People’s Nursing School
LUMHS, Jamshoro
Two-Year MSc Nursing Degree Program
Title : Ethics in Health Care
Credits : 3.0
Placements : Year I, Semester I
Course Description:
This course will synthesize ethical positions from the perspective of nursing on health-related
issues at the individual, group, population, and policy levels. Emphasis is on normative ethics,
the theoretical basis for positions taken, and Contextual implications for subsequent action.
Course Objectives:
At the completion of the course, the student will be able to:
1. Discuss selected theoretical perspectives in ethics including ethics in Islamic perspective.
2. Compare frameworks for ethical resolutions of health-related issues at the individual, group
population, and policy levels.
3. Synthesize ethically justifiable positions from a nursing perspective on health-related issues
while taking into account, personal, professional and societal factors.
4. Formulate plans for implementing positions at interpersonal, institutional policy and/or
governmental policy levels.
5. Explicate the potential contribution of a nursing perspective to interdisciplinary ethical
decision-making about health-related issues.
6. Generate a representation of one’s own evolving ethical framework.
Course Format / Teaching & Learning Strategies:
Seminar Student presentation, guest speakers and cooperative learning in small group discussion
would be the mode of teaching and learning throughout this course. This format is grounded in
active student participation, with the teacher often taking the role of “guide on the side,” an
approach that is associated with development of critical thinking and problem solving skills. This
approach is in contrast to the “sage on the stage” model in which the teacher lectures for most of
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each class period while students remain more passive in the learning process. The course
includes considerable reading and writing. In addition, there is a substantial discussion
component to the course.
Evaluation Criteria:
1. Internal Assessment 20%
2. Final Examinations 80%
________
Total 100
Unit Objectives
Unit I: Social, Philosophical, and other historical forces Influences on the Development of
Nursing
At the end of the unit learners will be able to:
1. Discuss the relationship between social need and the origin of the profession of nursing
2. Describe the relationship between moral reasoning and the origin of Nursing
3. Describe the mutually beneficial relationship between the broader society and its professions
4. Explain the effect of cultures prevailing belief system on the practice of nursing.
5. Identify how historic spiritual beliefs and religious practices influenced evolutionary changes
in nursing
6. Discuss how the historical background of the status of women in various culture is related to
practice of nursing.
Unit II: Ethical Theories
At the end of the unit learners will be able to analyze ethical theories :
1. Utilitarianism
2. Kantianism
3. Character ethics: Virtue-based Theory
4. Liberal individualism: Rights-based Theory
5. Communitarianism: community based theory
6. Ethics of care : relationship based theory
7. Casuistry case based reasoning
8. Principle based, common morality theories
Unit III: Ethical Principles
At the end of the unit learners will be able to:
1. Elaborate Ethical Principles: Respect of Autonomy
2. Discuss the Ethical Principles: Nonmaleficence
3. Analyze the Ethical Principles: Beneficence
4. Synthesize the Ethical Principles: Justice
5. Describe the Professional patient relationship
6. Demonstrate Professional Behavior
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Unit IV: Values Clarification and Development
At the end of the unit learners will be able to:
1. Define and differentiate personal, societal , professional ,organizational ,and normal values.
2. Explain the valuing process
3. Disuses how values are acquired
4. Describe values conflict and its implication for nursing care
Unit V: Ethical Dilemmas
At the end of the unit learners will be able to:
1. Definition and source of knowledge
2. Discuss Ways of thinking about ethics
3. Describe the Examples of ethical dilemmas.
Unit VI: Professional Ethics and Institutional Constraints in Nursing Practice
At the end of the unit learners will be able to:
1. Highlight the importance of nursing, some facts.
2. Explore the Multiple ethical obligations/ responsibilities
3. Discuss Moral distress
4. Elaborate Dynamic and loyalties.
5. Describe Nurse –doctor relations.
Unit VII: Rights Obligations and Health Care
At the end of the unit learners will be able to:
1. Concepts of right
2. Rights and obligations in health care
Unit VIII: Policy, Ethics, and Health Care
At the end of the unit learners will be able to:
1. Describe historical, legislative and political background
2. Analyze healthcare policy-recent decades
3. Discuss ethical dimensions of health policy
Course Schedule
Unit # Topics Faculty
Unit I Social, Philosophical, and other historical forces Influence on the
Development of Nursing.
