Ethics is one of the most important aspects of nursing. Reasonably, nursing should be based on the deontological and utilitarian ethical and moral principles. Utilitarianism is the ideas of moral preferences and actions in the interests of others. It is one of the powerful and persuasive approaches in philosophy. Utilitarianism is a right morally action. Utilitarianism supports the ideas of making good to other people. Utilitarian ethics determines moral principles of behavior of an individual. Deontological ethics is the ideas of following certain rules and duties. It defines right moral choice and what is permitted, required and forbidden. According to deontological philosophy, when a person follows duties, he/she behaves morally.

Ethics is a very important aspect for nursing. It defines wrongness and rightness of an individual conduct. Ethics is the following of moral rules; it criticizes deception, lying, hidden information, violation of rules, and abuse of power and requires the medical and healthcare workers to make the right decision. Ethics and professional behavior are the basis of nursing.

Nursing provides the safe conditions of life that is why it should be realized according to the ethical principles and moral laws. Nursing should promote the best practices and standards for security and safety. Nursing also includes performing professional and other responsibilities honestly and with diligence. According to ethical principles, nursing should be realized without any conflicts, injuries and damage (Bandman, 2002).

Nursing deals with such ethical challenges as misrepresentation of information, abuse, withholding of data, conflicts, and issues with management, clients and employees that is why the right ethical education and following ethical principles will help to avoid them.

At the present time, nurses deal not only with the problems of lack of costs, medical and healthcare issues but also with ethical dilemmas. It means that this problem is urgent and needs the immediate solutions. Nurses deal with the different patients; that is why, it should be one of the main aspects of their activity. Every day they accept ethical decisions and it is very difficult to say whether they are right or wrong ones. It is their ethical dilemma. A lot of nursing papers are stopped precisely on this issue.

It is necessary to mention that that decision making is realized through many ethical choices and to choose what is right is impossible. As we know, ethics is based on doing something good without causing any harm. However it is difficult to distinguish an ethical conduct in nurses that is why they have their own principles of ethics that regulate their behavior. Nobody denies that fact that every nurse has his/her ethical education that he/she uses in his/her work.

Every choice in medical practice involves any ethical dilemma. Let's distinguish the main ethical dilemmas in nursing practice. First of all, this is quality versus quantity of life. Secondly, this is the dilemma between pro-choice and pro-life. Thirdly, this is the choice between freedom and control. Fourthly, this is an ethical dilemma between truth telling and deception for the sake of life. Fifthly, this is the choice between knowledge and personal beliefs. As we see, all these dilemmas are very ambiguous and provoke many discussions (Bandman, 2002).

As to quantity it connected with measure of person's life. Quality is the state of person's life, good or bad. It is known that the quality of life of the patient does not depend only on him/her and therapy but also on the nurses who take care about him/her.

As to the ethical decision between pro-choice and pro-life, it is necessary to say that this decision has the impact not only on patient's life but also on life of the nurse who cares for a patient who does an abortion. Who is guilty in abortion murder? Is a nurse able to change the decision of the patient?

Regarding the ethical issue of freedom versus control, it is also difficult to understand who has the right to make choice: a patient or a nurse. Sometimes, too much freedom can lead to the fatal result, and too much control leads to the conflict between a nurse and a patient. Indeed, a nurse should be also a psychologist in order to help a patient not only physically but morally.

Speaking about the choice between telling truth and lying, it is necessary to admit that this ethical dilemma is very ambiguous. Very often family asks not to tell the truth about the state of health of their relative especially when he will die soon. However, from the moral point of view, it is not allowed to lie. Sometimes lie gives hope for surviving and it may be curing.

Another ethical dilemma concerns knowledge and personal beliefs. It means that not always a nurse should use his/knowledge and not always rely on the personal beliefs. However, there is the problem that knowledge contradicts personal beliefs (Bandman, 2002).

In conclusion, it is worth saying that ethical dilemmas in nursing are the unsolved problems that prevent making the right decisions or make hesitate in taking decision. There are such ethical dilemmas in nursing as quality versus quantity of life, the dilemma between pro-choice and pro-life, the choice between freedom and control, an ethical dilemma between truth telling and deception for the sake of life and the choice between knowledge and personal beliefs. As we see, all these dilemmas are very ambiguous and provoke many discussions.

Besides generally excepted rules and ethical principles, there is the special Code of Ethics for Nurses. This Code of Ethics includes the main ethical principles for nurses and their attitude to people who need healthcare. The Code of Ethics is appointed for the nurses and will be a good help in curing of sick people and in communication with them. The purpose of Code of Ethics for Nurses is to provide an ethical practice and ethical relationships between a nurse and a patient. Code of Ethics for Nurses gives the recommendations of ethical behaviors, responsibilities, and decision making.

To my mind, all nurses should know the Code of Ethics as it is based on the professional standards, regulations and laws. Indeed, the Code of Ethics for Nurses is a means of self-control, self-reflection, and self-evaluation. The Code of Ethics for Nurses is the ethical basement that raises the quality of healthcare environment and competent, ethical and safe care.

