Endoscopy departments tend to prioritize task efficiency, which may sometimes limit individualized and patient-centered nursing care. Structured workflows and time constraints can make it challenging for nurses to fully address patients' needs and ethical concerns. However, the ethical issues specific to endoscopic nursing remain largely unexplored. This study aims to clarify ethical issues perceived by nurses involved in endoscopic practices. A qualitative study was conducted with 14 nurses working in departments performing endoscopic practices in 3 hospitals in Japan. Data were collected using semi-structured interviews and analyzed using qualitative content analysis. Eight key ethical issues emerged: (1) Lack of Ethical Consideration in Physical Restraints; (2) Unalleviated Patient Pain; (3) Undervalued Patient Autonomy; (4) Disregard for Patient Dignity and Privacy; (5) Involvement Amid Professional Uncertainty and Ethical Concerns; (6) Inability to Provide Ideal Nursing Care; (7) Lack of Respect for Nurses; and (8) Inequity in Patient-Centered Care Delivery. These findings indicate that endoscopy departments face ethical challenges, including inadequate informed consent, routine sedation and restraints, time constraints, and a physician-centered hierarchy. Addressing these issues requires enhancing ethical sensitivity and competence, fostering interdepartmental and interprofessional collaboration, developing systems for patient-centered care, and setting ethical practice goals.