Ethical and Legal Issues in Nursing
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Questions and Answers

What does it mean for nurses to occupy 'in between' spaces?

  • Nurses are neutral and avoid taking sides.
  • Nurses strive to balance the needs of multiple stakeholders. (correct)
  • Nurses focus solely on patient needs over institutional policies.
  • Nurses operate independently without collaboration.

How is nursing practice described as a moral endeavor?

  • Nurses emphasize efficiency over patient care.
  • Nurses focus primarily on adhering to hospital protocols.
  • Nurses provide empathetic and culturally sensitive care. (correct)
  • Nurses avoid difficult conversations with patients.

What distinguishes deontological ethical theories from consequentialist theories?

  • Deontological theories prioritize outcomes over duties.
  • Consequentialist theories promote ignoring moral obligations.
  • Consequentialist theories assess actions based solely on intentions.
  • Deontological theories focus on adherence to duties toward others. (correct)

Which ethical dilemma do nurses frequently face in their practice?

<p>Respecting patient autonomy while maintaining confidentiality. (D)</p> Signup and view all the answers

Which of the following best describes the advocacy role of nurses?

<p>Advocating for patient well-being and rights consistently. (C)</p> Signup and view all the answers

What is negligence in the context of legal responsibilities within healthcare?

<p>Failure to act in a way that aligns with standard clinical practices. (C)</p> Signup and view all the answers

Which of the following is NOT a circumstance under which nurses may be held legally liable?

<p>Providing emotional support to patients. (A)</p> Signup and view all the answers

Which component is essential for ensuring legal compliance in documentation according to ethical guidelines?

<p>Timeliness and accuracy of the records. (B)</p> Signup and view all the answers

Which legal provision primarily addresses end-of-life care options?

<p>Advance care planning. (D)</p> Signup and view all the answers

What is a violation of a nurse's scope of practice?

<p>Conducting an assessment without proper training. (D)</p> Signup and view all the answers

What is a key difference between act utilitarianism and rule utilitarianism?

<p>Act utilitarianism focuses on the consequences of a single act, while rule utilitarianism focuses on the consequences of a set of rules. (C)</p> Signup and view all the answers

Which of the following best describes the primary focus of deontology?

<p>The intentions and motives behind actions are the most important. (D)</p> Signup and view all the answers

What is a potential critique of utilitarianism regarding its treatment of minority groups?

<p>Utilitarianism may harm minority groups for the greater good. (B)</p> Signup and view all the answers

In the concept of principlism, which of the following is NOT one of the core principles?

<p>Equity (C)</p> Signup and view all the answers

Which formulation of the categorical imperative asks whether an action could be applied universally?

<p>First formulation (B)</p> Signup and view all the answers

What is a significant strength of principlism in ethical discussions?

<p>It provides a common language to discuss ethical dilemmas. (D)</p> Signup and view all the answers

What is one of the key features of utilitarianism?

<p>It seeks to produce the greatest happiness for the greatest number of people. (A)</p> Signup and view all the answers

Which of the following critiques applies to deontology?

<p>It fails to recognize moral duties stemming from emotions. (A)</p> Signup and view all the answers

How does John Stuart Mill's perspective on utilitarianism differ from that of Jeremy Bentham?

<p>Mill believes in qualitative differences in pleasures. (A)</p> Signup and view all the answers

Which principle emphasizes the obligation to do no harm?

<p>Nonmaleficence (C)</p> Signup and view all the answers

What focuses on individual narratives in ethical discussions?

<p>Narrative Ethics (B)</p> Signup and view all the answers

Which ethical framework involves case studies to understand moral dilemmas?

<p>Casuistry (B)</p> Signup and view all the answers

What term describes the negative feelings experienced by a person who knows the right action but cannot take it due to constraints?

<p>Moral Distress (A)</p> Signup and view all the answers

Which concept refers to the capacity of individuals to engage in actions that are morally relevant?

<p>Moral Agency (A)</p> Signup and view all the answers

What is a potential consequence of ethical dilemmas in healthcare?

