Nursing Ethics
Nursing Ethics tests the four principles plus the professional virtues that shape bedside decisions: autonomy, beneficence, nonmaleficence, justice, veracity, fidelity and advocacy. Iranian items frequently place these principles inside an Islamic and family-centred cultural context, where the patient's wish still prevails over family preference.
Core principles in practice
Autonomy requires voluntary, informed choice by a competent patient. Beneficence means acting for the patient's good; nonmaleficence means avoiding harm, and the two are not interchangeable in option lists. Justice governs fair allocation of scarce beds, blood or organs. Veracity obliges truthful disclosure; fidelity obliges keeping promises and maintaining confidentiality.
Consent and confidentiality
Valid consent needs competence, disclosure, comprehension and voluntariness. Minors and patients lacking capacity require a legal guardian, except in emergencies where life-saving treatment proceeds. Confidentiality may be breached only for legally defined reasons: mandatory disease reporting, a serious threat to an identifiable third party, or suspected child abuse.
Worked example
A competent adult with a gangrenous foot refuses amputation after a full explanation. Reasoning: respect autonomy. Confirm understanding, explore the reasons, offer a second opinion, involve the family only with the patient's permission, and document the informed refusal. Operating without consent would be battery, even with good intentions.
Traps that cost marks
- Confusing beneficence with nonmaleficence.
- Disclosing a diagnosis to relatives before the patient has consented.
- Treating a competent refusal as depression or incompetence.