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The Concept of Ethics in Nursing

The Concept of Ethics in Nursing

Ethics is a Greek word, namely Ethos, which according to Araskar and David (1978) means habits or models of behavior, or expected standards and certain criteria for action, can be interpreted everything related to consideration of decision making , whether or not a deed is true or not. In the Oxford Advanced Learner’s Dictionary of Current English, US Hornby defines ethics as a system of moral principles or behavioral rules. According to the definition of AARN (1996), ethics focuses on what should be either wrong or right, or good or bad. Whereas according to Rowson, (1992). Text is all things related / reason about moral issues.

Moral is an activity / behavior that directs humans to choose good and bad actions, ethics can be said is a systematic awareness of behavior that can be accounted for (Degraf, 1988). Ethics is part of philosophy that relates to moral decisions concerning humans (Spike lee , 1994). According to Webster’s “the problem is good and bad moral duty and obligation, conceptual ethics offers tools to evaluate and guide moral decision making”.

Some definitions above can be concluded that ethics is moral and moral knowledge, life philosophy, moral strength, value system, agreement, and set of things that are required, prohibition for a group / society and not constitute law or law. And this confirms that moral is part of ethics, and ethics is the science of morals while morality is a unity of values ​​that humans use as the basis of their prilakun. So nursing ethics (nursing ethics) is a form of expression on how nurses should regulate themselves, and nursing ethics are regulated in the nursing code of ethics.

Moral concepts in nursing practice Nursing

practice according to Henderson in his book on nursing theory, namely everything that nurses do in dealing with nursing problems using scientific methods, when discussing nursing practice can not be separated from the phenomenon of nursing and the relationship between patients and nurses.

Nursing phenomenon is a deviation / non-fulfillment of basic human needs (bio, psycho, social and spiritual), starting from the individual level to reach the level of society which is also reflected in the level of functional organ systems to subcellular (Henderson, 1978, cf. Ann Mariner, 2003 ) Nursing care is a form of nursing practice, where nursing care is a process or series of nursing practice activities given to patients using nursing processes based on nursing standards, based on ethics and nursing etiquette (Kozier, 1991). Nursing care is intended to empower patients, (Orem, 1956, cf. Ann Mariner, 2003).

Nursing is a form of nursing care to individuals, families and communities based on science and art and has a relationship between nurses and patients as a professional relationship (Kozier, 1991). Professional relations in question is a therapeutic relationship between patient nurses based on trust, empathy, love, autonomy, and in the past there is a clear contract with the aim of helping patients in the healing process from illness (Kozier, 1991).

Moral principles in nursing practice

Respect for autonomy (facilitate autonomy)

A form of individual rights in regulating activities / behaviors and individual life goals. Freedom in choosing or accepting a responsibility for his own choice. The principle of autonomy confirms that a person has the freedom to determine his decision according to his own choice plan. Part of what is needed in the idea of ​​respect for someone, according to this principle, is to accept individual choices regardless of whether such choices are in their interests. (Curtin, 2002). The problem with the application of this principle is that there is a variation in the patient’s autonomy ability which is influenced by many things, such as the level of awareness, age, disease, hospital environment, economy, availability of information and others (Priharjo, 1995). Example: Freedom of patients to choose treatment and who has the right to treat it as desired.

Freedom (freedom)

Behavior without outside pressure, decide something without pressure or coercion from others (Facione et al, 1991). That anyone is free to make choices which in his view are the best.

Example: The client has the right to accept or reject the nursing care provided.

Truth (Veracity)

Do activities / actions in accordance with moral and ethical values ​​that are not contradictory (right, complete). The principle of honesty according to Veatch and Fry (1987) is defined as expressing the truth and not lying. An obligation to tell the truth or not to lie to others. Truth is fundamental in building trusting relationships with patients. Nurses often don’t tell the truth about patients who are seriously ill. But from the results of research on patients in terminal conditions explain that patients want to be informed about their conditions honestly (Veatch, 1978).

Example: The procedure for infusion must be carried out in accordance with the applicable SOP where the client is treated.

