beneficence” principle refers to actions that promote the well-being of others. The duty of professionals should be to benefit a party, as well as to take positive steps to prevent and to remove harm from the party. Non-maleficence reminds you that the primary concern when carrying out a task is to do no harm.