Ethical Practice

The Beautiful, Messy Science of Doing What’s Right: Bioethics in Nursing

If you think physiology is complicated, just wait until you have to deal with a human being's choices.

If I drop an apple, gravity dictates that it falls. It behaves the same way every single time. But what happens when a patient collapses, and they have explicitly refused the only medical intervention that can save their life? The neat, mathematical equations of medicine suddenly fall apart. We have officially left the realm of hard science and entered the fascinating world of bioethics.

Unlike the predictable, mathematical laws of physics governing a falling object, bioethics must navigate the unpredictable complexities of human choice.
Unlike the predictable, mathematical laws of physics governing a falling object, bioethics must navigate the unpredictable complexities of human choice.

Bioethics is the application of ethical principles to healthcare and biological sciences. Unlike calculating a medication dosage, bioethics doesn't always have a neat, objective answer. It requires us to understand the deep, internal drivers of human behavior. To start, we must recognize two foundational pieces of human psychology:

  • Values are personal beliefs influencing an individual's behavior and decisions. Think of values as the unique lenses through which your patient views the world.
  • Morals are personal standards of right and wrong behavior. If values are the lens, morals are the internal compass guiding what a person feels they ought to do.

Models of moral development, such as Kohlberg's, illustrate how an individual's internal compass for ethical decision-making matures over time.
Models of moral development, such as Kohlberg's, illustrate how an individual's internal compass for ethical decision-making matures over time.

As nurses, we step into our patients' lives when they are at their most vulnerable. To navigate this, we rely on a specific set of "laws of motion"—the core principles of ethical practice. Let's break them down.