Bioethics & Ethical Principles in Nursing - Concept Map
Bioethics in Nursing Practice
Related concepts
Core Ethical Principles
Sub concepts
- Autonomy (Self-determination)
- Beneficence (Do good)
- Non-maleficence (Do no harm)
- Justice (Fairness)
- Veracity (Truth-telling)
- Fidelity (Faithfulness)
Relationship to central
Foundation of all ethical decision-making in nursing
Ethical Frameworks & Theories
Sub concepts
- Deontology (Duty-based)
- Teleology/Utilitarianism (Consequence-based)
- Principlism (Four-principle framework)
- Double Effect Principle
Relationship to central
Philosophical approaches to resolving dilemmas
Informed Consent
Sub concepts
- Disclosure
- Comprehension
- Capacity/Competence
- Voluntariness
- Express Consent
- Implied Consent
- Emergency Doctrine
Relationship to central
Process operationalizing autonomy and veracity
Confidentiality & Privacy
Sub concepts
- Need-to-know basis sharing
- RA 10173 Data Privacy Act
- Legal exceptions to confidentiality
- Duty to warn vs. confidentiality
Relationship to central
Protects patient autonomy and trust
Patient Advocacy
Sub concepts
- Informing patients of rights
- Supporting patient decisions
- Protecting from unsafe practice
- Speaking up against unethical care
Relationship to central
Nurse's professional duty to protect patient interests
Ethical Dilemmas & Moral Distress
Sub concepts
- Ethical dilemma definition
- Moral distress definition
- Conflict between principles
- Structured resolution process
Relationship to central
Common challenges in clinical practice requiring resolution
Common Bioethical Issues
Sub concepts
- End-of-life care & DNR orders
- Reproductive & beginning-of-life ethics
- Truth-telling & cultural mediation
- Resource allocation & triage
- Whistleblowing
Relationship to central
Real-world applications of ethical principles
Cultural Context in Philippine Nursing
Sub concepts
- Family-centered decision-making
- Pakikisama (smooth relations)
- Utang na loob (gratitude debt)
- Deference to authority figures
- Respect for patient autonomy within culture
Relationship to central
Shapes how ethics are applied in Filipino healthcare
Professional & Legal Framework
Sub concepts
- RA 9173 (Nursing Practice Act)
- Code of Ethics for Nurses
- Professional accountability
- Scope of nursing practice
Relationship to central
Grounds ethical practice in nursing law
Concept connections
- AutonomyInformed ConsentAutonomy is operationalized through the informed consent process; consent requires respect for the patient's right to self-determination
- BeneficenceNon-maleficenceBoth are duty-based principles; beneficence promotes good while non-maleficence prevents harm; both guide clinical judgment
- VeracityInformed ConsentTruthful disclosure is essential to valid informed consent; without veracity, comprehension and voluntariness cannot be assured
- FidelityPatient AdvocacyFidelity (faithfulness and trust) is the foundation of the therapeutic relationship; it motivates advocacy for patient interests
- ConfidentialityRA 10173 Data Privacy ActRA 10173 legally codifies the nursing ethical duty of confidentiality; it establishes compliance requirements for health data protection
- JusticeResource AllocationJustice principles guide fair distribution of limited healthcare resources, especially critical in triage and disaster settings
- Ethical DilemmaStructured Decision-MakingWhen ethical principles conflict, a systematic assess-identify-explore-apply-act-evaluate process resolves dilemmas
- Moral DistressPatient AdvocacyMoral distress arises when institutional barriers prevent the nurse from acting ethically; advocacy and escalation resolve the constraint
- Double Effect PrincipleNon-maleficenceDouble effect justifies a foreseen harmful side effect when the primary intent is good and benefit outweighs harm; applied in palliative sedation
- End-of-Life EthicsAutonomyPatient autonomy (choice of DNR, palliative care, or full code) is central to ethical end-of-life decision-making
- DNR OrdersNon-maleficenceDNR respects the patient's refusal of potentially harmful or futile resuscitation; it prevents unnecessary suffering
- Family-Centered Decision-MakingCultural ContextFilipino culture emphasizes family involvement; ethical nursing balances family-centered practice with patient autonomy protection
- Pakikisama & Utang na LoobCultural ContextThese cultural values (smooth relations, gratitude debt) influence how Filipino patients and families engage with healthcare decisions
- RA 9173 Nursing Practice ActProfessional AccountabilityRA 9173 defines the scope of nursing practice and grounds professional accountability; violations are a breach of the nurse's legal duty
- Code of Ethics for NursesAll Ethical PrinciplesThe professional Code of Ethics incorporates all ethical principles; it serves as the standard for judging ethical conduct
- DeontologyNon-maleficenceDeontological ethics emphasizes duty; non-maleficence (do no harm) is a fundamental duty in nursing
