1 to 6 NURSING ETHICS.ppx kmu bsn 4th semester

education

1. UNIT I:
INTRODUCTION TO
NURSING ETHICS
By: Farzana Kausar Khattak
Lecturer
KMU-INS

2. OBJECTIVES:
At the end of the session learner will be able to :
Define the terms: ethics, nursing ethics and bio-ethics,
value, belief, moral, attitude, conflict, dilemma, ethical
dilemma.
Discuss the importance of ethic in nursing
Review criteria of a profession.
Develop characteristics of a professional Nurse.
Farzana Khattak 03/06/25

3. ETHICS
Derived from the Greek word “ethos”, which means
“way of living”.
Branch of philosophy that is concerned with human
conduct, more specifically the behavior of individuals in
society.
Ethics examines the rational justification for our moral
judgments; it studies what is morally right or wrong.
Farzana Khattak 03/06/25

4. ETHICS
It also refers to the method of inquiry that deals
with conduct which is the guiding principles for
good or bad.
Usually refers to the practices, beliefs, and
standards of behavior of a particular group
such as nurses.
Farzana Khattak 03/06/25

5. NURSING ETHICS
Nursing ethics is a branch of applied ethics that
concerns itself with activities in the field of nursing.
The values or moral principles governing relationships
between the nurse and patient, the patient's family, other
members of the health professions, and the general
public.
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6. BIOETHICS
Bioethics is a multidisciplinary field that explores the
ethical implications of advances in biology, medicine, and
healthcare, focusing on making moral decisions in these
fields while considering the well-being of individuals and
society.
Genetic Testing
End of life care
Abortion
Farzana Khattak 03/06/25

7. VALUE
Something of worth; enduring beliefs or attitudes about
the worth of a person, object, idea, or action. 
The value is a personal belief about the worth you hold
for an idea, a custom, or an object.
I value freedom of speech.
I value my family.
Farzana Khattak 03/06/25

8. BELIEF
Belief is when you think something is true or real, even
if you can't prove it.
For example, believing in luck or fate means you think
these things influence your life, even though you can't
see them.
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9. MORAL
Concerned with the principles of right and wrong
behavior.
Concerned with the judgment of the goodness or
badness of human action and character.
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10. ATTITUDE
Attitude is our presumed way of thinking about,. feeling
toward or responding to a person, thing or concept.
Attitude is mental position or feelings towards a person,
object or idea (compassion, acceptance).
Some clients may feel strongly about their need of
privacy, where as others may dismiss it as unimportant.
Farzana Khattak 03/06/25

11. CONFLICT
Conflict occurs when two or more people oppose one
another because their needs, wants, goals, or standards
are different.
A conflict is a clash of interest, opinion, or even
principles. 
Farzana Khattak 03/06/25

12. DILEMMA
The definition of a dilemma is a situation where there is
no clear easy choice or answer.
It is a situation in which we have to choose between two
equal unsatisfactory alternatives.
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13. ETHICAL DILEMMA
Ethical dilemma, also known as a moral dilemma, is a situation in
which there is a choice to be made between two options, neither of
which resolves the situation in an ethically acceptable fashion.
Euthanasia
Abortion
Confidentiality
Truth-telling
End-of-life
Informed consent
Farzana Khattak 03/06/25

14. IMPORTANCE OF ETHICS IN
NURSING
Ethics is important in nursing because it sets forth a
series of actions and decisions that are in the best
interests of a patient and dictate what must be done.
Ethics ensure that every person is given the greatest level
of attention and care possible.
It is a moral compass that pushes nurses to administer
services fairly and in a timely fashion.
Protecting the privacy rights of patients.
Farzana Khattak 03/06/25

15. CRITERIA OF A
PROFESSION
Education and Training: Ensuring nurses have the
necessary education and training to provide competent
care.
Ethical Standards: Upholding ethical principles and
codes of conduct in patient interactions.
Regulatory Compliance: Adhering to licensure and
regulatory requirements for nursing practice.
Farzana Khattak 03/06/25

16. CRITERIA OF A
PROFESSION
Quality of Care: Providing high-quality patient care through
best practices.
Patient Rights: Respecting patient rights, including
confidentiality and informed consent.
Professionalism: Demonstrating professionalism, integrity,
and accountability in nursing practice.
Continuing Education: Committing to ongoing
professional development and staying current in the field.
Farzana Khattak 03/06/25

17. CRITERIA OF A
PROFESSION
Safety: Ensuring patient safety and well-being in
nursing care.
Cultural Competence: Recognizing and addressing
diverse patient needs.
Community Engagement: Contributing to the
advancement of the nursing profession and community
health.
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18. CHARACTERISTIC OF
PROFESSIONAL NURSE
Empathy: Professional nurses demonstrate empathy by understanding and
caring about the emotional and physical well-being of their patients.
Clinical Competence: They possess the necessary knowledge, skills, and
expertise to provide safe and effective patient care.
Ethical Integrity: Professional nurses adhere to ethical standards and
maintain the highest level of integrity in their practice, including respecting
patient confidentiality and rights.
Advocacy: Professional nurses advocate for their patients, ensuring their
needs and preferences are heard and respected within the healthcare system.
Farzana Khattak 03/06/25

19. CHARACTERISTIC OF
PROFESSIONAL NURSE
Communication Skills: Effective communication is crucial in
nursing, and professionals excel in conveying information
clearly and compassionately to patients and their families.
Commitment to Lifelong Learning: They continuously seek
opportunities for education and professional development to
stay up-to-date with advancements in healthcare and nursing
practice.
Teamwork: They collaborate effectively with other healthcare
professionals, recognizing the importance of interdisciplinary
teamwork to provide comprehensive and holistic patient care.
Farzana Khattak 03/06/25

20. 03/06/25Farzana Khattak

21. REFERENCES
American Counseling Association (2005). ACA code of ethics.
Alexandria, VA: Author.
Kushner, H. S. (2001). Living a life that matters. NY: Anchor
Books
National Association of School Nurses (2010). Code of ethics.
Author.
www.google.com
Farzana Khattak 03/06/25

22. 03/06/25Farzana Khattak

23. UNIT-II: VALUE SET
By: Farzana Kausar Khattak
Lecturer
INS-KMU

24. OBJECTIVES
•Define Value &value clarification
•2. List types of values
•3. Identify personal, societal, organizational, professional and moral values
•4. Explain modes of value transmission
•5. Recognize value conflicts and its implication to nursing practice.
•6. List advantages of value clarification in nursing profession.
•7. Develop professional values
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25. VALUE
Something of worth; enduring beliefs or attitudes about the worth
of a person, object, idea, or action. 
The value is a personal belief about the worth you hold for an idea,
a custom, or an object.
I value freedom of speech.
I value my family.
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26. VALUE CLARIFICATION
•Value clarification is a process that involves examining and
understanding one's personal values, beliefs, and ethical principles.
•It is a self-reflective and often guided exploration of what matters
most to an individual, helping them gain greater clarity about their
core values and priorities.
•This process can be important for personal development, decision-
making, and moral reasoning.
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27. TYPES OF VALUES
•Personal Values
•Cultural Values
•Moral Values
•Social Values
•Family Values
•Organizational Values
•Spiritual or Religious Values
•Environmental Values
•Economic Values
•Aesthetic Values
•Political Values
•Health and Wellness Values
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•It's important to note that individuals may prioritize these values differently, and some
values may be in conflict with each other.
• Values can also change or evolve over time, influenced by life experiences, culture, and
personal growth.

