Red Flower Publications

Professionalism, Professional Values and Bioethics

Editor(s)/Author:

Noorul Amin, Sajad Hussain Naik & Mohd Rafiq Wani

Status:

Publication Year: 2024-07-01

The book “Professionalism, Professional Values and Bioethics” has been prepared in accordance with the INC syllabus for B.Sc Nursing course (IV semester). The same book can be used by GNM students as they are also having one “Professional trends and Adjustment” as part of their internship program in the third year of their course. This book delves into the intricate interplay between professionalism, the intrinsic values that guide ethical conduct, and the evolving field of bioethics. This book is not merely a theoretical exploration; it is a practical guide for professionals navigating the ethical complexities of their respective fields. Through reflective exercises, case studies, and ethical frameworks, readers are equipped with the tools and insights needed to navigate ethical challenges with confidence and integrity. As a Nursing student embarking on your career journey, “Professionalism, Professional Values, and Bioethics” offers invaluable guidance and inspiration. It is a roadmap for ethical excellence and a testament to the enduring importance of integrity and ethical conduct in the professions we serve.

Contents
Preface xiii
Foreword xv
Acknowledment xvii
CHAPTER-I
Definition of a Profession. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Concepts of a Profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Characteristics of a Profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Flexner’s Criteria (1915). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Kelly’s Criteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
General Criteria for a Profession. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Nursing as a Profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Why is Nursing Regarded as Profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Difference Between Occupation and Profression . . . . . . . . . . . . . . . . . . . . . . . . 32
Defnition of Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Characteristics of Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Concepts, Attributes, and Indicators of Professionalism. . . . . . . . . . . . . . . 33
Challenges to Professionalism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Personal Identity and Professional Identity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Difference Between Personal and Professional Identity . . . . . . . . . . . . . . . 36
Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Elements of Communication:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Levels of Communication: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Types of Communication: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Therapeutic Communication Techniques in Nursing . . . . . . . . . . . . . . . . . . . . . 41
Effective Communication and Building Strong
Relationships with Team Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Demonstrating Professional Conduct. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Ethical Principles in Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Respecting and Maintaining Professional Boundaries . . . . . . . . . . . . . . . . . . . . . 48
Roles and Responsibilities of Regulatory Bodies and
Professional Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Indian Nursing Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
National Nursing and Midwifery Commission. . . . . . . . . . . . . . . . . . . . . . . . . . . 53
State Nursing and Midwifery Commission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
State Nursing Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Professional Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Nursing Organizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
American Nurses Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Canadian Nurses Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
National League for Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
International Council of Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
National Student Nurses Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
International Honor Society (Sigma Theta Tau) . . . . . . . . . . . . . . . . . . . . . 62
Code of Professsional Conduct For Nurses In India . . . . . . . . . . . . . . . . . . . . . 63
Trained Nurses Association of India (TNAI) . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Importance of Professional Organizations in Nursing . . . . . . . . . . . . . . . . . . . . 65
CHAPTER-II
Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Types of Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Characteristics of Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Value Clarification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Personal and Professional Values in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Personal Values in Nursing: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Professional Values in Nursing:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Ethical Values in Nursing: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Professional Socialisation in Nursing: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Caring and its Elements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Caring Theories and Models in Nursing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Watson’s Caring Theory: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Swanson’s Theory of Caring:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
Leininger’s Culture Care Theory: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Roach’s Six C’s of Caring Model: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Caring Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Assessment:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Establishing a Therapeutic Relationship: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Diagnosis and Planning:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Implementation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Evaluation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Documentation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Reflection: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Compassion Between Sympathy and Empathy. . . . . . . . . . . . . . . . . . . . . . . 84
Altruism and its Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Altruistic Behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Altruistic Behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Conscientiousness and its Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Five Factor Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Dedication and Devotion to Work in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Case Scenario of Dedication and Devotion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Human Dignity and its Aspects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Human Dignity in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Privacy and its Aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Confidentiality and it’s Aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Differences Between Privacy and Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . 96
Disclosure of Privacy and Confidential Information. . . . . . . . . . . . . . . . . . . . . . 97
