Deontology in Nursing: Common Student Misconceptions and Real-World Applications

As a nursing student, you will encounter ethical dilemmas where patient care decisions are not always straightforward. In these situations, ethical frameworks like deontology help guide nurses in making morally sound choices. Deontological ethics is based on duty and moral obligations, meaning that nurses must follow ethical principles regardless of the outcome.

However, many students misinterpret deontology in their assignments, which can lead to weak ethical arguments. This article will clarify common student misconceptions about deontology and explore real-world nursing scenarios where deontological ethics play a critical role.

Common Student Misconceptions About Deontology in Nursing

Understanding deontology goes beyond memorising the principles of autonomy, beneficence, non-maleficence, and justice. You must apply them critically, recognising their real-world challenges. Here are some of the most common misconceptions students have when discussing deontology in nursing.

Misconception #1: Deontology Means Blindly Following Rules

• What students assume: Nurses must always follow hospital policies, regardless of the situation.
• The reality: Deontology is not just about obeying rules—it is about acting in accordance with moral duties and ethical principles.

Example: A hospital policy may prohibit nurses from administering pain medication without a doctor’s approval. However, if a patient is in extreme pain and no doctor is immediately available, a nurse’s ethical duty may be to advocate for the patient’s well-being, even if that means challenging hospital policy.

If you are writing about deontology in assignments, avoid reducing it to rule-following. Instead, discuss how nurses must balance professional guidelines with moral duties.

Misconception #2: Outcomes Do Not Matter in Deontological Nursing Ethics

• What students assume: Since deontology focuses on moral duty rather than consequences, nurses should never consider patient outcomes.
• The reality: While deontology prioritises ethical duties, it does not ignore outcomes entirely. Nurses still need to assess how their actions impact patient well-being.

Example: If a nurse knows that telling a terminally ill patient the full details of their condition may cause distress, they must balance truth-telling (a deontological duty) with the potential emotional harm it may cause.

When discussing deontology in assignments, do not assume that consequences are irrelevant. Instead, show how nurses must apply ethical reasoning to decide whether following a moral duty is the best course of action.

Misconception #3: Deontological Duties Are Fixed and Unchanging

• What students assume: Once a duty is established, it must be followed in all situations.
• The reality: Ethical duties evolve with medical advancements, societal changes, and legal frameworks.

Example: Informed consent is a key deontological duty, meaning patients have the right to understand medical procedures before agreeing to them. However, with the rise of telemedicine, obtaining proper informed consent has changed. Nurses must now adapt ethical duties to new healthcare settings.

If you are analysing deontological ethics in assignments, avoid stating that duties are absolute. Instead, discuss how nursing ethics evolve while still maintaining core deontological principles.

Misconception #4: Justice in Nursing Means Treating All Patients Equally

• What students assume: Nurses must provide the same treatment to all patients, regardless of their condition or background.
• The reality: Justice in nursing is about fairness, not strict equality.

Example: In emergency settings, a triage system prioritises critically ill patients over those with minor injuries. Although this means some patients receive immediate attention while others wait, it is an ethically justified approach to resource allocation.

If you are writing about justice in deontological ethics, remember that fairness does not always mean treating every patient the same way. Instead, focus on how healthcare resources are ethically distributed.

Now that you understand the common misconceptions, let’s explore how deontological ethics apply to real-world nursing scenarios in Singapore.

Real-World Nursing Scenarios Where Deontology Plays a Critical Role

Deontological ethics is deeply embedded in Singapore’s healthcare system. Here are key nursing scenarios where ethical duties shape clinical decision-making.

Informed Consent: The Nurse’s Duty to Respect Patient Autonomy

• Application: Under Singapore’s healthcare laws, patients must provide informed consent before undergoing medical procedures. Nurses play a critical role in ensuring patients fully understand their treatment options.
• Ethical Dilemma: What if a patient refuses a life-saving procedure due to cultural or religious beliefs?
• Deontological Justification: The duty of respect for autonomy means that nurses must uphold a patient’s right to refuse treatment, even if they disagree with the decision.

If you are discussing autonomy in nursing ethics, always analyse how nurses must balance respecting patient choices with their professional duty to advocate for well-being.

Truth-Telling vs. Protecting a Patient’s Emotional Well-Being

• Application: Singapore’s Patient Charter requires healthcare professionals to provide accurate and honest medical information to patients.
• Ethical Dilemma: Should nurses always tell the full truth, even if the information might cause extreme distress to a vulnerable patient?
• Deontological Justification: The duty to be truthful (veracity) means nurses must provide accurate information, but they can adjust how they communicate to minimise emotional harm.

If you are analysing truth-telling in assignments, show how nurses must uphold honesty while considering the psychological impact of their words.

Following Hospital Policies vs. Speaking Up Against Unsafe Practices

• Application: Singapore’s Nursing Code of Ethics requires nurses to report unsafe practices in hospitals, even if it means going against authority.
• Ethical Dilemma: What if a senior doctor prescribes a medication that could be harmful to a patient? Should a nurse follow orders or intervene?
• Deontological Justification: The duty to prevent harm (non-maleficence) means that nurses must prioritise patient safety, even if it means challenging authority.

If you are discussing deontological ethics in clinical decision-making, highlight how nurses must act as patient advocates, even when faced with hierarchical pressures.

Fair Allocation of Limited Healthcare Resources

• Application: Singapore’s MediShield Life programme ensures that all citizens have access to basic healthcare, but not all treatments are fully subsidised.
• Ethical Dilemma: Should a nurse prioritise resources for a critically ill elderly patient or a young patient with a higher survival chance?
• Deontological Justification: The duty of justice requires fair, need-based allocation of medical resources, even if it means making difficult choices.

If you are writing about justice in nursing ethics, focus on how nurses must consider fairness in decision-making, rather than just assuming all patients must be treated equally.

Final Thoughts

Understanding deontology in nursing requires more than just knowing ethical principles—you must apply them critically in real-world healthcare scenarios.

In your assignments, avoid common misconceptions, such as:

• Assuming autonomy means absolute freedom.
• Treating beneficence and non-maleficence as the same concept.
• Defining justice as equal treatment instead of fair distribution.

By analysing how deontology shapes nursing decisions in Singapore, from informed consent to truth-telling and resource allocation, you can write more compelling and well-reasoned ethical arguments.

Mastering nursing ethics is not just about learning theory—it’s about applying these principles to ensure the best patient care while upholding professional integrity.