28. PERSONAL VALUES
These are individual beliefs and principles that are important to a
person and guide one's behavior and decisions.
•Honesty
•Compassion
•Independence
•Creativity
•Loyalty
•Self-discipline
•Kindness
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29. SOCIETAL VALUES
Shared principles and norms that shape the culture and behavior of a society.
•Democracy
•Equality
•Freedom
•Justice
•Tolerance
•Human rights
•Social responsibility
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30. ORGANIZATIONAL
VALUES
Core principles that define the culture and conduct of a company or institution.
•Accountability
•Teamwork
•Innovation
•Customer focus
•Quality
•Leadership
•Adaptability
•Efficiency
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31. PROFESSIONAL VALUES
Ethics and standards that govern the conduct and behavior of individuals
within a specific profession or field.
•Professionalism
•Competence
•Confidentiality
•Trustworthiness
•Accountability
•Continuous learning
•Respect for colleagues
•Adaptability
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32. MORAL VALUES
Fundamental beliefs about what is right and wrong, shaping ethical decision-
making.
•Honesty
•Fairness
•Justice
•Empathy
•Responsibility
•Respect for others
•Truthfulness
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33. MODES OF VALUE TRANSMISSION
Common modes of value transmission include:
1.Modeling
2.Moralizing
3.Laissez-faire
4.Rewarding And Punishing
5.Responsible Choice
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34. 1. MODELING
•Mode of value transmission involves people learning and adopting
values by observing and imitating the behavior of role models they
admire.
•Example: If a child sees their parents consistently demonstrating
honesty in their interactions and daily life, the child is likely to model
their own behavior after their parents' honesty, thus learning and
internalizing the value of truthfulness.
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35. 2. MORALIZING
•Mode of value transmission involves teaching and instilling values
through moral instruction and guidance, often within a moral or ethical
framework.
•Example: In a religious context, a religious leader provides moral
instruction to their congregation, emphasizing the value of compassion
and helping those in need. This teaching encourages the congregation
to adopt these values in their lives, guiding their actions to align with
the moral teachings of their faith.
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36. 3. LAISSEZ-FAIRE
•It is a noninterference approach to value transmission,
where individuals are left to develop their own values without much
guidance or intervention.
•This approach is often used in situations where it is believed that
individuals should be free to develop their own values and beliefs.
•Example: Parents give their children a high degree of freedom to
explore and make choices about their values and beliefs. These children
often develop their values independently based on their experiences
and self-discovery, rather than being strongly directed by their parents.
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37. 4. REWARDING AND
PUNISHING
•Involves reinforcing certain values through the use of rewards for
desirable behavior and punishments for undesirable behavior.
•Involves using rewards or punishments to encourage or discourage
certain behaviors or values.
•Example: In a company, employees who consistently meet or exceed
targets are rewarded with financial bonuses, while those who engage in
unethical practices or violate company policies may face disciplinary
actions or job termination, reinforcing the organization's values of
performance and integrity.
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38. 5. RESPONSIBLE CHOICE
•Refer to individuals taking ownership of their decisions and
their consequences, reflecting their values.
•Example: A student chooses to study diligently for an exam,
acknowledging the value of education and personal growth,
even though it requires sacrificing some leisure time. This
responsible choice reflects his/her commitment to academic
excellence.
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39. CONFLICT
•Conflict refers to a state of disagreement, tension, or opposition between
individuals, groups, or entities. It often arises from differences in interests, values, or
goals and can manifest as emotional, verbal, or physical discord.
•Two coworkers are in conflict because one wants to work in a quiet environment to
concentrate, while the other prefers to have music playing in the background. Their
differing preferences lead to tension and disagreements in the workplace.
•There are 4 types of conflict:
•Interpersonal Conflict
•Intrapersonal Conflict
•Intergroup Conflict
•Intragroup Conflict
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40. VALUE CONFLICT
•Value conflict is a clash between individuals or groups with fundamentally different
beliefs and ethical principles.
•For example, a value conflict can occur when one person believes in strict
environmental conservation, while another believes in industrial development without
much concern for the environment, leading to disagreements and tension.
•Types of conflict in relation to value conflict:
•Interpersonal Value Conflict
•Intrapersonal Value Conflict
•Intergroup Value Conflict
•Intragroup Value Conflict
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41. INTERPERSONAL VALUE CONFLICT
This occurs when individuals have conflicting values with each other.
•For example, one person values staying up late and study in quite environment, while
another values getting a good night's sleep for early morning productivity.
INTRAPERSONAL VALUE CONFLICT
This happens when an individual experiences internal conflict due to conflicting personal
values.
•For instance, someone may have an intrapersonal value conflict if they value both career
success and spending more time with their family, but feel torn between the two.
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42. INTERGROUP VALUE CONFLICT
This involves conflicting values between different groups, which might be
religious, cultural, or social organizations.
•For example: In a school, there might be an intergroup value conflict between
students who value strict dress codes and those who value expressing their
personal style through clothing.
INTRAGROUP VALUE CONFLICT
•Conflict that arises within a specific group or organization due to differing values
among its members.
•This conflict occurs among individuals who share the same group.
•For Example: In a student group, some members value studying alone for exams,
while others value forming study groups.
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43. IMPLICATION OF VALUE
CONFLICTS TO NURSING
PRACTICE
•Ethical Dilemmas: Value conflicts can lead to ethical dilemmas.
Nurses may face situations where their personal values clash with the
values of the healthcare institution or the patient. This can create
moral distress and challenge their ability to make ethically sound
decisions.
•Patient Care: Value conflicts can impact the quality of patient care.
Differences in values related to treatment options, end-of-life
decisions, or other aspects of care may lead to disagreements among
healthcare providers, potentially affecting the care provided to patients.
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44. •Communication and Collaboration: Value conflicts can strain
communication and collaboration within the healthcare team. Effective
teamwork is vital for patient safety and positive outcomes, and conflicts can
hinder this collaboration.
•Patient Autonomy: Value conflicts may affect a patient's autonomy and their
ability to make informed decisions about their care. Nurses must balance their
values with the patient's right to make choices that align with their own values
and preferences.
•Job Satisfaction: Repeated value conflicts can lead to job dissatisfaction and
burnout among nurses. When they consistently face situations that challenge
their personal values, it can take a toll on their well-being and job satisfaction.
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IMPLICATION OF VALUE
CONFLICTS TO NURSING
PRACTICE

45. •Legal and Ethical Issues: Value conflicts may result in legal
and ethical challenges. If healthcare providers make decisions
that go against a patient's wishes or best interests due to value
conflicts, it can lead to legal repercussions or ethical complaints.
•To address these implications, nurses and healthcare institutions
often implement ethics training, encourage open communication
about values and ethical issues, and establish clear protocols and
policies to guide decision-making in ethically complex situations.
Additionally, ethical committees and consultants may be involved
in resolving value conflicts in healthcare setting.
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IMPLICATION OF VALUE CONFLICTS TO
NURSING PRACTICE

46. ADVANTAGES OF VALUE
CLARIFICATION IN NURSING
PROFESSION
•Ethical Decision-Making: It helps nurses identify and clarify their personal values, which is
crucial for making ethical decisions in patient care. This clarity enables them to align their actions
with their values while adhering to ethical standards.
•Improved Patient Care: Nurses with a clear understanding of their values can provide patient-
centered care by respecting and addressing the values, preferences, and beliefs of patients. This
leads to improved patient satisfaction and outcomes.
•Enhanced Communication: Value clarification encourages open and respectful communication
among healthcare team members. When nurses and colleagues understand each other's values, it
promotes effective collaboration and reduces conflicts.
•Conflict Resolution: It equips nurses with the skills to manage value conflicts and ethical
dilemmas more effectively. They can engage in constructive discussions to find ethical solutions
when values differ.
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47. •Personal Well-Being: Value clarification contributes to personal well-
being and job satisfaction for nurses. When they work in alignment with
their values, they are less likely to experience moral distress and burnout.
•Professional Growth: Value clarification is a part of ongoing
professional development. It encourages nurses to reflect on their
practice and make improvements, which can lead to career advancement.
•Compliance with Ethical Standards: It helps nurses adhere to the
ethical codes and standards set by professional nursing organizations
and regulatory bodies. This ensures that they maintain the highest ethical
standards in their practice.
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ADVANTAGES OF VALUE
CLARIFICATION IN NURSING
PROFESSION

48. •Patient Advocacy: Nurses can advocate for their patients more effectively
when they understand and respect their patients' values. They can represent the
patients' best interests within the healthcare system.
•Cultural Competence: Value clarification promotes cultural competence,
helping nurses understand and respect the values and beliefs of patients from
diverse cultural backgrounds.
•Quality Improvement: By promoting a culture of ethical reflection and value
clarification, healthcare institutions can improve the quality of care they provide,
resulting in better patient outcomes.
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ADVANTAGES OF VALUE
CLARIFICATION IN NURSING
PROFESSION

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51. UNIT-III: ETHICAL
PRINCIPLES AND
THEORIES
By: Farzana Kausar Khattak
Lecturer
KMU-INS

52. OBJECTIVES
At the end of the session learner will be able to:
• Discuss ethical principles in health care in the light of
ethical theories.
• Discuss the ethical dilemmas face by nurses and client.
• Discuss the strategies to resolve ethical dilemma in daily
nursing practice.
• List steps of ethical decision-making
Farzana Khattak 5203/06/25

53. ETHICAL PRINCIPLE AND
ETHICAL THEORIES
• Ethical principles are a set of ethical rules that provide the
framework/ tools which may facilitate individuals and society
to resolve conflict in a fair and moral manner.
• They are the foundations of ethical analysis because they are
the viewpoints from which guidance can be obtained along the
pathway to a decision.
• Each theory emphasizes different points such as predicting the
outcome and following one's duties to others in order to reach
an ethically correct decision.
Farzana Khattak 5303/06/25

54. ETHICAL PRINCIPLE AND
ETHICAL THEORIES
• However, in order for an ethical theory to be useful,
the theory must be directed towards a common set of
goals.
• Ethical principles are the common goals that each
theory tries to achieve in order to be successful. These
goals include all principles of Ethics.
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55. ETHICAL PRINCIPLES
• Autonomy: Right to make one’s own decisions and choices.
• Veracity: Refers to telling the truth.
• Confidentiality: Respect for a person’s privacy.
• Beneficence: The principle of doing good and benefits someone.
• Non-maleficence: The duty to do no harm (Prevent unintentional harm).
• Justice: The principle that deals with fairness, equity and equality.
• Fidelity: Means to be faithful to agreements and promises.
• Accountability: Answerable to oneself and others for one’s own actions.
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56. ETHICAL THEORIES
1.Consequence-based (teleological) theories.
2.Principle-based (deontological) theories.
3.Relationships-based (caring) theories.
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57. 1.TELEOLOGICAL THEORIES
 Teleological theories, also known as consequentialist theories,
are a category of ethical theories that focus on the outcomes or
consequences of actions to determine their moral value.
 In teleological ethics, the rightness or wrongness of an action
is determined by the overall good or value it produces. Here are
some notable teleological ethical theories:
•Utilitarianism
•Hedonism
•Egoism
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58. UTILITARIANISM
Developed by philosophers like Jeremy Bentham
and John Stuart Mill.
The right action is the one that maximizes overall
happiness.
In utilitarianism, happiness is typically understood
as pleasure and the absence of pain.
Actions that promote the greatest happiness for
the greatest number of people are considered
morally right (even if its ethically wrong).Farzana Khattak 5803/06/25

59. HEDONISM
 Hedonism specifically focuses on the pursuit of
pleasure and the avoidance of pain as the ultimate
goal of human life.
 Hedonistic theories argue that the right action is the
one that maximizes pleasure or minimizes suffering.
 Hedonism is based on the principle that actions are
morally right if they maximize pleasure or happiness
and minimize pain or suffering.
Farzana Khattak 5903/06/25

