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Nurses frequently encounter ethical challenges when caring for patients. To make ethically sound patient care decisions, you should first have a foundation of knowledge about ethics that includes the basic ethical principles and the major ethical theories that have helped influence the realm of ethics in healthcare.


Ethical theories provide a basis for understanding and analyzing situations in which there is a perceived right or wrong. They are based on the fundamental principles of autonomy, beneficence, nonmaleficence, justice, and fidelity (Wlody, 1996):

  • Autonomy: a person's right to make his or her own decisions

  • Beneficence: the desire to do good; benefit the person

  • Nonmaleficence: avoid harm to a person

  • Justice: what is equal and fair

  • Fidelity: being truthful

Chapter 2 covers each of these principles in more depth.

There are three primary categories of ethical theories:

  • Metaethics

  • Normative ethics

  • Applied ethics


Metaethics is defined as the analysis of the language, concepts, and methods of reasoning in ethics (Internet Encyclopedia of Philosophy, n.d.-c). This type of ethics studies the meanings of such ethical terms as right, obligation, virtue, principle, justification, sympathy, morality, and responsibility. It also includes study of moral epistemology (the theory of moral knowledge) and the logic and patterns of moral reasoning and justification. Questions for analysis include whether social morality is objective or subjective, relative or nonrelative, and rational or emotive.


  • Right: being in accordance with what is just, good, or proper

  • Obligation: something one is bound to do, as by a promise or vow

  • Virtue: conformity to a standard of right (morality)

  • Principle: a comprehensive and fundamental law, doctrine, or assumption; a rule or code of conduct

  • Justification: an acceptable reason for doing something

  • Sympathy: an affinity, association, or relationship between persons or things wherein whatever affects one similarly affects the other

  • Morality: a doctrine or system of moral conduct; conformity to ideals of right human conduct

  • Responsibility: moral, legal, or mental accountability

Source:, 2018.

Metaethics is also understood as the study of the foundations of morality. While applied ethics and normative theories question what is normal, metaethics asks what morality itself is (Internet Encyclopedia of Philosophy, n.d.-c). Metaethics explores the connection among values, reasons for action, and human motivation. This theory explores how moral standards might provide us with reasons to do or refrain from doing as it demands, and addresses many of the issues commonly associated with the nature of freedom and its significance for moral reasons.

There are two areas of metaethics: metaphysical and psychological.


While metaphysics in general is the study of being and the nature of existence, the metaphysical area of metaethics focuses ...

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