A code of ethics is a set of standards for professional behavior. Ethical codes are guidelines that are designed to set out acceptable behaviors for members of a particular group, association, or profession (Code of Ethics, n.d.). Many organizations govern themselves with a code of ethics, especially when they handle sensitive issues such as healthcare. Ultimately, a code of ethics serves as the written word declaring how professionals think of themselves, individually and collectively, and the serious responsibilities they have embraced (Code of Ethics, n.d.). The goals, basic ethical principles, grievance procedures, and feasibility of the Nursing Code of Ethics will be further discussed throughout this paper. The Nursing Code of Ethics is one such structure that displays nursing’s scope and responsibilities as a profession (Hook, 2001). The main goal of the code is to outline the distinct duties and rights for nurses. The code discusses the role of nurses as they relate to people, their practice, society, their coworkers, and their profession (Fremgen, 2009). It additionally outlines the nurses’ obligation to protect patients’ privacy, respect patients’ dignity, maintain competence in nursing, and assume responsibility and accountability for individual nursing judgments (American Nurses Association, 2001).
The Code of Ethics is continuously evolving and reflects nurses’ expanded professional roles including administrators, care coordinators, educators, and researchers in addition to direct patient care providers (Hook, 2001). As a result of the expanded responsibilities of nurses, the relationship between nurses and patients has been challenged more than ever. Nurses are being faced with ethical issues and stresses more frequently. The Nursing Code of Ethics is in place to help nurses handle these challenges and remain attentive to provide patient and family centered care (Scanlon, 2000). Ethics is an integral part of the foundation of nursing. Because of this, a Code of Ethics for nurses is essential. The goal of nursing ethics centers on patient care. The Nursing Code of Ethics articulates nursing’s commitment to provide high quality care to patients and communities, supporting each other in the process, so that all nurses can fulfill their ethical and professional obligations, as well as meet their own professional career goals (Hook, 2001). The Nursing Code of Ethics exists to identify the explicit goals, values, and obligations of the profession. Many decisions nurses make have an ethical component, which many times bring about conflicts among ethical responsibilities. The code is in place to help guide nurses through these conflicts.
The Nursing Code of Ethics addresses the more “traditional’ principles of health care including respect for autonomy, the ethical right of the patient to make their own decisions (if competent), beneficence, the duty to help patients, nonmaleficence, the principle that states “do no harm”, and justice, the principle of treating all people fairly without regard to socioeconomic status, personal attributes, or the nature of patients’ health problems (Scanlon, 2000). In addition to these basic principles, which lay the foundation for nurses, the responsibilities derived from them are also included. Current provisions of the Nursing Code of Ethics reflect modernized principles addressing patient dignity, commitment to the patient, patient rights, optimum patient care, integrity, continued personal and professional growth, advancement of the profession, collaboration with other professionals, and improved health care environments and conditions of employment (Hook, 2001). Confidentiality is a vital principle reflected in the Nursing Code of Ethics.
This means nurses should not divulge any information about their patients to anybody unless they are permitted to do so by the patient (Nursing Avenue, 2010). The decision to divert information in dire circumstances, such as preserving a life, lies with the nurse. Nursing ethics also relies heavily on competence (Nursing Avenue, 2010). A nurse is completely responsible for all nursing interventions they are performing therefore competency is a necessary principle in the Code of Ethics. Fidelity is another principle that the nurse is obliged follow. The nurse needs to stay faithful to the agreement or the understanding that is reached with the patient regarding the care to be given (ANA, 2001). As a nurse, it is necessary to act as a professional but it is equally as important to be compassionate and caring towards the patient. Health care relies on compassion because it is one of the most effective ways of treating an individual with ill health, which is what makes compassion another essential principle of the Nursing Code of Ethics (Nursing Avenue, 2010).