60. EGOISM
 Ethical egoism argues that individuals should act in
their own self-interest and seek to maximize their
own happiness.
 Egoism argues that individuals should act in their
self-interest to maximize their own well-being.
 It's a form of ethical egoism that focuses on the
personal consequences of actions.
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61. 2.DEONTOLOGICAL THEORIES
Deontological ethics, often referred to as duty-based ethics, is
an ethical theory that emphasizes the intrinsic nature of actions
or duties as the basis for determining their moral value.
In deontological ethics, certain actions are considered
inherently right or wrong, regardless of their consequences.
Here are some notable deontological theories:
•Kantian Ethics (Deontology)
•Divine Command Theory
•Rights-Based Ethics
Farzana Khattak 6103/06/25

62. KANTIAN ETHICS
 Developed by the philosopher Immanuel Kant.
 Kantian ethics states that individuals should act only
according to principles that could be universal laws
without contradiction.
 It emphasizes the importance of moral duties and the
inherent worth of individuals, asserting that we have
a duty to act morally regardless of the consequences.
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63. DIVINE COMMAND
THEORY
 This theory asserts that the moral rightness or
wrongness of actions is determined by divine
commands or the will of a higher power, such as
God.
 It relies on religious texts and authority for moral
guidance, where obedience to divine rules is
paramount.
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64. RIGHTS-BASED ETHICS
 Rights-based ethics, influenced by the works of
philosophers like John Locke and Immanuel Kant,
emphasizes individual rights as a fundamental aspect of
morality.
 It argues that individuals have certain inherent rights, and
respecting these rights is a moral duty.
 Actions are considered morally wrong if they violate
someone's rights, and it is our moral duty to protect and
uphold these rights, regardless of the overall consequences.
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65. 3. CARING THEORIES
Relationship-based caring theories emphasize the significance of
interpersonal relationships and human connection in healthcare
and caregiving.
These theories guide healthcare professionals in building
meaningful relationships with patients and providing care that is
both patient-centered and culturally sensitive. Here are some
relationship-based caring theories:
•Madeleine Leininger's Cultural Care Theory
•Swanson's Theory of Caring
•Travelbee's Human-to-Human Relationship Model
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66. MADELEINE LININGER'S
CULTURAL CARE THEORY
•Madeleine Lininger's theory highlights the
importance of culturally congruent care,
where healthcare providers understand and
respect the cultural beliefs and values of
their patients.
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67. SWANSON'S THEORY OF
CARING
 Developed by Kristen M. Swanson.
 This theory outlines five caring processes that guide the
nurse-patient relationship:
1.Maintaining Belief
2.Knowing
3.Being With
4.Doing For
5.Enabling
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68. TRAVELBEE'S HUMAN-TO-
HUMAN RELATIONSHIP
MODEL
•Joyce Travelbee's model focuses on the
interpersonal aspects of nursing care and
therapeutic relationship between the nurse and
patient, highlighting the significance of
communication, empathy, and understanding
in providing holistic care.
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69. ETHICAL DILEMMAS IN
NURSING
 Nurses face ethical dilemmas on a daily basis
regardless of where they practice. No matter where
nurses function in their varied roles, they are faced
with ethical decisions that can impact them and their
patients.
 There is no “right” solution to an ethical dilemma.
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70. There are many ethical issues nurses can encounter in the
workplace. These include:
 Quality vs quantity of life
 Pro-choice (abortion) vs Pro-life (conception).
 Freedom vs control.
 Truth telling vs deception (trick or fraud).
 Distribution of resources.
 Empirical knowledge vs personal beliefs.
Farzana Khattak 7003/06/25
ETHICAL DILEMMAS IN
NURSING

71. QUALITY VS QUANTITY OF
LIFE
Quantity may address how long a person lives or perhaps
how many people will be affected by the decision.
Quality pertains to how “good” a life a person may have
and this varies depending on how a person defines
“good”.
So how does the nurse support a patient deciding between
a therapy that will prolong life but the quality of life will
be compromised? The person may live longer, but will
likely experience significant side effects from the therapy.
What should the nurse’s position be?
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72. PRO-CHOICE VS PRO-LIFE
 This issue affects nurses personally. Many of the positions
nurses assume in this dilemma are influenced by their own
beliefs and values.
 How does a nurse care for a patient who has had an abortion,
when the nurse considers abortion murder?
 Can that nurse with very opposing values support that patient’s
right to choose her autonomy?
Farzana Khattak 7203/06/25

73. FREEDOM VS CONTROL
 Does a patient have the right to make choices for
one’s self that may result in harm, or should the
nurse prevent this choice?
 For example, a patient wants to stop eating, but the
nurse knows the consequences will harm the patient.
 Does the nurse have the “right” to force the patient
to eat?
Farzana Khattak 7303/06/25

74. TRUTH TELLING VS
DECEPTION
 This is another issue that nurses may have to deal with,
especially when families want to deny telling the patient the
truth about the medical condition.
 What should a nurse do when a family insists telling the
patient the prognosis will cause harm?
 How can a nurse know if this is true?
 Does the patient have the right to know?
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75. DISTRIBUTION OF
RESOURCES
 A nurse may encounter a distribution of resources
dilemma when deciding how to allocate limited medical
supplies like ventilators during a healthcare crisis, such as a
pandemic.
 They must determine which patients will benefit the most
from the available resources, balancing the need for fair
distribution while saving as many lives as possible.
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76. EMPIRICAL KNOWLEDGE VS
PERSONAL BELIEF
 In these dilemmas, research based knowledge in nursing
practice is contrasted to beliefs gained from such things as
religious beliefs.
 For example, what should a nurse do when a patient is
admitted to the hospital that desperately needs a
transfusion to live but has the belief that transfusions are
unacceptable? The nurse knows this patient will die
without the transfusion.
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77. STRATEGIES TO ENHANCE
ETHICAL DECISION
The following strategies should be taken by a nurse to overcome the
moral distress on the job:
Become aware of your own values and ethical aspects of nursing.
Be familiar with nursing codes of ethics.
Seek continuing education opportunities to stay knowledgeable about
ethical issues in nursing.
Respect the values, opinions, and responsibilities of other health care
professional that may be different from your own.
Serve on institutional ethics committees.
Strive for collaborative practice in which nurses function effectively in
cooperation with other health care professionals.
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78. STEPS OF ETHICAL DECISION
MAKING
1.Gather the facts
2.Define the ethical issues
3.Identify the affected parties (stakeholders)
4.Identify the consequences
5.Identify the obligations (principles, rights, justice)
6.Consider your character and integrity (honest).
7.Think creatively about potential actions
8.Check your gut
9.Decide on the proper ethical action and be prepared to deal with
opposing arguments.
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79. 1.GATHER THE FACTS
The first step is to gather all relevant information and facts
related to the ethical dilemma.
This includes understanding the situation, the individuals
involved, and any contextual details.
Don’t jump to conclusions without the facts.
Questions to ask: Who, what, where, when, how, and why.
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80. 2.DEFINE THE ETHICAL
ISSUES
Identify and clarify the specific ethical problems or
dilemmas that exist within the given situation.
What are the conflicting values or principles at play?
Don’t jump to solutions without first identifying the
ethical issues in the situation.
Define the ethical basis for the issue you want to focus
on.
There may be multiple ethical issues, focus on one major
one at a time.
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81. 3.IDENTIFY AFFECTED
PARTIES
Identify all of the stakeholders.
Determine who is impacted by the ethical decision.
Consider the various stakeholders and their interests in
the outcome.
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82. 4.IDENTIFY
CONSEQUENCES
Think about potential positive and negative
consequences for affected parties by the decision
(Focus on primary stakeholders to simplify analysis
until you become comfortable with the process).
What are the magnitude of the consequences and the
probability that the consequences will happen.
Short term vs. Long term consequences-will
decision be valid over time.
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83. 5.IDENTIFY THE RELEVANT
PRINCIPLES, RIGHTS, AND JUSTICE
ISSUES
 Consider ethical principles, rights, and notions of justice
that apply to the situation.
 What moral obligations do you or the organization have?
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84. 6.CONSIDER YOUR CHARACTER &
INTEGRITY
 Reflect on your own character and integrity. Are you being
honest with yourself about your motivations and values? How
do your actions reflect your character?
 Consider what your relevant community members would
consider to be the kind of decision that an individual of
integrity would make in this situation.
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85. 7.THINK CREATIVELY ABOUT
POTENTIAL ACTIONS
 Generate a list of possible actions or solutions to the
ethical dilemma.
 Be open to innovative approaches that may reconcile
conflicting values.
 If you have come up with solutions “a "and “b,” try to
brainstorm and come up with a “c” solution that might
satisfy the interests of the primary parties involved in the
situation.
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86. 8.CHECK YOUR GUT
Trust your intuition and emotions to some extent. Even
though the prior steps have argued for a highly rational
process, but it is always good to “check your gut.”
How do you feel about the potential solutions? Gut
feelings can sometimes provide valuable insights.
Particularly relevant if you have a lot of experience in
the area-expert decision making.
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87. 9.DECIDE ON YOUR COURSE OF ACTION
AND PREPARE RESPONSES TO THOSE
WHO MAY OPPOSE YOUR POSITION
 Based on the previous steps, make a decision on
the most ethically sound course of action.
 Be ready to defend your decision and address
opposing arguments, as ethical dilemmas often
involve differing perspectives.
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88. SCENARIO
•You are a nurse working in a hospital. A patient, Mr.
Smith, has been admitted with a severe illness. After a few
days, he tells you in confidence that he's been secretly
taking an experimental, unapproved drug he bought online
because he believed it would cure him. He's worried about
the potential side effects of this drug and asks you not to
inform the medical team or his family.
 Make a decision for this patient in light of Ethical
Decision-Making Steps.
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89. ETHICAL DECISION-MAKING
STEPS
1.Gather the facts: You gather information by listening to Mr. Smith's
story and understanding the nature of the drug and his concerns.
2.Define the ethical issues: The primary ethical issue is patient autonomy
and informed consent. It's also about ensuring patient safety and well-
being.
3.Identify the affected parties (stakeholders): The affected parties
include Mr. Smith, his family, the medical team, and yourself.
4.Identify the consequences: If Mr. Smith's secret drug use is not
disclosed, there's a risk of potential harm due to drug interactions or side
effects. On the other hand, breaching his confidentiality might harm the
trust between the patient and healthcare professionals.
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90. 5.Identify the obligations (principles, rights, justice): You have an
obligation to uphold patient confidentiality, but you also have an ethical
duty to protect Mr. Smith's well-being. The principles of autonomy,
beneficence, and non-maleficence come into play.
6.Consider your character and integrity (honest): Reflect on your own
integrity and values. Are you acting honestly and in the best interest of
the patient?
7.Think creatively about potential actions: Explore various options,
such as discussing the situation with Mr. Smith, seeking guidance from
a medical ethics committee, or informing his family while respecting
his autonomy.
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ETHICAL DECISION-
MAKING STEPS

