These challenges can be especially difficult for nurses who struggle both to become accepted into a new society and to exercise moral courage in an unfamiliar environment. Scholars of moral courage have addressed the question of whether there is a common moral framework that exists across cultures.
While it is evident that values and principles vary worldwide, scholars point to ethical values that are shared across cultures, such as honesty, integrity, fairness, respect, responsibility, empathy, compassion, and courage.
Moral Courage in Healthcare: Acting Ethically Even in the Presence of Risk
The scholars who study moral courage, however, have observed that diverse cultures place different priorities on these ethical principles. This position statement has noted that nurses who bring varying cultural customs, philosophical views, and ethical principles to the professional setting can strengthen and broaden healthcare delivery as they help their colleagues understand differing perspectives regarding illness and treatment modalities ANA, Moral courage can be seen in a staff nurse such as Emily described above , who, when under pressure from administration, refuses to document patient care that wasn't provided; in a researcher who declines to engage in scientific misconduct for the purpose of receiving funding to help the organization enjoy better standing in the research community; or in an academician who rejects unrelenting demands to pass failing students despite threats to tenure Murray, a.
All of these healthcare professionals exemplify moral courage in doing what they believe is ethically correct. Scholars have questioned whether or not moral courage is instinctive or a trait that is learned. Aristotle in particular argued that moral virtues are teachable Day, ; Miller, Most scholars who study ethics agree with Aristotle that everyone, regardless of profession, can benefit from education and training in the area of moral courage Kidder, Moral courage can only be developed and strengthened through regular application Miller, Healthcare professionals need to recognize their responsibility to address unethical behaviors in the workplace Murray, ; Saver, When nurses are mentored in developing moral courage, they come to learn and take-hold-of new behaviors, such as taking action when unethical behaviors are observed.
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Academic programs at the undergraduate and graduate levels, internships, fellowships, and continuing education programs in which participants dialogue about ethical dilemmas can serve to develop moral courage. Healthcare organizations that acknowledge the importance of following ethical principles can create an expectation that morally courageous behavior will occur when personnel face ethical dilemmas that threaten deeply held values pertinent to the work environment Purtilo, Furthermore, hospitals, academic institutions, research centers, and professional organizations are encouraged to make resources related to moral courage available to all healthcare providers.
Valuable resources include professional journal articles, textbooks, and continuing educational offerings, along with institutional policies that support an ethical environment Aultman, ; Murray, ; a. Table 1 lists a number of websites offering resources to strengthen moral courage among healthcare professionals. Demonstrating moral courage when confronted with ethical misconduct is critical to good professional practice whether in a clinical setting, the classroom, a research laboratory, or the boardroom Day, Table 2 presents critical checkpoints to assist healthcare professionals demonstrate moral courage in healthcare settings.
Determine what moral values and ethical principles are at risk or in question of being compromised. Ascertain what principles need to be expressed and defended in the situation — focus on one or two of the more critical values. Avoid stumbling blocks that might restrain moral courage, such as apprehension or over reflection leading to reasoning oneself out of being morally courageous in the situation.
A number of challenges can circumvent moral courage. Individuals should be familiar with the behaviors that have the potential to disrupt morally courageous actions.
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Table 3 offers examples of inhibitors of moral courage. It is important that all healthcare professionals value and support their peers who have the courage to stand up and speak out against unethical behavior even when others are silent or differ in opinion. This article has highlighted the critical need for healthcare professionals who both understand the importance of moral courage in the workplace and are willing to take action when ethical values are being compromised.
All levels of educational programs, and also continuing education programs are encouraged to address the need for moral courage and to teach strategies that enable healthcare providers to act courageously when ethical standards are compromised. Healthcare institutions can address moral courage and ethical principles in their position descriptions, performance appraisals, and strategic planning sessions.
It is essential that the healthcare industry develop leaders with strong ethical values, leaders who are willing to live these values with integrity and courage, even when doing so risks their professional relationships and their position in their organizations Murray, In these roles he has authored resolutions for ANA and peer-reviewed articles for professional journals addressing workplace abuse and harassment of nurses. He is now working on legislation to protect nurses who report workplace abuse and harassment.
Murray was a nominee for The John F. Kennedy Profile in Courage Award, the nation's most prestigious honor awarded to individuals whose actions best demonstrate the qualities of politically and morally courageous leadership, for his efforts related to workplace ethics. Cultural diversity in nursing practice.
Retrieved February 17, from www. Code of ethics for nurses with interpretive statements. Retrieved December 20, from www. Moral courage through a collective voice. The American Journal of Bioethics, 8 4 , 67 — Perspectives on transcultural care. Nursing Clinics of North America, 44 , — Of courage, honor and integrity. Mapping the Moral Landscape. The Johns Hopkins University Press. Moral courage for a university ethics capstone class? Retrieved February 15, from www. Nursing Administration Quarterly, 27 2 , — Courage as a virtue necessary to good nursing practice.
American Journal of Critical Care, 16 6 , — A definition and conceptual model. The Leadership Quarterly, 18, — A Systematic Approach 2 nd Ed. A virtue in need of development? Moral courage in action: A clinical case example. Ethical challenges in healthcare - Developing your moral compass. Moral courage definition and development. Retrieved December 20, from http: Letter to the editor.
Nursing Outlook, 58 , 6 — 7. No more nurse abuse.
Moral Courage in Healthcare: Acting Ethically Even in the Presence of Risk
American Nurse Today, 3 7 , 17 — Creating ethical environments in nursing. Bioethics , branch of applied ethics that studies the philosophical, social, and legal issues arising in medicine and the life sciences. It is chiefly concerned with human life and well-being, though it sometimes also treats ethical questions relating to the nonhuman biological environment. Such questions are studied primarily in the independent…. Aristotle , ancient Greek philosopher and scientist, one of the greatest intellectual figures of Western history.
He was the author of a philosophical and scientific system that became the framework and vehicle for both Christian Scholasticism and medieval Islamic philosophy. Traditionally, it was also described as final causality, in contrast with explanation solely in terms of efficient causes the origin of a change or a state of rest in something. Help us improve this article! Contact our editors with your feedback. You may find it helpful to search within the site to see how similar or related subjects are covered. Any text you add should be original, not copied from other sources.
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Ethics Principles
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