Nursing and the Ethical Dimension of Practice

  • P. Anne ScottEmail author


Nurses are important to patients. Nurses touch people’s lives during some of the peaks and troughs of human existence. Therefore it is important that we think about nurses and nursing. What do our patients require from nurses and how do we, as a society, as nurses, and as health service leaders, meet patient need? The first step is to recognise that nursing, as a practice, has moral values at its core. The nurse-patient relationship, which is central to the provision of nursing care, has ethical importance and is of ethical significance. It is also vital to consider that the context within which nurses practice can shape and be shaped by the moral values of nursing. These moral values form what can be termed the ethical dimension of nursing. It is therefore important that we explore and examine these moral values. Codes of conduct are examples of the nursing profession’s collective attempt to express its underlying values. The institutions within which nurses work help or hinder the actual expression of these values in nursing practice and patient care. We need to recognise the interplay of these various factors in order to ensure that we as nurses, as potential patients, and as members of society understand what good nursing practice means, what it looks like in practice, and how it can be supported. This chapter sets out to identify the ethical domain of nursing practice, and signal its relevance for good nursing care and a safe, supportive patient experience. The chapters which follow provide theoretical and conceptual lenses through which to identify, analyse and discuss ethical issues in nursing practice, with a view to providing tools for the nurse to practice in an ethically sensitive and appropriate manner.


Ethical domain Nurse-patient relationship Nursing ethics Patient-centred care Codes of conduct 


  1. Ausserhofer D, Zander B, Busse, R, Schubert M, De Geest S, Rafferty A M, Ball J, Scott PA, Kinnunen J, Heinen M, Strømseng Sjetne I, Moreno-Casbas T, Kózka M, Lindqvist R, Diomidous M, Bruyneel L, Sermeus W, Aiken L, Schwendimann R (2014) Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf 2(23):126–135. Available online 11 Nov 2013. Accessed 30 July 2016.CrossRefGoogle Scholar
  2. Austin W (2012) Moral distress and the contemporary plight of health professionals. HEC Forum 24(1):27–38CrossRefGoogle Scholar
  3. Department of Health (DoH) (2016) Position paper one: values for nurses and midwives in Ireland. Accessed 30 July 2016.
  4. deRaeve L (2002) Trust and trustworthiness in the nurse-patient relationship. Nurs Philos 3(2):152–162CrossRefGoogle Scholar
  5. Edwards SD (2001) Philosophy of nursing: an introduction. Palgrave, Basingstoke, HampshireGoogle Scholar
  6. Francis R (2010) Independent inquiry into care provided by Mid Staffordshire NHS Foundation Trust January 2005 – March 2009. Vol 1. Chaired by Robert Francis QC. Stationary Office, LondonGoogle Scholar
  7. Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Chaired by Robert Francis QC. Stationary Office, LondonGoogle Scholar
  8. Health Education England (HEE) (2015) Raising the bar – shape of caring: a review of the future education and training of registered nurses and care assistants, Health Education England. Accessed 1 Oct 2016.
  9. HIQA Regulation Directorate (2015) Compliance monitoring inspection report designated centres under the Health Act 2007 as amended. Accessed 30 July 2016.
  10. Holm S (1997) Ethical problems in clinical practice: the ethical reasoning of health care professionals. Manchester University Press, ManchesterGoogle Scholar
  11. Institute of Medicine (IoM) (2011) The future of nursing: leading change, advancing health. Committee on the Robert Wood Johnson Foundation Initiative on the future of nursing at the Institute of Medicine. The National Academies Press, Washington, DCGoogle Scholar
  12. Levine M (1977) Nursing ethics and the ethical nurse. Am J Nurs 77(5):845–849PubMedGoogle Scholar
  13. Morse J (1991) Negotiating commitment and involvement in the nurse-patient relationship. J Adv Nurs 16:455–468CrossRefGoogle Scholar
  14. Niven CA, Scott PA (2003) The need for accurate perception and informed judgement in determining the appropriate use of the nursing resource: hearing the patient’s voice. Nurs Philos 4(3):201–210CrossRefGoogle Scholar
  15. Nortvedt P (2001) Clinical sensitivity: the inseparability of ethical perceptiveness and clinical knowledge. Sch Inq Nurs Pract 15(1):25–43PubMedGoogle Scholar
  16. Nursing and Midwifery Board of Ireland (2014) Code of professional practice and ethics for registered nurses and midwives. Nursing and Midwifery Board of Ireland, Blackrock, Dublin. Accessed 7 July 2016.
  17. Nursing and Midwifery Council (2015) The Code: professional standards of practice and behaviour for nurses and midwives. Nursing and Midwifery Council, Portland Place, London. Accessed 7 July 2016.
  18. Scott PA (2006) Perceiving the moral dimension of practice: insights from Murdoch, Vetlesen, and Aristotle. Nurs Philos 7:137–145CrossRefGoogle Scholar
  19. Scott PA (2014) Character and nursing. Guest editorial. Int J Nurs Stud 51(2):177–180CrossRefGoogle Scholar
  20. Scott PA, Treacy MP, MacNeela P, Hyde A, Morris R, Byrne A, Butler M, Drennan J, Henry P, Corbally, Irving K, Clinton G (2006) Report of a Delphi Study of Irish Nurses to articulate the core elements of nursing care in Ireland. Dublin City University, Dublin. ISBN 1872327605Google Scholar
  21. Scott PA, Matthews A, Kirwan MP (2014) What is nursing in the 21st century and what does the 21st century health service require from nurses? Nurs Philos 15:23–34CrossRefGoogle Scholar
  22. Sellman D (2011) What makes a good nurse: why the virtues are important for nurses. Jessica Kingsley Publishers, LondonGoogle Scholar
  23. Vale of Leven Hospital Inquiry Report (2014) Chaired by Rt Hon Lord MacLean. Published on behalf of the Vale of Leven Hospital Inquiry by APS Group Accessed 3 Aug 2016.

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.National University of Ireland, GalwayGalwayIreland

Personalised recommendations