Currently, the grievance procedures for the Nursing Code of Ethics are not clearly defined. The American Nurses Association’s (ANA) Code of Ethics does not state grievance procedures or disciplinary actions. The Code of Ethics for nurses has been criticized for being idealistic and lacking content and repercussions (Numminen, van der Arend, & Leino-Kilpi, 2009). At this time, the individual State Boards of Nursing govern grievances and disciplinary action. This is a major weakness in the Nursing Code of Ethics and the nursing profession. Because no disciplinary action is clearly defined, the ANA does not show nurses recourse for their actions. Therefore, the lack of grievance procedures and disciplinary action leads to a lack of enforcement of the Code of Ethics for nursing. State Boards of Nursing have taken over these procedures but every state has a different set of ethical standards. This leads to inconsistency within the profession. The feasibility of enforcing the Nursing Code of Ethics can be difficult at this current time because of the lack of grievance procedures or disciplinary actions in place. The Nursing Code of Ethics needs to be enforced and exemplified by each nurse as an individual.
The nurse needs to be committed to respect the dignity of each patient and to foster each patient’s freedom to make his or her own decisions. Every patient needs to be treated with dignity and worth, taking into account the differences and special needs of each patient. The Nursing Code of Ethics requires that nurses justify their ethical decisions and the consequences of those decisions on universal moral principles, the most basic of which is respect for all humans (Hook, 2001). This requires promotion of patient autonomy (ANA, 2001). To further ensure respect is given to each patient, the nurse must make decisions through a reasoning process that incorporates professional judgments, clinical observations, and the practical matters of technical feasibility (ANA, 2001). This process is a vital component in nursing. In doing so, the nurse has a responsibility to be certain that any approach taken does not violate the moral principles, which need to be considered when assessing an ethical dilemma (Nursing Avenue, 2010).
A nurse has a moral obligation to do good for the patient. The nurse needs to consider the consequences of all actions taken and determine in what manner any objections to the decisions that have been made will be handled. This justifies the decision from a moral standpoint while satisfying all of the principles of decision-making (Nursing Avenue, 2010). The Nursing Code of Ethics needs to be protected and enforced by each nurse independently. Inherent in the duty to enhance the patient’s responsibility to maintain an autonomous existence is the duty to assess and evaluate, in an ongoing manner, the nurse’s clinical competence, decision-making capabilities, and clinical judgments (Hook, 2001).
The main weakness in the Nursing Code of Ethics is the lack of grievance procedures and disciplinary actions previously discussed. Nursing should have one board that governs the entire profession. This would ensure consistent disciplinary actions, certifications, and ethical beliefs throughout the nursing profession. The Nursing Code of Ethics discussed in this paper is for all nurses, regardless of the setting or specific nursing role. Nurses may be challenged to fulfill moral and ethical obligations of their profession while providing care for their patients (Hook, 2001). The code sets the ethical standards for the profession of nursing and provides an enduring framework for all nurses to use in ethical decision-making (ANA, 2001).
American Nurses Association. (2001). Code of ethics for nurses. Retrieved from http://www.nursingworld.org/about/01action.htm Code of Ethics. (n.d). Retrieved from EBSCOhost.
Fremgen, B. F. (2009). Medical law and ethics (3rd ed.). Upper Saddle River, NJ: Prentice Hall. Hook, K. (2001). Code of ethics for nurses with interpretive statements. NursingWorld. Retrieved from http://nursingworld.org/mods/mod580/code.pdf Numminen, O., van der Arend, A., & Leino-Kilpi, H. (2009). Nurses’ codes of ethics in practiceand education: a review of the literature. Scandinavian Journal Of Caring Sciences,23(2), 380-394. Retrieved from EBSCOhost. Nursing Avenue. (2010). Be protected! Know your nursing code of ethics. Retrieved fromhttp://www.nursingavenue.com/Code-of-Ethics.html Scanlon, C. (2000). A professional code of ethics provides guidance for genetic nursing practice.Nursing Ethics, 7(3), 262-268. Retrieved from EBSCOhost.