Code of ethics for the nursing professionals

Presented by
Dr Nilima Sonawane
Institute of Nursing education, sir J J
Hospital campus , Mumbai India
CODE OF ETHICS: The
Guiding Principles For Nursing Professionals

“Nursing is an art; and if it is to be made an art, it
requires as exclusive a devotion, as hard a
preparation, as any painters or sculptors work;
for what is the having to do with dead canvas or
cold marble, compared with having to do with the
living body - the temple of Gods spirit? It is one
of the Fine Arts; I had almost said the finest of
the Fine Arts.”
- Florence Nightingale

Nursing …..
Care to humanity.
Universal.
Working for a noble cause.
Dealing with human life.
Respect for human rights, including cultural
rights.
Right to life.
Treating client with dignity.

Nursing is a noble profession
Based on the criteria that a profession must have
 Service provided is vital to humanity and welfare of society
 Special body of knowledge
 Intellectual activity
 Accountability
 Educated in institutions
 Relatively independent: autonomy.
 Motivated by job / service
 Code of ethics: to guide decisions
 Organization (association): to encourage and support
practice
Kelly: - 1981

Ethics : Greek word ethos’= character
Webster dictionary = The science of moral
duty or ideal human character’

 Ethics – Philosophical ideals of right and
wrong behavior.
Tells us how human beings should behave
Personal standards of conduct, or attitude
It is a science of ideal human behaviour

Essence of ethics is……
Personal goodness
Moral behaviour
Righteous
Justice
Honesty
Rules and Regulation of
conduct
Principles
Attitude
Values

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
What is Ethics
“A system of rules or principles that are
used to guide human behavior”
Guiding force in the development,
implementation and evaluation of nursing
practice since the “Florence Nightingale
Era”.

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• Ethics includes values, codes, and principles that
govern decisions in nursing practice.
• Guide for action based on social values and needs.
• Provide means to professional standards
• Formal guidelines for the professional action
• Basis for Self regulation and relationship with
others.
• Evaluating the merits, risks, and social concerns.
• Ethical principles are necessary to guide to the
professional development
Why nursing code of ethics…

• Help in assessing the complex situations
• Better decision making
• Enhances interaction between the health
professionals and with the community
• Provide well defined policy and procedure in
resolving ethical dilemma.
• Unethical practices will be minimized
• Reflect the good image of the nurses and
the organization they work.

• Provide a sign of the profession’s
commitment to the public .
• Give a framework for the standards of
conduct.
• Provide general guidelines for professional
behavior.
• Helps to protect the rights of the individual,
family and the community
• Provide standard curriculum .

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• The International Council For Nurses (ICN)
• American Nurses Association
• Canadian Nurses Association
• Trained Nurses Association Of India (TNAI)
• Indian Nursing Council.(INC)
Who recommends the Code of Ethics for Nurses…

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
The ICN- Code of Ethics for Nurses
Preamble
• Nurses have four fundamental
responsibilities:
• To promote health,
• To Prevent illness,
• To restore health and
• To alleviate suffering.

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• Nursing care is for all irrespective of
age, colour, creed, culture, disability or
illness, gender, sexual orientation,
nationality, politics, race or social
status.
• Nurses render health services to the
individual, the family and the community
The ICN- Code of Ethics for Nurses
Preamble……….

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Ethical Principles
• Autonomy
• Beneficence
• Non malfeasance
• Confidentiality
• Double Effect
• Fidelity
• Justice
• Paternalism
• Respect for
Persons
• Sanctity of Life
• Veracity
• Informed consent

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Definition: “autos” = self, “nomos” = rule
– It is person’s independence and self reliance
– People should have control on their own lives
– Individual rights of self determination for
making decisions.
– Freedom of choice
– Informed consent. right to know procedure,
complications, other options.
– Nurse should respect client’s decision and
choices….
Autonomy

Nursing …..
Universal.
rights.
Right to life.
Beneficence
Duty to do good, goodness, kindness,
Positive actions to help others
Client interest is more important than
personal
Care should be beneficial to all
Treating client with dignity.
Care to humanity.

