Health Promotion Ethics: Nurse Educators Prepare for Emerging Ethical Dilemmas

Monday, November 2, 2009: 2:20 PM

Patricia Hinton Walker, PhD, RN, FAAN
Office of the Senior Vice President, Uniformed Services University of the Health Sciences, Bethesda, MD
Gloria C. Ramsey, JD, RN, FAAN
Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD
Diane Padden, PhD, RN, FNP-BC
Graduate School of Nursing, Uniformed Services University, Bethesda, MD

Learning Objective 1: Outline ethical risks for both nurses and patients in a growing trend towards the "Nanny State" control related to health habits of individuals and families.

Learning Objective 2: Explore differences between the Code of Ethics for Nurses, Public Health Code of Ethics and the need for health promotion ethics.

Leaders in nursing education need to think futuristically in the context of changing health care policy and its impact on nurses and culturally diverse patients locally and globally.  With a shift to personal responsibility for health (generally thought to be helpful) there are significant risks for culturally diverse and poor populations, already experiencing health disparities. Emerging literature warns of the dangers of the “nanny state,” originally coined in England, (state actions that stem from a belief that it has a duty to protect citizens from their own harmful behaviors) and emphasizes the need for public health and health promotion ethics. 
Neither the nursing nor medical code(s) of ethics adequately address conflicts that arise between individual rights and population and community rights and its impact on practice.  
Additionally, one important traditional role of nursing – that of patient advocate – may become increasingly compromised due to “nanny state-oriented” changes, government obligations to protect the health of the population, locally and globally. A key ethical question in this debate includes grappling with the question of personal responsibility, self care, in the public health context. There is a dearth in the nursing literature about this important shift in policy and practice that has significant implications for both basic and advanced practice learners.  This presentation will highlight policy changes, ethical and legal challenges and bring this important interdisciplinary discussion related to health promotion ethics to nursing education leaders.  Changes in technology, including genetics and informatics, will challenge nurses from an ethical perspective in the future; however, this issue has the potential to impact ethical practice in ways that have yet to surface in the nursing literature.