Cultural Diversity: An Ethical Issue
Donna M. Dufford
Chamberlain College of Nursing
NR 504 Leadership and Nursing Practice: Role Development
Summer B, 2014
Cultural Diversity: An Ethical Issue Understanding if not embracing cultural diversity is a common ethical issue facing nurses in the twenty first century. Nurses often find themselves attempting to navigate multi-cultural world in daily practice. Patients from multiple religious and cultural backgrounds live longer and have multiple health problems requiring complex interventions eventually become hospitalized for care. The conflict of the nurse’s background of empirical knowledge versus a patient’s cultural beliefs can often cause stress for nurses, patients and families.
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Ethics education and patient advocacy go hand in hand to reduce stressors and burnout. Nurses spend a great deal of time with patients allowing for the building of relationships and trust. It stands to reason that nurses would suffer more stress in health care from patient cultural and spiritual issues which may or may not be compatible with a nurse’s personal philosophy. “Nurses who are poorly prepared to effectively manage ethical issues consistently experience moral distress in their practice,” (Lang 2009 p.18). According to Leever, (2013), cultural competence for staff will help not only minimize the stressors for the nurse, but also improve patient care and satisfaction. In addition to these benefits, ”Cultural competence represents significant moral progress in the way that health care is delivered ” (Leever 2013 p. …show more content…
He is quite clear in the number of participants and the limitations of his study which include a smaller sample size due to what he categorizes as the lengthy and complicated nature of the data collection tool, a survey, used to gather data. The third and final prong of a strategy to deal with ethical issues is to provide support for the American Nurses Association (ANA) Code of Ethics. The code is available online with interpretive statements and according to the ANA is an “integral part of the foundation of nursing.” In addition to being readily available, the ANA recognizes that ethics is a dynamic field with continuously changing information. This allows for current research and findings to be available for the public. The ANA code of ethics is widely accepted as a cornerstone of basic nursing practice. It is widely held as a credible organization. The ANA makes ethics resources available to the public without a conflict of interest. It must be noted that the website does offer advertising opportunities and is a professional organization. This may be deemed a
American Nurses Association (ANA), (2001), Code of Ethics for Nurses, American Nurses Association, Washington, D.C.
The first provision of the American Nurses Association’s (ANA) “Code of Ethics” states, “ The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.” The second provision states, “The nurse’s primary commitment is the patient, whether the patient is an individual, family, group, or community” (Fowler, 2010). As nurses we need to respect the autonomy and allow for the patient to express their choices and concerns. We also need to provide them with support by giving them knowledge and understanding so they
A code of ethics provides a standard by which nurses conduct themselves and their practice, observing ethical obligations of the profession and providing quality care. To achieve its purpose, a code of ethics must be understood, internalized, and used by nurses in all aspects of their work” (Aliakvari, 2015, p. 494).
The four ethical virtues of health care must be shown, compassion, discernment, integrity and trustworthiness. Respecting a person’s autonomy understanding and acting on the belief the people have the right decision to make decisions and take action based on their beliefs and value systems. The ethical issues that would be encountered will be to treat each person with passion and respect regardless of sex, race, and religious preference. The environment has no human rights violations, sustains nursing ethical
(3) To serve as an expression of the understanding on nursing’s commitment to society.” (Nurses Code of Ethics, 2015). With our ever-changing society and healthcare, also comes changes to the American Nurses Association’s code of conduct as well. Nursing is one of the fastest growing professions in the world and the basics of nursing describes it as a career that focuses on, providing protection, education
American Nurses Association. (2015, January 2015). Code of Ethics for Nurses With Interpretive Statements, 1-76. Retrieved from
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
The Code of Ethics for Nurses was created to be a guide for nurses to perform their duties in a way that is abiding with the ethical responsibilities of the nursing profession and quality in nursing care. The Code of Ethics has excellent guidelines for how nurses should behave, however; these parameters are not specific. They do not identify what is right and wrong, leaving nurses having to ultimately make that decision. Ethics in nursing involves individual interpretation based on personal morals and values. Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best interest of the patient and practicing sound nursing ethics.
According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.
Fowler, M. D., & American Nurses Association (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association.
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
Leininger’s theory of cultural care diversity and universality is about caring, which is the essence of nursing and is recognized in the theory of basic human needs. Her theory incorporates anthropology, which focuses towards caring, culture values, and pattern rather than medical symptoms and treatments. Concepts of Leininger’s theory revolves around caring, which is essential for growth, development and survival. Leininger’s transcultural nursing is our “‘cultural knowledge that is used in our actions to promote positive health behavior among patients and foster culturally sensitive and congruent care’ (Campesino, 2008)” (Posner p.151). Providing client centered care not only enables trust, but also fulfills the patient’s potential health needs and nursing roles with the best outcome. I believe it is important to understand that America has more demands for cultural diversity; therefore, we must be able to meet these demands with the appropriate interventions. Cultural misunderstandings and applying inappropriate interventions become a cultural stress for the nurse-patient relationship; distrust could lead to nurses being unable to collect the necessary information to effectively provide the right care. To understand and respect different religious cultures are also important in the nursing process. This can help nurses to understand and improve quality of
Ethics asses the values, morals, and principles of nurses. Legal codes or laws are rules established by our government. It’s important that nurses have a clear and comprehensive understanding of ethical and legal codes within their career. The understanding of these codes is essential for nurses to safely practice and to protect their patients. Nurses must abide by these principles or face the consequences of legal action. These principles include autonomy, utilitarianism, confidentiality, and many others. Autonomy is the agreement to respect ones right to determine a course of action, while utilitarianism is what is best for most people as defined in American Nurses Association. In order to give you a
The nursing code of ethics has a very standard definition. It is the base on how nurses should guide themselves in conduct by making the right decision regarding ethical issues. According to the National Student Nurses Association “students of nursing have a responsibility to society in learning the academic theory and clinical skills needed to provide nursing care” (2003). In the clinical setting nurses have a lot of responsibilities while caring for an ill patient, they have the obligation to practice their profession with compassion, love, and respect the uniqueness of each patient, as nurses we are not supposed to deny care to a patient because of their economic status, their skin color, race, or the nature of health problems, we are here to help the people in need in particular those of susceptible populations. The NSNA states that the code of conduct is based on an understanding that to practice nursing as a student is an agreement that trust and honesty is depended on us by society. The announcement of the code provided direction for the nursing student in the personal development of an ethical foundation and not limited to the academic or clinical environment but can assist in the holistic development of a person. (National Student Nurses Association, 2003)
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be