Justice (Justice) 

right of every person to be treated equally (facione et al, 1991). It is a moral principle to be fair to all individuals. This means that individuals get the same actions have relatively the same contribution for the good of one’s life. The principle of fairness according to beauchamp and childress is that they are equal money must be treated equally, while those who are not equal are treated unequally, according to their needs.

When a person has great health needs, according to this principle must also get large sources, for example: Nursing actions carried out by a nurse both in the ward and in the VIP room must be the same and in accordance with IFRS

Not Harmful (Nonmaleficence)

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Actions / behaviors that does not cause accidents or harm others (Aiken, 2003). Example: If there is a client treated with a decrease in consciousness, side drives must be installed.

Generosity (Beneficence)

Balancing things that are beneficial and detrimental / harmful to the actions taken. Do things that are good for others. Is the principle to do good and not harm other people / patients. This principle is often difficult to apply in nursing practice. Various actions carried out often have a detrimental effect on the patient, and there is no clear certainty whether the nurse is responsible for all the ways that benefit the patient. Example: Every nurse must be able to treat and treat clients properly and correctly.

Fidelity

Fulfill obligations and duties with full trust and responsibility, fulfill promises. Veatch and Fry define it as the responsibility to remain loyal to an agreement. Responsibility in the context of nurse-patient relationships includes the responsibility of keeping promises, maintaining confidence and paying attention / caring. Caring for patients is one of the principles of obedience. Care for patients is the most important component of nursing practice, especially in patients in terminal conditions (Fry, 1991). A nurse’s sense of care is manifested in giving nursing care with an individual approach, being kind, giving comfort and showing professional abilities

Example: If the nurse has promised to give an action, then it is not permissible to deny the promise.

Confidentiality

Protecting personal information, the principle that nurses value all information about patients and nurses realize that patients have privileges and all that relates to patient information is not to be disseminated inappropriately (Aiken, 2003). Example: Nurses may not share the client’s secrets with others, except with the permission of the client or with family permission for legal purposes.

Right

behaving in accordance with the agreement of law, regulations and morality, related to legal law (Webster’s, 1998). Example: The client has the right to know information about the disease and everything he needs to know

The rights of nurses, according to Claire and Fagin (1975), that nurses have the right:

  1. Obtain legal protection in carrying out tasks in accordance with his profession
  2. Develop yourself through competency skills in accordance with the educational background
  3. Refusing patient wishes that conflict with laws and regulations as well as standard and professional code of ethics
  4. Get complete information from patients or their families about health complaints and dissatisfaction with the services provided
  5. Obtain his knowledge based on the development of science and technology in the field of nursing / health continuously.
  6. Treated fairly and honestly both by service institutions and by patients
  7. Get guaranteed protection against work risks that can cause harm both physically and emotionally
  8. Included in the preparation and determination of health service policies.
  9. Privacy and the right to sue if his name is defiled by the patient and or his family and other health workers.
  10. Refusing to be transferred to another assignment, either through advice or written announcements because it is needed, to take actions that are contrary to professional standards or nursing codes of ethics or other statutory rules.
  11. Obtain decent rewards and rewards for professional services given based on agreements or conditions that apply in the relevant service institutions
  12. Obtain the opportunity to develop a career in accordance with the field of profession.

Nurse’s responsibilities / obligations

Besides some nurse rights that have been described above, in achieving the right balance of nurses, nurses must also have their obligations as a form of responsibility to recipients of nursing practice. (Claire and Fagin, 1975l, in Fundamental of nursing, Kozier 1991)

Obligations of nurses, as follows:

