Ethics refers to the moral principles that guide decision-making a behavior (Stephens and Brighton 2015) or how to best live a life which is moral (Johnstone2016). Harris et al (2014) further clarify the definition of ethics as the rules and standards by which a community regulates the behavior of its members. Moral principles, therefore, arise from beliefs about what can be considered right or wrong, which may be socially, professionally or philosophically based (Stephens and Brighton 2015). Johnston (2016) states there is no philosophically significant difference between the terms ethics and morality which can be used interchangeably however, Atkins et al (2014, p26) disagree, believing ethics differ from morals stating that moral principles are rule like expectations or beliefs that a person considers to be ethical.(Words, 2017)
A set of ethical principles often cited in nursing texts are those described by Beuchamp and Childress (1994) in their book Principles of Biomedical Ethics. They are so well known that they have been called “The Georgetown Mantra” as the authors were from Georgetown University. These include the following: • The principle of respect for autonomy – meaning state of self governance • The principle of non maleficence – meaning not doing harm to others • The principle of beneficence – meaning charitable or generous (promote the wellbeing of others) • The principle of justice – meaning being fair in resource allocation and fairness.
However, these principles were developed for medicine in general rather than nursing in particular.(Council, 2009)
The first Code of Ethics and Conducts for Public Service in Tanzania was issued for the first time since independence in 1961. During that period code of ethics and conducts was inherent in different laws and regulations and was not available to all employees as such they were unable to know exactly of the expected standards. To counter that shortcoming in 2005, Tanzania developed a new code of ethics and conducts stipulating clearly the standard of behavior expected for public servants. The existing code has been widely distributed so that public servants clearly understand what is required of them in terms of ethical conduct and standards of performance acceptable in the Public Service, URT (2005). As part of induction programme, all public servants in Tanzania are oriented with these codes to enable them discharge their duties with great care. It is within this framework that all behaviors, actions decisions made by public servants should conform to these codes.(Yusuph, Guohua, & Abeid, 2017)
Negligence’s and lack of knowledge of nursing ethical principle among the nursing students during clinical practices,
Statement of the problem
Notwithstanding the fact that “Nursing Ethics” has been, to some extent, handled as a topic in a number of nursing curricula developed in the country, the emphasis of the subject has not been adequate. Tanzania has decided to give priority to health issues in order to achieve Millennium Development Goals. However, these goals will never be realized if the health of Tanzanians remains poor. Due to this fact, the Tanzania Nurses and Midwives Council embarked on a program to improve knowledge of ethics for nurses in Tanzania. Various approaches have been applied including the development of various guides. The guide consists of five units covering the following themes, which include ethical principles, patients?/client and nurses? rights, ethical dilemmas, ethical decision making, and the Professional Code of Conduct. For each of the broad objectives, specific objectives have been developed including methods and content for handling them. Although this guide’s primary target groups are practicing nurses, it is nevertheless useful for pre-service and in-service trainee nurses.(Council, 2009)
In general, there seems to be three common reasons for nurses’ failure to observe the ethical codes: inef- fectiveness of the codes in daily clinical practices, disparity between the codes and the realities in clinical environments, and nurses’ unawareness of the codes.18 Moreover, the differences between the nurses’ and patients’ viewpoints regarding nurses’ adherence to ethical codes in Iran imply that although the ethical codes for nurses have been set in accordance with the Iranian culture, it is essential to hold more educational programs for the staff as well as nursing students and monitor nurses’ ethical performance more carefully.9 In fact, more informed nurses can respect and protect their patients’ rights more effectively.19 Factors, such as disproportion between the number of nurses and patients, can affect nurses’ ethical performance, as well. Bennett et al.20 also mentioned insufficient time and staff, compared to the large number of patients, as the main barriers to nurses’ observance of professional ethics at work.(Momennasab ; Koshkaki, 2016)
The purpose of this study of this study is to assess knowledge of nursing ethical principles among the Bachelor nursing students (BNS), this will help to address the challenges facing the nursing students to practice and maintain ethical code of conduct during their clinical routine.
The main objective of this study is to improve and maintain knowledge of the ethical code of conduct among the nursing students at MUHAS during clinical practices
Specific objectives of the study
• To assess the knowledge of nursing students on the nursing ethical of conducts.
• To assess level of understanding of ethical principles between the male nursing students and female nursing students
• To assess challenges facing nursing students to practice and maintain nursing ethical principle.
• What is the knowledge of nursing student concerning abut nursing ethical of conducts?
• Does the level of understanding of understanding on nursing code of ethics differ between that of male nursing student and female nursing student?
? Alternative hypothesis
Male nursing student are more likely to have higher level of understanding on nursing ethical principles if compared to the female nursing students
Conceptual framework is a written or visual presentation that explains either graphically or in narrative form the relationship of ideas or the main things to be studied can be the key factors, concepts or variables.