91. 8.Check your gut: Consider how you feel about each option. Your
intuition may guide you toward the most ethical action.
9.Decide on the proper ethical action and be prepared to deal with
opposing arguments: After careful consideration, you decide to
discuss the situation with Mr. Smith, emphasizing your concern for
his well-being. You're prepared to address his fears and explore the
best path forward.
In this example, the ethical decision-making process involves balancing
respect for patient autonomy and confidentiality with the
responsibility to ensure patient safety and well-being. The chosen
action prioritizes open communication and trust-building with the
patient while considering the potential consequences of the situation.
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ETHICAL DECISION-
MAKING STEPS

92. ETHICAL
DILEMMAS What should a health professional do when he/she sees a
colleague engaging in an unethical act?
 Because of the family’s wish, the terminal ill status has not been
told the patient but the nurse is sure he/she knows he/she is dying.
What should the nurse do ethically when this patient directly asks
her/him about his/her condition?
 Is lying to a patient ever ethical? What constitutes a lie? Is a
placebo a lie?
 Should the nurse follow a doctor’s order if she/he thinks there is a
potential problem with the order?
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93.  Two ethical principles are ‘Do No Harm and Do Good’. What
do we mean by Harm and Good?
 Health professionals have two basic ethical obligations: (1) to
extend life & (2) to lessen pain and suffering. Can they do both
in this situation when Morphine may shorten patient’s life?
 How do you balance a patient's right to make their own
medical decisions (autonomy) with your duty to provide the
best care possible (beneficence) when they refuse a treatment
that you believe is in their best interest?
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ETHICAL
DILEMMAS

94. 03/06/25Farzana Khattak 94

95. REFERENCES
 American School Counselor Association. (2004). Ethical
standards for school counselors, Alexandria, VA: Author.
 Kushner, H. S. (2001). Living a life that matters. NY:
Anchor Books
 National Association of School Nurses (2010). Code of
ethics. Author.
 www.google.com
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96. Farzana Khattak 9603/06/25

97. UNIT: IV
CONFIDENTIALITY AND
INFORMED CONSENT
By: Farzana Kausar Khattak
Lecturer
KMU-INS

98. OBJECTIVES
At the end of this session learners will be able to:
•Define confidentiality and informed consent
•Discuss the importance of confidentiality & consent
•List ethical and legal elements of informed consent
•Discuss the process informed consent.
•Discuss nurse’s roles and responsibilities in consent process
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99. INFORMED CONSENT
•It is an agreement by a client to accept a course of a
treatment, procedure or research after being provided
complete information including benefits and risks.
•Obtaining informed consent is the responsibility of the
person performing the procedure or research.
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100. TYPES OF CONSENT
Types of consent
1- Expressed Consent
2- Implied Consent
• Expressed Consent
•May either be oral or written.
•Written consent is preferred if there are greater risks of a
procedure.
•Implied consent
•Exists when the client’s non-verbal behavior indicates
agreement.
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101. CONFEDENTIALITY
•Confidentiality means that any information provided by
individuals as part of the informed consent process,
including their personal and medical details, must be kept
confidential and not disclosed to unauthorized parties.
•Respecting confidentiality is essential to maintain trust and
ensure that individuals are comfortable sharing
information when making informed decisions about
medical treatments, research participation, or other
relevant matters.
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102. IMPORTANCE OF
CONFIDENTIALITY &
CONSENT
CONFIDENTIALITY
•Respect for Privacy: Maintains individuals' privacy and dignity by
safeguarding their personal information.
•Trust Building: Fosters trust between individuals and professionals,
enabling open and honest communication.
•Ethical Responsibility: Upholds the ethical duty to protect sensitive data
and maintain trustworthiness.
•Legal Compliance: Often required by law and regulations to protect the
rights and privacy of individuals.
•Psychological Well-being: Preserves emotional and psychological well-
being by ensuring that personal information is not misused or disclosed
without consent.
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103. CONSENT
•Autonomy and Respect: Empowers individuals to make informed
decisions about their own bodies and participation, respecting their
autonomy.
•Ethical Research: In research, it ensures that individuals voluntarily
agree to participate.
•Legal Compliance: Required in many contexts, including healthcare,
research, and business, to comply with laws and regulations.
•Protection from Coercion: Guards against coercion, ensuring that
decisions are made willingly and without undue pressure.
•Clear Communication: Promotes clear communication between
parties, reducing misunderstandings and disputes.
IMPORTANCE OF
CONFIDENTIALITY & CONSENT
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104. ETHICAL ELEMENTS OF
INFORMED CONSENT
•Autonomy: Respecting an individual's right to make decisions about their own
body and participation.
•Beneficence: Person providing consent understands the potential benefits and
risks involved and their well being is protected.
•Non-maleficence: Minimizing harm and ensuring that any risks are reasonable
and justifiable.
•Veracity: Providing honest and accurate information to enable informed
decision-making.
•Respect for Privacy: Safeguarding the confidentiality of personal information
shared during the consent process.
•Withdraw Consent: The right to withdraw consent at any point during the
procedure or activity without negative consequences.
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105. LEGAL ELEMENTS OF
INFORMED CONSENT
•Capacity: The individual providing consent must be legally capable of
making decisions, often determined by age or mental competence.
•Voluntariness: Consent should be freely given, without coercion or pressure.
•Comprehension: The person must fully understand the information
provided about the consent request.
•Disclosure (Information): Complete and clear information must be
provided about the matter at hand.
•Authorization: In some cases, a formal written agreement may be required,
such as a consent form.
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106. INFORMED CONSENT
PROCESS
The process of informed consent typically involves the following steps:
1.Introduction and Information Disclosure:
•The individual is introduced to the situation or procedure, and the relevant
information is disclosed.
•This includes the nature of the procedure, its purpose, potential risks and
benefits, and any available alternatives.
2.Comprehension:
•The individual is given the opportunity to ask questions and seek
clarification on any aspects of the information presented.
•It's essential that they fully understand what they are consenting to.
3.Voluntariness: The person is assured that their consent is entirely voluntary, and
they have the right to decline or withdraw their consent at any time without facing
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107. 4.Documentation:
•In many cases, written consent is obtained through a consent form,
which both the individual and the person obtaining consent sign.
•This form may summarize the key information provided.
5.Continued Communication: Throughout the procedure or
activity, there should be ongoing communication to address any
concerns or changes in the individual's consent.
6.Respect for Privacy: Any information disclosed during the
consent process is kept confidential and not shared without
proper authorization.
INFORMED CONSENT
PROCESS
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108. 7.Ethical Principles: The process adheres to ethical principles, including:
•Respect for autonomy (the individual's right to make decisions about
their own body)
•Beneficence (ensuring their well-being)
•Non-maleficence (minimizing harm)
•The goal of the informed consent process is to ensure that individuals make
voluntary, informed, and autonomous decisions regarding their participation
in a procedure, research study, or any situation where their consent is
required. It aims to protect their rights and well-being.
INFORMED CONSENT
PROCESS
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109. NURSE’S ROLES AND
RESPONSIBILITIES IN
CONSENT PROCESS
•The nurse is responsible and accountable for the verification of and
witnessing that the patient or the legal representative has signed the consent
document in their presence.
•The patient, or the legal representative, is of legal age and competent to
provide consent.
•They also confirm that the patient has sufficient knowledge to make a
knowledgeable decision.
•Advocate for the patient's right to make decisions about their care and
ensure their preferences are respected.
•Safeguard the confidentiality of any information shared during the consent
process, respecting the patient's privacy.
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110. •Consider cultural and linguistic factors that may impact the patient's
comprehension and willingness to provide consent.
•Confirm the patient's identity to prevent errors in the consent process.
•Address any questions, concerns, or uncertainties the patient may have
regarding the procedure or treatment.
•Accurately document the informed consent process, including the
patient's understanding and agreement, which is often done by
witnessing the patient's signature on the consent form.
NURSE’S ROLES AND
RESPONSIBILITIES IN
CONSENT PROCESS
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111. 03/06/25
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112. 03/06/25Farzana Khattak 112