  1. Comply with all regulations of the institution concerned
  2. Providing services or nursing care in accordance with professional standards and their usefulness
  3. Respect for patient rights
  4. Refer patients to nurses or other health workers who have more competent skills or abilities, if the person concerned cannot overcome them.
  5. Provide opportunities for patients to connect with their families, as long as they do not conflict with existing professional regulations or standards.
  6. Provide opportunities for patients to carry out their worship in accordance with their respective religions and beliefs as long as they do not disturb other patients.
  7. Collaborate with medical personnel (doctors) or other health personnel in providing health and nursing services to patients
  8. Provide accurate information about nursing actions given to patients and / or their families according to their ability limits
  9. Documenting nursing care accurately and continuously
  10. Keep up with the development of science and technology in nursing or health continuously
  11. Conduct emergency services as humanitarian duties in accordance with the limits of their authority
  12. Keep everything you know about patients a secret, except when asked by the authorities.
  13. Meet things that have been agreed upon or agreements that have been made in advance of the institution where they work.

Patient rights

Besides some of the rights and obligations of nurses, nurses must also recognize patient rights as objects in nursing practice. As a basic right as a human being, the recipients of nursing care must also be protected by their rights, according to developments and demands in current nursing practice patients also ask to determine themselves and control their own bodies if they are sick; consent, confidentiality, and the patient’s right to refuse treatment are aspects of self-determination. These things need to be appreciated and cared for by the nursing profession in carrying out their obligations.

But on the other hand, an individual who experiences pain is often unable to express his rights, because he states that rights require good energy and self-awareness while in sick conditions a person experiences weakness or is bound by his illness and in this condition often individuals are not aware of their rights, this is where the role of seoran professional nurses is.

Therefore as professional nurses must analyze the rights of patients, according to Annas and Healy, 1974, the rights of patients are as follows:

1) Right to truth as a whole

2) The right to get privacy and dignity independently

3) The right to maintain self-determination in participating in decisions regarding a person’s health.

4) The right to obtain medical records, both during and after being treated at the hospital.

While the patient rights statement (Patient’s Bill of Right), published by “The American Hospital Association” 1973, covers several things, which are intended to provide an effort to increase the rights of patients treated and can explain to patients before patients are admitted.

The patient’s rights are as follows: the patient has the right:

1) Maintain and consider and get nursing care attentively

2) Obtain the latest information, complete diagnosis, treatment and rehabilitation program from the medical team, and information should be made for people which precisely represents the patient, because the patient has the right to know from the responsible and coordinate his nursing care.

3) Receive important information to give approval before starting a procedure or treatment except in an emergency, including several important things, namely; length of incompetence, other alternative actions and who will take action

4) Refuse treatment to the extent permitted by law and be informed about the consequences of the action.

5) Every action always takes into account their privacy including nursing care, medication, case discussions, examinations and actions, and is always kept confidential and carried out with care, anyone who is not directly involved in nursing care and treatment of patients must obtain permission from the patient.

6) Expect that all communication and records regarding nursing care and treatment must be treated confidentially.

7) Patients have the right to understand if a reference is needed to another place that is more complete and obtain complete information about the reasons for the referral, and the designated hospital can receive it.

8) Obtain information about the relationship of the Hospital with other agencies, such as education and / or other relevant agencies in connection with the care it receives, for example: the relationship between the individual who cared for him, the name of the nurse and so on.

9) Advisors / assistants are given if the Hospital submits to be involved or play a role in human experiments that influence care or treatment. The patient has the right to refuse to participate in the research / research project.

10) Expect sustainable care that is acceptable. Patients have the right to know more about the time the agreement with the doctor is available. The patient has the right to expect the Hospital to provide a mechanism so that he gets information from the doctor or staff delegated by the doctor about the patient’s subsequent health.

11) Knowing the rules and regulations of the hospital that he must follow as a patient

12) Knowing the rules and regulations of the Hospital that he must follow.

NURSING PRINCIPLES OF AUTONOMY, BENEFICENCE, JUSTICE, NON MALEFICENCE, MORAL RIGHT, COMMUNITY VALUES AND NORMS 

practice of nursing as a professional service is given based on science, using nursing methodology and based on the nursing code of ethics. The nursing code of ethics regulates the relationship between nurses and patients, nurses to officers, nurses to fellow health team members, nurses to the profession and nurses to the government, nation and homeland.

