Ethical Considerations in Nursing Education - Dissertation Example

?Running head: ETHICAL CONSIDERATIONS IN NURSING EDUCATION Ethical Considerations in Nursing Education Insert Insert Grade Insert Name February 9, 2012 Ethical Considerations in Nursing Education Introduction The nature of nursing profession is that, many ethical and moral issues are likely to emerge, while the professional is working or conducting his or her duties. Dealing with human lives constitutes very sensitive roles where there is likely to be many issues of interest that may emerge (Pozgar, 2010). However, some authors have observed that, as the controversial and sensitive ethical issues continues to challenge many nurses and related health professionals, many have begun to develop a unique appreciation for the diverse ethical viewpoints of others. At the moment, in the history of the world, it is viewed that moral uncertainty concerning different issues within the nursing profession is at its highest level in history and this has forced the concerned stakeholders to look for necessary and appropriate practical approaches in resolving the cases and situations concerning ethical issues. Nurses, for a long time, are known to make independent ethical decisions, and it has been established that they can play a critical role when they participate within wider team of decision makers (Fry and Johnstone, 2002). At the same time, it has been established that patients and family members take part in dialogue with nurses and this is actually done to resolve any bioethical and health care issues. As a result, it has been established that, nurses need to develop theoretical knowledge and the necessary skills required to establish foundation in order to practice right actions and develop moral character. In order to achieve this goal more appropriately, it requires nurses to be able to distinguish among the various terms, theories, and principles that concern ethics. This should therefore help nurses to identify and analyze ethical dilemmas in appropriate way. What is Ethics? The term ethics has been described and defined differently by different authors. However, broadly, ethics can be said to constitute standards of conduct by which people choose or select in order to act based on conceptions of what is good and what is not good (Bosek and Savage, 2007). More definitions have incorporated aspects such as viewing ethics to be principles that underlie decisions in order to conform to one or another standard of conduct. Looking at the concept of ethics, which also has to do with morality, it becomes clear that it constitutes laws that basically constitute the socially accepted rules of conduct and that have been established in order to protect the larger society (Bosek and Savage, 2007). Laws, at the same time, are rooted in wider values that are held by majority of people in any given society, and they function with intention to create order in activities that humans may be involved in (Bosek and Savage, 2007). As a result, laws largely tend to bring fairness and justice and this has to do with protection of the rights of individuals and society. To be moral or ethical, as individual would be largely acting or behaving in a specific way in order to accomplish particular ethical practices. This is particularly evident given that individuals, including nurses have different ideas of what they believe is moral, as well as how they interpret what constitutes moral experience. Individuals are not the same, and as a result, they are likely to possess different viewpoints concerning what is moral and what is not, a situation that is further likely to results into conflicting doctrines or theories about how people should live, as well as how everyday moral problems can be resolved. Billington (2003 cited in O’Connor, 2006) developed key aspects, which can be used to describe what constitutes morality and ethical practices. According to the author, morals and ethics exhibit the following characteristics: it is impossible for any one to avoid making moral or ethical decisions since the social connection with other people make it necessary to put into consideration how to relate or interact with others in the most ethical manner. At the same time, different people are always involved with one’s moral and ethical decisions, a situation that makes it impossible to have private morality. In other words, private morality does not exist. Another element of morality and ethics has to do with making moral decision, whereby, the moral decision matters a lot, since every decision affects or influences another person’s life, self-esteem or even happiness (O’Connor, 2006). More so, ethics and morality can be said to have no clear or concrete answers, since no particular valid or perfect conclusions or resolutions can ever be reached at in ethical dilemmas or debates. Furthermore, morals and ethics can be said to involve choices where choice of various option is inevitable in order to make sound moral judgment. Lastly, people are perceived