113. Unit-V: Bills of
Rights

By: Farzana Kausar Khattak
Lecturer
INS-KMU

114. Objectives
 Define rights & bills of right.
 List the types of rights.
 Describe the role of nurse in relation to bills of right.
 Explain patient’s bills of right in a tertiary care health facility.
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115. rights
That which is morally good, justified , or acceptable.
 Human rights are the basic rights and freedoms that belong to
every person in the world, from birth until death.
 They apply regardless of where you are from, what you believe
or how you choose to live your life.
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116. Types of rights in islam
These rights are as follows:
 The right to life
 The right to live in dignity
 The right to justice
 The right to equal protection of the law
 The right of choice
 The right of free expression
 The right to privacy
 The right of property
 The right to basic necessities of life
 The right to revolt (rising up)
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117. universal human rights
Some examples of human rights include:
 The right to life.
 The right to liberty and freedom.
 The right to the pursuit of happiness.
 The right to live your life free of discrimination.
 The right to control what happens to your own body and to make
medical decisions for yourself etc.
 The right to grow old.
 The right to a fair trial and due process of the law.
 The right to be free from cruel and unusual punishment.
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118. universal human rights
 The right to freely exercise your religion and practice your religious beliefs
without fear of being prosecuted for your beliefs.
 The right to be free from prejudice on the basis of race, gender, national
origin, color, age or sex.
 The right to be free from slavery.
 The right to freedom of speech.
 The right to freely associate with whomever you like and to join groups of
which you'd like to be a part.
 The right to freedom of thought.
 The right to be free from torture.
 The right not to be prosecuted from your thoughts.
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119. Controversial Human Rights
 Right to abortion: a divisive issue involving debates about when life begins, fetal
rights, and the autonomy of pregnant individuals.
 Right to privacy: controversial due to the tension between personal privacy and
security concerns, especially in the digital age.
 Right to freedom of speech: controversial when balancing free expression with
concerns like hate speech and false information.
 Right to bear arms: contentious in debates over gun control, with differing views
on the necessity and regulation of firearms.
 Right to religious freedom: controversial when religious practices conflict with
other human rights or when they are seen as promoting discrimination or
extremism.
 Right to be free from discrimination: on the basis of sexual orientation,
including the right to marry a person of the same sex.
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120. bills of rights
Definition:
A formal declaration of the legal and civil rights of the
citizens of any state, country, federation, etc.
03/06/25Farzana Khattak 120

121. role of nurse in relation to bills of
rights
 Nurses have the right to freely and openly advocate for themselves
and their patients, without fear of retribution.
 The code of ethics for nurses (2001) asserts that
the nurse promotes, advocates for and strives to protect the health,
safety, and rights of the patient, as one of its non-negotiable tenets.
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122. CONT…
 Right to practice in a manner that fulfills their obligations to
society & to those who receive nursing care.
 Right to practice in environments that allow them to act in
accordance with professional standards and legally authorized
scopes of practice.
 Right to a work environment that supports and facilitates ethical
practice, in accordance with code of ethics for nurses.
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123. CONT…
Right to fair compensation for their work, consistent with their
educational preparation, knowledge, experience and professional
responsibilities.
 Right to a work environment that is safe for themselves and their
patients.
 Right to negotiate, either as individuals or collectively, the conditions
of their employment.
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124. A Patient’s Bills of Rights
 Make autonomous decisions about their medical care including
their right to accept and reject any treatments.
 Complete freedom from abuse and neglect.
 Access to emergency services.
 Competent and compassionate care.
 Religious freedom.
 Accurate bills for the care and services that are given to the
person.
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125. Cont…
 The right to considerate and respectful care and is encouraged to
obtain from physician and other direct care-givers relevant, current,
and understandable information.
 Right to expect all communications & records pertaining to
his/her care will be treated as confidential by the hospital.
 Right to review the records pertaining to his/her medical care
 Express their complains and have these complaints and concerns
addressed.
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126. Cont…
 Right to consent or decline to participate in proposed
research studies.
 Right to expect reasonable continuity of the care.
 Right to be informed of hospital policies and practices that
relate to patient care, treatment, and responsibilities.
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127. Questions?
03/06/25Farzana Khattak 127

128. UNIT-VI:
CODE OF
ETHICS
By: Farzana Kausar Khattak
Lecturer
INS-KMU

129. OBJECTIVES
Define code & code of Ethics.
Discuss the elements & functions of ethical code.
Explain code of ethics by ICN and Pakistan Nursing Council.
Compare code of ethics by ICN and Pakistan Nursing Council.
Application of code of ethics in clinical settings.
Define Nursing Pledge in relation to code of ethics.
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130. DEFINITIONS
Code:
A set of rules or principles.
“Constitution” of the organization.
Code of Ethics:
A set of rules and guidelines of conduct.
A Code of Ethics is a document created to:
•Set the standards for ethically acceptable behavior
•Communicate those standards to all stakeholders.
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131. BENEFITS
Requires identification of core values
Encourages reflection on the meaning and
application of values
Enhances reputation
Builds trust – internally and externally
Increases awareness of ethics issues
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132. BENEFITS
Stimulates ethical talk
Guides decision-making
Reduces ethics risks
Encourages seeking advice
Enhances good governance and leadership
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133. FUNCTIONS
It helps members of a profession to recognize their
responsibilities.
It helps create an environment in which ethical behavior is
the norm.
It serves as a guide or reminder in specific situations.
It serves as an educational tool, providing a focal point for
discussion in classes and professional meetings.
It indicates to others that the profession is seriously
concerned with responsible, professional conduct.
03/06/25Farzana Khattak

134. ICN CODE OF ETHICS
(Overview)
An international code of ethics for nurses was first adopted
by the International Council of Nurses (ICN) in 1953.  
It has been revised and reaffirmed at various times since,
most recently with this review and revision completed in
2021.
The ICN Code of Ethics for Nurses has four principal
elements that outline the standards of ethical conduct.
•Nurses and patients or other people
•Nurses and practice
•Nurses and the profession
•Nurses and global health
03/06/25Farzana Khattak

135. ICN CODE OF ETHICS
Self Study (Link and Material Provided)
https://
www.icn.ch/sites/default/files/2023-06/ICN_Cod
e-of-Ethics_EN_Web.pdf
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136. COMPARISON IN CODE OF
ETHICS BETWEEN ICN &
PNC
Pakistan Nursing Council and (PNC) International
Council of Nurses (ICN) have almost same codes
of Ethics.
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138. 03/06/25Farzana Khattak

139. APPLICATION OF CODE OF
ETHICS IN CLINICAL SETTINGS
The code of ethics is intended to provide guidance and
standards of professional conduct for a nurse.
Commitment to code of ethics helps you to resolve
conflict in a responsible manner.
It assists health personnel to provide safe care.
A health system adhering not to code of ethics fails to
provide people requiring care.
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140. CONT…
To benefit and not to harm patient is only possible by
following code of ethics.
Code of ethics teaches a health care provider code of
conduct, patients’ Bill of rights, legal and moral rights
to deal patients and others.
It tells you to provide care that respects human rights
and is sensitive to the values, customs and beliefs of
people.
03/06/25Farzana Khattak

141. PLEDGE FOR NURSES
Nightingale Pledge
The Nightingale Pledge is a modified version of the
Hippocratic oath specifically for nurses.
It was created by nursing pioneer Lystra Gretter and a
Committee for the Farrand Training School for Nurses in
Detroit in 1893.
According to the American Nurses Association, the pledge
was named after Florence Nightingale, who is considered
the founder of modern nursing.
In the pledge, nurses promise to uphold the Hippocratic
oath, do no harm, practice discretion and be dedicated to
their work as a nurse. 
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142. PLEDGE CONT….
Three versions of the pledge have been used by nurses:
1.The Original 1893 Pledge: 
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 shall abstain from whatever is
deleterious and mischievous and shall not take or knowingly
administer any harmful drug. I shall 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. I shall be loyal to my work and
devoted towards the welfare of those committed to my care.
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143. PLEDGE CONT….
2.The Updated 1935 Pledge:
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. 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 as a
'missioner of health' I will dedicate myself to devoted
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144. PLEDGE CONT….
3.Modern Practical Nurse Pledge:
While the pledge hasn’t drastically changed, many nursing schools that still
use the Nightingale Pledge have made updates to the earlier versions. One
change was made specifically to remove the phrase, “loyal to physicians”
to promote more independence in the nursing profession.
Before God and those assembled here, I solemnly pledge; To adhere to the
code of ethics of the nursing profession; To co-operate faithfully with the
other members of the nursing team and to carry out faithfully and to the
best of my ability the instructions of the physician or the nurse who may be
assigned to supervise my work; I will not do anything evil or malicious, and I
will not knowingly give any harmful drug or assist in malpractice. I will not
reveal any confidential information that may come to my knowledge in the
course of my work. And I pledge myself to do all in my power to raise the
standards and prestige of practical nursing; May my life be devoted to
service and to the high ideals of the nursing profession. 
03/06/25Farzana Khattak

145. 03/06/25Farzana Khattak

146. REFERENCES
American Counseling Association (2005). ACA code
of ethics. Alexandria, VA: Author.
American School Counselor Association. (2004).
Ethical standards for school counselors, Alexandria, VA:
Author.
National Association of School Nurses (2010). Code
of ethics. Author.
03/06/25Farzana Khattak

147. 03/06/25
Farzana Khattak

148. THE ICN
CODE OF ETHICS
FOR NURSES
REVISED 2021
International
Council of Nurses

149. All rights reserved, including translation into other languages. This work may
be reprinted and redistributed, in whole or in part, without alteration and
without prior written permission, provided the source is indicated.
Copyright © 2021 by ICN - International Council of Nurses, 3, place Jean
Marteau, 1201 Geneva, Switzerland
ISBN: 978-92-95099-94-4

150. TABLE OF CONTENTS
PURPOSE OF THE CODE PREAMBLE
THE ICN CODE
APPLYING THE ELEMENTS OF THE CODE
SUGGESTIONS FOR USE
of the ICN Code of Ethics for Nurses
DISSEMINATION
of the ICN Code of Ethics for Nurses
2
2
3
3
4
4
ELEMENTS OF THE CODE
1. NURSES AND PATIENTS OR OTHER PEOPLE
REQUIRING CARE OR SERVICES
5
7
2.NURSES AND PRACTICE
3.NURSES AND THE PROFESSION
12
15
4. NURSES AND GLOBAL HEALTH
ICN Code of Ethics for Nurses
Professional Values
18
21
GLOSSARY OF TERMS USED
in the ICN Code of Ethics for Nurses 23
REFERENCES 28