In essence nursing as a profession is always devoted to humanity, prioritizing the interests of the community above personal interests, the form of service is humanistic, uses a holistic approach, is carried out based on nursing knowledge and tips and uses a code of ethics as the main demand in carrying out nursing services. By understanding the ethical concept, each nurse will get direction in implementing nursing care which is his moral responsibility and will not make decisions carelessly.

The norms in health ethics are formed by the health professional group itself, which when collected (codified) is often referred to as a code of ethics. The nursing code of ethics is a comprehensive statement of the profession that provides guidance for its members in carrying out nursing practices, both relating to patients, the community, colleagues and themselves. In other words the notion of a nurse’s code of ethics is a public statement / belief that expresses moral concern, values ​​and goals of nursing, which aims to provide reasons for ethical decisions. The code of ethics is organized in moral values ​​which are central to ethical nursing practices, all leading to a professional relationship of nurses with clients and showing what nurses care about in that relationship.

These moral values ​​are: The principle of respect (respect) towards people, from the principle of appreciation arises the principle of autonomy relating to the rights of people. To choose for themselves, what according to their thinking is the best for themselves, then generosity (Beneficence ) is the principle of doing good and not harming / harming others. The Veracity principle is an obligation to tell the truth or not to lie to other people. The principle of confidentiality means that the nurse respects all information about the client to be a patient’s privilege and not to be disseminated inappropriately. Fidelity means that the nurse is obliged to be loyal to the agreements and responsibilities that have been made, including keeping promises, keeping secrets and “Carring”. The principle of Justice (justice), is a moral principle to be fair to all individuals.

All moral values ​​are always and must be carried out in every implementation of nursing practice and while interacting with patients and other health workers. This condition often creates conflict of ethical dilemmas. Then the resolution of the ethical dilemma must be in a wise and mutually satisfying manner both nursing care providers (nurses), patients and other professions (colleagues)

Objectives 

purpose of writing this paper is to fulfill the tasks of the basic concepts of nursing and to further understand about ethical principles in nursing.

 

THEORETICAL REVIEW

Definition 

Ethics is a word originating from Greece, namely Ethos, which according to Araskar and David (1978) means habits or models of behavior, or expected standards and certain criteria for something action, can be interpreted everything related to the consideration of making decision, correct or not an action. In the Oxford Advanced Learner’s Dictionary of Current English, US Hornby defines ethics as a system of moral principles or behavioral rules. According to the definition of AARN (1996), ethics focuses on what should be either wrong or right, or good or bad. Whereas according to Rowson, (1992). Text is everything related / reason about moral issues.

Moral is an activity / behavior that directs humans to choose good and bad actions, ethics can be said is a systematic awareness of behavior that can be justified (Degraf, 1988). Ethics is part of a philosophy that relates to moral decisions concerning humans (Spike Lee, 1994). According to Webster’s “duty and obligation” and “moral duty and obligation”, conceptual tools to evaluate and guide moral decision making “

Some definitions above can be concluded that ethics is moral and moral knowledge, philosophy of life, moral strength, value system, agreement, and set of things that are required, prohibition for a group / community and not a law or law. And this confirms that moral is part of ethics, and ethics is the science of morals while morality is a unity of values ​​that humans use as the basis of their treatment

. So nursing ethics (nursing ethics) is a form of expression on how nurses should regulate themselves, and nursing ethics are regulated in the nursing code of ethics.

  1. Nursing Ethics

Code Professional ethics is a comprehensive statement of the forms of duties and services of the profession that provide guidance for members in carrying out their practice in the field of their profession, both relating to patients, families, communities and peers, professions and themselves. While the nursing code of ethics is a list of behaviors or forms of guidelines / ethical guidelines for professional nursing behavior (Aiken, 2003). with the main purpose of the nursing code of ethics is to provide protection for the perpetrators and recipients of nursing practice.