to make use of moral reasoning to make moral judgments or to make discovery of what right actions or behaviors are (O’Connor, 2006). The ethical and moral reasoning and application as a field developed largely from the works of different philosophical authors and researchers. At the same time, the subject of morality for a long time has been studied within two major approaches of philosophical inquiry, which include normative ethics and meta-ethics (Butts and Rich, 2005). Normative ethics has largely involved attempts by ethicists to make decisions of what is morally right or wrong, and what should be accepted as a common set of behaviors or actions. In most cases, normative ethicists are involved in making claims and statements concerning how humans ought to behave or what should be done in particular cases that require decisions. Moreover, normative ethicists have been found to largely take the role of prescribing courses of action and give their views of what should be done in certain cases. Due to this, normative ethicists are likely to prescribe courses of action, and at the same time, be able to evaluate judgments about what is right, what is wrong, what is good, and what can be worth (Butts and Rich, 2005). Therefore, in summary, it can be said that normative ethics normally attempts to resolve a specific moral problem or ethical dilemma, which is normally followed by attempt to determine whether the resolution can be justified. On its part, meta-ethics is concerned with investigating and evaluating moral judgments and theoretical systems, together with the meaning of ethical language attached to it (Butts and Rich, 2005). This is the second major philosophical mode of inquiry, whereby, majority of meta-ethicists do not put focus on what ought to be done, prescribe behavior, or attempt to justify moral judgments. The primary ground of their concern is the language of morality. In most cases, meta-ethicists get involved in analyzing and examining terms and meanings, attempt to clarify moral concepts, attempt to identify the sources of ethics, and attempt to obtain knowledge about what constitutes ethical aspects (Butts and Rich, 2005). Moreover, meta-ethicists are likely to be involved in studying the rationale or justification of particular ethical systems of thought that may include ethical theory (Butts and Rich, 2005). One applicable case where meta-ethicists may be involved is a situation where meta-ethicists become involved in the understanding of how people identify and justify a human right, specifically in relation to a theory of justice (Butts and Rich, 2005). Nursing education and ethics Nursing can be considered a profession that purely advocates for moral conduct and practice, and even as this remains so, it has been established that in many circumstances, nurses encounter challenges when making decisions (Dossey, Keegan and American Holistic Nurses Association, 2009). For instances, nurses are likely to find it challenging to determine what is right or what is wrong as they carry on with their nursing practices (Schwab and Gelfman, 2005). However, even when they are in such situations, nurses have to put much consideration with regard to giving assurance for legal and ethical protection of patients’ rights. Such rights become more evident in circumstances that require decision making especially from the patient. In most cases, nurses are likely to find that their training and acquired knowledge may be challenged by patient’s needs, demands or decisions. When it reaches to such level, it becomes necessary for the nurse to make a critical decision, which of course has to reflect more of ethical consideration (Dossey, Keegan and American Holistic Nurses Association, 2009). It can be postulated that the ultimate goal of nursing education is largely to prepare the student and impact critical skills of critical thinking, communicate accurately, and perform therapeutic nursing interventions in patient care situations (Cashin and Cook, 2010). Other roles that nursing students are likely to acquire through education include enabling students to exhibit caring behaviors that are inherent in nursing actions, applying ethical perspectives in clinical decision making, and being able to function effectively as team member within the organizational structures (Cashin and Cook, 2010). As a result, it can be said that goals of nursing education center on fulfilling the following. Giving the students necessary skills and knowledge that enable them to apply theoretical learning to patient care situations using critical thinking skills and be able to recognize and resolve patient care problems. In addition, the nursing education is aimed at giving the students ability and knowledge to design therapeutic nursing interventions and be able to evaluate their effectiveness. Moreover, nurses are trained to have adequate communication skills, which are necessary in order to work and relate with patients, families, and related health care providers in the most appropriate way. It