Professional Ethics
What this domain tests
Professional Ethics tests ethical principles, informed consent, capacity, confidentiality, advocacy, and resolution of ethical dilemmas.
Core rules
- Autonomy respects a competent patient's choice; beneficence acts for the patient's good; nonmaleficence avoids harm; justice distributes fairly; veracity requires truthfulness; fidelity requires keeping promises.
- Paternalism overrides autonomy and must be justified only when the patient lacks capacity or poses a serious danger.
- Informed consent requires capacity, disclosure of risks, benefits, and alternatives, understanding, and voluntariness. The provider obtains consent; the nurse witnesses and advocates.
- Confidentiality can be breached only when required by law or to prevent serious harm, such as duty to warn.
- An ethical dilemma has no single right answer; use the facts, stakeholders, options, and principles, then act and review.
Worked example
A competent adult Jehovah's Witness refuses a blood transfusion after hemorrhage. What should the nurse do? Reasoning: autonomy governs. Confirm capacity and that the refusal is informed and documented, explore alternatives such as blood conservation, and ensure the team respects the decision. Do not obtain family consent to override the patient. Escalate only if capacity is genuinely in doubt.
Traps
- Allowing family to consent for a competent adult.
- Confusing ethics with law; something can be legal but unethical.
- Promising confidentiality absolutely when reporting duties exist.
- Confusing beneficence with doing what the clinician prefers.