Ethics of Care and Ethics of Justice - Essay Example

?Introduction There is a growing concern in identifying the gist of constructive relationship in the healthcare industry today. More and more specialists become involved into the practical peculiarities of the profession communicating with patients and underpinning the healthcare standards to the highest level. Thereupon, ethical prospects in nursing are at the core in this paper. Ethics of care seems to be taken for granted in nursing by many observers. It accompanies the idea of the Hippocratic Oath. Moreover, it makes the nurse-patient dialogue possible with emphasis on relief and recovery. However, this concept runs into the ethics of justice which can be narrowed down to a set of prescribed steps and norms in following nursing practice. Thus, the question of both ethical theories in their approaches toward contemporary medicine are to be duly analyzed so that to find out the best decision. Ethics of care Needless to say, current hospitals are full of professionals and those assisting them who can find out the right way in communication with patients. It is all about some psychological and moral obligations every nurse has at her/his disposal. The need for care is viewed to be paramount in hospitals. It makes the overall idea of recovery powerful. It goes without saying that a person can fight his/her illness starting from the inner decisions and inclinations. Believe it or not, such practice is well shared in the world. Moreover, it constitutes the need for care as a predominant impulse toward the inner recovery materializing in the physical healing. Ethics of care is well based on the personal relationships with a patient. It can be interpreted as the consideration of other’s point of view (Ashcroft, Dawson, & Draper, 2007). Care is a stimulus for every patient. Thus, a nurse able to follow up the prescriptions of her/his moral obligations before concrete patients, in particular, and the mankind, on the whole, has to use care every now and then. In other words, care is called to reduce patient’s vulnerability at the moment when it is critically high. Chesnay & Anderson (2011) admit in their study that ethics of care is generally focused on “attending to and meeting the needs of the particular others for whom we take responsibility” (p. 372). Thus, speaking ethically, the word “care” is already incorporated in the word “healthcare” justifying, therefore, the overall goal of the medicine. On the other hand, ethics of care seeks to pinpoint the need for relationship for the sake of striking a balance in gender roles. Definitely, women are more devoted to the caring; and the nursing ethics and ethics of care have become the pivotal virtues in the nursing practice far long ago (Yeo, 2010). To say more, ethical concerns should bear a confident character when applying to serious patients and those getting through some training and educational programs as a part of their recovery process (Klingberg-Allvin et al., 2007). Thus, the ethics of care is one of the first intentions coming on the part of a nurse despite of any circumstances or other impediments on her/his way. Again, relationship-based approach is what each nurse urges for. There is nothing more significant for a good and professionally fit nurse than to think about the need for assuring patients that they will be taken care of. To manage this prospect means to have an idea of where the nursing practice starts from: “The care ethics perspective cannot be understood in abstract or hypothetical terms, but only in actions stemming from caring relationships between people” (Sellman & Snelling, 2009, p. 60). Thus, any dispute on the nature of the ethics of care can be diminished due to a host of arguments on the importance of the first care aid and continuous care for patients throughout the period of hospitalization. Moreover, ethically grounded attitude of care on the part of a nurse is never a malfeasance. Ethics of justice Most researchers and observers are likely to state that ethics of justice serves a constraint for the previously mentioned ethics of care. However, one should bear it in mind that ethics of justice is based upon the norm of principle or a set of principles for every nurse. The thing is that nursing requires a great rate of responsibility. Thus, it is crucially important to have a justice mode underpinning assertiveness, power, control of emotions, and the like (Evans, Forney, & Guido, 2010). In this vein, the ethics of justice plays a significant role in the determination of the roles among nurses. It is a so-called means to keep control of nurses’ activities during their working schedules. Apprehending nursing ethics is not that easy as might be seen at a glance. It incorporates the ethics of justice as a theoretical approach to detect all shortcomings at the moment or in the past so as to decrease such cases to a minimum rate. Nevertheless, the ethics of justice also considers nurse/patient relationship but on the basis of principle (Melia, 1994). The question is that nurses are to follow the code of conduct before getting down to their duties. It concerns every single nurse as the price is too high. Although in many