should further be known that nurses are supposed to demonstrate superior skills, especially when dealing with patients and selecting the most appropriate therapeutic nursing interventions in order to provide care for the patients. As a result, nurses should be in a position to exhibit and evidence caring behaviors regarding nursing actions. Furthermore, nursing students, when they start to carry out their roles, are expected to have skills and abilities of being able to consider the ethical implications of clinical decisions and nursing actions. Lastly, nurses are trained and supposed to acquire knowledge and skills regarding experiences with regard to various roles of the nurse, especially within the health care delivery system (Cashin and Cook, 2010). With regard to the above roles and experiences that nurses need to acquire, it is clear that ethics is actually likely to be present. Nurses are likely to find themselves involved in different roles of care for the patients, which sometimes require ethical decisions. All in all, nursing as a profession constitutes care for the patients and this is the essence upon which nursing has been established and developed. The International Council of Nurses (ICN), which is an alliance that brings together about 128 countries, has identified the four major universal responsibilities for nurses who conduct their activities anywhere in the world (Cashin and Cook, 2010). The four identified responsibilities are promotion of health, prevention of illness, restoration of health, and elimination of suffering (ICN, 2006). According to ICN, nursing is a profession that should see and conduct its activities based on primary principles of respect for human rights that may include cultural rights and rights to life and choice, as well as dignity and respect (Cashin and Cook, 2010). ICN goes ahead to advise nurses that they should be respectful and be unrestricted by considerations in aspects of age, color, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race and social status (Cashin and Cook, 2010). The aspect of ethics can further be evidenced in other countries, especially when one analyzes their code of conducts that guide nursing profession. For example, in United Kingdom, the Nursing and Midwifery Council established Code of Conduct where nurses and midwives are advised to conduct their roles and duties in such a way that patients develop trust in them and can have confidence in such nurses to handle their health and wellbeing issues (Cashin and Cook, 2010). From what the Code expresses and promotes, nurses can be seen to carry out their activities in four major caring ethical concepts including beneficence, non-malfeasance, autonomy, and justice. Beneficence requires nurses to act or carry out their activities in such ways that promotes and encourages elements of mercy, kindness, and charity. As a result, nurses should have key characteristics of altruism, love humane, and always being good to others. On the other hand, non-malfeasance postulates that nurses should avoid all activities that may harm patients. As a result, it is postulated that all nursing interventions and actions have to be planned and enacted in such a way that positive outcome is achieved. The third aspect has to do with autonomy whereby, nurses are supposed to promote self-governance and self-determination in their activities. Lastly, the justice aspect requires nurses to act in the most fair way that will see patients receive what they deserve or require in the most appropriate way. The ethical consideration in nursing education can therefore be said to be premised on key aspects as follows. First, nursing education emphasizes care whereby, nurses are supposed to ensure maximum care is extended towards the patients while conducting their duties. Although treatment is the major aim of many nurses, it is paramount to state that care is encouraged, and in this respect, nurses are supposed to exhibit and extend their commitment of love, kindness, beneficence, as well as other characteristics of good care, as a way of performing their duties. At the same time, nurse students are taught the importance of establishing and fostering good relationships with their patients. In this respect, nurses are encouraged and required to establish and nurture good and collaborative relationships with their patients and to avoid tendencies of facilitating authoritative relationships. Nurses should at all times appear to be sympathetic with the patient’s situation but at same time, they should know how to observe boundaries. In other words, they should not get immersed in the patient’s situation and compromise the treatment and care process. Another aspect has to be with the independence and self-governance of nurses. In order to observe ethical and moral accomplishment of duties, nurses are required to always act with ethical and moral consideration, but to also observe patient autonomy. This aspect has been seen as necessary, especially with regard to informed consent. Informed consent is