Bioethics is a significant concept in healthcare and particularly for nursing professionals. It encompasses medical ethics and the achievement of equilibrium between duties, benefits, and harm. The influence of bioethics is not only seen in nursing professionals but also in patients. The study and appreciation of bioethics provide nurses with a tool for ethical decision-making and ensuring that all procedures and processes within the care facility are in line with the patient's desires. More importantly, bioethics pays significant attention to unresolved dilemmas that have implications on the entire medical community as established by research ideas and new technologies. As a concept, bioethics revolves around four main principles, including autonomy, beneficence, non-maleficence, and justice. Some of the fundamental considerations in nursing bioethics include professional code of ethics, legislations, and policies. The numerical strength of nurses and their increased contact with patients makes them a unique subject in bioethics. Also, the nurses' role has continued to expand, especially with the advancement of research and technology. Therefore, bioethics remains a significant area of concern for nurses and the entire nursing profession. Bioethics provides nurses with an opportunity to advance patient rights, enhance social justice, engage in ethical decision-making, and guarantee a dignified research process.
Background
Nurses have continued to play a critical role in the field of healthcare over the last three centuries. As the nursing profession continued to rise and influence healthcare, rapid changes also took shape. The bioethics movement did not emerge out of a vacuum (Scher & Kozlowska, 2018). Over the years, the advances in medicine necessitated establishing an ethical field that would identify and address any ethical challenges. The advancement in research, especially in the 20 th and 21 st centuries, has contributed to the need for moral policing to ensure that patients' interests are considered. Bioethics' origin dates back to the creation of the Nuremberg Code, which was a follow up of the unethical Nazi experiments of 1926. The code would guide future scientific experimentations and research (Mandal, Ponnambath, & Parija, 2017). Legislative changes worldwide have sought to empower the patient against the healthcare worker (Scher & Kozlowska, 2018). The need for more patient-centered care has triggered legislators to establish policies and laws that favor and protect the patients. Bioethics hinges on four main principles, including autonomy, beneficence, non-maleficence, and justice. Autonomy focuses on providing patients with much-needed independence in making medical decisions. Beneficence is a moral obligation for the nurse to engage only in practices that promote the patient's benefit. Non-maleficence aims at keeping patients from harm, and justice encompasses equal treatment of people (Huston, 2013). As advocates, nurses have a critical role in acting ethically and protecting the interests of the patient.
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Bioethics and Patient Rights
Nurses must understand and appreciate the role of bioethics because it directly influences the rights of the patients. With the advancement in research and technology, courts and stakeholders in government recognized that the unilateral decisions could negatively implicate the patient's interests and goals (Scher & Kozlowska, 2018). Today, nurses are engaged in intrusive and delicate procedures aimed at improving the condition of the patient. In realizing the importance of human rights, nurses must provide patients with informed consent to enlighten them on the nature and risk associated with the medical procedures. As consumers of health, patients have the right to safety, which encompasses their prevention from hazardous procedures that could adversely affect their health and wellbeing. Patients have the right to information and the right to choose (Scher & Kozlowska, 2018). They also have the right to be heard. The patient's rights and freedoms form a significant part of bioethics, and nurses must enhance adherence to avoid legal pitfalls. The American Nurse Association (ANA) codes of ethics play a vital role in emphasizing nurses' ethical responsibilities. Other legislative underpinnings include the Patients' Bill of Rights and the Nurse Practice Acts (Johnstone, 2019). As custodians of patient care, bioethics should inform nurse practice and influence their interaction with patients.
Bioethics and Social Justice
The role of nurses as patient advocates is well-documented. Nurses have an essential role that traverses their impact as caregivers. Through advocacy, nurses are at the forefront of promoting social justice and ensuring equality and wellbeing for all. Scientific advancement has brought a vast array of changes that have directly affected patient care. However, the innovations have also established a fertile ground for unethical behavior. As illustrated by Mandal et al. (2017), "Due to unrestricted research in science and technology, ethical issues of human rights violation, discrimination between individuals, races, and socioeconomic status of countries have arisen leading to injustice" (5). Bioethics rose mainly to counter the legal, social, cultural, ethical, and epidemiological issues arising from advances in research studies. Currently, the healthcare field continues to grapple with a wide array of issues such as discrimination and biasness that contribute to disparities. Ethnic and racial minorities such as the African American communities and Hispanics are mostly affected by the health disparities (Huston, 2013). A significant pillar of bioethics is establishing ethical guidelines that promote social justice among communities with the primary objective of guaranteeing health for all.