- Teleology/UtilitarianismJusticeUtilitarian thinking seeks greatest good for greatest number; justice distributes benefits and burdens fairly to maximize overall good
- Consent for MinorsInformed ConsentParents/guardians provide consent for minors; however, adolescents' developing autonomy may be respected through assent
- Emergency DoctrineImplied ConsentWhen patient cannot consent and no surrogate is available, emergency doctrine permits life-saving treatment based on implied consent
- WhistleblowingPatient AdvocacyWhistleblowing is a form of advocacy; it protects patients from unsafe or unethical practice when internal reporting fails
- Duty to WarnConfidentialityDuty to warn identifiable third parties at serious risk can override confidentiality when the threat is imminent and specific
- Mandatory ReportingConfidentialityLegal duty to report abuse, communicable diseases overrides confidentiality; nurse must balance patient privacy with public safety
- Ethics CommitteeEthical DilemmaEthics committees provide structured consultation and deliberation for complex dilemmas; they support nurse decision-making
- Reproductive EthicsCultural ContextFilipino reproductive decisions are heavily influenced by religion and family values; nurses navigate ethical issues within this context
- Triage in DisasterJusticeFair allocation of scarce resources (beds, ventilators, personnel) during disasters is guided by justice principles and transparent criteria
Diagrams
Bioethics & Ethical Principles in Nursing - Concept Hierarchy
Comprehensive mind map showing the hierarchical relationships between bioethics, core principles, frameworks, informed consent, patient advocacy, ethical decision-making processes, common bioethical issues, confidentiality obligations, and cultural considerations in Philippine nursing practice.
Ethical Decision-Making Process in Nursing
Step-by-step flowchart depicting the structured approach to recognizing, analyzing, and resolving ethical dilemmas in nursing. Includes assessment, principle identification, options exploration, consultation with ethics committee when appropriate, implementation, and evaluation phases aligned with nursing practice standards.
Informed Consent Process - Components & Validity
Detailed flowchart outlining the informed consent process, emphasizing the four essential components (disclosure, comprehension, capacity, and voluntariness), the roles of physician and nurse, and the documentation requirements. Shows decision points for validity and remedial steps when consent is incomplete or questioned.
Distinguishing Ethical Dilemma from Moral Distress
Decision tree distinguishing between ethical dilemmas (conflict between two or more principles with no fully right answer) and moral distress (knowing the right action but being constrained from implementing it). Shows appropriate resolution pathways for each situation and how moral distress may require escalation and advocacy.
Confidentiality & Information Sharing in Philippine Healthcare
Comprehensive flowchart showing when patient information may be shared versus kept confidential, incorporating Philippine legal requirements (RA 10173 Data Privacy Act) and exceptions to confidentiality (mandatory reporting, duty to warn, court orders). Emphasizes the need-to-know basis principle and documentation requirements.
Patient Autonomy & Decision-Making Capacity States
State diagram illustrating the different states of patient decision-making capacity and the appropriate pathways for obtaining consent or surrogate decision-making. Shows how competent adults' autonomy is prioritized, the role of surrogate decision-makers for incapacitated individuals, and the nurse's advocacy role when patient and family wishes conflict.
End-of-Life Ethical Decisions - DNR, Withdrawal, & Palliative Care
Flowchart demonstrating the ethical framework for end-of-life decisions in nursing, including code status (full resuscitation vs. DNR), discussion of goals of care, palliative and hospice options, withdrawal of futile treatment, and the principle of double effect in palliative sedation. Emphasizes the legal status in the Philippines (active euthanasia is not legal) and the roles of patient, family, physician, and ethics committee.
Distribution of Ethical Principles in Common Nursing Dilemmas
Pie chart showing the relative frequency of ethical principle conflicts in typical clinical dilemmas encountered by Filipino nurses. Demonstrates that autonomy-beneficence conflicts are most common, followed by confidentiality-safety tensions and resource allocation justice issues. Useful for understanding which principles require greatest deliberative attention in NLE scenarios.
Nurse Advocacy & Whistleblowing When Care is Unsafe or Unethical
Comprehensive flowchart outlining the nurse's obligation to advocate for patient safety and ethical practice, including the escalation pathway from informal reporting to formal advocacy and whistleblowing. Aligned with RA 9173 and Philippine nursing Code of Ethics, emphasizing documentation at each step and protection against retaliation.