The professional code of ethics is compiled and endorsed by his own professional organization which will foster members of his profession both nationally and internationally. (Fortune, 2005). The concept of ethics which is a guide to the profession is the responsibility of the members to implement it. Nursing profession as one professional profession and has moral values ​​/ principles in carrying out its practice, a code of ethics is very necessary. Nurses as members of the nursing profession should be able to run the nursing code of ethics that has been made as well as possible while remaining firm and always based on their professional moral values ​​(Misparsih, 2005).

Nursing ethics gives decisions about actions that are expected to be truly appropriate or moral. Nursing ethics as a guide fosters responsibility or obligation for its members about the rights expected by others. Professional members have special knowledge or skills that are used to make decisions that affect others (Samporno, 2005).

The ethics of the nursing profession is a practice discipline and as its implementation is realized in the care of nursing practice. Nurses must get used to fully applying the existing code of ethics as an illustration of their responsibilities in nursing practice (Priharjo, 1995).

 

  1. Objectives and Functions of Nursing Ethics

In general according to Kozier (1992). It is said that the purpose of the nursing profession’s code of ethics is to improve nursing practice with morale and quality and describe responsibility, accountability and prepare instructions for its members. The ethics of the nursing profession is a tool for measuring moral behavior in nursing. In compiling this measuring device the decision is taken based on a code of ethics as a standard that measures and evaluates the moral behavior of nurses (Suhaemi, 2002). The use of a nursing code of ethics, nursing professional organizations can lay the nurse’s framework of thinking to make decisions and be responsible to the community members of other health teams and to the profession.

The main objectives of the ethical formulation as outlined in the nursing code of ethics are nurse ethical standards, namely: a.

Explain and apply responsibilities to patients, institutions and society

  1. Help staff / nurses in determining what to do in the face of ethical dilemmas in nursing practice .

  2. Provide opportunities for the nursing profession to maintain the reputation or name and function of the nursing profession.

  3. Reflect / imagine the moral expectations of the community.

  4. Is the basis for maintaining behavior and integration.

In accordance with the above objectives, nurses are given the opportunity to be able to develop professional ethics continuously in order to accommodate new desires and problems and be able to reduce the ethics of the nursing profession to young nurses. Besides this purpose, it is important to lay the foundation of nursing philosophy so that each nurse can understand and enjoy his profession.

According to the American Ethics Commission Bureau on Teaching, the goal of nursing ethics is to be able to:

  1. Get to know and identify moral elements in nursing practice

  2. Establish strategies / ways and analyze moral problems that occur in nursing practice

  3. Connect moral principles / lessons that are good and can be accountable to oneself, family, society, and to the Almighty God .

Some of the goals and functions of the nursing ethics code above can be concluded that the function of the nursing code of ethics is:

1) Providing guidance on decision making about nursing ethical issues.

2) Can connect with values ​​that can be applied and considered

3) Is a way of self-evaluation of the nurse profession

4) Become the basis for initiating peer feedback

5) Inform prospective nurses about the values ​​and standards of the nursing profession

6) Inform other professions and the community about the value moral.

While the nursing code of ethics in Indonesia issued by professional organizations (PPNI) has been regulated by five ethical principles, namely: the relationship of nurses and patients, nurses and practice, nurses and the community, nurses and colleagues, nurses and the profession. The five principles of nursing ethics are a form of code of ethics that has become a guideline for all Indonesian nurses to carry out their profession

  1. Moral concepts in nursing practice Nursing

practice according to Henderson in his book on nursing theory, namely everything a nurse does in dealing with nursing problems using scientific method, when discussing the practice of nursing can not be separated from the phenomenon of nursing and the relationship between patients and nurses.

Nursing phenomenon is a deviation / non-fulfillment of basic human needs (bio, psycho, social and spiritual), starting from the individual level to reach the level of society which is also reflected in the level of functional organ systems to subcellular (Henderson, 1978, cf. Ann Mariner, 2003 ) Nursing care is a form of nursing practice, where nursing care is a process or series of nursing practice activities given to patients using nursing processes based on nursing standards, based on ethics and nursing etiquette (Kozier, 1991). Nursing care is intended to empower patients, (Orem, 1956, cf. Ann Mariner, 2003).

