Importance of Beneficence of Ethical Issue on Nursing Practice

According to Hall, (1992; cited in Silva and Ludwick, 1992), "the ethics incorporated into good nursing practice are more important than knowledge of the law; practicing ethically saves the effort of trying to know all the laws. " Clinical ethics literature pertaining to nursing profession identifies four important values and principles, namely, respect to autonomy of the patient and to act with nonmaleficence, beneficence and justice (Nettina, 2006).

Of these, beneficence is the fundamental principle that affirms the inherent professional aspiration of not only the nursing personnel, but also other health professionals to help promote other's well-being. Infact, it is the main motivating factor for many nurses to opt for this profession as career. This essay will discuss the concept of beneficence relevant to nursing practice. Beneficence and ethics related to nursing profession The principle of beneficence comes across in everyday nursing practice.

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The term beneficence actually connotes acts of merciness, charity and kindness which are suggestive of love, humanity, altruism and promotion of good to others (Stanford Encyclopedia of Philosophy, 2008). This broad notion is a principle or rule when it comes to medical profession. Nurses have a moral obligation to act in ways which benefit others. There are many theories which have been put forward about beneficence. These include the moral-sentiment theory of David Hume, the Utilitarian theory and Kant's theory. According to Hume's theory, in any moral life, motives of beneficence are very important.

Hume's arguments were much against the Mandeville's theory which proposed that most of the human actions are based on private interest and human beings are neither benevolent nor sociable. Hume argues that beneficence is an "original" feature of human nature and it designates a class of virtues which are rooted in generosity, goodwill and love directed at others. According to the utilitarian theory by John Stuart Mill, "actions are right in proportion to their promotion of happiness, and wrong as they produce the reverse.

" Thus, as per this theory, concepts of duty, right and obligation are actually determined by balance between maximum benefits and minimum harm. However, Kant argued that every individual has a duty to be beneficent, in the sense, that every one has to be helpful to others as per one's means without any hope for personal gain (Stanford Encyclopedia of Philosophy, 2008). Whenever there is a conflict between what is good between patients and nurses, between organizations and patients, between states involved in interstate practice and also between patients, the principle of beneficence rises certain ethical issues.

Any differences in the ethical issues can initiate ethical implications which can terminate in approved cervices, financial reimbursement, change in laws on reporting certain diseases and abuse and also development of protocols from whom nurses can accept orders (Silva and Ludwick, 1999). Beneficence has a major role as far as conceptualizing the goals of medicine as a social practice is concerned. The goal of medicine becomes a beneficent undertaking only if the end of medicine is healing. Nurses are often confused as to what act of theirs is good for the patient and what is bad.

What they believe is good for the patient may not be what is actually good for the patient and it is very difficult to act in a way which is against anyone's belief. Another famous debate about constitutes of what is good for the patient without infringing on the autonomy of the patient or causing serious harm to the patient (Silva and Ludwick, 1999). The question that pops up in the debate is whether it is ethical to overrule the preferences of the patient. Beneficence issues also rise when a patient is not in a position to make any decisions as far as his or her treatment is concerned.

Beauchamp and Childress (1994; cited in Silva and Ludwick, 1999) used paternalism to discuss this aspect of argument. According to them, paternalism can be weak or strong. While weak paternalism means "that the health care provider is protecting the patient when the patient is unable to make decisions due to problems such as depression or the influence of medications", strong paternalism refers to “interactions intended to benefit a person despite the fact that the person's risky choices and actions are informed, voluntary, and autonomous" (Beauchamp and Childress, 1994; cited in Silva and Ludwick, 1999).

As Thompson (1987, pg. 1465) rightly put it: "The duty to care is not only about recognizing a reciprocal responsibility for one another but also in particular about recognizing a duty to protect the vulnerable- that is, accepting the role of advocate of the rights of those who are unable to defend their own rights. " Conclusion To conclude, it can be said that beneficence is a fundamental principle in nursing ethics with definite meaning and implications when applied to the analysis of the relationship between the nurse and patient.

Though beneficence is a natural human feature, it becomes a moral obligation in certain professions like nursing and thus is a source for ethical issues and implications. References Nettina, S. M. (2006). Lippincott Manual of Nursing Practice. 8th edition. Singapore: Lippincott Williams and Wilkins. Silva, M. C. , and Ludwick, R. (1999). Ethics: Interstate Nursing Practice and Regulation: Ethical Issues for the 21st Century. Online Journal of Issues in Nursing, 4(2).

Retrieved on July 18th, 2009 from www. nursingworld .org//MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/  Volume41999/No2Sep1999/InterstateNursingPracticeandRegulation. aspx Thompson, I. E. (1987).

Fundamental ethical principles in health care. British Medical Journal, 295(6611), 1461- 1465. Stanford Encyclopedia of Philosophy. (2008). The Principle of Beneficence in Applied Ethics. Retrieved on July 18th, 2009 from http://plato. stanford. edu/entries/principle-beneficence/

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