developed countries including the USA there are strict ethic guidelines, it does not mean that nurses should protest, but comply with all of those guidelines in order to provide patients with the best they can (Wilson, 2008). This approach claims to figure out the image of a proficient nurse in her/his being subject to the ethics of justice. Justice serves as a fundamental prerequisite of both ethics and law (Hendrick, 2011). This is why a nurse has to do everything for the patient’s security. That is to say, a nurse is ethically obliged to be near the patient and keep an eye open on patient’s well-being. Moreover, according to the ethics of justice, a set of requirements for a nurse can be excerpted out of the following remark: “Nurses uphold principles of justice by safeguarding human rights, equity and fairness and by promoting the public good” (Humphreys & Campbell, 2010, p. 81). These code notes put emphasis on the need for the ethics of justice. It incorporates the principles of living in a state governed by the rule of law. The vulnerability of patients is at stake every single hour of the extensive treatment. In this respect nurses are to be responsible for and aware of the ethics of justice in its perspective to fasten the whole process of recovery. Dickenson, Huxtable, & Parker (2010) have studied different approaches in the domain of ethics stating that “within psychiatric ethics, concern for rights and justice must be important because patients are made vulnerable by their mental illness, and are also vulnerable to abuse by others” (p. 119). In this case ethics of justice plays especially significant role in justifying and strengthening the position of the medical personnel. Comparison To compare both theories is to point out all peculiarities thereof. When speaking about nursing practice, care or justice provide an observer with a set of different prescriptions and prerequisites. However, first of all, one should keep it in mind that the art of nursing presupposes the use of either concept depending on the situation (Kjervik & Brous, 2010). This is why when the situation requires more care, a nurse is to promote care respectively. Conversely, when the rights and security of a patient are under a significant threat, ethics of justice should take place. Notwithstanding, comparing both ethical approaches should be with an extent of differences set by an independent judgment on their appropriateness. However, patients differ. Their claims are not always consistent and full of sound-mindedness. Definitely, it is a great stress for them to be in hospital, as there is a subliminal fear of being hurt or injured mistakenly. In this case the conflict between ethics of care and justice springs up eventually, since a nurse has to handle the situation when, for example, a patient refuses to keep up with the assigned treatment (Lundy & Janes, 2009). By and large, such cases remind one of providing justice through the imposed care. As was aforementioned, both approaches in the nursing ethics deal with the means to reduce the extent of patient vulnerability and to make their vulnerability secure respectively. Henceforth, both ethic of care and ethic of justice can be integrated in terms of a nurse’s decision-making process (Hammer, Moynihan, & Pagliaro, 2009). This is why two prospects are taken in their juxtaposition in solving difficult problems in accordance with the tight schedule. On the other side, Carol Gilligan, a psychologist who impacted the research on the ethics of care, once questioned the idea of “justice based” approaches to moral discussions” (Icheku, Icheku, & M.Phil, 2011, p. 21). Hence, there is a slight dependence of one concept on the other and vice versa. Moral obligations and necessity are to have some background in the field of justice. It is as easy as two and two makes four. Further still, ethics of justice seeks to embrace the claims on morality whereas ethics of care seeks to understand and accomplish the cure (Ashcroft, Dawson, & Draper, 2007). It is vital to note that care goes as a natural force coming from a man and in accordance with all good inclinations nurtured to him/her since the childhood. However, maturity comes when a person is aware of the principles of justice. What is more, both ethics of care and justice tend to separate nursing from the medicine, as a full-fledged discipline with its own moral and legal identities (Allmark, 1995). It is another way to justify and highlight the peculiarities of both approaches in their goal toward caring prospects throughout the three stages of cure, namely previous, current, and follow-up. Thus, two modes are significantly different, but each of them unites in accomplishing the ethics of healthcare through particular attention to patients. Extensive arguing for the appropriateness of the nursing between two approaches Various recommendations on the appropriateness of two concepts within the nursing practice are taken into account today. Along with the dispute between Gilligan and Kohlberg on the necessity of one or another ethical implementation, there should be a note on the decrease of the ethical conflicts that may simply happen between two or more nurses or between a