Nursing is a form of nursing care to individuals, families and communities based on science and art and has a relationship between nurses and patients as a professional relationship (Kozier, 1991). Professional relations in question is a therapeutic relationship between patient nurses based on trust, empathy, love, autonomy, and in the past there is a clear contract with the aim of helping patients in the healing process from illness (Kozier, 1991).

  1. Moral principles in nursing practice

  2. Respect for autonomy (facilitate autonomy)

A form of individual rights in regulating activities / behaviors and individual life goals. Freedom in choosing or accepting a responsibility for his own choice. The principle of autonomy confirms that a person has the freedom to determine his decision according to his own choice plan. Part of what is needed in the idea of ​​respect for someone, according to this principle, is to accept individual choices regardless of whether such choices are in their interests. (Curtin, 2002). The problem with the application of this principle is that there is a variation in the patient’s autonomy ability which is influenced by many things, such as the level of awareness, age, disease, hospital environment, economy, availability of information and others (Priharjo, 1995). Example: Freedom of patients to choose treatment and who has the right to treat it as desired

  1. Freedom (freedom)

Behavior without outside pressure, decide something without pressure or coercion from others (Facione et al, 1991). That anyone is free to make choices which in his view are the best.

Example: The client has the right to accept or reject the nursing care provided.

  1. Truth (Veracity) à truth

Conduct activities / actions in accordance with moral and ethical values ​​that are not contradictory (right, complete). The principle of honesty according to Veatch and Fry (1987) is defined as expressing the truth and not lying. An obligation to tell the truth or not to lie to others. Truth is fundamental in building trusting relationships with patients. Nurses often don’t tell the truth about patients who are seriously ill. But from the results of research on patients in terminal conditions explain that patients want to be informed about their conditions honestly (Veatch, 1978).

Example: The procedure for infusion must be carried out in accordance with the applicable SOP where the client is treated.

  1. Justice (Justice)

right of every person to be treated equally (facione et al, 1991). It is a moral principle to be fair to all individuals. This means that individuals get the same actions have relatively the same contribution for the good of one’s life. The principle of fairness according to beauchamp and childress is that they are equal money must be treated equally, while those who are not equal are treated unequally, according to their needs.

When a person has great health needs, then according to this principle must also get great resources, for example: Nursing actions carried out by a nurse both in the ward and in the VIP room must be the same and in accordance with IFRSs

  1. No Harm (Nonmaleficence)

Action / behavior that does not cause accidents or harm others (Aiken, 2003). Example: If a client is treated with a decrease in consciousness, side drill must be installed.

  1. Generosity (Beneficence)

Balancing things that are beneficial and detrimental / harmful from the actions taken. Do things that are good for others. Is the principle to do good and not harm other people / patients. This principle is often difficult to apply in nursing practice. Various actions carried out often have a detrimental effect on the patient, and there is no clear certainty whether the nurse is responsible for all ways that benefit the patient.

Example: Every nurse must be able to treat and treat clients properly and correctly.

 

  1. Fidelity

Fulfill obligations and duties with full trust and responsibility, fulfill promises. Veatch and Fry define it as a responsibility to remain loyal to an agreement. Responsibility in the context of nurse-patient relationships includes the responsibility of keeping promises, maintaining confidence and paying attention / caring. Caring for patients is one of the principles of obedience. Care for patients is the most important component of nursing practice, especially in patients in terminal conditions (Fry, 1991). A nurse’s sense of care is manifested in giving nursing care with an individual approach, being kind, giving comfort and showing professional abilities.

Example: When caring has promised to give an action, then it is not permissible to deny the promise.

  1. Confidentiality

Protecting personal information, the principle that nurses value all information about patients and nurses realize that patients have special rights and all that relates to patient information is not to be disseminated inappropriately (Aiken, 2003). Example: Nurses may not share the client’s secrets with others, except with the permission of the client or with family permission for legal purposes.

 

  1. Right to

behave in accordance with legal agreements, regulations and morality, related to legal law (Webster’s, 1998). Example: The client has the right to know information about the disease and everything he needs to know.

