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Bioethics gets to the heart of who we are
Workplace ethics are only part of the picture for nurses
© 2021 from Relias. All rights reserved.
By Carol Taylor
All of us should reflect on the first question periodically and ask what kind of person we are becoming by virtue of the decisions and choices we make every day.

In his book, "The Road to Character," David Brooks focuses on the deeper values that should inform our lives. Responding to what he calls the culture of the "Big Me," which emphasized external success, Brooks challenges us to
rebalance the scales between our “resume virtues”— achieving wealth, fame and status — and our “eulogy virtues,”
those that exist at the core of our being — kindness, bravery, honesty, faithfulness and focusing on what kind of relationships we have formed. What words would those who know you best use to describe you to others?
Ask yourself:
What does striving for excellence look like for you? Reflect on activities you undertake to promote personal integrity and excellence.
What growth opportunities are you intentionally addressing? Do they involve intellectual, interpersonal, technical, ethical or legal skills? Or perhaps consider the Quality and Safety Education for Nurses competencies.
What do you think your eulogy will say about you? Are you hoping to have many more years to develop your virtues?
Carol Taylor, PhD, RN, is a senior clinical scholar in the Kennedy Institute of Ethics at Georgetown University in Washington, D.C., and a professor of nursing and the former director of the university’s Center for Clinical Bioethics.
The ethical choices we make in the nursing profession are always important, but our ethical values influence our lives when we're off the clock, as well.
Dan Callahan, one of the founders of U.S. bioethics and cofounder of the Hastings Center, wrote in an introduction to bioethics in the Encyclopedia of Bioethics that three paramount human questions are at the
heart of bioethics
: What kind of person should I be in order to live a moral life and make good ethical decisions? What are my duties and obligations to other individuals whose life and well-being may be affected by my actions? What do I owe the common good or the public interest, in my life as a member of society?
Nursing ethics: What is my duty to others?
Questioning our responsibilities to individuals who are affected by our actions moves us to the professional realm. While it encourages us to reflect on our duties as spouses, parents, sons and daughters, it also requires us to reflect on what it means to be an ethical nurse, one who is responsible for the well-being of our patients and colleagues. Nursing ethics formally studies issues that arise in the practice of nursing and the analyses nurses use to make ethical judgments. The best way to familiarize oneself with nurses’ ethical obligations is to read the
American Nurses Association 2015 Code of Ethics
. The first provision of the code reads, “The nurse practices with compassion and respect for the inherent dignity, worth and unique attributes of every person.” Practicing with compassion and respect often is a challenge in today’s stressful practice environments. The ANA 2015 position statement, "Incivility, Bullying and Workplace Violence," is an example of the profession’s effort to address ongoing challenges related to respect. The code also addresses our
obligations to patients
to self-care
(which comes as a surprise to many), to create ethical work environments, to the profession and to society.
Ask yourself:
Have you ever felt uncomfo
rtable because you believed you knew the right thing to do in a practice situation but were prevented from acting on your beliefs by internal or external variables? This is called moral distress.
Do you have resources to consult when
experiencing moral distress
? What are they? How helpful do you find them?
When moral distress continues unchallenged it can result in our disengaging from distressing situations as a means of protecting ourselves. This can compromise our clinical effectiveness, patient outcomes and our own sense of well-being. Have you ever experienced this cycle of disengagement?
Would you describe yourself as morally resilient? When times get tough do you thrive and flourish?
What words would those who know you best use to describe you to others?"
- Carol Taylor, RN
Social ethics: What do I owe the common good?
The ANA Code of Ethics for Nurses (2015) makes clear that as citizens, nurses are obligated to work to create a society that promotes the interests of all. Nurses must address the context of health, including social determinants of health such as poverty, access to clean water and clean air, sanitation, human rights violations, hunger, nutritionally sound food, education, safe medications and healthcare disparities. Nurses must lead collaborative partnerships to develop effective public health legislation, policies, projects and programs that promote and restore health, prevent illness and alleviate suffering. Denise Thornby, a former president of the
American Association of Critical-Care Nurses
, was famous for asking nurses what they were passionate about. She believed every nurse was called to act courageously to address some societal need. She explained that courage is derived from the French word couer, which means heart. What are you passionate about? What act of courage is calling you? Thornby, who passed way in 2012, was quoted in her obituary as saying, "Every day, every moment, you make choices on how to act or respond. Through these acts, you have the power to positively influence. ... So I ask you: What will be your act of courage? How will you influence your environment? What will be your legacy?"

She also quoted John Quincy Adams, who sagely said, "The influence of each human being on others in this life is a kind of immortality.”
The 2017 Women’s March on Washington brought millions of women around the world to the streets to advocate for women’s issues. Prominent in the marches were colorful banners and signs, each expressing someone’s passion. What would your poster say? What will be your legacy?

Personal ethics: What kind of person should I be?
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