Ethics and Forensic Nursing Practice

Ethics and Forensic Nursing Practice
I. Law versus Ethics
A. Laws are compulsory rules of conduct that are enforced by authority.
B. Ethics examine values, actions, and choices to establish right and wrong.
C. Occasionally, law, ethics, and best practice do not agree.
D. Based on one’s individual philosophy and perceptions, certain actions may be considered morally or legally vague.
II. Ethics Related to Forensic Nursing/Nursing Practice
A. Ethics supply tools for solving dilemmas based on personal or social values.
B. Clinical ethics guide the clinician relating to ethical behavior.
C. Health care ethics are related to the law.
D. Ethics in relation to forensic nursing practice should reflect
1. Respect for persons
2. Beneficence
3. Justice
4. Respect for community or society
5. Caring
III. Ethical Issues Arising in Forensic Nursing
A. Victims or perpetrators may be labeled based on factors specific to disease, occupation, lifestyle, mental capacity, gender, or any number of physical and psychological factors.
B. The practice of forensic nursing places the nurse into relationships involving criminal activities and the victims injured or killed by criminal actions.
C. Relationships with perpetrators may expose the nurse to violence, and behaviors of the perpetrator may result in nursing decisions that are not legally or ethically sound.
D. Problems in developing a helpful and caring relationship may be altered when the patient is the victim.
E. Sympathy may prevail over empathy when caring for the victim.
F. Accept the concept of victim responsibility and consequence
1. For recommended care and follow-up
2. To the court if possible
3. To society
G. Accept the concept of perpetrator responsibility and consequences
1. For criminal action
2. For actions for own care and healing

IV. Ethical Issues Relating to Forensic Nursing
A. Decisions in forensic nursing practice need to consider the most appropriate course of action based on the patient’s immediate needs.
B. Regarding treatment versus confinement:
1. Is the care and treatment of the patient secondary to maintaining the safety of the patient and nurse?
2. Is care and treatment essential to maintain life, and is sedation or restraint necessary to provide immediate care?
C. Privacy and confidentiality vary depending on the situation and circumstances:
1. Working within the jail, prison, or detention center
2. Providing care and treatment to a prisoner in a clinical setting

V. Moral Ethical Dilemmas
A. Are ethical problems that cause a conflict of right, responsibilities, and values
B. Cause a great deal of individual stress and anxiety
C. May be complicated by psychological pressures and personal emotions
D. May involve choices about justice or fairness

VI. Types of Moral Dilemmas



VII. Ethical Decisions
A. The following criteria are necessary to make an ethical decision:
1. Should be best clinical practice
2. Should be within the scope of practice
3. Should be within established policies and procedures
4. Should be legal
5. Should be the right moral action to take
B. Understand that value conflicts occur among forensic nurses, nurses, physicians, clients, families, law enforcement personnel, established law, all forensic investigative team members.
C. The forensic nurse needs to clarify personal values.

VIII. Forensic Nursing Practice
A. The Scope and Standards of Forensic Nursing Practice Standard V
(American Nurses Association and International Association of
Forensic Nurses, 1997)
1. Identifies the forensic nurse’s responsibility to the victim, perpetrator, family, and community
2. Identifies the need for respect, integrity, and justice for the victim in investigating and caring for the victim of crime
B. International Association of Forensic Nurses (IAFN) Code of
Ethics (2006)
1. Was revised as a separate document in 2006
2. Identifies five basic ethical concepts
a. Responsibility to the public and the environment
b. Obligation to science
c. Care of the profession
d. Dedication to colleagues
e. Fidelity to clients










IX. The Nursing Process and Ethical Decisions
A. The systematic organizational and objective approach of the nursing process can be used effectively when making ethical decisions:













B. It is important to remember when addressing ethical and moral dilemmas that individual values and morals may result in planning goals that may not be for the greater good of the patient; professional ethics and legal responsibility must remain the primary focus in the decision-making process.
C. As a result of the numerous issues regarding ethical dilemmas, the nursing process offers the forensic nurse an organized outline for identifying issues and for planning toward an outcome that will provide for the greater good.