Ethical Behavior in Healthcare
The first IPEC competency relates to the values and ethics required for interprofessional practice. The competency states a healthcare professional must, “Work with individuals of other professions to maintain a climate of mutual respect and shared values.”[1] This chapter will define morals, values, and ethics and how they must be identified for patient-centered care.
Morals
Morals are the prevailing standards of behavior of a society that enable people to live cooperatively in groups. “Moral” refers to what societies sanction as right and acceptable. Most people tend to act morally and follow societal guidelines, and most laws are based on the morals of a society. Morality often requires that people sacrifice their own short-term interests for the benefit of society. People or entities that are indifferent to right and wrong are considered “amoral,” while those who do evil acts are considered “immoral.”[2]
Values
Values are individual beliefs that motivate people to act one way or another and serve as guides for behavior considered “right” and “wrong.” People tend to adopt the values with which they were raised and believe those values are “right” because they are the values of their culture. Some personal values are considered sacred and moral imperatives based on an individual’s religious beliefs.[3] See Figure 6.1 for an image depicting choosing right from wrong actions.
In addition to personal values, organizations also establish values. The American Nurses Association (ANA) Professional Nursing Model states that nursing is based on values such as caring, compassion, presence, trustworthiness, diversity, acceptance, and accountability.
The National League of Nursing (NLN) has also established four core values for nursing education: caring, integrity, diversity, and excellence[4]:
- Caring: Promoting health, healing, and hope in response to the human condition.
- Integrity: Respecting the dignity and moral wholeness of every person without conditions or limitations.
- Diversity: Affirming the uniqueness of and differences among persons, ideas, values, and ethnicities.
- Excellence: Cocreating and implementing transformative strategies with daring ingenuity.
The following video from the McCombs School of Business defines values. (1:46)
Ethics
Ethics can refer to rules or guidelines that establish what conduct is right and wrong for individuals and for groups. For example, codes of conduct express relevant ethical standards for professionals in many fields, such as medicine, law, journalism, and accounting. Patient-centered care would be considered an ethical standard required for healthcare.
Some philosophers make a distinction between ethics and morals. But many people use the terms ethics and morals interchangeably when talking about personal beliefs, actions, or principles. For example, it’s common to say, “My ethics prevent me from cheating.” It’s also common to use morals in this sentence instead (Ethics Unwrapped).
So, whether we use the term ethics to refer to personal beliefs, or rules of conduct, or the study of moral philosophy, ethics provides a framework for understanding and interpreting right and wrong in society.
Healthcare Ethical Standards
To avoid confusion about expected moral behavior, each healthcare institution creates moral and ethical standards that they expect every employee to abide by. These standards are often referred to as the “Vision, Mission, and Values” or philosophy statement. The vision statement offers inspiration by describing the organization’s goals and aspirations for the future. The mission statement focuses on the present and defines how the organization will achieve its goals. The values statement of the organization defines the organization’s core principles and ethics, and how people are expected to behave. It provides moral direction for decision making and a standard for assessing actions.
In a healthcare setting, the Vision, Mission, and Values apply to all employees. Everyone, regardless of position within healthcare, is expected to share the hospital vision, mission, and values. It is important to identify one’s personal vision, mission, and values before agreeing to employment at a healthcare facility.
Vision Statement
A vision statement should inspire and describe future goals and aspirations. The statement should define a future state of achievement over time, possibly the next five or ten years. When developing a vision statement, one should evaluate why they are choosing to work in healthcare, a career that requires helping others. An example of a vision statement created by a surgical technologist may be, “To live in a community where everyone is happy and healthy”, or “To help create a better, healthier world.”
Mission Statement
A mission statement should describe how one would achieve their vision. The mission statement is concerned with the present state and should answer the questions, “What do I do to work towards my vision?” The mission statement should be in the present tense, leading to the future. An example of a mission statement for a certified nursing assistant may be “To help nurses offer the best possible care to every patient.”
Values Statement
Values are the characteristics that define ethical behavior. Most value statements include a list of characteristics that guide decision making and moral behavior. Each person will have a unique set of values that are most important to them. A surgeon may list the following values statement, “To offer professionalism, excellence, and innovation.” While a patient care technician may list the following value statement, “To always offer empathy, respect, and accountability”. Although both value statements are quite different, all characteristics would guide a patient-centered philosophy.
Healthcare Philosophy
The vision, mission, and value statement will help create a healthcare philosophy that will guide ethical decision making in healthcare. In healthcare, employee’s are often alone while caring for patients. Due to frequent decision making and critical thinking, it is crucial all healthcare workers understand the required values necessary for patient-centered care.
Case Study
A patient care technician (PCT) is working at a hospital on a pediatric floor. The PCT was asked to change a surgical dressing on a young patient. As the PCT is preparing the new dressing, it falls to the floor. The PCT has dropped an item in the past and was yelled at for costing the hospital money. The ethical decision is this: Should the PCT admit to the error, and request new sterile supplies, or should the PCT use the contaminated dressing that was dropped on the floor to save money and avoid embarrassment?
The answer seems simple, why would anyone go against their ethical values and hurt a child to avoid confrontation? Unfortunately, many people do not evaluate their personal healthcare philosophy and choose the least difficult path when it comes to ethical decision making. Identifying a healthcare philosophy and committing to patient-centered care will offer the strength to make ethical decisions even when it is the most difficult option.
References
Forsyth, D. (2019). Making Moral Judgments (1st ed.). Taylor & Francis.
Interprofessional Education Collaborative. IPEC core competencies. https://www.ipecollaborative.org/ipec-core-competencies
McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https://ethicsunwrapped.utexas.edu/glossary
National League for Nursing. Core values. https://www.nln.org/about/about/core-values
Attribution
This section is adapted from Nursing Management and Professional Concepts by Chippewa Valley Technical College and used under a Creative Commons Attribution 4.0 International License.
- Interprofessional Education Collaborative. IPEC core competencies. https://www.ipecollaborative.org/ipec-core-competencies ↵
- Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https://ethicsunwrapped.utexas.edu/glossary ↵
- Ethics Unwrapped - McCombs School of Business. (n.d.). Ethics defined (a glossary). University of Texas at Austin. https://ethicsunwrapped.utexas.edu/glossary ↵
- National League for Nursing. Core values. https://www.nln.org/about/about/core-values ↵