<p>Compromised well-being (D)</p> Signup and view all the answers

Which of the following is NOT a component of an ethical dilemma?

<p>Clarity of the situation (C)</p> Signup and view all the answers

Which ethical framework is illustrated by the IDEA method?

<p>Ethical Decision-Making Tools (C)</p> Signup and view all the answers

What does moral courage enable individuals to do in ethical practice?

<p>Take morally relevant actions (A)</p> Signup and view all the answers

How can an individual support the restoration of moral integrity in a healthcare environment?

<p>Reflect and reconnect to original purpose (C)</p> Signup and view all the answers

Why can laws be considered unethical?

<p>They can be outdated or conflict with personal beliefs. (A)</p> Signup and view all the answers

What is an example of an ethical action that can be illegal?

<p>Civil disobedience against unjust laws (C)</p> Signup and view all the answers

Which is a key aspect of how Canadian law influences nursing practice?

<p>Each province has its own regulatory body with specific requirements. (B)</p> Signup and view all the answers

What does the term 'moral community' refer to in a workplace?

<p>An environment promoting shared values and ethical action. (D)</p> Signup and view all the answers

What is a key critique of deontologic theories?

<p>Identifying conflicting duties can be challenging. (C)</p> Signup and view all the answers

What is a primary challenge of consequentialist theories?

<p>Predicting outcomes can be inherently uncertain. (C)</p> Signup and view all the answers

How do professional codes of ethics typically guide practitioners?

<p>By detailing responsibilities, obligations, and reporting mechanisms. (B)</p> Signup and view all the answers

What differentiates organizational ethics from clinical ethics?

<p>Organizational ethics deals with ethics at a macro level. (D)</p> Signup and view all the answers

Which level of moral response involves critically reflected justification based on principles and values?

<p>Reflective (C)</p> Signup and view all the answers

What significant ethical consideration is raised by the subjective nature of happiness?

<p>Different individuals may perceive happiness differently. (D)</p> Signup and view all the answers

Which of the following aspects is NOT typically included in a Code of Ethics?

<p>Detailed job descriptions (A)</p> Signup and view all the answers

What is a characteristic of cultural humility in nursing?

<p>Recognizing and addressing power differentials. (C)</p> Signup and view all the answers

Which ethical theory focuses on the empirical analysis of people's behaviors and reasons?

<p>Descriptive ethics (A)</p> Signup and view all the answers

What does the concept of 'accountability for reasonableness' aim to clarify?

<p>What ethical decisions should be made and the reasons behind them. (A)</p> Signup and view all the answers

What ethical considerations do nurses face in relation to organizational ethics?

<p>Resource allocation and care access can present ethical challenges. (A)</p> Signup and view all the answers

Which framework emphasizes the relationship between care and respect in the ethical practice of nursing?

<p>Relational ethics (D)</p> Signup and view all the answers

How can nurses be considered moral agents in their practice?

<p>They must ensure integrity and ethical soundness in patient care. (A)</p> Signup and view all the answers

What is the primary ethical obligation reflected in the concept of beneficence in research?

<p>To avoid causing harm to participants (A)</p> Signup and view all the answers

Moral resilience is defined as the ability to:

<p>Maintain integrity despite ethical challenges (B)</p> Signup and view all the answers

What major ethical issue arises when researchers cannot guarantee anonymity to subjects?

<p>Concerns over confidentiality (B)</p> Signup and view all the answers

Which of the following is NOT typically included in the informed consent process?

<p>Detailed list of personal identifiers (D)</p> Signup and view all the answers

Why might nurses experience vulnerability in research settings?

<p>They feel unprepared and lack a voice against unethical practices (D)</p> Signup and view all the answers

Which ethical principle emphasizes the welfare of research participants while ensuring that risks do not outweigh benefits?

<p>Beneficence (D)</p> Signup and view all the answers

What is an advocacy dilemma faced by nurses in research contexts?

<p>Protecting patients from researchers' unethical behavior (A)</p> Signup and view all the answers

What is the significance of the Gifts of the Seven Grandfathers in healthcare?