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Commitment ……. Balance risk and benefits
Not to cause harm
Prevent harm
Remove harm
Non malfeasance

Maintain Confidentiality
Personal and medical
information of the client
will not disclosed to other
unless the the client gives
informed consent.
 Share information
selectively
NURSING CONFIDENTIALITY

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Confidentiality
• Share or discuss patient information
only if it is necessary .
• Never share patient’s identification
number or password with anyone.
• Follow the hospital’s or healthcare
provider’s policies.
• Log off your computer when you are not
by your workstation/ nurses station
• Be careful about computer records

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Justice
• Providing nursing care equally
to all as per needs
• Fairness/ unbiased
• Giving equal treatment
• Equal distribution of benefits,
costs and even risk.
• Some time equality
distribution is not possible
during emergency , the
services are based on priority.

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Respect
Call by name
Respect as an individual
Respect their opinion
Respect relatives
Especially respect the women
in labour/delivery room

– Establish a culture of privacy to ensure
that personal information of patients is
kept as private as possible
– Provide space
– Ensure that the patient’s body is
appropriate covered
– Informed consent
Respecting Privacy

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Responsibility
 Remember you are taking
responsibility of human life
 Willing to take responsibilities
 Having to be answerable for the
action
 Be accountable
 Need to remain competent-
 Knowledge
 Attitude
 Practice
 Take those responsibility which are

 Be answerable to oneself and others for
one’s own actions.
 Nurses are accountable for judgments made
and actions taken in the course of nursing
practice.
 It is all about justifying actions, explaining
why something was (or was not) done
 Account for their actions is therefore to
establish whether they had good enough
reasons for acting in the way they did.
Accountability

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Accountability

 Support for a cause
 As a nurse you support for the health
,safety, and rights of the clients.
 Follow institutional policy and procedure
 Report any unethical occurrence that
may cause harm to the clients
Advocacy

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Veracity
“If you tell the truth , you don’t have to
remember anything”.
Truth is the basis for mutual trust between
clients and health professionals.
Provide all information truthfully

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Double Effect
Some actions can be morally justified even
though consequences may be a mixture of good
and evil
• Must meet 4 criteria:
– The action itself is morally good or neutral
– The agent intends the good effect and not the evil
(the evil may be foreseen but not intended)
– There is no favorable balance of good over evil

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• Duty to be faithful to
one’s commitments
• Faithfulness
• Keep promises
• Don’t make promises you
cant keep;
Fidelity

Nursing ….. Paternalism
To treat someone
paternalistically is to treat
the person in a way that
ignores or discounts his/her
wishes.
When one individual assumes
the right to make decisions
for another
• Limits freedom of choice
• Think about parents making
decisions for children

Sanctity of Life
• It depends in which context, law, religion,
philosophy etc.
But in general terms, it's the belief that all life,
from the moment of conception is sacred and,
therefore has the right to live
• If life is the highest good, is it ethical to keep a
brain dead person alive?

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
ELEMENTS OF CODE OF ETHICS

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
COMPONENTS OF NURSING ETICS

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• The nurse’s primary professional
responsibility is towards people
requiring nursing care.
• nurse promotes an environment in which
human rights, values, customs and
spiritual beliefs of the individual, family
and community are respected.
NURSES AND THE PEOPLE

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• The nurse ensures that the individual
receives sufficient information
• The nurse holds in confidence personal
information and uses judgment in
sharing this information.
• The nurse shares with society the
responsibility for initiating and
supporting

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
• Action to meet the health and social
needs of the public, in particular those
of vulnerable populations.
• The nurse also shares responsibility to
sustain and protect the natural
environment from depletion, pollution,
degradation And destruction.
• Provide health education

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Nurses and the practice
• Provide care as per set standards
• Maintains standards of personal
conduct
• Respect individual and family
• Enhance the competency
/knowledge and skill with
changing needs.

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Nurses and Practice
• The nurse, in providing care, ensures
that use of technology and scientific
advances are compatible with the
safety, dignity and rights of people.
• Promote participation of individuals and
others in patient care

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
NURSES AND THE PROFESSION
• Develop professional knowledge
• Developing research based
professional knowledge.
• Work in the professional organization
• Developing equitable and social
working condition for nurses.