nurse and a patient by means of the managerial supervision of following ethics, values, safe, and care (Carney, 2011). Nursing practice can find out equilibrium once healthcare delivery is guaranteed by rich and encouraging organizational culture. Talking about the impediments in the nursing, it is no doubt that the human factor matters much. Thus, care and justice should be speculated through the mechanisms of their implementation, first. Then, it is vital to promote particular incentives based on the moral and legal obligations. It is not all about the life of a nurse, but the life of patients that might be suffering from the misconception within the medical staff. It is necessary to state that there is a certain correlation between nurses’ organizational commitment and motivation to learn, based on the sample of the registered nurses working in the USA (Kang, Stewart, & Kim, 2011). Thus, nursing cannot go without two modes of attitudes (care and justice) implemented separately into the practical field of relationships with patients. Another barrier on the way of the high-quality healthcare delivery is the organizational change or restructuring. In this case ethics of care and justice are to be shared in a straight-forward manner through increasing employees’ satisfaction and by applying autonomy, workload and resource availability, and interpersonal relationships as the focal initiatives (Wall, 2010). Thus, appropriateness of the nursing relies not only on the sharpness and up-to-datedness of the medical treatment (surgeries, therapeutic methodology, other therapies), but also on the humane and morality evident through the way nurses work individually and collectively as well. Judging from the consensual approach toward ethics of care and justice, nursing practices should try more on improving patient safety culture by virtue of developing systems approach aimed at disclosing some latent factors (Hellings et al., 2010). It is important, however, to make out that some nurses may be agenda-driven in their work just because of different outside factors. Notably, the organizational culture serves to find out a golden mean in solving particular problems through the concepts of care and justice. Nonetheless, as was mentioned above nursing has become more independent with an increased attention to the ethical aspects in caring. All in all, talking on the extensiveness of the ethical approaches in the field of contemporary high standards of nursing in the developed countries, it is quite possible to suppose that the nursing practice is being constantly improved; and an individual management grows into the collective relationship-oriented perspective for the structural cohesion of the personnel. By selecting either care or justice, there is no categorical interpretation of which ethical flow is the most important as it depends on situation. Integration of both ethics for the nursing practice As might be seen, the overall discussion on the ethics of care and justice has been made in order to sequentially justify the need for integrating both modes in the nursing practice. Frankly speaking, it would be incomplete to follow one ethical approach without bearing in mind the other. It is especially amplified, as the nursing profession has been dynamically developing since the post-war period (Pate, Fischbacher, & Mackinnon, 2010). Current nurses are especially required to be aware of the legal prospects in their sincere attitudes to help patients. People will be people, and the first thing to do is to rally thoughts over the medical application accompanied by personal assistance of a nurse. Furthermore, in many cases, ethics of care stays in juxtaposition to an ethics of justice (Chesnay & Anderson, 2011). One of the examples is when a patient has been injured just in hospital by someone and a nurse provides him with the first care aid remembering that she/he has to ask somebody to report to the police keeping in mind a distressed mental and physical state of the patient. By no means, nurses are the first to be within easy reach to a patient. Thus, a specific emphasis should be put on the ethical appropriateness of moral and legal specifications embodied into the code of conduct for current nurses. Admittedly, nursing professionals are likely to be more altruistically mature so that to maintain appropriate set of actions to make patients relax (Valentine et al., 2009). It is not simply about finding out a compromise. Organizational improvement is what all hospitals and healthcare establishments seek today. Starting from the ethics, such improvement is likely to come true. All challenges concerning unequal relationships, power differences and some other socioeconomic disparities are solved through the ethics of care (Chesnay & Anderson, 2011). However, there should be a significant standpoint on the implementation of both perspectives in critical situations. Therefore, Chesnay & Anderson (2011) admit that “an ethics of care and an ethics of justice ought to be kept conceptually distinct from each other, and applied as the event or situation warrants” (p. 372). This is the point. Here comes a constructive suggestion on using both modes in nursing. Practicing