Ethical Principles in Health Care

A smiling nurse takes down a patient’s information on a clipboard.

Ethics are the backbone of health care, because they shape the concept of care delivery in numerous and fundamental ways. A facility that consistently upholds ethical principles ensures every action is legally compliant and conducted with integrity. These principles are applied throughout health care, from relationships in the patient/provider dynamic to research methodologies used to discover the next medical breakthrough. Collectively, they allow the health care industry to commit to the greater good of society,  regardless of how the care-focused tools and systems in the industry evolve.

These ethical principles provide a structure that guides health care professionals, such as nurse leaders, in building strategies to provide optimal patient care and improve outcomes. One way nurse leaders learn these basic principles is through education, such as a Master of Science in Nursing (MSN) program.

What Are Ethical Principles in Health Care?

Ethical health care is governed by principles that ensure patients are offered the best available care, while simultaneously respecting their wishes. These principles are designed to support a respectful, dignified, and humane approach to care. They are key to the patient/provider relationship, and also guide a facility’s administrative functions.

In their 1979 classic The Principles of Biomedical Ethics, coauthors Thomas Beauchamp and James Childress listed four ethical principles that can be used to govern health care. Nursing leaders should consider these principles as they build care delivery strategies.


This principle refers to the obligation of nurses to act for the patient’s benefit. This not only obliges nurses to promote patient welfare, but also to mitigate the threat of self-harm. This element is critical, because it establishes the foundation of a patient/provider dynamic that allows trust and rapport to organically occur.


This principle ensures caregivers will not inflict harm to patients. This can be interpreted in many ways, from not incapacitating a patient to not causing suffering or death. This principle helps nurse professionals provide care that aligns with common moral convictions, and the law.


This principle obliges health care professionals to make sure patients fully understand the options open to them regarding their health, so they can freely make their own decisions. This principle lays the groundwork for informed consent.


This principle compels health professionals to treat patients fairly, equitably, and appropriately. This means developing strategies that ensure no one is disadvantaged in their ability to access essential health care needs.

These four principles can be used by nurse leaders to build a holistic care approach that respects patients regardless of their situation.

Ethical Issues in Health Care

A number of ethical dilemmas can develop in the course of patient treatment that can make adhering to these principles challenging.

One issue involves doctor/patient confidentiality. While there are instances where confidentiality can be breached, such as concern for the patient’s safety, there may be less severe instances where a nurse may feel compelled to breach this arrangement. For instance, a nurse may be tempted to share the patient’s condition with another nurse or with a patient’s family member. However, this is only allowed in situations of implied consent, where sharing such information can be critical to improving the patient’s outcome.

Another issue concerns dying with dignity, the end-of-life practice that allows a patient to legally request a medical professional to prescribe medication to humanely expedite death. This scenario, which is allowed in several states, may cause a dilemma for nurses who feel such a situation conflicts with their personal ethics.

Some nurses may also struggle with care equity and underserved populations. This could involve cross-cultural communication challenges or discrimination. Access to health care is also an issue in many rural areas, which don’t have the facilities that larger cities do. A March 2021 report by the Kaiser Family Foundation found 61.47% of primary care health professional shortage areas (HSPAs) were located in rural regions.

Additionally, technological advancements such as artificial intelligence (AI) can create new ethical dilemmas for nurses. These dilemmas may stem from concerns about flaws within the AI process, such as data bias or error margins producing inaccurate or incomplete information. Other concerns regarding AI may include issues of data privacy and informed consent.

These dilemmas illustrate why ethical principles in health care are so crucial. Following these basic principles can help nurses navigate difficult situations to focus on patients’ needs and wishes, while providing optimal care.

How Nurses Practice Ethical Care

Nurses can apply ethical principles in health care to their own practice by following The Code of Ethics for Nurses with Interpretive Statements, also known as The Code. The American Nurses Association established these standards as a support tool to help nurses deliver care in a humane and respectful manner. The Code consists of nine provisions that address three areas:

  • Provisions 1-3: Establish the fundamental values and commitments associated with the nursing role.
  • Provisions 4-6: Identify the boundaries of a nurse’s responsibility.
  • Provisions 7-9: Describe a nurse’s responsibilities beyond individual patient encounters.

By relying on these provisions in their own practice, nurse leaders can promote ethical practices among their staff.

Creating Ethical Nurse Leaders

Applying ethical standards in nursing isn’t just about doing the right thing. It’s also about providing patients with the best possible care. Nurse leaders can play a key role in applying standards that treat patients equitably and with dignity.

Hawai‘i Pacific University’s online Master of Science in Nursing program and its three concentrations offer a holistic approach to creating patient-centered change, with a focus on transcultural care. HPU students study evidence-based practice, professionalism and ethics, and health policy and advocacy alongside clinical care.

Learn how HPU can help you on your path to success as an ethically driven health care leader.

Recommended Reading:

Non-Bedside Nursing: 8 Alternatives Beyond the Bedside

Nursing Job Growth: Opportunities for Advancement

Trauma Nursing in Vacation Cities


The American Journal of Bioethics, "Principles of Biomedical Ethics: Marking Its Fortieth Anniversary"

American Nurses Association, Ethics and Human Rights

Artificial Intelligence in Healthcare, "Ethical and Legal Challenges of Artificial Intelligence-Driven Healthcare"

Houston Chronicle, "What Is the Importance of Good Ethical Standards in Health Organizations?"

Kaiser Family Foundation, Primary Care Health Professional Shortage Areas (HPSAs)

MDLinx, "Prevalent Ethical Dilemmas in Practice Today - as Told by Doctors"

Medical Principles and Practice, "Principles of Clinical Ethics and Their Application to Practice"

Reuters, "Ethical Issues Surrounding Research of AI in Health Care"

Rural Health Information Hub, Healthcare Access in Rural Communities

StatPearls, "Nursing Ethical Considerations"