This chapter provides an overview of ethics and the nursing challenges in practice including: cost, technology, and most significantly, patient rights. It focuses on ethics, philosophy, virtues, principles, rules, values, and the definition of patient rights.

Nursing practice evolved based upon an expressed social need specific to the delivery of health care. It has been strongly influenced by religion and women.

The authors identify four traits or virtues as the foundation for an ethically principled discipline including: compassion, discernment, trustworthiness, and integrity. Values are defined as beliefs about truth ideals, standards, principles, objects, and behaviors that give meaning to life. Values are individualized and may not be universal. Ethical rules and principles are detailed including beneficence (duty to do good and maintain balance between norm and benefits), nonmaleficence (doing no harm), justice (fairness), autonomy (respect for individual right to self-determination), fidelity (promise), respect (right of people making their own decision), and veracity (obligation to tell the truth).

A number of ethical issues confront nurses. The guide for decision making has been cited as helpful in ethical dilemmas.

The Patient Bill of Rights is reviewed to ensure that there is an understanding of its content and respect for the rights and responsibilities of patients, families, doctors, and caregivers. The purpose of the bill is to encourage open communication, respect for values, and sensitivity to differences.

Nurses play a pivotal role in the adherence of ethical principles in practice settings. Nursing ethical leadership includes integrity and courage to create the ethical models for organizations.