part of the ethical care where patients are given opportunity to be part of their treatment and care process, and this has led to more emphasis on ethics of care as opposed to ethics of curing. Nurses are frequently required to ensure the interests of their patients become top priority against any other interests, but even as this becomes the norm, it should not be forgotten that emphasis has to be put on maintaining and remaining committed to patient’s dignity as well as the dignity of the nurse. Apart from the above aspects, nursing education is also centered on emphasizing the aspect of confidentiality whereby, the focus is put on need to maintain and observe patients’ confidentiality as part of patient autonomy. In this respect, patients are viewed to have the right to reveal their information and medical status to any person they perceive to be relevant and necessary, concerned or affected by their state. Nursing profession and ethical theories Nurses are supposed to act and carry out their professional duties in a morally upright manner throughout their interaction with patients. Hence, to have moral status accepted by society and in the nursing profession is largely morally considerable or morally standing (Warren, 2000). Ethical status should therefore be exercised towards patients and the entire nursing profession, where professionals should always operate and conduct their activities within aspects of moral obligations. If a nurse therefore has moral status and integrity, he or she does not just treat and care for the patients in the way they please, but they are much obliged to give weight in their deliberations to their needs, interests and the well-being, because their needs have moral importance in their own right (Warren, 2000). Utilitarianism Theory The theory is largely associated with Mill’s conceptualization of utilitarianism. The concept of ethics is largely concerned with investigating the ‘ultimate good’ of human beings. However, the means of attaining it sometimes is not applied universally, while morality may be seen as intuitional, according to which conduct is held to be right when conformed to certain precepts or principles of duty (Sidgwick, 1981).The underlying principle of utilitarianism is ‘the greatest happiness for the greatest number’ (Peil, 2009, p. 555). Moreover, “an act is right if the sum total of utilities produced by that act is greater than the sum total of utilities produced by any other act the agent could have performed in its place” (Velasquez, 1998 cited in Peil, 2009, p. 555). Sidgwick (1981) concurs with this and states that, “the constantly proper end of action on the part of any individual at the moment of action is his real greatest happiness from that moment to the end of his life” (p.10). In applying utilitarianism, the basic procedure is of cost-benefit analysis, for example, when an individual decides whether to perform action A, the rule is that he must perform if the benefits for present and future populations exceed those of the next best alternative course of action, and if this is not the case then the individual should not perform A (Peil, 2009, p. 72). Utilitarianism has the practical value since it is consistent with the value of efficiency and in harmony with how policies are made by looking at the beneficial and harmful consequences of a particular act. Consequentialism in regard to utilitarianism states that, “Actions, choices or policies must be morally exclusively in terms of the resulting, or consequent, effects, rather than by any intrinsic features they may have. Outcomes matters-not process, intention or motivation. Since the consequences of an action are almost always uncertain, most utilitarianism speak of the expected outcomes of actions. The expected outcome of actions is calculated by multiplying the value of the outcome by the probability of its occurring. In consequentialism argument, the entire focus is therefore on future consequences of choice, actions or policies. Utilitarianism does not look back to the past in order to judge whether a certain policy can be justified” (Peil, 2009, p. 556). The second characteristic of utilitarianism has to do with welfarism. Welfarism is concerned with answering the questions: what are good consequences? What is the value of an outcome? In many cases, welfarism requires that goodness of a state of affairs be a function only of the utility or welfare obtained by individuals in that state (Peil, 2009). Furthermore, there exist different varieties of utilitarianism where some people have regarded welfare to be a mental state of happiness or pleasure and since all pleasures and all pains are structurally similar sensations it should be possible to calculate a net total sum of utility. The promotion of happiness is at the heart of the principle of utility and as Mills asserts “by the principle of utility is meant that principle which approves or disapproves of every action whatsoever, according to the tendency which it appears to have to augment or diminish the