<p>They encourage culturally sensitive patient-centered care (D)</p> Signup and view all the answers

What does the term 'informed consent' primarily aim to protect?

<p>Patient autonomy and decision-making (A)</p> Signup and view all the answers

Which of the following virtues is NOT considered a focal virtue in healthcare?

<p>Arrogance (C)</p> Signup and view all the answers

Which principle establishes a conflict between care and research in nursing?

<p>The focus on patient benefit (C)</p> Signup and view all the answers

What challenge is presented by randomized control trials in a nursing context?

<p>Potentially withholds beneficial treatments from participants (A)</p> Signup and view all the answers

How is the concept of phronesis related to virtue ethics?

<p>It is practical wisdom guiding moral actions (A)</p> Signup and view all the answers

What is a common limitation found in virtue ethics?

<p>It addresses only individual actions, not interpersonal ethics (D)</p> Signup and view all the answers

Flashcards

Nursing's 'in-between' spaces

Nurses balance multiple stakeholders' needs in their practice.

Moral endeavor in nursing

Nursing involves moral principles like empathy, compassion, and patient advocacy.

Deontological ethics

Focuses on duties and adherence to rules for moral action, not outcomes.

Consequentialist ethics

Judges actions based on the outcomes or consequences.

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Patient-centered care

Nursing care that prioritizes the patient's needs and values.

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Negligence in Healthcare

A failure to act with the care and caution a reasonable professional would under similar circumstances, leading to harm.

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Nurse Legal Liability

Nurses can be held responsible for actions that deviate from the standard of care, potentially causing harm to patients.

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Medical Malpractice

Negligence that occurs in a professional medical context, causing harm to the patient.

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Informed Consent

A patient's agreement to a medical procedure or treatment after receiving clear and understandable information about the risks and benefits.

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Documentation Standards in Healthcare

Accurate, complete, and timely records of patient care, legally safeguarding against malpractice and ethical breaches.

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Utilitarianism

An ethical theory that focuses on maximizing overall happiness and well-being for the greatest number of people.

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Act Utilitarianism

A type of utilitarianism that assesses the morality of each individual action based on its potential to maximize overall good in that specific situation.

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Rule Utilitarianism

A type of utilitarianism that evaluates the morality of actions based on whether they conform to rules that, if consistently followed, lead to the greatest overall good for the greatest number of people.

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Deontology

An ethical theory emphasizing moral duties, rules, and principles as the basis for right actions, regardless of their consequences.

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Categorical Imperative

In deontology, a moral principle that dictates that actions should be judged by whether their maxim, or underlying principle, can be universally applied.

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Principlism

An ethical framework using key moral principles (autonomy, beneficence, non-maleficence, justice) for guiding decision-making.

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Autonomy

The ethical principle emphasizing an individual's right to self-determination and making their own choices.

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Beneficence

The ethical principle to promote well-being and do good.

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Nonmaleficence

The ethical principle of doing no harm.

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Justice

The ethical principle of fairness and equitable treatment of all individuals.

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Deontological theory

An ethical theory that emphasizes moral duties and rules, regardless of the consequences.

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Consequentialist theory critiques

Criticisms of consequentialist theories, highlighting challenges in predicting future outcomes and measuring happiness/goodness objectively.

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Expressive moral response

A moral response that simply states a feeling about something without justification.

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Prereflective moral response

A moral response that cites legal, religious, or professional norms without critical reflection.

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Reflective moral response

A moral response that is justified using principles and values.

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Code of Ethics

A set of guidelines that outlines values, responsibilities, standards, and prohibited conduct for a profession.

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Metaethics

Branch of ethics that looks at deep philosophical questions about morality, defining terms, and asking 'what is meaning?'

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Normative ethics

Branch of ethics that focuses on forming and defending basic principles governing moral behavior.

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Descriptive ethics

Branch of ethics that describes what people do and why.

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Applied ethics

Branch of ethics that focuses on applying ethical theories to practical situations.

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Organizational ethics

Applied ethics/bioethics that focuses on the values, conflicts, and ethical decision-making within organizations.

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Clinical ethics

Ethics applied to patient care in clinical settings.

