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Ethical Principles


Ethics is important for every organization including healthcare institutions. Code of ethics dictates the behavior of nurses and outlines their responsibilities and thus, this paper introduces what ethics is in healthcare organizations. It identifies the ethical principles in healthcare settings and applies them to Silver’s case. The paper also includes information on how an ethics consultant would have handled Silver’s case and concludes by summarizing the ethical principles that are exhibited in her case.

Ethical Principles


The nursing profession is one of the most respected professions worldwide. Every individual admires how nurses and physicians handle their daily activities because their obligation is to take care of patients despite the time of day or night. The nursing profession falls among the few professions where practitioners are prompted to take an oath to ensure proper administration of their duties and operations. The profession has attracted a number of people who have the passion for providing services to others and apparently, ethical behavior among nurses has contributed to the trust that exists among patients and the nurses. Families, friends, and relatives often trust nursing professionals with their sick colleagues, and this is determined by the ethics that is dominant in healthcare settings. Every healthcare setting must have a code of ethics that reminds nursing professionals of their responsibilities as required of them by patients, families, groups, communities and organizations. The responsibility of nurses is similar in all healthcare settings as they have to protect, promote and restore health of individuals. They also have the responsibility of reducing the amount of pain or suffering that a patient goes through (Mai et al., 2012). Besides, in cases where an individual is healthy, they have to prevent any sickness through administration of vaccination. For all these responsibilities to be successfully carried out, nurses must not discriminate patients on the basis of gender, color, race, community or physical appearance. Protection of the rights of patients is contained in every healthcare institution’s code of ethics and judgments made in healthcare institutions especially by nursing professionals is based on ethical principles, which include beneficence, non-maleficence, respect for autonomy, fairness, truthfulness or veracity, justice, beneficence, fidelity, altruism, and caring.


There are a number of ethical principles that are highlighted in Silver’s case. One of the ethical principles highlighted in her case is non-maleficence, which is a principle that prevents nurses from doing anything or revealing any information that could cause harm to patients, the individuals using the healthcare facilities, groups and communities (Mai et al., 2012). In the case, once Dr Jones suspected that she had colon cancer. However, her sons prevented him from revealing the information to her as they thought that she would be harmed or die on hearing the information. Dr Jones upheld this, and after a colonoscopy that revealed that Silver had cancer, he did not reveal the information to her. Instead, he put a note in the chart stating that as instructed by the family members, the patient was not to be told of her diagnosis. This was purposefully to prevent her from being harmed or killed by the revelation of her condition as argued by her two sons in the case.


Beneficence is another ethical principle demonstrated in Silver’s case, which is a principle that forces nurses and other healthcare professionals to be good and friendly to patients, and always choose the best options for them (Kangasniemi et al., 2015). The principle also states that a nurse and other healthcare professionals must be kind to their patients at all times as demonstrated by the nurses in the case. In the case, Dr Jones cares for her and chooses the best option for her, and to exhibit this, he suspects that she might be having colon cancer and wants to order a colonoscopy with the aim of confirming the diagnosis. However, he faces resistance from her sons who prevent him from revealing the information about the diagnosis of her after he carried out the diagnosis and found out that she did have colon cancer. After that, he again prefers to conceal the information from Silver as ordered by her two sons. By doing so, he shows how much he cares for the patient, and other nurses also demonstrate beneficence. They care for her so much that they are afraid of concealing any information from her, and this makes them feel uncomfortable taking care of her for fear that they would have to lie or face a lawsuit if they let the secret slip. They resist Dr Jones’ idea of not revealing the information to the patient.

Social Justice

The other ethical principle highlighted in the case is social justice, which articulates that nursing practitioners are obliged to act in a fair and equitable manner when dealing with patients. Nurses in healthcare institutions are often forced to take care of patients without any form of discrimination. Besides, the principle prompts nurses to advocate patients who are vulnerable and disadvantaged (Kangasniemi et al., 2015). In this case, Silver is disadvantaged in that, she is sick and is unable to instruct the nurses and Dr Jones on what to do, and thus, Dr Jones advocates on her behalf and orders a colonoscopy in order to confirm that she did have colon cancer. However, the sons of Silver prevent Dr Jones from revealing the information to her. The staff members of the healthcare institution also demonstrated the ethical principle of social justice as they prioritized care for her, although they were afraid of the fact that keeping the secret from her would land them in big trouble. They also advocated on behalf Silver that it was necessary for her to know about her condition as she would need additional surgery and treatment later on.


The ethical principle of truthfulness or veracity also comes out in the case, which is a principle that opines that truthfulness among nurses and other healthcare professionals is paramount, and it is for the good of the patients (Kangasniemi et al., 2015). The principle also forces nurses and other healthcare professionals to reveal information that is useful and to the best of interest of the patients or other healthcare users (Butts, 2013). Veracity, in this case, is demonstrated by Dr Jones because after suspecting that Silver has colon cancer, he orders for colonoscopy. Silver did have colon cancer, and Dr Jones wanted her to know about her situation although her sons prevented him from conveying the information to her. The interns and other staff members at the healthcare institution are also truthful and want her to know the truth about her condition in order for her to undergo surgery and treatment. They disagreed with Dr Jones’ idea that the patient was not to be told of her diagnosis.