happiness of the party whose interest is in question: or, what is the same thing in other words, to promote or to oppose that happiness” (Arrington, 1998, p.320). Deontology Theories The major theory in this category is associated with Kant. Kant dwells on the duty aspect, which humans and professionals have to observe. According to Kant, duties can be seen to possess some roles that people usually play in a social institution, arrangement or relationship (Wood, 2008). The duties may transcend in many social arrangements that involve people in behaviors that sometimes may be morally questionable or even worse. As a result, “appeals to duty are commonly used not only to override our temptations to avoid playing our part in some arrangement but also to put out of action any reservations or more principles we might have about playing that part” (Wood, 2008, p.158). Kant views duty exclusively to the respect individuals owe to humanity in them and also to others and to the various forms of moral self-constraint that they must exercise when necessary in order to be rationally self-governing beings (Wood, 2008). From this, Kant defines duty to be “the act of freely making yourself desire something and do it because you appreciate the objective moral reasons there for doing it” (Wood, 2008, p.159). To the author, to do something from duty basically means to obey reason and contribute to one’s happiness. From this, the author expresses that duty can be regarded as self-constraint not only in opposition to inclinations that oppose reason, but also to the dictates of merely instrumental or prudential reason, which moral reasons override (Woods, 2008). Consequently, it can be deduced that duty may represent what an individual or professional knows and hence has reason to do it. This is in addition to what an individual may want to constrain because of his awareness. Kant is convinced that duty is a term that can be given to all actions that individuals have moral reasons to do, even those actions that may seem not to be popular by many. In such cases, what is needed is the awareness by individuals to exercise inner rational constraint if they have to perform the morally valuable actions. The conviction that can be derived from Kant’s notion is that, acting from duty will always involve desire even to do the action for its own sake. And because it creates an immediate desire to do the action, the motive of duty is inevitably expressed not merely as an objective reason for wanting something and doing something, but also as a feeling (Sullivan, 1994). Moreover, in Kant’s own perspective, he categorizes four types of feelings, which include: 1) moral feelings, which constitute the feelings of approval or disapproval, directed at actions. 2) Conscience, which is moral feelings directed to oneself with regard to some action performed or contemplated. 3) Love of human being, which is any form of benevolent caring or concern for the welfare of another as a person who is an end in itself; and lastly, respect which refers to the dignity of a person, or for the moral law as the basis of individual’s own rational to self-control. These feelings constitute the direct and natural acknowledgement of moral reasons. Furthermore, Kant expresses that the general duties individuals have as human beings are the foundation of all their duties and that it is within this framework that individuals acquire duties in consequence of social customs, institutions, and relationships where some of the duties might be to themselves and in most cases to others. Writing on duties of respect and love, Kant promote the idea that violation of these two concepts may appear in actions such as arrogance, defamation, and ridicule. Kant is convinced that humans have a duty to respect others, avoid defaming others for personal pleasure, respect the privacy of others and refrain from ridiculing others by exposing them in order to be laughed at by making their ‘faults’ an immediate object of amusement and lastly, individuals should exercise acute judgment of others that should stick to respecting them. Ethical Egoism Theories The theories advance principles aimed at telling people how they should live (Hinman, 2007). The theories advance the notion that individuals should always act in their own self-interest where they are the only people to determine what is right or wrong to them depending on the consequences (Hinman, 2007). In promoting the idea of acting in self-interest the theories postulate that nothing come prevent individuals from acting their desires and anything else should be regarded as irrelevant where they have no obligation to tell others how they are going to act. Further, the theories promote the idea that individuals are free to seek pleasure and also to reflect on the future alternatives and choose those alternatives that will be most beneficial to them in the long run. The theories it can be identified that they place no restrictions on what can count as legitimate or accepted self-interest and therefore individuals