ethical and moral medicine should be derived from some socio-political responsibility to comply with the ethics of justice in its widespread significance (Parhizgar, Parhizgar, & Parhizgar, 2009). Arriving at this statement, the right integration of both types of ethics makes a change in the overall understanding of nursing as a body of medical and social solutions for patients. In a psychiatric setting, the need for both care and justice is apparent due to the mental and moral vulnerability of patients having their own rights (O’Regan & Ryan, 2009). Once again, nursing staff should be cohesive keeping up with the demands of the event or situation. Implementing both ethics of care and justice, it seems quite possible and efficient in providing patients with suffice care. Conclusion Looking at the overall discussion, the need for ethics of care and justice in their integrated and united character is undoubtedly vital. In the dynamic sphere of healthcare industry, being the largest in the USA and many other countries, incorporation of morality- and principle-based objectives is really needful. Thus, culture of knowledge and cohesive attitudes throughout the medical staff should be well integrated through following up the two approaches (Isetta, 2008). As might be seen, each of the ethical trends improve on the nursing practice today. However, the picture of Medicaid and healthcare delivery becomes wider in quality of services and proficiency of nurses through integrating ethics of care and justice. Reference Allmark, P. (1995). Can There Be an Ethics of Care? Journal of Medical Ethics , 21, 19-24. Ashcroft, R. E., Dawson, A., & Draper, H. (2007). Principles of health care ethics (2 ed.). Hoboken, NJ: John Wiley and Sons. Carney, M. (2011). Influence of organizational culture on quality healthcare delivery. International Journal of Health Care Quality Assurance , 24 (7), 523-539. Chesnay, M. d., & Anderson, B. A. (2011). Caring for the Vulnerable (3 ed.). Sudbury, MA: Jones & Bartlett Publishers. Dickenson, D., Huxtable, R., & Parker, M. (2010). The Cambridge Medical Ethics Workbook (2 ed.). Canbridge: Cambridge University Press. Evans, N. J., Forney, D. S., & Guido, F. M. (2010). Student development in college: theory, research, and practice (2 ed.). Hoboken, NJ: John Wiley and Sons. Hammer, R., Moynihan, B., & Pagliaro, E. M. (2009). Forensic Nursing: A Handbook for Practice. Sudbury, MA: Jones & Bartlett Learning. Hellings, J., Schrooten, W., Klazinga, N. S., & Vleugels, A. (2010). Improving patient safety culture. International Journal of Health Care Quality Assurance , 23 (5), 489-506. Hendrick, J. (2011). Law and Ethics in Children's Nursing. Hoboken, NJ: John Wiley & Sons. Humphreys, J., & Campbell, J. C. (2010). Family Violence and Nursing Practice (2 ed.). New York, NY: Springer Publishing Company. Icheku, V., Icheku, V., & M.Phil. (2011). Understanding Ethics and Ethical Decision-Making. Bloomington, IN: Xlibris Corporation. Isetta, M. (2008). Evidence-based practice, healthcare delivery and information management. Aslib Proceedings: New Information Perspectives , 60 (6), 619-641. Kang, D.-s., Stewart, J., & Kim, H. (2011). The effects of perceived external prestige, ethical organizational climate, and leader-member exchange (LMX) quality on employees’ commitments and their subsequent attitudes. Personnel Review , 40 (6), 761-784. Kjervik, D. K., & Brous, E. A. (2010). Law and Ethics for Advanced Practice Nursing. New York, NY: Springer Publishing Company. Klingberg-Allvin, M., Tam, V. V., Nga, N. T., Ransjo-Arvidson, A. B., & Johansson, A. (2007). Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview. International Journal of Nursing Studies , 44 (1), 37-46. Lundy, K. S., & Janes, S. (2009). Community health nursing: caring for the public's health (2 ed.). Sudbury, MA: Jones & Bartlett Learning. Melia, K. M. (1994). The Task of Nursing Ethics. Journal of Medical Ethics , 20, 7-11. O’Regan, C., & Ryan, M. (2009). Patient satisfaction with an emergency department psychiatric service. International Journal of Health Care Quality Assurance , 22 (5), 525-534. Parhizgar, F. F., Parhizgar, S. S., & Parhizgar, K. D. (2009). Analysis of multicultural meta-ethical clinical perceptions concerning life and death of patients. Competitiveness Review: An International Business Journal , 19 (5), 409-422. Pate, J., Fischbacher, M., & Mackinnon, J. (2010). Health improvement: countervailing pillars of partnership and profession. Journal of Health Organization and Management , 24 (2), 200-217. Sellman, D., & Snelling, P. (2009). Becoming a Nurse. Austin, TX: Pearson Education. Valentine, S., Godkin, L., Page, K., & Rittenburg, T. (2009). Gender and ethics: Ethical judgments, ethical intentions, and altruism among healthcare professionals. Gender in Management: An International Journal , 24 (2), 112-130. Wall, S. (2010). Critical perspectives in the study of nursing work. Journal of Health Organization and Management , 24 (2), 145-166. Wilson, A. (2008, September 30). FOREIGN-TRAINED NURSES: Letter Addresses New Ethics Guidelines. American Health Line . Yeo, M. (2010). Concepts and Cases in Nursing Ethics (3 ed.). Peterborough, ON: Broadview Press. Read More