Honesty and its Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Integrity and its Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Trust and Credibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Trust in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Factors Influencing Trust . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Case Scenario: Trust in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Credibility in Nursing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Factors Influencing Credibility: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Building and Sustaining Trust and Credibility in Nursing . . . . . . . . . . . . . 104
Scenario: Credibility in Nursing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Fidelity in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Loyalty in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Advocacy for Patient Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Advocacy for Nursing Education and Practice . . . . . . . . . . . . . . . . . . . . . . . . . 111
Advocacy for Nursing Profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
CHAPTER- III
Ethics and its Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Sources: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Branches of Ethics: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Different Levels of Ethics: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Importance of Ethics: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Bioethics: Guiding Principles in the Face of Progress. . . . . . . . . . . . . . . . 117
Bioethics: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Ethical Principles: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Principle of Beneficence: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Principle of Non-Maleficence: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Principle of Justice: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Principle of Care without Discrimination: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Principle of Autonomy: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Principle of Fidelity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Principle of Veracity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Ethical Issues and Ethical Dilemmas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Differences Between Ethical Issues and Ethical Dilemmas. . . . . . . . . . . . 125
Common Ethical Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Privacy and Confidentiality: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Valid Consent and Refusal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Refusal of Treatment: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Allocation of Scarce Nursing Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Conflicts Concerning New Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Whistle-Blowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Beginning of Life Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Ethics and Abortion: A Multifaceted Issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Causes of Substance Abuse: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Consequences of Substance Abuse: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Personal Consequences:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Social Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Understanding Substance Abuse: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Ethical Issues in Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Areas of Concern: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Fetal Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Reasons For Fetal Therapy: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Ethical and Legal Considerations: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Selective Deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Ethics and Selective Deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Intrauterine Treatment of Fetal Conditions Balancing Hope and Ethics. . . . . 152
Reasons for IUFT: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Mandated Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Arguments for Mandated Contraception: . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Arguments Against Mandated Contraception: . . . . . . . . . . . . . . . . . . . . . . 153
Fetal Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Consequences of Fetal Injury:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Infertility Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Infertility Treatment and Ethics: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
End of Life Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Euthanasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Do Not Resuscitate (DNR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Issues Related to Psychiatric Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Restrain and Seclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Refuse to Take Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Ethical Decision Making: Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Assess the Situation (Collect Information) . . . . . . . . . . . . . . . . . . . . . . . . . 165
Identify the Ethical Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Identify the Alternative Decisions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Choose the Solution to the Ethical Decision . . . . . . . . . . . . . . . . . . . . . . . 166
Implement the Decision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Evaluate the Decision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Ethical Committee and its Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Historical Perspectives of Ethical Committees . . . . . . . . . . . . . . . . . . . . . . . . . 170
Role of Ethical Committees in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
International Council of Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
ICN Code of Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Indian Nursing Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
INC Code of Ethics and Professional Conduct. . . . . . . . . . . . . . . . . . . . . . . . .179
Charter of Patients’ Rights for Adoption by
NHRC Patient’s Rights are Human Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Rights of Disabled Patients: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Responsibilities of Patient and Caretaker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Sajad Hussain Naik is working as Senior Nursing Officer at SKIMS Soura. He has completed his M.Sc Nursing from SKIMS Soura. He is empanelled as editorial board member in ADR publications, MAT journals. Sajad Hussain Naik has more than 10 papers to his credit and has contributed to his field. He is working on few more research and educational projects that will be released very soon.

Mohd Rafiq Wani is avnative from Jammu and Kashmir, India started his career as Bachelors in Nursing from BHNC karan nagar Srinagar through University of Kashmir. He was selected as Junior Nursing officer at Govt medical college Srinagar and later on was selected as Senior Nursing officer at SKIMS soura srinagar and he is rendering his services there. He completed masters in Nursing
in community health nursing as an inservice candidate from Mader i Meherbaan Institute of Nursing and research sciences soura srinagar through SKIMS
deemed university. He pursued Post Graduate diploma in health and hospital management and Diploma in Nursing Administration through distance mode from IGNOU to have specialization in Management Skills. He has been keenly
interested in writing research papers and has published many papers in national and international journals and magazines. He is also working as guest faculty in many nursing colleges of Kashmir. He has more than 10 papers to his credit and has contributed to his field. He is working on few more research and educational projects that will be released very soon.