are allowed to pursue what they deem to be good for them. Gewirth (1981) advances the notion of ethical egoism theories by observing and outlining the necessary and sufficient conditions. First, individuals set forth a practical requirement for their behavior, which they approve. Secondly, they normally have a reason on which they ground this requirement. Thirdly, they hold that the requirement and reason they adopt justifies in some way and prevents or discourages the persons addressed from violating the requirement. Lastly, they hold that the fulfillment of the requirement is due to themselves or to the persons on whose behalf they set it forth (Gewirth, 1981). In summing up the bedrock of the theories, Gewirth writes that individuals have rights to freedom and well-being and that individual’s freedom and wellbeing is necessary, and as a result, all other persons ought to refrain from interfering with the freedom and well-being of individuals. Dealing with Ethical and Legal Issues in Nursing Education The above section has explained the three main areas of ethical theories, which operate and result into ethical and moral dilemmas facing nurses and even students. However, it has been observed that, an understanding of these basic approaches to ethical decision-making process provides an opportunity for nursing instructors to elicit from students their reasoning in response to the moral issues they are likely to encounter in their practice of nursing (Killion and Dempski, 2000). As a result, students have to be helped and this help can largely emanate from the idea of developing and impacting knowledge among students that largely helps them to have ability of considering the different alternative perspectives. Instructors have a duty to help students develop and use their individual moral development processes as professionals. In this perspective, the issues nursing students are likely to encounter during their clinical learning experiences are likely to raise profound questions on what is right and what is wrong. As a result, nursing student should be prepared to respond to such issues in the most appropriate and productive way (Hendrick, 2000). Ethical training for majority of nursing students should largely center on establishing the best ways of dealing with how well to avoid egocentrism tendencies that may be the source of conflict in the profession. In most cases, individuals have own or personal belief systems, which they consider appropriate, and sometimes superior as compared to the beliefs of others. This notion, when it becomes past of nursing students, is likely to be the major impediment in conducting or carrying out one’s duty. Due to this, nursing students have to gain and utilize knowledge that expresses explicitly how well they can minimize egocentrism tendencies, hence reduce likelihood of ethical dilemma (O’Connor, 2006). Student should be made not to pay greater attention to individual lust, likes, desires, and so on, but should be made to be supportive to the patient’s needs especially with regard to decision-making. In the circumstance that ethical dilemma becomes inevitable, students have to possess wide range of skills, knowledge and experiences, which will enable them to identify the various available alternatives that can be used to make appropriate and ethical decisions. This therefore means that, students should not only be exposed to limited number or ways of ethical decision-making processes, but also have to possess a wide range of ethical decision-making skills. Another critical aspect that students have to be aware of together with instructors is that, value prioritization is essentially critical in dealing with ethical dilemmas. Students need to have knowledge and capacity that enables them to categorize issues and needs that require immediate response given the veracity of the issue (O’Connor, 2006). Given that these diverse aspects are likely to results into conflicts, especially in making decisions, students have to be trained into developing abilities that enable them to be aware of ethical standards and principles that are necessary in dealing with critical and urgent issues. In such way, students have to be aware when to make an ethical decision, how to make it and in case of conflict, where to seek guidance. On overall, it has to be known that, the nursing profession has numerous challenges and students are likely to be faced with numerous constraints on their ability to act as individuals, especially regarding personal values and beliefs. This is likely to lead into ethical dilemma and as a result, students need to have adequate training of ethical issues in nursing so that when faced with such dilemmas, they are in position to make an appropriate ethical decision. Conclusion Nursing is a profession that, like other professions, has progressively become a field that considers ethical and legal issues with great seriousness. Nursing involves working with people who, apart from treatment, require care. The care management extended to