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Cultural humility

Lifelong process of self-reflection, learning, and recognizing the impact of power differentials.

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Relational ethics

A care ethic that focuses on respecting others through meaningful relationships.

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Moral Resilience

Maintaining integrity when facing moral challenges in healthcare, rather than trying to eliminate the challenges.

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Moral Suffering

Ethical conflicts, confusion, or uncertainty in healthcare leading to negative consequences.

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Confidentiality

Protecting private information during research.

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Vulnerable Groups

Groups needing extra care in research (e.g., children, elderly).

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Virtue Ethics

Ethical theory focusing on the character of the actor and the moral agent.

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Eudaimonia

The good life, flourishing.

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Phronesis

Practical wisdom or judgment.

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The Aristotelian Mean

Finding the balance between two extremes to achieve virtue.

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Compassion

Feeling or showing sympathy and concern for others.

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Discernment

Skillful judgment.

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Advocacy Dilemma

Conflict between protecting patients from unethical research practices and the researcher.

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Conflicting Values

Disagreements between different types of values (eg. societal, nursing, scientific.)

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Cultural Competence

Understanding and appropriately interacting with different cultures.

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Feminist Ethics of Care

An ethical approach emphasizing relationships, respect, and interconnectedness.

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Casuistry

Ethical reasoning method focusing on case studies to analyze specific dilemmas.

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Ethical Dilemma

A situation requiring a choice between conflicting values with uncertain consequences.

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Moral Distress

Negative feelings when knowing the right action but unable to do it due to constraints.

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Moral Agency

The capacity to make morally relevant decisions and act on them.

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Moral Courage

Steadfastness and determination in acting morally, even when facing opposition.

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Ethical Decision-Making Tools

Frameworks/models (e.g., IDEA, CAN) to aid in navigating ethical dilemmas.

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IDEA Framework

A common ethical decision-making framework in many fields today

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Unethical Laws

Laws conflicting with current moral standards (e.g., laws from the past, biased laws )

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Ethical Actions (Illegal)

Morally right actions that may be contrary to current law.

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Canadian Nursing Law

Regulations dictating practice standards and requirements for nurses in different provinces.

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Study Notes

  • Nurses navigate "in-between" spaces, balancing multiple stakeholder needs.
  • Nursing is a moral endeavor due to its patient-centered approach incorporating empathy, cultural sensitivity, integrity, safety, and advocacy.
  • Nurses face ethical dilemmas like respecting autonomy, maintaining confidentiality, and ensuring just resource allocation.

Analyzing Ethical Theories

  • Deontological: Actions are right based on duty adherence, regardless of consequences.
  • Consequentialist: Rightness/wrongness is determined by outcomes. (e.g., utilitarianism maximizes overall good.)
  • Critiques of Deontology: Difficulty defining duties, potential for conflicting duties, disregarding consequences.
  • Critiques of Consequentialism: Uncertainty about predicting outcomes, challenges measuring subjective "good."
  • Critiques of Both: Difficulty in applying theories to real-world dilemmas, lack of clear decision-making principles.

Moral Responses to Ethical Problems

  • Expressive: Stating feelings without justification.
  • Prereflective: Relying on norms (legal, religious, professional) without critical reflection.
  • Reflective: Justification based on critically reflected principles and values.

Codes of Ethics and Law

  • Code of Ethics Contents: Statement of values, responsibilities, professional standards, prohibited conduct, conflict resolution, reporting mechanisms, and consequences.
  • Codes and Law Relationship: Legal actions may not be ethical, and vice-versa. Nurses must understand legal boundaries of their roles and patient rights to avoid liability.

History of Bioethics

  • Important Events: Nuremberg Code, residential school nutrition studies, Tuskegee Syphilis study, Guatemala studies, radiation studies, development of REBs, Declaration of Helsinki, Belmont Report are pivotal events in bioethics history.
  • Fields of Ethics: Metaethics (meaning of moral terms), Normative (principles of moral behavior), Descriptive (factual observations of moral behaviors), and Applied (practical application of ethics to specific contexts).

