“Ethics is knowing the difference between what you have a right to do and what is right to do.”
– Potter Stewart, former U.S. Supreme Court Justice
Ethical practice is a foundation of modern nursing. Effective nurses don’t just demonstrate medical competence. They adhere to certain moral principles and professional standards. One of these principles, beneficence, plays a key role in the outcome of patient care.
Beneficence in Nursing
Beneficence is one of four ethical values that inform modern American medical practice. According to philosophers Tom Beauchamp and Jim Childress, beneficence is defined as “mercy, kindness, and charity.” The federal government takes this definition further in the The Belmont Report. Here, beneficence means two things: refraining from maltreatment and maximizing potential benefits to patients while minimizing potential harm.
In practice, nursing beneficence takes on many different forms. Examples might include:
- Resuscitating a drowning victim
- Providing pain medication as soon as possible to an injured patient in the emergency room
- Lifting side rails on a patient’s hospital bed to prevent falls
- Providing vaccinations
- Performing daily tasks for patients who are unable to carry them out alone
Beneficence is valuable because it encourages a superior standard of nursing performance. It also emphasizes compassionate care and advocates for continual striving toward excellence. Nurses must be wary, however, of the downside of this principle, as it can lead to paternalism when executed improperly. When a patient’s autonomy is sacrificed for providing care that is deemed “right,” acting in the name of beneficence can be damaging rather than helpful.
For example, if a patient denies a certain treatment on religious grounds and a nurse decides to provide it anyway, the nurse has taken away the patient’s autonomy. Although the nurse may have saved the patient in one way, the nurse has taken away the patient’s clearly defined right to choose his or her own course of treatment.
Principles of Ethics
Beneficence is not the only ethical concept relevant to nursing. Nursing in the United States is guided by a philosophy called “ethical principlism,” according to Role Development in Professional Nursing Practice. Beauchamp and Childress described three additional principles that, together with beneficence, establish a proper moral code for the practice of medicine:
- Autonomy: The recognition that people have the right to make their own choices, hold their own views and take actions based on their own personal values and belief systems.
- Justice: Treating others equitably and with fairness.
- Nonmaleficence: Doing no harm, whether intentionally or unintentionally.
Together, these four principles offer ample benefits to the field.
- The principles correspond to values that are part of American life, so they are familiar to everyone.
- The principles are both useful and specific.
- The principles can transcend practice areas and can be applied to both bioethics and clinical ethics.
For all their benefits, the principles of Beauchamp and Childress are not without challenges.
These challenges include:
- Conflict between principles, without clearly outlined decision-making procedures.
- The fact that the principles discussed are difficult to compare; they all appear to have equal moral weight and value.
- The concept of autonomy, specifically, may not transcend cultural barriers. It may refer to individual autonomy in some cultures, and community or group autonomy in others.
Conflicts between principles can and do occur. An example might be a cancer patient refusing treatment. How can a nurse respect the autonomy of the individual while ensuring the patient still receives life-saving care? Resolving conflicts between these principles is difficult, and solutions are rarely black and white. While these principles are meant as a guide, it is up to nurses themselves to find the ethically appropriate solutions to the problems they face.
Ultimately, adhering to defined ethical principles helps nurses provide exceptional care throughout their careers. A deeper understanding of these principles is a crucial tool for success.
Developing as a Nurse
All nurses can benefit from learning more about their field, particularly in the area of ethics. For working professionals seeking to train further, the online RN to BSN degree from Husson University can help them gain the credentials they need to become leaders in their field. This accelerated program can be completed in as little as one year.