PHILIPPINE NURSES LICENSURE EXAMINATION 2025

PALMERJ NOTES

Ethical and Legal Aspects of Nursing ●​ Influences: Family, cultural beliefs, and societal
1. Introduction norms.
●​ Nursing practice is deeply influenced by laws,
ethics, patient rights, and nursing duties,
shaping nurses' careers and decisions.
●​ Ethical nursing involves applying moral beliefs Morality
and making consistent, logical decisions. ●​ Definition: Personal standards of right and
●​ All practicing nurses must be licensed by the wrong, often shaped by cultural and religious
Professional Regulation Commission (PRC) and beliefs.
can use the title Registered Nurse (R.N.). Nursing Ethics
●​ Definition: A study of the moral foundations of
2. Key Legal and Ethical Guidelines for Nurses nursing practice, focusing on what is
●​ Philippine Nursing Act of 2002 (R.A. 9173): considered "good" in nursing actions.
Defines the scope of nursing practice.
●​ Standards of Safe Nursing Practice (ANSAP): Ethical Dilemmas
Outlines the professional standards and ●​ Definition: A situation where a choice must be
guidelines. made between two or more equally undesirable
●​ Code of Ethics for Nurses: Guides ethical alternatives.
conduct and decision-making. ●​ Characteristics (Leah Curtin, 1982):
●​ Job Descriptions: Nurses must adhere to 1.​ Cannot be solved using only empirical
defined roles and responsibilities. data.
2.​ The problem is confusing, making it
Helpful Guidelines for Ethical Decision-Making difficult to decide what facts to
consider.
1.​ Know Your Values: Understand your personal
3.​ The consequences of the decision have
values to avoid compromising them.
far-reaching effects.
2.​ Follow the Code of Ethics: Familiarize yourself
with the ethical standards that guide nursing
Approaches to Ethical Decision-Making
practice.
3.​ Respect Others' Values: Avoid imposing your 1.​ Deontological (Duty-Based): Focuses on the
values on others. rules or duties that determine the rightness of
4.​ Patient Well-being: Your primary responsibility actions.
is to ensure the well-being and safety of your 2.​ Teleological (Outcome-Based): Focuses on
patients. the outcomes of actions, with an emphasis on
the greatest good for the most people.
Ethical Terms and Concepts 3.​ Situational: No prescribed rules—decisions are
made based on the specific circumstances of
Ethics
each case.
●​ Definition: A study of what is right and wrong,
based on knowledge, not just opinions.
Ethical Theories
●​ Origin: Derived from the Greek word "ethos,"
meaning character. 1. Teleology (Consequentialism)
●​ Focus: The moral decision-making process and ●​ Definition: A moral theory where actions are
the consequences of actions. judged based on the consequences or results.
Morals ●​ Utilitarianism: The greatest good for the
●​ Definition: Standards of conduct, character, greatest number, focusing on minimizing harm
and motives in human actions. Morals often and maximizing happiness.
include the terms "good," "right," and "worthy." 2. Deontology (Duty-Based Ethics)
●​ Source: Influenced by personal, cultural, and ●​ Definition: The rightness of actions is based on
societal factors. their inherent nature, not on the consequences.
Values ●​ Golden Rule: "Do unto others as you would
●​ Definition: Personal beliefs that guide behavior have them do unto you."
and give meaning to life.
Universal Principles of Biomedical Ethics
 1.​ Rights: Entitlements or privileges that 7.​ Compare with Ethical Philosophy: Align the
individuals hold, such as the right to decision with your ethical principles.
self-determination, informed consent, and 8.​ Follow-Up: Review the outcome and learn from
privacy. it for future decisions.
○​ Self-Determination: The right of
individuals to make decisions about Nursing Implications
their own healthcare. 1.​ Respect Human Dignity: Provide services with
○​ Advanced Directives: Legal respect for the uniqueness of each patient.
documents specifying a person’s 2.​ Confidentiality: Safeguard patient privacy.
healthcare choices if they become 3.​ Responsibility: Ensure patient safety and
incapacitated (e.g., Living Will, Do Not professional accountability.
Resuscitate [DNR], Power of Attorney). 4.​ Competence: Maintain professional
2.​ Cultural Relativism: Respect for individuals' competence and contribute to the development
beliefs and values, understanding them in the of nursing knowledge.
context of their own culture. 5.​ Collaboration: Work with other healthcare
3.​ Right to Competent Care: Ensuring that professionals to meet public health needs.
patients receive appropriate and safe care. 6.​ Protection from Misinformation: Help protect
4.​ Right to Informed Consent: Patients must be the public from inaccurate health information.
fully informed about their treatment options and
give consent voluntarily. Moral and Spiritual Responsibility of Nurses
●​ Golden Rule: Treat others as you would like to
Ethical Principles for Nurses be treated.
1.​ Autonomy: Respect for the patient’s right to ●​ Two-Fold Effect: An action may have both
make their own healthcare decisions. good and bad effects, but the good must
2.​ Beneficence: The duty to do good for the outweigh the bad.
patient. ●​ Principle of Totality: The whole is greater than
3.​ Nonmaleficence: The duty to avoid causing the sum of its parts.
harm to the patient. ●​ Epika (Exceptions): Recognize when
4.​ Justice: Fair treatment and allocation of exceptions to the rule are justified.
resources, ensuring that all patients are treated
equitably. International Council of Nurses (ICN)
5.​ Fidelity: Keeping promises and being loyal to ●​ Mission: Represent nursing worldwide, promote
the patient’s needs. the well-being of nurses, advocate for health
6.​ Veracity: The obligation to tell the truth and policies, and ensure quality nursing care
maintain honesty in all aspects of care. globally.
7.​ Confidentiality: Ensuring that patient ●​ Membership: Comprises over 130 national
information remains private unless consent is nurses' associations, representing millions of
given or it is necessary to disclose for safety nurses worldwide. Nurses who are part of their
reasons. national association are automatically part of
ICN.
Ethical Decision-Making Models
Murphy and Murphy's (1976) Approach to Ethical Nursing Code of Ethics
Problem Solving Preamble
1.​ Identify the Problem: Recognize the ethical ●​ Nurses have four fundamental responsibilities:
issue. 1.​ To promote health
2.​ Why is it an Ethical Problem?: Clarify the 2.​ To prevent illness
ethical dilemma. 3.​ To restore health
3.​ People Involved: Identify stakeholders in the 4.​ To alleviate suffering.
decision-making process. ●​ Nursing care is universal and not restricted by
4.​ Role of Decision-Maker: Determine who is age, color, creed, culture, disability, illness,
responsible for making the decision. gender, nationality, politics, race, or social
5.​ Consider Consequences: Evaluate both short- status.
and long-term consequences. ●​ Nurses respect human rights, including the right
6.​ Make the Decision: Choose the best course of to life, dignity, and respectful treatment.
action.