patients is likely to be a complex process, especially where the issue of decision-making and individual rights are concerned. Apart from this, nursing as a field is viewed as the critical avenue in which treatment, healing, and care of patient is adequately achieved, and it is from this matter that ethical issues and consideration in nursing have progressively become necessary. Ethical training and moral development of nursing students is critical, since it enables the students to prepare adequately for roles of nursing in future endeavors. The students should be aware that, nursing process is likely to results into numerous ethical and legal issues, which in one or the other are likely to results into ethical dilemma. Ethical dilemma on the other hand constitutes a situation a nursing professional is likely to find it hard to maker a decision. Nevertheless, by having adequate and appropriate ethical and legal training, nursing students are holistically prepared to deal with ethical dilemmas in the most appropriate and productive way. This is possible given that the students are exposed to numerous and different alternatives of ethical decision-making and this enables the students to have a wide range of opportunities and skills of making appropriate ethical decisions. Ethical decision-making process as a result is likely to be possible when the various ethical theories have been evaluated. This is likely to allow the nurse to adequately outline how well he or she can ensure ethical and moral decision has been reached. At the same time, some ethical issues are likely to be complex in a way that nurses are largely forced to integrate different ethical theories in order to have the appropriate way of dealing with ethical dilemmas. However, some of these challenges have largely been addressed through Code of Conducts and legislative Acts found in different states and in different nations. References Arrington, R. L. (1998). Western Ethics: An Historical Introduction. MA: Wiley-Blackwell. 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CA: Cengage Learning. Retrieved February 8, 2012 from http://books.google.com/books?id=O3iGF7h3O0MC&pg=PA114&dq=Universal+Ethical+Egoism+theories&hl=en&ei=_hEwTPeKGc2TjAf0uvHDBQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCUQ6AEwAA#v=onepage&q&f=false. Killion, S. W., & Dempski, K. (2000). Legal and Ethical Issues. MA: Jones & Bartlett Learning. Retrieved February 8, 2012 from http://books.google.com/books?id=I20ZNJHFRVcC&printsec=frontcover&dq=ethical+and+legal+issues+in+nursing+education&hl=en&sa=X&ei=ncg0T43TE-KR0AWH4LGSAg&ved=0CEYQ6AEwAw#v=onepage&q=ethical%20and%20legal%20issues%20in%20nursing%20education&f=false. O’Connor, A. B. (2006). Clinical Instruction and Evaluation: A teaching Resource. MA: Jones & Bartlett Learning. Retrieved February 8, 2012 from http://books.google.com/books?id=Ah_MZCoq3qMC&pg=PA293&dq=nursing+education+and+ethics&hl=en&sa=X&ei=zW4zT5yeDcmx0QXr3OSrAg&redir_esc=y#v=onepage&q=nursing%20education%20and%20ethics&f=false. Peil, J. (2009). Handbook of Economics and Ethics. UK: Edward Elger Publishing. Retrieved February 8, 2012 from http://books.google.com/books?id=YahcdBQ5nqQC&pg=PA497&dq=systems+of+ethics&lr=&as_brr=3&cd=10#v=onepage&q=systems%20of%20ethics&f=true. Pozgar, G. D. (2010). Legal and Ethical Issues for Health Professionals. MA: Jones & Bartlett Publishers. Retrieved February 8, 2012 from http://books.google.com/books?id=nEVFzrypsgwC&printsec=frontcover&dq=ethical+and+legal+issues+in+nursing+education&hl=en&sa=X&ei=ncg0T43TE-KR0AWH4LGSAg&ved=0CFsQ6AEwBg#v=onepage&q=ethical%20and%20legal%20issues%20in%20nursing%20education&f=false. Schwab, N., & Gelfman. (2005). Legal Issues in School Health Services: A Resource for School Administrators, School Attorneys, School Nurses. NY: iUniverse. Retrieved February 8, 2012 from http://books.google.com/books?id=F8JmObZT0gYC&pg=PR6&dq=ethical+and+legal+issues+in+nursing+education&hl=en&sa=X&ei=ncg0T43TE-KR0AWH4LGSAg&ved=0CE0Q6AEwBA#v=onepage&q=ethical%20and%20legal%20issues%20in%20nursing%20education&f=false. Sidgwick, H. (1981). The Methods of Ethics. Hackett Publishing. Retrieved February 8, 2012 from http://books.google.com/books?id=YYYsGTuH8HYC&pg=PR37&dq=utilitarianism+and+ethics+of+innovation&lr=&as_brr=3&cd=2#v=onepage&q=utilitarianism%20and%20ethics%20of%20innovation&f=false. Sullivan, R. J. (1994). An Introduction to Kant’s Ethics. NY: Cambridge University Press. Retrieved February 8, 2012 from http://books.google.com/books?id=a5AQeWC_jAcC&pg=PA63&dq=Kant%E2%80%99s++Ethics+of+duty&hl=en&ei=kyMwTOjVCYWUjAfrv43DBQ&sa=X&oi=book_result&ct=result&resnum=7&ved=0CEIQ6AEwBjgK#v=onepage&q=Kant%E2%80%99s%20%20Ethics%20of%20duty&f=false. Wood, A. (2008). Kantian Ethics. NY: Cambridge University Press. Retrieved February 8, 2012 from http://books.google.com/books?id=adzpa0_7L1cC&pg=PA159&dq=Kant%E2%80%99s+Duty+Ethics,&hl=en&ei=AjEvTLYPzY2MB5ip7JYG&sa=X&oi=book_result&ct=result&resnum=3&ved=0CDIQ6AEwAg#v=onepage&q=Kant%E2%80%99s%20Duty%20Ethics%2C&f=false Read More