151. An international code of ethics for nurses was first adopted by
the International Council of Nurses (ICN) in 1953. It has been
revised and reaffirmed at various times since, most recently with
this review and revision completed in 2021.
PURPOSE OF THE CODE
The ICN Code of Ethics for Nurses is a statement of the ethical
values, responsibilities and professional accountabilities of
nurses and nursing students
1 that defines and guides ethical
nursing practice within the different roles nurses assume. It is
not a code of conduct but can serve as a framework for
ethical nursing practice and decision-making to meet
professional standards set by regulatory bodies.
The ICN Code of Ethics for Nurses provides ethical guidance in
relation to nurses’ roles, duties, responsibilities, behaviours,
professional judgement and relationships with patients, other
people who are receiving nursing care or services, co-
workers and allied professionals. The Code is foundational
and to be built upon in combination with the laws,
regulations and profes- sional standards of countries that
govern nursing practice. The values and obligations
expressed in this Code apply to nurses in all settings, roles
and domains of practice.
PREAMBLE
From the origins of organised nursing in the mid-1800s and
recognising nursing care is deeply rooted in the traditions
and practices of equity and inclusion and in the appreciation
of diversity, nurses have consistently recognised four funda-
mental nursing responsibilities: to promote health, to prevent
illness, to restore health, and to alleviate suffering and
promote a dignified death. The need for nursing is universal.
Inherent in nursing is a respect for human rights, including
cultural rights, the right to life and choice, the right to dignity
and to be treated with respect. Nursing care is respectful of
and unrestricted by considerations of age, colour, culture,
eth- nicity, disability or illness, gender, sexual orientation,
nation- ality, politics, language, race, religious or spiritual
beliefs, legal, economic or social status.
1 The practice of the nursing student needs to be in line with the ICN Code of
Ethics. Depending on the level of education, the responsibility for the
student nurse’s conduct is shared between the student
and her/his supervisor.
2

152. 3
Nurses are valued and respected for their contributions to
improving the health of individuals, families, communities
and populations locally, nationally and globally. They
coordinate services with those of other health care
professionals and related groups. Nurses demonstrate
values of the profession such as respect, justice, empathy,
responsiveness, caring, compassion, trustworthiness and
integrity.
THE ICN CODE
The ICN Code of Ethics for Nurses has four principal
elements that provide a framework for ethical conduct:
nurses and patients or other people requiring care or
services, nurses and practice, nurses and the profession,
and nurses and global health.
APPLYING THE ELEMENTS OF THE CODE
The charts that follow the description of each element of
the Code are intended to assist nurses to translate the
standards into action. Note that these charts present
examples of the main tenets included in the elements of
the Code and are not intended to be an exhaustive or
complete list of concepts. The ethical duties and values of
nursing apply to all forms of nursing services and roles:
clinicians, educators, students, researchers, managers,
policy makers and others. Professional associations are
also guided by these duties and values. A diagram (p. 21)
illustrates the relationship of the values and duties to the
nursing profession.

153. SUGGESTIONS FOR USE
of the ICN Code of Ethics for Nurses
The ICN Code of Ethics for Nurses is a guide for action based
on social values and needs. It will have meaning only as a
living document if applied to the realities of nursing and
health care in all settings in which nursing care is delivered.
To achieve its purpose the Code must be understood,
internalised and used by nurses in all aspects of their work.
It must be available to students and nurses throughout
their study and work lives.
Nurses can therefore:
•Study the standards under each element of the Code.
•Personally reflect on what each standard means.
Think about ways to apply ethics to the personal domain of
nursing practice, education, research, management,
leadership or policy development.
•Discuss the Code with co-workers and others.
•Use a specific example from experience to identify ethical
dilemmas and standards of conduct as outlined
in the Code. Identify ways in which the Code guides in the
resolution of dilemmas.
•Work in groups to clarify ethical decision making
and reach a consensus on standards of ethical conduct.
•Collaborate with the National Nurses Association,
co-workers, and others in the continuous application of
ethical standards in nursing practice, education,
management, research and policy.
DISSEMINATION
of the ICN Code of Ethics for Nurses
To be effective the ICN Code of Ethics for Nurses must be
familiar to nurses. We encourage its dissemination to
schools of nursing, nurses in their workplace, the nursing
press and other mass media. The Code should also be
disseminated to other health professions, the general
public, consumer and policy- making groups, human rights
organisations and employers of nurses. NNAs are
encouraged to adopt this Code, translating it into local
language(s), or use it as a framework to support their own
codes of nursing ethics.
4

154. ELEMENTS OF THE CODE

155. 1.NURSES AND PATIENTS OR OTHER PEOPLE
REQUIRING CARE OR SERVICES
2
1.Nurses’ primary professional responsibility is to people requiring
nursing care and services now or in the future, whether individuals,
families, communities or populations (hereinafter referred to as
either ‘patients’ or ‘people requiring care’).
2.Nurses promote an environment in which the human rights, values,
customs, religious and spiritual beliefs of the individual, families and
communities are acknowledged and respected by everyone.
Nurses’ rights are included under human rights and should be upheld and
protected.
3.Nurses ensure that the individual and family receive understandable,
accurate, sufficient and timely information in a manner appropriate to
the patient’s culture, linguistic, cognitive and physical needs,
and psychological state on which to base consent for care and related
treatment.
4.Nurses hold in confidence personal information and respect the
privacy, confidentiality and interests of patients in the lawful
collection, use, access, transmission, storage and disclosure of
personal information.
5.Nurses respect the privacy and confidentiality of colleagues
and people requiring care and uphold the integrity of the nursing
profession in person and in all media, including social media.
• Nurses share with society the responsibility for initiating and
supporting action to meet the health and social needs of all people.
• Nurses advocate for equity and social justice in resource allocation,
access to health care and other social and economic services.
3.Nurses demonstrate professional values such as respect, justice,
responsiveness, caring, compassion, empathy, trustworthiness
and integrity. They support and respect the dignity and universal rights of
all people, including patients, colleagues and families.
2 The two terms ‘patients’ and ‘people requiring care or nursing services’ are used
interchangeably. The two terms refer to the patient, family, community and populations
requiring nursing care and services. Practice settings span across hospital, home
and community care, primary care, public health, population health, long term care, correctional
care, academic institutions and government and are not limited to sectors.
7

156. 8
9.Nurses facilitate a culture of safety in health care environments,
recognising and addressing threats to people and safe care in
health practices, services and settings.
10.Nurses provide evidence-informed, person-centred care,
recognising and using the values and principles of primary health
care and health promotion across the lifespan.
11.Nurses ensure that the use of technology and scientific advances are
compatible with the safety, dignity and rights of people. In the
case of artificial intelligence or devices, such as care robots or
drones, nurses ensure that care remains person-centred and that
such devices support and do not replace human relationships.
Applying the Elements of the Code #1: NURSES AND
PATIENTS OR PEOPLE REQUIRING CARE
OR SERVICES
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Provide people
focused, culturally
appropriate, care that
respects human rights
and is sensitive
to the values, customs
and beliefs of people
without prejudice
or unjust
discrimination.
In curricula, include
content on cultural
norms, safety and
competence, ethics,
human rights, equity,
human dignity, justice,
disparities
and solidarity as the
basis for access to
health care. Design
studies to explore
human rights issues.
Develop position
statements, standards
of practice
and guidelines that
support human rights
and ethical standards.

157. 9
Applying the Elements of the Code #1: NURSES AND
PATIENTS OR PEOPLE REQUIRING CARE
OR SERVICES
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Participate in
continuing
education on ethical
issues, ethical
reasoning and ethical
conduct. Encourage
open dialogue among
all stakeholders.
Design curricula to
encompass currently
peer reviewed
and published
approaches to nursing
ethics.
Provide teaching and
learning opportunities
for ethical issues,
ethical principles and
reasoning,
and ethical decision
making. This includes
respect for autonomy,
nonmaleficence,
beneficence
and justice.
Establish standards
for ethics education
and provide
continuing ethics
education for nurses.
Ensure informed
consent for nursing
and/or medical care.
This includes the right
to choose or refuse
treatments.
Educate about respect
for autonomy,
informed consent,
privacy
and confidentiality.
Respect research
participants’ right
to refuse to participate
in or withdraw from
studies without
prejudice.
Provide guidelines
for human participants
in research, position
statements, relevant
documentation
and continuing
education related to
informed consent for
nursing
and medical care.

158. 1
0
Applying the Elements of the Code #1: NURSES AND
PATIENTS OR PEOPLE REQUIRING CARE
OR SERVICES
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Exercise professional
ethical judgement
in the use
of information, health
records and reporting
systems, whether
electronic
or paper-based,
to ensure protection
of human rights,
confidentiality
and privacy
in accord with patient
preferences
and community safety
and in compliance
with any relevant laws.
In curricula, include
accuracy,
confidentiality
and privacy on the use
of media, reporting
and recording
systems, whether
images, recordings,
or comments.
Be familiar with
the use of required
reporting for extreme
emergencies.
Prepare guidelines
and standards
of practice
on appropriate use of
information
and reporting systems
that ensure protection
of human rights,
confidentiality,
privacy,
and mandated
reporting mechanisms
for public health
outbreaks or extreme
emergencies.
Communicate to
appropriate
supervisors
and/or authorities any
risks, inappropriate
behaviours or misuse
of technologies that
threaten people’s
safety, and provide
facts supporting
this. Nurses need to
be involved when
technology
is developed, and
observe and report
risks with technology
and scientific
advancements.
Include in curriculum
and conduct research
on what constitutes
safe care that respects
dignity
and rights and
considers new
technology.
Lobby governments,
health organisations,
medical device
and pharmaceutical
companies
to include nurses
during research and
development of
technology
for patient use.