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
NURSES AND CO-WORKERS
• Co-operative relationship
• Respect
• Collaborate
• Acceptance
• Respect point of view

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
ETHICS IN INDIA

Nursing …..
Care to humanity.
Universal.
rights.
Right to life.
Respect Uniqueness of the person
Indian Nursing Council : Code Of Ethics
Respect rights
of the individual
Respect privacy and confidentiality
Maintain competency
to render quality
care
Practice within
framework of ethical,
legal and professional
boundaires
Demonstrate personal
etiquettes

• Abortions
• Disclosure of HIV/AIDS status to spouse
• Sterilization
• Genetic research and congenital
malformation in foetus
• Surrogacy and sperm donation
• Age for written consent
• Test tube baby
• Resuscitation
Situations of ethical dilemma in nursing

• Euthanasia (Physician Assisted Suicide)
• Inappropriate Medication Orders:
• Unsafe nurse-patient ratio:
• Life threatening patient’s decision:
• Inappropriate task: for floating nurse
• Unresponsive physician:
Situations of ethical dilemma in nursing

• Be aware about yourself and your values
• Be Knowledgeable about professional
standards
• Know your job and develop skill to perform
• Develop effective interpersonal relationship
• Develop rapport with the clients and relatives
• Participate in the ethical committee meetings
• Perform what is been taught
• Work in policy framework
• Develop and implement Team of ethics
committee and actively participate in it.
Nurse’s Ethical Challenge

Care to all without discrimination
Respect to the clients and relatives
Use words carefully
Accept patient with his /her religious belief
Take responsibility and delegate
responsibility carefully
Act as per informed decision and choices
Always act in the best interest of the client
Be aware about legal precedents
Plan and organize in-service education
programme
Nurse’s Ethical Challenge

 Rights of personal dignity:
 Calling by name.
 Give due respect as per age.
 Maintain privacy.
 Modesty : knocking doors, pulling curtains.
 Provide Best possible appearance, personal
hygiene and care.
 Listening to the patient carefully.
 Accepting the individuals feeling as real
without judging right or wrong.
Rights of the patients

• Right to receive timely and qualified care in a
setting appropriate to health care needs.
• Right to participate in decisions
• Right to refuse treatment
• Right to receive information regarding their
illness, the course of treatment, and prospects
for good health
• Right to approve and refuse the release of their
medical records.
• Patient has the right to access their medical
record.

• Right to express complaints and satisfaction
regarding services rendered without fear of
discrimination..
• Right to comment and make suggestions for
improvement of the quality of care and
services.
• Right to receive respectful care in a safe and
secure environment with respect and regard
for privacy, individuality, personal beliefs and

• Right to privacy and confidentiality of their
records – records are to be maintained in a safe
and secure environment.
• Right to know the professional status of the
person(s) treating them
• Right to know, in advance of services, the cost of
services and any applicable payment policy.
• Right to appoint a legal representative to make
decisions regarding their health care.
• Right to refuse to participate in
research/experimental activities.

 Motivate and build self esteem for self
care
 Assist in activity of daily living
 Helping attitude and show interest while
caring
 Involve family members
 Direct or provide necessary information
for self care
 Be around
Rights of the patients…
Rights to assistance towards independence

 Provide Care based on needs
 Respect the client while performing the
nursing procedure
 Allow family member to be with the client as
far as possible
 Plan diet as per cultural back ground
 Allow personal belongings
 Allow religious rituals , if it is not disturbing
to other and client or treatment
Rights of the patients…
individual care

“They may forgot your name; but they will
never forget how you made them feel.”
Proud to be a nurse ,
Practice safe , be safe
Thank You

I solemnly pledge myself before God and in
the presence of this assembly, to pass my life
in purity and to practice my profession
faithfully. I will abstain from whatever is
deleterious and mischievous, and will not take
or knowingly administer any harmful drug.
Florence Nightingales Pledge

I will do all in my power to maintain and elevate the
standard of my profession, and will hold in
confidence all personal matters committed to my
keeping and all family affairs coming to my
knowledge in the practice of my calling. With
loyalty will I endeavor to aid the physician, in his
work, and devote myself to the welfare of those
committed to my care.
Florence Nightingales Pledge

Code of ethics for the nursing professionals

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