Introduction

Ethics involve the knowledge and application of certain principles utilized to guide decisions about what is right and wrong (Ethic, n.d.).

In healthcare, ethics help guide and influence the way physicians, nurses, and other members of the healthcare team care for patients and make decisions. The core construct of ethics addresses the moral dilemmas that arise out of conflicts with duties or obligations, as well as the consequences of decision-making. Nurses are faced with ethical decisions and dilemmas every day, not only with respect to patient care, but also in their own lives.

Our view of the world has changed in the last several decades. In the current global environment, we have immediate access to information. We view the lives of others through social media and are exposed to political influences, opinions, and adversity like never before. All these factors influence our ethical nature as individuals.

Nurses are uniquely positioned to serve as leaders in healthcare ethics as the field continues to change and evolve. They are intricately involved in all aspects of patient care, including care coordination, recommendations for plans of care, provision of life-sustaining interventions, and patient education, among other practices. Registered nurses have been identified repeatedly through Gallup polls as the most honest professionals and regarded as having the highest ethical standards (Windland-Brown, Lachman, & Swanson, 2015). While various nursing consultative services have emerged over the past several decades in specialties such as intravenous therapy and wound care, healthcare ethics is another area that would benefit from nurses' varied skill sets and expertise.

This handbook is the first of its kind—focused entirely on a nurse-led ethics consultative service. It is divided into two parts:

HEALTHCARE ETHICS IN THEORY

To understand ethics as it applies to healthcare, it's important to first familiarize yourself with the basic theories within the study of ethics. Chapter 1 covers a general overview of these theories. Chapter 2 provides a closer look at healthcare ethics—from how healthcare ethics evolved since the time of Hippocrates to the basic principles that govern nurses as they work to solve ethical dilemmas. Chapter 3 presents some of the landmark cases that helped shape modern healthcare ethics as we know it today.

HEALTHCARE ETHICS IN PRACTICE

After you've gained solid foundational knowledge about healthcare ethics from the first three chapters, how do you use these core principles to lead healthcare ethics committees? Chapter 4 details a step-by-step process for nurse-led ethics consultations. Chapter 5 focuses on some of the most ethically challenging issues in the healthcare industry today. And Chapter 6 presents case studies that explore ethical dilemmas that occur in everyday practice. These can serve as either independent or team-based exercises.

The respect for patient autonomy and the obligation to protect the health, safety, and rights of the patient have led the registered nurse along this journey to break tradition from an outdated practice of physician-led ethical consultation. In today's healthcare environment, the RN is poised to provide this valuable ethical consultative service in the acute care setting. This book will provide a different solution to healthcare ethical problems in the acute care setting by supplying the tools necessary for RNs to begin evaluation of ethical situations and develop consultative skills for ethical cases. The last chapter engages the reader to walk through ethical cases by providing real-life ethical case scenarios and critical thinking questions. This is a one-of-a-kind book. It provides a road map for nurse-driven ethics consultative services to be developed all around the country. This unique opportunity for RNs to provide ethical consultative services will drive nurses to fully develop the context of what they do each and every day: advocate for the patient. With knowledge, practice, and mentorship, ethics consultation will come naturally to any RN.