159. 1
1
Applying the Elements of the Code #1: NURSES AND
PATIENTS OR PEOPLE REQUIRING CARE
OR SERVICES
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Meet nurses’ ethical
obligations
and responsibilities
and actively affirm the
values and ideals of
the profession.
In curricula, include
professional values
and ideals, ethical
responsibilities
and obligations, and
ethical frameworks
with worldviews.
Contribute to and
disseminate
emphasis on ethical
research guidelines.
Design studies
to explore human
rights issues.
Express the values
and ideals of nursing
in their foundational
documents
and incorporate into
national codes of
ethics for nurses.
Develop
and monitor safety in
the workplace.
Teach and facilitate
learning about
attributes, risk factors
and skills to ensure
practice environments
that are healthy,
safe and sustainable
for everyone
in the health care
setting.
Influence employers to
promote healthy and
safe workplaces for
nurses and other
health care workers.
Provide guidelines
that assure a safe
environment
and healthy
communities.
Advocate
for clear, accessible,
transparent
and effective reporting
procedures to protect
health and safety.

160. 1
2
2.NURSES AND PRACTICE
1.Nurses carry personal responsibility and accountability for ethical
nursing practice, and for maintaining competence by engaging
in continuous professional development and lifelong learning.
2.Nurses maintain fitness to practice so as not to compromise their
ability to provide quality, safe care.
3.Nurses practise within the limits of their individual competence
and regulated or authorised scope of practice and use professional
judgement when accepting and delegating responsibility.
4.Nurses value their own dignity, well-being and health. To achieve
this requires positive practice environments, characterised
by professional recognition, education, reflection, support structures,
adequate resourcing, sound management practices and
occupational health and safety.
5.Nurses maintain standards of personal conduct at all times.
They reflect well on the profession and enhance its image and public
confidence. In their professional role, nurses recognise and maintain
personal relationship boundaries.
• Nurses share their knowledge and expertise and provide feedback,
mentoring and supporting the professional development of student
nurses, novice nurses, colleagues and other health care providers.
• Nurses are patient advocates, and they maintain a practice culture
that promotes ethical behaviour and open dialogue.
• Nurses may conscientiously object to participating in particular
procedures or nursing or health-related research but must facilitate
respectful and timely action to ensure that people receive care
appropriate to their individual needs.
• Nurses maintain a person’s right to give and withdraw consent
to access their personal, health and genetic information. They protect
the use, privacy and confidentiality of genetic information and
human genome technologies.
• Nurses take appropriate actions to safeguard individuals, families,
communities and populations when their health is endangered
by a co-worker, any other person, policy, practice or misuse of
technology.
• Nurses are active participants in the promotion of patient safety.
They promote ethical conduct when errors or near misses occur,
speak up when patient safety is threatened, advocate for transparency,
and work with others to reduce the potential of errors.

161. 1
3
2.12 Nurses are accountable for data integrity to support and
facilitate ethical standards of care.
Applying the Elements of the Code #2: NURSES AND
PRACTICE
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Pursue professional
development through
reading and study.
Request and
participate
in continuing
education to enhance
knowledge and skills.
Teach and facilitate
learning the value and
obligation
of lifelong learning
and competence
to practice. Explore
current concepts and
innovative teaching
methods for theory
and practice.
Develop a range of
continuing education
opportunities, through
journals, media,
conferences
and distance
education,
that reflects advances
in nursing theory
and practice.
Initiate continuing
education
and participate in
workplace
governance, systems
for professional
performance,
appraisal
and systematic
renewal of licensure
to practice. Monitor,
promote and evaluate
fitness to practice
in nursing staff.
Conduct and
disseminate research
that explores links
between continual
learning
and competence
to practice.
Promote national
policies for high
quality nurse
education
and educational
requirements for
continued
authorisation
to practice.
Seek a work-life
balance, ongoing
personal growth, and
maintain a healthy
lifestyle.
Teach obligations to
self as well as
obligations to patients,
the importance
of fitness to practice,
and using
evidence-informed
care.
In curricula, include
promoting resilience
in the workplace.
Lobby for working
environments that
promote healthy
lifestyle standards for
nurses.
Provide guidelines on
safe and decent work
conditions
for nurses.

162. 1
4
Applying the Elements of the Code #2: NURSES AND
PRACTICE
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Foster
interprofessional
collaboration
for managing conflict
and tensions. Promote
an environment
of shared ethical
values.
To improve quality of
care and safety, fear
of reprisal must be
extinguished.
This will create a more
open, transparent
culture that embraces
crucial conversations
for advancing health
for all.
Teach methods
and skills of situational
assessment
and conflict
management
as well as the roles
and values
of other health care
disciplines.
Inform other
disciplines and the
public about the roles
of nurses and the
values
of the nursing
profession. Promote a
positive image
of nursing. Champion
work environments
and conditions that
are free from
abuse, harassment
and violence.
Develop appropriate
professional
relationships
with patients and
colleagues;
exercise professional
judgement
and decline gifts
or bribes and avoid
conflicts of interest.
Maintain
and teach professional
boundaries and skills
to safeguard them.
Teach identification of
and methods
to avoid conflicts of
interest.
Set standards for
professional
boundaries and
establish processes
for the expression of
recognition
and gratitude.
Assure continuity
of care for the patient
when exercising
conscientious
objection, where
an action may cause
harm or is morally
objectionable
to the nurse.
Encourage
self-reflection
and teach frameworks
and processes
of conscientious
objection.
Develop standards
and guidelines
for refusal
of participation
in specific medical
procedures.
Include guidance on
conscientious
objection in national
codes of ethics.

163. 1
5
3.NURSES AND THE PROFESSION
1.Nurses assume the major leadership role in determining
and implementing evidence-informed, acceptable standards of clinical
nursing practice, management, research and education.
2.Nurses and nursing scholars are active in expanding research-
based, current professional knowledge that supports evidence-
informed practice.
3.Nurses are active in developing and sustaining a core of
professional values
4.Nurses, through their professional organisations, participate in
creating a positive and constructive practice environment
where practice encompasses clinical care, education, research,
management and leadership. This includes environments which
facilitate a nurse’s ability to practice to their optimal scope of
practice and to deliver safe, effective and timely health care, in
working conditions which are safe as well as socially and
economically equitable for nurses.
5.Nurses contribute to positive and ethical organisational
environments and challenge unethical practices and settings.
Nurses collaborate with nursing colleagues, other (health)
disciplines and relevant communities to engage in the ethical
creation, conduct
and dissemination of peer reviewed and ethically responsible research
and practice development as they relate to patient care, nursing
and health.
6.Nurses engage in the creation, dissemination and application of
research that improves outcomes for individuals, families and
communities.
7.Nurses prepare for and respond to emergencies, disasters,
conflicts, epidemics, pandemics, social crises and conditions of scarce
resources. The safety of those who receive care and services is a
responsibility shared by individual nurses
and the leaders of health systems and organisations. This involves
assessing risks and developing, implementing and resourcing plans
to mitigate these.

164. 1
6
Applying the Elements of the Code #3: NURSES AND
THE PROFESSION
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Collaborate with
colleagues to support
the conduct,
dissemination and use
of research related
to patient care,
nursing and health.
Teach research
methodology, ethics
and evaluation.
Conduct, disseminate,
utilise and evaluate
research to study
and advance nursing
knowledge.
Develop position
statements,
guidelines, policy and
standards informed
by nursing research
and scholarly inquiry.
Promote participation
in national nurses’
associations
to create solidarity
and cooperation
to promote favourable
socio-economic
and working
conditions for nurses.
Emphasise to learners
the nature, function
and importance
of professional nursing
associations
and international
nursing collaboration.
Communicate the
importance of
membership
in professional nursing
organisations
and promote
participation
in national nurses’
associations.
Practice ethical
behaviours and
develop
strategies to deal with
moral distress during
emergent crises, such
as pandemics or
conflicts.
Prepare students for
local response to
global issues with a
broader vision of
solidarity and the
common
good. Include health
disparities, particularly
for infants, frail
elderly, prisoners,
economically
disadvantaged,
trafficked, displaced
persons and refugees.
Collaborate with
global organisations
to address current
and emergent social
justice issues.

165. 1
7
Applying the Elements of the Code #3: NURSES AND
THE PROFESSION
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Develop guidelines
for workplace issues,
such as bullying,
violence, sexual
harassment, fatigue,
safety, and local
incident management.
Participate in studies
regarding ethics
and ethical workplace
issues in every setting.
Teach identification of
unhealthy work
environments
and skills to develop
resilient
and healthy workplace
communities. Conduct
research on ethical
workplace issues
across the profession.
Influence, pressure
and negotiate for fair
and decent working
conditions. Develop
position statements
and guidelines
to address workplace
issues.
Prepare
for and respond to
emergencies,
disasters, conflicts,
epidemics, pandemics
and conditions
of scarce resources.
Ensure that curricula
include essential
elements of caring for
people
and populations in
high risk, challenging
environments.
Advocate and lobby
governments
and health
organisations to
prioritise.
and protect the health,
safety and well-being
of health care workers
during a response
to health
emergencies.
Practice
non-discrimination
against colleagues
from other cultures
and countries
regardless
of nationality, race,
ethnicity or language.
Teach the principles of
the WHO
Code of Practice on
International
Recruitment of Health
Personnel to support
the ethical recruitment
of nurses.
Promote the ethical
recruitment
of nurses and work
with government
and licensing boards
to reduce barriers
to employment
for migrant nurses.

166. 1
8
4.NURSES AND GLOBAL HEALTH
1.Nurses value health care as a human right, affirming the right to
universal access to health care for all.
2.Nurses uphold the dignity, freedom and worth of all human beings
and oppose all forms of exploitation, such as human trafficking and
child labour.
3.Nurses lead or contribute to sound health policy development.
4.Nurses contribute to population health and work towards
the achievement of the United Nations Sustainable Development Goals
(SDGs). (UN n.d.)
5.Nurses recognise the significance of the social determinants of
health.
They contribute to, and advocate for, policies and programmes that
address them.
6.Nurses collaborate and practise to preserve, sustain and protect the
natural environment and are aware of the health consequences of
environmental degradation, e.g. climate change. They advocate
for initiatives that reduce environmentally harmful practices to promote
health and well-being.
1.Nurses collaborate with other health and social care professions
and the public to uphold principles of justice by promoting
responsibility in human rights, equity and fairness and by promoting
the public good and a healthy planet.
2.Nurses collaborate across countries to develop and maintain global
health and to ensure policies and principles for this.