Bioethics and Ethical Decision-Making
Bioethics is vital for nursing because of the trust nurses receive from patients and family members as primary health caregivers. Nurses have the numerical strength and are therefore responsible for most of the care needs. However, in their quest to provide healthcare, nurses face significant moral dilemmas (Forte, Kawai, & Cohen, 2018). Moral dilemmas can exist in many forms and shapes and mostly affect nurses working in terminal and end-of-life care facilities. Nurses must continuously endeavor to find the most morally plausible decision out of the alternatives. Bioethics ensures that nurses consider the four primary ethical pillars of practice, in addition to other specific considerations. Examples of additional factors nurses could consider include respect for human dignity, client's right to privacy, and protection of information (Forte et al., 2018). Some ethical considerations, such as patient privacy and confidentiality of information, have serious legal ramifications. For instance, the Health Insurance Portability and Accountability Act (HIPAA) require nurses and other health professionals to protect patient information in their electronic health records. Failure to do so could attract significant legal ramifications to a nurse or the healthcare organization. Bioethics provides nurses with a tool to escape unethical decisions and adhere to the applicable laws and policies.
Bioethics and Nursing Research
Bioethics as a field became popular after the unethical Nazi research studies that led to the Nuremberg Code. The stakeholders identified the need for ethical guidelines in research involving human subjects (Mandal et al., 2017). The need for evidence-based practice has called on nurses to actively participate in research studies. As elaborated by the authors, “One reason for this attention is that nursing has gradually become an independent scientific discipline which requires its own body of knowledge” (Chen, Sun, Tang, & Castro, 2019). The last few decades have seen the development of new pathologies and pandemics. The need for high-quality evidence to guarantee patient care has also necessitated the need for research. In this regard, nurses must directly engage in clinical trials to determine the efficacy of drugs, vaccines, and different treatment methods (Huston, 2013). In the course of their studies, nurses will directly work with human participants. Bioethics calls on nurses to respect human dignity by providing the participants with informed consent and empowering their autonomy. Nurses must adhere to the Nuremberg guidelines of research, such as ensuring voluntary participation and guaranteeing that the research benefits society (Mandal et al., 2017). Nurses must ensure that human participants' dignity is protected and the research adheres to ethical principles such as beneficence and non-maleficence.
Conclusion
Bioethics provides nurses with an opportunity to advance patient rights, enhance social justice, engage in ethical decision-making, and guarantee a dignified research process. Patients, like any other consumer, have several rights that nurses must consider. The prime examples include the right to information and the right to choose. Bioethics positions nurses as advocates and allows them to promote social justice by limiting discrimination and bias. This strategy's overall objective is to mitigate instances of health disparities that disproportionately affect people of color. The nursing profession is full of ethical dilemmas. Nurses occasionally find themselves in situations where ethical principles clash. In some cases, their values contradict the professional code of ethics. However, nurses must respond with a sound decision that serves the interest of the patient and profession. Bioethics provides a set of guidelines and principles that assist nurses in overcoming such situations. Lastly, the nursing profession receives significant influence from research, thanks to the need for evidence-based practice. Research studies and trials must adhere to bioethical standards. More importantly, the research must respect the dignity of the person and enhance societal benefits.
References
Chen, Q., Sun, M., Tang, S., & Castro, A. R. (2019). Research capacity in nursing: a concept analysis based on a scoping review. BMJ Open , 9 (11).
Forte, D. N., Kawai, F., & Cohen, C. (2018). A bioethical framework to guide the decision-making process in the care of seriously ill patients. BMC medical ethics , 19 (1), 78.
Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities . Lippincott Williams & Wilkins.
Johnstone, M. J. (2019). Bioethics: a nursing perspective . Elsevier Health Sciences.
Mandal, J., Ponnambath, D. K., & Parija, S. C. (2017). Bioethics: A brief review. Tropical Parasitology , 7 (1), 5.
Scher, S., & Kozlowska, K. (2018). The Rise of Bioethics: A Historical Overview. In Rethinking Health Care Ethics (pp. 31-44). Palgrave Pivot, Singapore.
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