Professional values ​​that must be applied by nurses

1.JUSTICE (Justice): Maintain ethical and legal principles, attitudes that can be seen from Justice, are: Courage (courage, Integrity, Morality, Objectivity), and some activities that relating to justice nurses: Acting as a client defender, Allocating resources fairly, Reporting actions that are incompetent, unethical, and not legally objective and based on facts.

  1. TRUTH (truth): Conformity with facts and reality, attitudes related to nurses that can be seen, namely: Acontability, Honesty, Rationality, Inquisitiveness, activities related to this attitude are: Documenting nursing care accurately and honest, get complete data before making a decision, participate in professional efforts to protect the public from misinformation about nursing care.

3.AESTHETICS: The quality of objects, events, people that lead to the gratification of behavior / attitudes shown by Appreciation, Creativity, Imagination, Sensitivity, nurse activities related to aesthetics: Provide a pleasant environment for clients, Create a pleasant work environment for self and others, self-appearance that can improve the “image” of a positive nurse

  1. ALTRUISM: Care for the welfare of others (sincerity) with the attitude shown, namely: Caring, Commitment, Compassion (love), Generosity (generous), Perseverance (perseverance, patience), nurse activities related to Altruism: Giving full attention to caring for clients, Helping other people / nurses in providing nursing care if they cannot, Show concern for social issues and trends that affect care health.

5.QUALITY: Has the same rights and status a, attitudes that can be shown by nurses, namely: Acceptance, Fairness, Tolerance, Assertiveness, nurse activities related to equality: Providing nursing care based on client needs, without discriminating clients, Interacting with energy health / colleagues in a non-discriminatory manner

6. FREEDOM (Freedom): Capacity to make choices, attitudes that can be shown by nurses, namely: Confidence, Hope, Independence, Openness, Self direction, Self Discipline, activities related to Freedom: Respect the right of the client to refuse therapy, Support the right of peers to advise on improving nursing care plans, Support open discussion if there are controversial issues related to the nursing profession

  1. HUMAN DIGNITY (Respect for human dignity):respect human dignity and the uniqueness of human dignity and individual uniqueness, attitude which can be shown by nurses, namely: Empathy, Kindness, Respect full, Trust, Consideration, activities related to attitudes Human dignity: Protecting the right of individuals to privacy, Greeting / treating others in accordance with their wishes to be treated, Maintaining the confidentiality of clients and peers
  2. Conclusion

Nursing as a profession is responsible and accountable for services / nursing care provided. Therefore the provision of nursing services / care must be based on the legal foundation and nursing ethics. Nursing care standards in Indonesia are very necessary to carry out nursing practice, while nursing ethics are regulated by professional organizations, only the code of ethics that is made is still difficult to implement in the field because the existing code of ethics has not been elaborated in detail and in the form of technical instructions.

Ethics is a systematic awareness of behavior that can be accounted for, ethics talk about the right thing and the wrong thing and in ethics there are moral values ​​that are the basis of human behavior (intention). Moral principles have been described in many theories including how moral values ​​in the nursing profession. The application of professional moral values ​​is very important and something that should not be negotiated and must be implemented in nursing practice.

Every human being has basic rights and rights to develop, so also for patients as recipients of nursing care have the same rights even though they are in a state of illness. Likewise nurses as providers of nursing care have the rights and obligations of each. Both have rights and obligations according to their position. This is where ethical dilemmas often occur, ethical dilemmas are a form of conflict that occurs due to several factors, both internal and external factors, besides that because of the interaction or relationship that requires each other. Therefore ethical dilemmas must be resolved at the individual and institutional and professional organization levels with full responsibility and completeness.

 

  1. Suggestion

  2. The importance of making standards of nursing practice clear and accountable.

  3. The need for regulations or legislation that regulates and as a form of legal protection for providers and recipients of nursing practices

  4. The existing code of ethics in Indonesia needs to be supported by the existence of clear rules of regulation so that they can be implemented properly in the field.

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