Describe the three criteria that can be used to achieve/improve some level of professional practices compliance with the proffessional code of ethics
Sources (adapted and modified from Gberegbe, Ferry Barineka 2016)
Description of the diagram above
A professional code of ethics should have local perspective. That is, the guidelines on professional conduct must be consistent with the values, The individual/personal value can provide the basis of assessing professional codes of ethics in terms of personal culture, so that the likely success of professional code of ethics. The professional code must be able to satisfy or proscribe behaviors. Thus, we recognize the use of punitive measures (loss of membership for those violates the standards) to check unethical behaviour. Velayutham (2003) asserts that disciplinary measures can be used to support enforcement of professional code of ethics.
The mere existence of professional code of ethics is not enough to guarantee an individual profession’s compliance (Cohen, Pant and Sharp, 1992). Miller (in Cohen et al. 1992) acknowledges that professional code of ethics may be respected more in one place than in another. Accordingly, we recognized professional code of ethics as an important valuable.(Gberegbe & Gabriel, 2016)
An overview of the nursing ethical principle
Ethics is, and always has been, an essential component of nursing practice. Ethical principles such as the value of life principle, the principle of goodness or rightness, the principle of justice or fairness, the principle of truth telling or honesty, and the principle of individual freedom are basic to nurse-patient relationship. However, the application of these principles in specific situations is often problematic, since nurses, patients, their family members and other healthcare personnel may disagree about what is the right way to act in a situation(Council, 2009). Despite of being the essential component of nursing practice but the knowledge and maintain of principle of ethics among the nursing student during their clinical rotation it has been a big challenges.
Some study have just try to describes some factors that are thought to be the main factor for this nursing students not to adhere to the nursing codes of conduct and these are analyzed as follow disproportion between the number of nurses and patients, can affect nurses’ ethical performance, as well as insufficient time and staff, compared to the large number of patients, as the main barriers to nurses’ observance of professional ethics at work.
Most studies in this area have focused on nurses’ attitudes toward ethical codes, while the real beneficiaries of the codes are patients, and their opinions have to be taken into account in order to improve the quality of care. Moreover, evidence has shown that nurses and patients hold significantly different views about nurses’ adherence to ethical codes. According to one study, while 91.9% of the nurses believed that their performance was satisfactory regarding the ethical codes, only 41.8% of the patients rated their per- formance as acceptable.(Momennasab & Koshkaki, 2016)
Some study has just tried to describe among those principle of conduct no principle is weighted higher than the other principle, both should considered having a vital role in biomedical ethics.” Beauchamp and Childress examined considered moral judgments and the way moral beliefs cohere and found that the general principles of beneficence, nonmaleficence, respect for autonomy, and justice play a vital role in biomedical ethics. These authors believe that the four principles are not only specific for biomedical ethics, they are found in all cultures in everyday life because they are part of a cross-cultural common morality shared by all persons committed to morality. The four clusters of principles provide a framework of norms to start with in biomedical ethics. As a starting point no principle is weighted higher than the other principles. When occasion arises, the principles are weighted, balanced, and specified”(Ebbesen, 2016)
Another study conducted in Australia show that has a code of Ethics by which all nurses should abide it, it does it matter where it is in hospital setting, in education institution or conducting the research, this just try to describe the need for approval in conducting of research among the human being while maintain the ethical principles and sound the knowledge of the ethical principles that guide nursing practice and research are essential for any researcher.
The Nursing and Midwifery Board of Australia (NMBA) (2013) has a Code of Ethics by which all nurses should abide whether practicing within a hospital setting, an educational institution or whilst undertaking any research to protect the moral interests and welfare of patients (Adrian and Chiarella 2016; Johnstone and Crock 2016) and act as advocate (Epstein and Turner 2015; NMBA 2013). If a researcher is specifically undertaking human research it falls under the label of Bioethics (Stephens and Brighton 2015) which is derived from the Greek bios meaning life (Johnstone 2016). Bioethics refers specifically to ethics that are applied to human life or health decisions (Johnstone 2016).(Words, 2017)
Council, M. (2009). Nursing Ethics A Facilitator ‘ s Guide.
Ebbesen, M. (2016). Bioethics across Cultures – Philosophical and Empirical Justification of the Four Principles of Biomedical Ethics Clinical Research ; Bioethics Bioethics across Cultures – Philosophical and Empirical Justification of the Four Principles of Biomedical Ethi. Article, (April). https://doi.org/10.4172/2155-9627.1000259
Gberegbe, F. B., ; Gabriel, A. (2016). Does Professional code of ethics influence Professional Accounting Practice in Rivers State , Nigeria?? Lilian Okorite Nkanbia-Davies, 4(1), 14–21.
Momennasab, M., ; Koshkaki, A. R. (2016). Nurses ‘ adherence to ethical codes?: The viewpoints of patients , nurses , and managers, 23(7), 794–803. https://doi.org/10.1177/0969733015583927
Words, K. E. Y. (2017). A nurses ‘ guide to ethical considerations and the process for ethical approval of nursing research, 35(1), 40–47.
Yusuph, M. L., Guohua, W., ; Abeid, A. R. (2017). Code of Ethics and Conducts in Public Service?: The Litmus Test for Public Administrators Ethical Decision Making in … Code of Ethics and Conducts in Public Service?: The Litmus Test for Public Administrators Ethical Decision Making in Resolving Ethical, 18(January), 79–87. https://doi.org/10.9790/487X-1812037987