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 ●​ Nursing services are rendered to individuals, ●​ Maintain professional identity while working in
families, and communities, with coordination health teams.
among related groups. ●​ Ensure all health team activities conform to
ethical-legal standards.
Elements of the ICN Code of Ethics for Nurses ●​ Contribute to colleagues’ professional
1.​ Nurses and People development.
2.​ Nurses and Practice ●​ Participate actively in professional
3.​ Nurses and the Profession organizations.
4.​ Nurses and Co-workers ●​ Respect and safeguard the reputation and
dignity of colleagues.
1. Nurses and People
4. Nurses, Society, and Environment
Ethical Principles:
●​ Respect the values, customs, and spiritual Ethical Principles:
beliefs of individuals. ●​ Preserve life, respect human rights, and
●​ Respect the individual’s freedom to make promote a healthy environment.
rational and unconstrained decisions. ●​ Promote health and social needs by establishing
●​ Maintain strict confidentiality of personal linkages with the public at local, national, and
information acquired during nursing care. international levels.
Guidelines: Guidelines:
●​ Treat patients as individuals and consider their ●​ Nurses must be conscious of their civic duties
totality in care. and actively participate in community concerns.
●​ Respect spiritual beliefs and practices, ●​ Be knowledgeable about community health
particularly concerning diet and treatment. resources and participate in primary health care.
●​ Uphold the rights of individuals and respect ●​ Actively contribute to programs, projects, and
cultural values in care provision. activities that address societal problems.
●​ Uphold ethical conduct and proper decorum in
2. Nurses and Practice personal and professional life.
●​ Promote the nursing profession through positive
Ethical Principles:
personal and professional image.
●​ Human life is inviolable.
●​ Quality and excellence are the goals in nursing
5. Nurses and the Profession
practice.
●​ Accurate documentation of actions and Ethical Principles:
outcomes reflects nursing accountability. ●​ Maintain loyalty to the nursing profession and
●​ Nurses advocate for clients, safeguarding their preserve its integrity.
rights and privileges. ●​ Uphold and support the by-laws of professional
●​ Recognize the professional, ethical, moral, and organizations, such as the Philippine Nurses
legal dimensions of nursing actions. Association (PNA).
Guidelines: ●​ Commit to continual learning and the
●​ Be aware of the scope of nursing practice as development of the profession.
defined by R.A. No. 9173 ("Philippine Nursing ●​ Contribute to the socio-economic and welfare
Act of 2002") and related regulations. improvements of nurses through appropriate
●​ Uphold the “Patients’ Bill of Rights” in care legislation.
delivery.
●​ Provide full information to patients or their Violations of the Code of Ethics
families, excluding only information harmful to ●​ A nurse found guilty of violating any provision of
their well-being. the Code of Ethics will face disciplinary actions,
●​ Uphold patients' rights when conflicts arise including censure, reprimand, suspension, or
about care management. revocation of their certificate of registration.