Nursing Ethics

  • Nursing as a Moral Practice: Strives to maximize good (health, comfort, dignity) and minimize bad (suffering). Nurses are moral agents, ensuring integrity and ethical conduct when interacting with others.
  • Nursing Codes: Canadian Nurses Association (CNA) and Ordre des infirmières et infirmiers du Québec (OIIQ) codes provide guidance.

Organizational Ethics

  • Aspect of Applied Ethics: Organizations define core values, manage conflicts between values, and ensure actions reflect espoused values.
  • Issues: Resource allocation; business development; access to care (e.g., uninsured patients); treatment decisions; and disagreements.

Cultural Humility and Safety

  • Relational Ethics: Emphasizes respect and meeting individuals' needs.
  • Essential Nurse Qualities: Mindfulness, humility, open-mindedness, nonjudgmentalism, curiosity, self-reflection, understanding diverse views and cultures.
  • Cultural Humility: Lifelong learning, self-reflection, acknowledging power differentials; crucial for ethical practice with diverse patient populations.

Research Ethics

  • Nurses' Role in Research: Conflict among values of society (human rights), nursing (caring ethics), and science (scientific inquiry).
  • Ethical Issues in Research: Informed consent, beneficence/non-maleficence, anonymity/confidentiality, privacy, vulnerable populations, researcher skills, conflicts of interest.
  • Conflicts in Nurses: Beneficence-non-maleficence, advocacy challenges, vulnerability, research vs caring.
  • Addressing Conflicts: Nurses can advocate for ethical research practices and patient safety.

Ethical Theories

  • Virtue Ethics: Focuses on character traits (virtues and vices), aiming for the golden mean (ideal balance). Key virtues in healthcare include compassion, discernment, trustworthiness, integrity, and conscientiousness.
  • Utilitarianism: Emphasizes maximizing overall good for the greatest number of people. Act utilitarianism focuses on individual acts, while rule utilitarianism focuses on rules yielding maximum good.
  • Deontology: Emphasizes moral duty and principles (e.g., Kant's categorical imperative). Involves respecting human dignity and autonomy while following rules.
  • Principlism: Applies ethical principles (autonomy, beneficence, non-maleficence, justice) to guide decision-making.
  • Feminist Ethics and Ethics of Care: Focuses on relationships, narratives, and case studies, emphasizing responsiveness to individuals' needs.

Ethical Decision-Making

  • Ethical Dilemmas: Choosing among multiple alternatives with potential consequences, generating uncertainty about the best course of action.
  • Decision-Making Process: Determining the best alternative based on ethical community norms and moral values. Additional components include conflicting values/principles, compromised well-being, and communication difficulties.
  • Ethical Decision-Making Tools: IDEA framework, CNA guidelines, Storch model, community ethics toolkit.

Moral Suffering and Resilience

  • Moral Distress: Negative feelings when one knows the right course of action but cannot act due to constraints. Contrast with moral uncertainty where the correct course of action is unknown.
  • Moral Agency: Stronger framework for understanding nurses' moral role in clinical practice—a capacity to engage in deliberate, morally relevant actions.
  • Addressing Moral Distress: Recognition, reflection, reconnecting with purpose/intention, committing to well-being, supporting others, promoting ethical competence and speaking up.
  • Moral Courage and Resilience: Sustaining integrity through moral challenges.
  • Laws and Ethics: Laws can be unethical when rooted in outdated morals, clashing with moral beliefs, requiring unethical actions, or having unintended consequences. Also, ethical actions can be illegal (e.g., civil disobedience, conscientious objection).
  • Canadian Law's Impact: Governs licensure, scope of practice, patient privacy, informed consent, reporting obligations, cultural competence, medication administration, end-of-life care (e.g., MAID), and discrimination.
  • Legal Requirements and Documentation: Accurate, timely, truthful documentation, confidentiality, informed consent, standard of care.

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Description

This quiz explores the ethical and legal challenges faced by nurses in their practice. It covers the moral principles guiding nursing, including patient autonomy, confidentiality, and resource allocation. Additionally, it analyzes different ethical theories and their application in real-world nursing dilemmas.

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