The relationship between social need and the origin of the profession of
nursing
The relationship between moral reasoning and the origin of Nursing
The mutually beneficial relationship between the broader society and its
professions
The effect of cultures prevailing belief system on the practice of nursing.
3
Identify how historic spiritual beliefs and religious practices influenced
evolutionary changes in nursing
the historical background of the status of women in various culture is
related to practice of nursing.
Unit II Ethical Theories
Ethical Theories part I
Utilitarianism
Kantianism
Character ethics: Virtue-based Theory
Liberal individualism: Rights-based Theory
Ethical Theories II
Communitarianism: community based theory
Ethics of care : relationship based theory
Casuistry case based reasoning
Principle based, common morality theories
Unit III Ethical Principles
Respect of Autonomy
Informed consent
Decisional capacity
Competence
Surrogate decision-making
Advance directives: living wills, durable power of attorney of health care
Substituted Judgment
Nonmaleficence
Normal. vs. beneficence
Withdrawing vs. withholding treatment
Ordinary vs. extraordinary Rx
Sustenance vs. medical technologies
Intended vs. foreseen effects
Optional vs. obligatory Rx
Killing vs. letting die
Beneficence
Rules of beneficence
Paternalism: beneficence vs. autonomy
Futility
Balancing benefits, costs and risks (benefits vs. burden)
Ethics consultation and committees
End of life care
Justice
Formal principle of justice
Material principles of justice
Theories of justice
Fair opportunity
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Health care as right
Allocation of health care resources
Professional patient relationship
Truth Telling
Privacy
Confidentiality
Fidelity
Professional Behavior
Professional Virtues
Professional Caring
Exemplary Professional Behavior
Unit IV Values clarification and development
Define and differentiate personal , societal , professional ,organizational
,and normal values.
Valuing process
Values are acquired .
Conflict and its implication for nursing care
Unit V Introduction to ethics and Ethical dilemmas
Definition and source of knowledge
Ways of thinking about ethics
Examples of ethical dilemmas
Unit VI Professional ethics and institutional constraints in nursing practice.
The importance of nursing, some facts.
Multiple ethical obligations/ responsibilities
Moral distress
Dynamic and loyalties.
Nurse –doctor relations.
Unit VII Rights obligations and health care
Concepts of right
Rights and obligations in healthcare
Unit VIII Policy, Ethics, and Health Care
Historical ,legislative and political background
Health care policy-recent decades
Ethical dimensions of health policy
References:
Butts JB, Rich KL. Nursing ethics: Across the curriculum and into practice. 4th ed.
Burlington, MA: Jones & Bartlett Learning; 2016.
Burkhardt MA, Nathaniel AK. Ethics & issues in contemporary nursing. 4th ed. Cengage
Learning; 2014.
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Davis, A., & Aroskar, M. (2010). Ethical Dilemmas & Nursing Practice. New York:
Appleton-Century-Crofts.
Thompson, I., Melia, K., & Boyd, K. (2000). Nursing Ethics (4th ed.). Edinburgh: Churchill
Livingstone.
Suggested Articles:
Cheraghi, R., Valizadeh, L., Zamanzadeh, V. et al. Clarification of ethical principle of the
beneficence in nursing care: an integrative review. BMC Nurs 22, 89 (2023).
https://doi.org/10.1186/s12912-023-01246-4
Robichaux C, Grace P, Bartlett J, Stokes F, Saulo Lewis M, Turner M. Ethics Education for
Nurses: Foundations for an Integrated Curriculum. Journal of Nursing Education.
2022;61(3):123-130. doi:10.3928/01484834-20220109-02
Safavi F, Yousefi Z, Bavani SM, Khodadadi E. The Relationship Between Nurses' Ethical
Reasoning with the Quality of Nursing Care. Int J Appl Basic Med Res. 2022 Jul-
Sep;12(3):196-202. doi: 10.4103/ijabmr.ijabmr_637_21. Epub 2022 Jul 26. PMID:
36131857; PMCID: PMC9484511.