3. Nurses and Co-Workers Patient’s Bill of Rights

Ethical Principles: 1.​ Right to Respectful Care: Patients are entitled

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 3.​ Right to Informed Consent: Patients must be Patient’s Responsibilities
informed of the risks, benefits, and alternatives 1.​ Provide accurate and complete health
of any treatment or procedure and give consent information.
voluntarily. 2.​ Follow prescribed treatments and instructions
4.​ Right to Refuse Treatment: Patients have the for their benefit.
right to refuse treatment and to be informed of 3.​ Inform physicians if refusing treatment.
the consequences of such actions. 4.​ Seek a second opinion or consult other
5.​ Right to Privacy and Confidentiality: Patients physicians if desired.
have the right to privacy regarding their medical 5.​ Pay for medical services.
care and information, with limited exceptions 6.​ Consider the rights of other patients and
based on law or public safety. healthcare providers by following hospital rules
6.​ Right to Refuse Participation in Research: and respecting privacy.
Patients can refuse to participate in medical
research without penalty.
7.​ Right to Bill Explanation: Patients are entitled Source:Leadership Roles and Management Functions
to a detailed explanation of the medical charges in Nursing: Theory and Applications
incurred. Author: Bessie L. Marquis, Carol Huston
8.​ Right to Ongoing Care Information: Patients
Nursing Code of Ethics
have the right to be informed of their continuing
healthcare needs after discharge.
9.​ Right to Choose Providers and Facilities:
Patients have the right to choose healthcare
providers and consult specialists for a second
opinion.
10.​ Right to Self-Determination: Patients can
make decisions about their care, including
advance directives.
11.​ Right to Medical Records: Patients have the
right to access a summary of their medical
history and condition.
12.​ Right to Be Informed of Rights and
Obligations: Patients should be informed about
their rights and obligations.
13.​ Right to Leave: Patients can leave healthcare
institutions against medical advice but not due
to financial issues.

Informed Consent
●​ Consent Process:
○​ Consent must be obtained from the
patient if they are of legal age and
sound mind.
○​ In cases where the patient cannot
consent, third-party consent is required
(spouse, children, parents, etc.).
●​ Exceptions to Consent:
○​ In emergencies when withholding
treatment may cause imminent harm.
○​ When public health requires mass
health measures (e.g., epidemics).
○​ As required by law.
○​ When a patient is a minor or legally
incompetent, third-party consent is
needed.
○​ If the patient waives their right to
consent in writing.

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