Code of Ethics for Nurses with Interpretive Statements

Contributors and Acknowledgments

This revision of the Code of Ethics for Nurses with Interpretive Statements was informed by over 7,800 responses from 2,780 nurses in an online public survey of the 2001 Code. After a revised code was drafted, it was posted for public comment to which more than 1,500 additional responses, representing approximately 1,000 nurses were posted. The contributions of these nurses are gratefully acknowledged.

The revisions were implemented by a steering committee convened to revise the 2001 Code. The members of that committee represented a variety of nursing roles and settings and were drawn from across the United States. The following persons were members of the Steering Committee for the Revision of the Code of Ethics for Nurses with Interpretive Statements:

Margaret Hegge, EdD, RN, FAAN – Chair

Marsha Fowler, PhD, MDiv, MS, RN, FAAN

Dana Bjarnason, PhD, RN, NE-BC

Timothy Godfrey, SJ, DNP, RN, PHCNS-BC

Carla Lee, PhD, APRN-BC, FAAN

Lori Lioce, DNP, FNP-BC, CHSE, FAANP

Margaret Ngai, BSN, RN

Catherine Robichaux, PhD, RN, CNS

Kathryn Schroeter, PhD, RN, CNOR, CNE

Josephine Shije, BSN, RN

Elizabeth Swanson, DNP, MPH, APRN-BC

Mary Tanner, PhD, RN

Elizabeth Thomas, MEd, BS, RN, NCSN, FNASN

Lucia Wocial, PhD, RN

Karen Zanni, MSN, FNP-C

The Steering Committee was staffed by Laurie Badzek, LLM, JD, RN, FAAN, Director of ANA’s Center for Ethics and Human Rights (Co-Chair), and Martha Turner, PhD, RN-BC, Assistant Director for ANA’s Center for Ethics and Human Rights, who served as content editor, revision coordinator, and co-lead writer. Committee member Marsha Fowler, PhD, MDiv, MS, RN, FAAN, who was named Historian and Code Scholar, served as co-lead writer.

Contents

Contributors and Acknowledgments i

Provisions of the Code of Ethics for Nurses with v Interpretive Statements

Preface vii

Introduction xi

Provision 1 1

1.1 Respect for Human Dignity

1.2 Relationships with Patients

1.3 The Nature of Health

1.4 The Right to Self-Determination

1.5 Relationships with Colleagues and Others

Provision 2 5

2.1 Primacy of the Patient’s Interests

2.2 Conflict of Interest for Nurses

2.3 Collaboration

2.4 Professional Boundaries

Provision 3 9

3.1 Protection of the Rights of Privacy and Confidentiality

3.2 Protection of Human Participants in Research

3.3 Performance Standards and Review Mechanisms

3.4 Professional Responsibility in Promoting a Culture of Safety

3.5 Protection of Patient Health and Safety by Acting on Questionable Practice

3.6 Patient Protection and Impaired Practice

Provision 4 15

4.1 Authority, Accountability, and Responsibility

4.2 Accountability for Nursing Judgments, Decisions, and Actions

4.3 Responsibility for Nursing Judgments, Decisions, and Actions

4.4 Assignment and Delegation of Nursing Activities or Tasks

Provision 5 19

5.1 Duties to Self and Others

5.2 Promotion of Personal Health, Safety, and Well-Being

5.3 Preservation of Wholeness of Character

5.4 Preservation of Integrity

5.5 Maintenance of Competence and Continuation of Professional Growth

5.6 Continuation of Personal Growth

Provision 6 23

6.1 The Environment and Moral Virtue

6.2 The Environment and Ethical Obligation

6.3 Responsibility for the Healthcare Environment

Provision 7 27

7.1 Contributions through Research and Scholarly Inquiry

7.2 Contributions through Developing, Maintaining, and Implementing Professional Practice Standards

7.3 Contributions through Nursing and Health Policy Development

Provision 8 31

8.1 Health Is a Universal Right

8.2 Collaboration for Health, Human Rights, and Health Diplomacy

8.3 Obligation to Advance Health and Human Rights and Reduce Disparities

8.4 Collaboration for Human Rights in Complex, Extreme, or Extraordinary Practice Settings

Provision 9 35

9.1 Articulation and Assertion of Values

9.2 Integrity of the Profession

9.3 Integrating Social Justice

9.4 Social Justice in Nursing and Health Policy

Afterword 39

Glossary 41

Timeline: The Evolution of Nursing’s Code of Ethics 47

Index 49

Provisions of the Code of Ethics for Nurses with Interpretive Statements

Provision 1 | The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

Provision 2 | The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.

Provision 3 | The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.

Provision 4 | The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.

Provision 5 | The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

Provision 6 | The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.

Provision 7 | The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

Provision 8 | The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.

Provision 9 | The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

Preface

The Code of Ethics for Nurses with Interpretive Statements (the Code) establishes the ethical standard for the profession and provides a guide for nurses to use in