Although fidelity conflicts with truthfulness, it is one of the ethical principles highlighted in the case and it suggests that confidential information such as the health condition and records of patients should be well protected, respected and maintained (Kangasniemi et al., 2015). Silver’s sons demonstrate this ethical principle and they were of the opinion that Dr Jones should not reveal to Silver about her health condition as that would harm her or even depress her to death. Dr Jones conducted the colonoscopy and indeed, Mrs Silver had colon cancer. He concealed the information from her and made it confidential. He went ahead to warn the other interns and members of staff from revealing the information to the patient, as that was an order of her sons. Other interns and staff members also demonstrated fidelity by concealing information about Silver’s diagnosis. However, they felt uncomfortable later on and pushed Dr Jones to reveal the vital information to her as she would require surgery and treatment because of her condition.


The other ethical principle highlighted in the case is altruism. The principle states that nursing professionals together with other healthcare professionals should be concerned with the wellbeing and welfare of patients and other healthcare users (Butts, 2013). According to the principle, nurses are forced to go against the wishes of healthcare users that are not in accordance with the code of ethics of healthcare institutions (Kangasniemi et al., 2015). The other interns and staff members demonstrate altruism. They are against Dr Jones’ idea of concealing the diagnosis from Silver. They see this as an act that is not in accordance with the code of ethics of their healthcare institution.


Autonomy is also highlighted in the case, which is an ethical principle states that healthcare users have the freedom or are eligible to make their decisions that regard their health of that of persons they are closely related to (Butts, 2013). In this case, Dr Jones has allowed the sons of Silver to make decisions on what should be done and what should not be done to their mother. The two sons decide that the diagnosis should not be revealed to their mother as it could hurt her or depress her to death and Dr Jones, a health professional applies the ethical principle of autonomy by upholding the decision made by the two sons. He goes ahead to advise the other interns and staff members to follow the instructions from her sons by concealing information about her diagnosis.


Caring is a common ethical principle in all healthcare settings, and it is also highlighted in the case. The ethical principle articulates that nurses should provide or apply emotions that are positive that will be accepted by the healthcare user (Butts, 2013). The ethical principle of caring is demonstrated by other staff members who take care of Silver and ensure that she has access to anything that she is in need of at any particular time. The nurses want to see her happy and want the best for her although they are haunted by the fact that they are concealing some important information from her. In fact, some of them have the feeling that hiding the information from her could land them into trouble.

An ethics consultant’s handling of the case

If called in as an ethics consultant in the case, I would opt for the best for Silver. Colon cancer is a big and dangerous problem that if not addressed, may lead to her death later in life. I would demonstrate the ethical principle of truthfulness and talk to her about the diagnosis and tell her that colon cancer can be treated if she undergoes surgery and treatment. The approach would reduce her depression, and she will readily accept her condition and agree to undergo surgery and treatment.

Besides, I would approach the family members, in this case, Silver’s two sons and advise them on the possible negative implications of hiding the diagnosis information from her. I would demonstrate the ethical principle of autonomy by respecting their decisions though I would advise them that if the information is concealed, she might not accept to undergo surgery and treatment without knowing the reasons for the two. The significance of this is that it would prevent treatment of the illness, which might lead to death if not addressed. I would also advise them to keep off the treatment room and trust Dr Jones and the nurses with their patient. The code of ethics of the healthcare institution would ensure that the patient is well attended to, and I would also advise them to be patient with the operations of the nurses and Dr Jones.

I would advise Dr Jones to demonstrate the ethical principle of beneficence by proceeding with his colonoscopy aimed at confirming whether Mrs. Silver has colon cancer. Since he went ahead and discovered that she did have colon cancer, I would push him to reveal to her about the condition and this would enable her to prepare for surgery and treatment to address the problem. However, if Dr Jones does not reveal to her about the diagnosis, she might resist any attempts to be taken for surgery and treatment. The implication of this is that the colon cancer may not be addressed, and she may end up dying.

As an ethics consultant, I would advise the interns and other staff members to demonstrate the ethical principle of care. This would entail treating Silver well and making her feel comfortable. The benefit of this is that it would help in her healing process. I would also advise them to exercise the ethical principle of truthfulness. This would involve them revealing to her about the diagnosis. Although she would be depressed and hurt, she would overcome the depression and accept to undergo surgery and treatment. However, if the nurses and other interns concealed the vital information from her, she would not accept or be ready to undergo surgery and treatment. This would be a big blow to her recovery and healing from colon cancer. I would also advise the nurses to exercise the ethical principle of non-maleficence by ensuring that they do not harm Silver in any way. The significance of this is that it would help reduce depression for Silver.


Evidently, ethics is integral in every healthcare institution. Almost all healthcare institutions have codes of ethics that dictate how healthcare professionals, including doctors and nurses should behave or go about their duties (Kangasniemi et al., 2015). The health profession is the most respected worldwide because of the high level of ethics exhibited by nurses and other healthcare professionals. Nurses are always there to care for healthcare users at any time, and in this case is a demonstration various ethical principles. For instance, by advocating and pushing for a colonoscopy, Dr Jones is demonstrating the ethical principle of social justice. Other ethical principles demonstrated in the case include non-maleficence, beneficence, veracity or truthfulness, fidelity, altruism, autonomy, and caring. The ethical principles can be in conflict although they help ensure smooth running of operations in healthcare institutions.


Butts, J. B. (2013). Ethics in professional nursing practice. Nursing ethics: Across the curriculum and into practice, 81-93.

Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal of advanced nursing.

Mai, E. L., El-Karmalawy, E. M., & Hassan, M. A. S. (2012). Assessment of Professional Ethics Practiced By Nurses Working In Primary Health Care Centers in Port Said. Journal of American Science, 8(12).