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Ethical Decisions In Nursing Practice

Ethical decisions are defined as a complex state that represents two conflicting mental resolutions. However, a choice has to be made out of the options available. The decision to choose one issue from the other available choices in a particular situation may result in indiscretion, resulting in dire consequences (Gordon, 2016). s. Ethical decisions ensue in everyday life, and individuals are obligated to make choices irrespective of the outcome. A crucial factor that affects our choices when faced with an ethical decision in nursing is our behaviour toward others, our everyday relations, our decisions, and several other areas of our individual values. The individual values of a person are important to them and have a lasting effect. Personal values develop as one grows up, and they have a great influence on an individual’s attitudes and behaviour. They form the elementary guidelines that an individual makes reference to when confronted with an ethical decision. They reflect on what a person considers right or wrong.

The issue of ethical decisions in nursing has been discussed by various theories, but in this paper, the deontological theory is the focus. It is the theory that was introduced by a philosopher by the name Immanuel Kant; hence, it is sometimes referred to as Kantian theory(Gordon, 2016). The theory puts forward that ethics is an action that is considered to be morally good simply because of some behaviours of the action but not the results of the action. The theory hold that, some actions are morally obligatory regardless of their significances for human welfare the explanations of such ethics are such expressions as the “duty for duty sake” the issue of virtue is the only reward and justice should be done.

Deontological ethics is a decision-making model that lays emphasis on the rightness or wrongness of activities themselves as opposed to the consequences of the actions. This theory stresses the devotion to duty as the prime degree of moral virtue. The code of respect is profoundly embedded in this model and indicates the impression that respect for another comprises respect for autonomous choices (Gordon, 2016). The use of this model to analyse the nurse’s case will suggest that breaking the confidentiality of the client’s information is morally wrong. This is because, first, it would not have obeyed the duty at work to respect patient confidentiality at the workplace. In addition, disclosing the information will show disrespect to the nurse’s autonomy.

Sometimes, ethical decisions are prone to arise in professional endeavours. We may be faced with choices as to whether to follow our own values or respect and follow the ethics and rules of the organizations where we are employed, which might be conflicting with our personal ethics and beliefs. For example, many psychologists have ranked the subject of breaking confidentiality as a common ethical disturbing incident that they face many times (Pope & Vasquez, 2016). The law says that it is not wrong to break confidentiality in situations where the client or any other affected parties are in danger; nevertheless, the American Psychological Association stresses the significance of keeping clients’ information confidential (Knapps et al.,2015). Hence, once psychologists are faced with this kind of incident, they rely on their personal values in order to make a decision. While making an ethical decision, one needs to bear in mind the well-being of the client and other people, be truthful, and deal fairly with the client.

When faced with an ethical dilemma in nursing, it is of paramount importance to consider the various dimensions that the client has and the fact that the choice made will touch all these parts of the client’s life. When faced with choices regarding the mental well-being of a client and the guidelines provided in the business where one is working, which are not enough to guide in making a convincing decision, it is vital to turn to decision-making models. Have been presented with an ethical dilemma concerning the information gathered while working in the office of a primary care medical facility.

The theory of Deontology is the obligation of duty, where the molarity of acts relies on their nature. Engaging in harmful actions is not accepted, irrespective of the consequences. The decision made by an individual might be appropriate at a personal level, but it does not necessarily result in good outcomes for other people. For instance, the doctor-patient association or interaction is by nature. Medical practices involve traditions, and when deontological phenomena are applied, the issue of medical negligence arises. According to tradition, doctors are supposed to do their patients well. Goodness tries to strengthen the bond between the doctor and the patient.

Confidentiality in clinical practice is an essential code for obtaining the anticipated therapeutic effect. Therapy is a concerted process where the client and the psychotherapist need to build trust, hence the need for confidentiality of information (Pope & Vasquez, 2016). The psychologist has a major obligation to safeguard the information obtained during therapy and take the essential measures to protect the patient’s information. Many other associations approve of these, while others argue that in some circumstances, the confidentiality code is not pertinent. For example, the American Counseling Association recommends three circumstances where defiance of confidentiality is necessary. It advocates that in situations where a child is involved, when legal necessities force us, or when there is an instant danger toward the client or other stakeholders, we should contemplate breaking confidentiality (Domenech et al., 2014). Despite the presence of ethical guidelines that advise as conditions when breaking of confidentiality is suitable, it is up to personal values and ethics where decisions come from.

In many cases, for instance, the doctor has been prescribed antipsychotic medication for the control of schizophrenia. Although the duty to respect patient confidentiality in the workplace, he fears the potential harm such a person could cause in a position of authority over patients (Pope & Vasquez, 2016). The choice he is experiencing is whether he should keep the confidentiality of the information the doctor gathered about the patient. The motive for thinking about breaching confidentiality is that if people do not know the doctor’s psychological status, and he has a psychotic break or experiences side effects from the antipsychotic medications, there is a chance of harming the patient who is under his care.

In this case, the doctor is faced with numerous questions. Should he break the patient’s confidentiality and let the hospital and other people know about his schizophrenic and antipsychotic medications? What if the doctor harms or even kills the patient? According to the ethics guidelines, disclosing the information, hence breaking confidentiality, is appropriate since there are patients involved. However, on the other hand, the doctor is posed with the challenge of determining what kind of harm he will cause to the patient if he breaks confidentiality. The doctor found himself thinking, will the hospital and the people support the patient? Will the doctor lose his healing license? Therefore, there is a need to find a balance between protecting the confidentiality of the doctor and protecting the patient.

The deontological theory tries to explain how doctors are supposed to adopt the issue of making appropriate decisions in their various workplaces. The deontological outlines three major guidelines that should be followed in making the right decision at various workplaces. The principles include: First, Doctors should be autonomous (Pope & Vasquez, 2016). Through this principle, doctors have the freedom to make decisions. This implies that they should be free to make choices based on their subjective concerns about what they desire and fear by considering the negative repercussions or other relevant decision-making influences. Secondly, nurses should be categorically imperative. They should believe that ethical decisions are universal. It should applied consistently all over the time, societal norms, and even the cultures. Finally, ethical consideration involves duty, respect for others and intention. The duty involves an individual who does the right thing, and intention implies continuing to behave and do right and keeping dignity and respect for other people(Gordon, 2016).

When faced with this kind of ethical decision, it is essential to employ a decision-making model to guide the decision-making process, hence avoiding confusion and anxiety (Gordon, 2016). During the ethical decision-making, the doctor will try to evaluate this case using the recommendations of deontologists like Immanuel Kant to pass the right ethical judgment in order to avoid making unwanted mistakes that might affect clients negatively and interfere with their lives. On the same note, integrity plays a very important role in ethical decision-making because integrity makes the decision-maker feel autonomous. If denied the opportunity due to external pressures, the decision maker might make an unethical decision.


Pope, S., & Vasquez, M. J. (2016). Ethics in psychotherapy and counseling: A practical guide. John Wiley and Sons.

Domenech Rodriguez, M. M., Erickson Cornish, J. A., Thomas, J. T., Forrest, L., Anderson, A., & Bow, J. N. (2014). Ethics education in professional psychology: A survey of American Psychological Association accredited programs.

Knapps, S. J., Gottlieb, M. C.,& Handelsman. M. M. (2015). Ethical dilemmas in psychotherapy: positive approaches to decision making. American Psychological Association.

Gordon, J. S. (2016). Clinical ethics consultation: theories and methods, implementation, evaluation. Routledge.



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