Code of Ethics for Nurses has information and educational functions. It informs about the main principles of the ethical conduct, indicates the main responsibilities and duties of nurses. Code of Ethics for Nurses consists of two parts: Nursing Values and Ethical Responsibilities and Ethical Endeavours (Chaloner, 2007).

The first part “Nursing Values and Ethical Responsibilities” gives the main responsibilities of ethical nursing practice. The main nursing values are to provide health, ethical, safe and competent care, promote well-being, safety and health, inform decision-making, preserve dignity, maintain confidentiality and privacy, promote justice, being accountable etc.

The second part “Ethical Endeavours” is devoted to change, access, choice, rights, and equality in nursing practice.

Concluding, it is necessary to say that in their activity and practice, the nurses should regulate with the help of the Code of Ethics for Nurses. The Code of Ethics is appointed for the nurses and will be a good help in curing of sick people and in communication with them. The purpose of Code of Ethics for Nurses is to provide an ethical practice and ethical relationships between a nurse and a patient. Code of Ethics for Nurses gives the recommendations of ethical behaviors, responsibilities and making decision.

There is nothing strange that nurses use the principles of ethics in their work. To my mind, ethics is vital for them. It is relevant to apply ethics in clinical and professional nursing practices. In order to apply the ethical principles effectively, the nurses should develop constantly their professional skills and understand ethical concepts and principles (Woods, 2005).

The main ethical concepts applying to nursing practice are the following:

1) Avoiding harm. Indeed all nurses should work in such a way in order to help their patients and not to bring harm to them. The purpose of nurses is to help and take care. For the nursing practice this concept is the main one. It is also the basement of a good healthcare practice.

2) Moral duties and obligation. These ethical concepts will help nurses to define what is good and what is wrong. For example, truth telling to a patient is always a hard decision.

3) Assessing the consequences of actions. Any nurse always should assess the results of their activity and thinks in advance about the bad consequences.

4) Autonomy and rights. Nurses should be autonomous, free and self-determining. They should not be influenced by the patients. Autonomy means freedom from interference of other people.

5) Best interests. Curing people nurses should take into consideration other people's interests but this does not mean that they should forget about theirs ones.

6) Values and beliefs. Nurses should respect values and beliefs of their patients and their actions should be moral and ethical.

7) Emotions, relationships and context. Sometimes emotions in nursing practice may prevent from taking the right decisions that is why nurses should not be influenced by their own emotions and emotions of other people.

8) Moral character. Every nurse should know the character of moral behavior and follow it (Chaloner, 2007).

Concluding, it is worth saying that the main concepts of ethics applying in nursing practice are: avoiding harm, moral duties and obligation, assessing the consequences of actions, autonomy and rights, best interests, emotions, relationships and context and moral character.

Qualities of Ethical Nurses

There are numerous ethical virtues necessary for a good nurse but there are also the main ones that are extremely important. This integrity of moral qualities only benefits a good work and brings the positive results. Moral integrity is the whole person's character and the qualities of the character. Moral integrity is the combination of a good character, performance and intent. Nurses that are morally integrated have personal and professional approach to their work. Moral integrity is the capacity to be trustful, honest and morally courageous.

Nurses deal with moral distress in those cases when they cannot act according their moral integrity, when their professionalism contradicts their moral values. Nursing practice involves hard choices that can end with the conflicts, contradictions, discussions, emotional and physical sufferings, frustration, painful ambiguity, anger and guilt.

There are some scientists that connect moral distress with incompetence, poor healthcare, ineffective policy, and inadequate staff. As we see, moral distress is one of the main issues of nursing practice.

Honesty is an extremely important quality of nurses. To be honest means to be real, genuine, sincere and authentic. However, not always truth telling can help a patient, it can decrease his/her moral spirit that is why deception is present in nursing practice. Honesty is not only the quality being sincere with the patients. It is the quality of being honest with oneself.

Trustfulness is not less essential quality for nurse. Truthfulness is truth telling and in medical practice truth telling only prevents from a positive result. Ethically, nurses are obliged to tell the truth to their patients. In some Western countries, it is forbidden to withhold information concerning the state of health of a patient.

The next quality that should be present in nurses is moral courage. Rushworth Kidder wrote “Without moral courage, our brightest virtues rust from lack of use. With it, we build piece by piece a more ethical world.” Moral courage is associated with respect, honesty, fairness, responsibility and compassion. To be morally courageous means to overcome fear and panic, to be confident and follow moral values.

In conclusion, it is necessary to say that the main qualities of ethical nurse are moral integrity, trustfulness, honesty, moral courage, struggling with moral distress. This integrity of moral qualities only benefits a good work and brings the positive results. Moral integrity is the whole person's character and the qualities of the character.

References

Bandman, E. & Bandman, B. (2002). Nursing ethics through the life span. (4th ed.). Upper Saddle River, NJ: Prentice Hall.

Chaloner, C. (2007). An introduction to ethics in nursing. Nursing Standard. 21, 32, 42-46.

Woods, M. (2005). Nursing ethics education: Are we really delivering the good(s)? Nursing Ethics. 12, 1, 5-18.