Ethical Changes in Nursing Practice: A Comparative Analysis Across Different Healthcare Settings

Abstract

Changes in nursing ethics represent a dynamic interplay between medical technology advances, societal changes, and health delivery complexities. Nursing ethics have evolved from principles of beneficence, nonmaleficence, and justice to include such current issues as resource allocation, patient autonomy, and interprofessional collaboration. These changes are influenced by broader systemic factors, including cultural diversity, healthcare policies, and global health crises.
This study will provide an in-depth analysis of ethical changes in nursing practice within primary care, hospitals, long-term facilities, and community-based settings. The research, via a comparative analysis, identifies those ethical dilemmas that are unique to a particular context and those shared by the nurses in all these contexts. Specific issues, such as informed consent, confidentiality, cultural competence, end-of-life care, and equitable resource distribution, are considered.
The methodology combines a systematic literature review, case studies, and semi-structured interviews with nursing professionals. Findings indicate that ethical challenges are shaped not only by the clinical environment but also by institutional policies, societal expectations, and advancements in medical practices. For example, while nurses in acute care are often required to make high-stakes decisions under pressure, those in long-term care face different challenges in maintaining patient dignity during cognitive decline.

The findings highlight the urgent need for targeted educational programs, robust ethical guidelines, and supportive institutional frameworks to prepare nurses for the multifaceted ethical landscape of modern healthcare. Health systems can better equip nurses to maintain professional values amidst the challenges of change by fostering ethical resilience and promoting interdisciplinary collaboration.
The paper concludes by providing actionable recommendations for improving ethical decision-making in nursing, including integrating technology into ethical training, revising institutional policies to reflect contemporary challenges, and promoting a culture of free speech and continuous learning.