his topic has been chosen to examine in detail the impact of law and ethics upon nursing practice and midwifery, including the ethical dilemmas that face nurses and midwives on a day-to-day basis. It is thereby demonstrated that despite the governance of health professional practice by bodies such as the Royal College of Nursing and the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, ethics and law play a very important role, and health professionals must always act within the law to avoid legal actions being brought against them. The various schools of thought in relation to ethics are also examined and utilisation of the same via decision-making models.
In relation to the general ethical dilemmas which face nurses and other healthcare workers in practice, Fletcher et al 1 discuss the ethical principles, explaining that although all health professionals face such dilemmas during practice, a multi-disciplinary approach has to be adopted in solving ethical problems. Fletcher et al outline the main ethical principles applicable to nursing ethics as the principle of respect for persons, respect for autonomy, justice, beneficence and non-maleficence.
Fletcher et al explain that the origins of moral philosophy date from 600 BC, and that the two most influential schools of thought are consequentialism and deontology. Consequentialism is explained as the justification of an action by examining the consequences of undertaking that action. Branching out from this school of thought are the various approaches, the first explained is teleological theories or unilitarianism, associated with the philosophical writings of Jeremy Bentham and John Stuart Mill. Fletcher et al state that Mill stipulated that the utility or ‘happiness’ principle stated that actions can only be regarded as moral if they promote the greater amount of happiness and the absence of pain.
Thompson et al 2 explains this ideology as a means to try to justify moral principles with regard to an overall goal or sense of purpose in society, the purpose being the pursuit of happiness, which is ‘built in’ in man. They discuss that that this stemmed from Aristotle in 320 BC, and that this form of ethics is known as teleological eudaemonism, the former word referring to his belief in the ‘built in’ purpose in nature, and the latter word describing the quest for happiness. They further explain the significance to health care, as they are under a duty to try to prevent or reduce pain wherever possible and promote the health and well-being of patients.
1 ‘Ethics, Law and Nursing’ (1995) pp 7-17
2 ‘Nursing Ethics’, pp233-238
Thompson et al justify the means by which health professionals can evaluate what likely consequences of treatment may be including side-effects. As act unilitarianism, although they note that where health professionals have to take into account the wider responsibilities to the patient, the hospital, research or otherwise, then rule utilitarianism is more applicable. They conclude that this ideology emphasises the achievement of goals that are important to the context of human life, and the practical application of principles or rules and that consideration of the consequences of application are important to consider to determine whether a particular course is right or wrong.