167. 1
9
Applying the Elements of the Code #4: NURSES AND
GLOBAL HEALTH
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Participate in human
rights efforts, such as
trafficking prevention
and detection,
helping vulnerable
populations, providing
universal education,
and mitigating hunger
and poverty.
Ensure that curricula
include human rights,
SDGs, universal access
to care, culturally
appropriate care, civic
responsibility, equity,
and social
and environmental
justice.
Collaborate with
nursing regulatory
bodies, voluntary
organisations,
and global agencies to
develop position
statements
and guidelines
that support human
rights, environmental
justice and
international peace.
Educate oneself and
colleagues about
global health,
including current and
emergent
technologies.
Advocate
for the ethical use of
technology and
scientific
advances compatible
with safety, dignity,
privacy, confidentiality
and human rights.
Seek opportunities to
evaluate the short
and long-term ethical
consequences
of the use of diverse
technologies
and emerging
practices, including
innovative equipment,
robotics, genetics and
genomics, stem cell
technologies
and organ donation.
Contribute to
legislation and
policies
on the ethical use of
technology and
scientific
advances adapted to
the health
and social norms and
context
of the country.
Acquire
and disseminate
knowledge about the
negative effects of
climate change on
people’s health and
on the planet.
Teach about the facts
and consequences
of climate change on
health
and the many
opportunities
to support climate
health at policy
and institutional levels.
Participate
in the development of
legislation
to reduce the impact
of hospitals
and the health care
industry
on the environment
and address climate
changes that
negatively affect
the health
of populations.

168. 2
0
Applying the Elements of the Code #4: NURSES AND
GLOBAL HEALTH
Nurses, Nurse
Leaders and Nurse
Managers
Educators and
Researchers
National Nurses
Associations
Support the ethical
and proficient use of
social media and
technologies
to improve population
health consistent
with the values of the
nursing profession.
Participate
in developing,
implementing and
evaluating
new and emerging
technologies,
including social media,
for prevention
initiatives, public
health education, and
the health
and well-being of
populations.
Prepare curricula and
engage
in research in support
of the UN SDGs.
Update knowledge
and increase
awareness about the
UN SDGs
for population health
and actively strategize
nursing’s participation
in achieving these
goals.
Act on local
and global issues that
affect health, such as
poverty, food security,
shelter, immigration,
gender, class,
ethnicity, race,
environmental health,
dignified work,
and education.
Educate about socio-
political
and economic issues
that affect health,
including gender,
ethnicity, race, culture,
inequality and
discrimination.
Research
socio-political factors
that contribute
to individual
and population health
and illness.
Collaborate
with other national
and international
nursing organisations
to formulate policies
and legislation
that address
the socio-economic
determinants
of health.
Embed the concepts
of peace, peace
diplomacy and peace
building into everyday
practice.
Educate and research
for peace diplomacy
and peace building
in communities and
globally.
Collaborate globally,
nationally
and regionally with
governments
and nursing agencies
to further the ends
of global peace and
justice
and ameliorate
the causes of illness.

169. ICN Code of Ethics for Nurses
Professional Values
Nurses and Patients or People
Requiring Care and Services
Respect
Privacy Advocacy
Competence
Service
Leadership
Expertise
Integrit
y
Judgement
Knowledge
Public goodAccountabilityResponsibility
Collaboration
Responsiveness
Compassion
Dignity
Care
InclusivityEmpathy
Fairness
Justice
Equity
Solidarity
Trust
Skill
Confidentialit
y
Safety
Nurses and Global Health
Nurses and Practice
Nurses and the Profession
NURSE
I
2
1
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d
ivid
ualF
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n
R
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Clinicalpractic
e
A
d
m
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a
t
i
o
n
E
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c
a
t
i
o
n
Policy

170. 24
Advocate Actively supporting a right and good cause; supporting others
in speaking for themselves or speaking on behalf of others
who cannot speak for themselves. Advocacy is ultimately carried
through with consent from the person themself.
Competence The integrated knowledge, skills, judgement and attributes
required of a nurse to practise safely and ethically in a designated
role
and setting.
Confidentiality Confidentiality refers to the duty of the nurse to refrain from sharing
patient information with third parties unrelated to the patient’s
care. Confidentiality is a limited duty, sometimes it may be
overridden by law or regulation, e.g. mandated reporting of specific
diseases.
Conscientious
objection
Refusing to participate in required action, or seeking exemption
from participation in classes of interventions (e.g. abortion, gender
reassignment surgery, organ transplantation)
that threaten a person’s sense of moral integrity. It also includes
refusal to participate in an action or intervention perceived
to be inappropriate for a specific patient or it ignores the patient’s
wishes.
Co-workers Nurses and other health and non-health related workers and
professionals.
Environmental
justice
Environmental justice seeks an equitable distribution of benefits
(e.g., pure water, green spaces, clean air), and a safe
and equitable distribution of burdens (e.g. toxic waste disposal,
noise, factory air pollution). It includes sustainability, representative
participation, and the avoidance of environmental discrimination.
Equity Equity is an aspect of social justice. It refers to an absence of
systemic disadvantages that result in health disparities
for particular segments of society. Equity is essential to the full
recognition of human rights.
Ethics A branch of philosophy. Applied normative ethics is most commonly
used in health care and professional ethics. It helps to determine
the “ought” at the social, community or individual level. It also
addresses broad social issues such as human rights, global
cooperation, climate change, global pandemics, social-structural
disparities.
Evidence-Informed
Practice
Evidence-informed practice (EIP) is a process for making informed
clinical decisions. Research evidence is integrated with clinical
experience, patient values, preferences and circumstances.
(Woodbury & Kuhnke 2014)

171. 25
Family A social unit composed of members connected through blood,
kinship, emotional or legal relationships.
Fitness to practiceHaving the skills, knowledge, health and character to do one’s job
safely and effectively. (UK NMC 2021)
Genetics The study of single genes, genetic variation and heredity in
organisms.
Genomics The study of the complete set of a person’s genes, the genome, to
find variations that affect health, drug response, interactions among
genes or with the environment.
Human rights Human rights are inherent to all persons, regardless of nationality,
sex, national or ethnic origin, colour, religion, language, or any
other status. They range from the most fundamental – the right to
life –
to the rights to food, education, work, health, healthy living
conditions, and liberty. (Adapted from OHCHR n.d.)
National Nurses
Associations
(NNAs)
Any professional national nursing group that clarifies, researches,
educates and promotes the continued development of nurses and
nursing.
Nurse The nurse is a person who has completed a programme of basic,
generalised nursing education and is authorised by the appropriate
regulatory authority to practice nursing in his/her country. Basic
nursing education is a formally recognised programme of study
providing a broad and sound foundation in the behavioural,
life and nursing sciences for the general practice of nursing, for a
leadership role, and for post-basic education for specialty or
advanced nursing practice. The nurse is prepared
and authorised (1) to engage in the general scope of nursing
practice, including the promotion of health, prevention of illness,
and care of physically ill, mentally ill, and disabled people
of all ages and in all healthcare and other community settings;
(2) to carry out healthcare teaching; (3) to participate fully as
a member of the healthcare team; (4) to supervise and train nursing
and healthcare auxiliaries; and (5) to be involved in research.
(ICN 1987)
Nurse manager A nurse manager is responsible for the daily operations of a nursing
unit and supervising the nursing personnel in a particular unit
or department.
Personal
information
Information obtained during professional contact that is private
to an individual or family, and which, when disclosed, may violate
the right to privacy, cause inconvenience, embarrassment, or harm
to the individual or family.

172. 26
Person-centred
care
Valuing and respecting the characteristics, attributes
and preferences of the patient, such as cultural and religious
beliefs, and incorporating them into the planning
and implementation of nursing care, services or programmes
design.
Professional
relationship
A professional relationship is an ongoing interaction between
two people that observes a set of established boundaries or limits
that is deemed appropriate under governing ethical standards.
Primary Health
Care
Primary health care is a whole-of-society approach to health and
well-being centred on the needs and preferences
of individuals, families and communities. It addresses the broader
determinants of health and focuses on the comprehensive
and interrelated aspects of physical, mental and social health and
well-being. (WHO 2019)
Privacy Privacy is the right to freedom from intrusion into one’s personal
matters, information, or one’s physical body.
Related groups Other nurses, health care workers or other professionals providing
service to an individual, family or community and working toward
desired goals.
Self-determinationThe right to have one’s autonomous decisions respected.
Self-determination is not absolute. It may be limited by cognitive
or affective incapacity, age of majority, potential for harm to
oneself or others, or the infringement of the liberty of others.
Self-reflection The ability to evaluate one’s own thoughts, plans and actions in
relation to ethical responsibilities and ethical guidelines.
Social determinants
of health
The conditions in which people are born, grow, live, work and age.
These circumstances are shaped by the distribution of money,
power and resources at global, national and local levels. The social
determinants of health are mostly responsible for health
inequities,
i.e. the unfair and avoidable differences in health status seen within
and between countries. (WHO 2020)
Social justice Achieving equity and equality for society and the profession
(ICN Strategic Plan 2019-2023). Social justice is a form of fairness
requiring an impartial distribution of social goods and benefits and
an equally impartial distribution of social burdens and affirms
universal human rights. Social inequalities may exist only in order
to benefit the least advantaged in society. Social justice applies to
all persons, whether citizen or non-citizen.

173. 27
Social media Social media is an umbrella term used to describe social interaction
through technology-based tools, many of which are online. This
includes, but is not limited to internet forums, blogs, and
networking sites such as Facebook, Twitter, Instagram and
LinkedIn. (Institute of Business Ethics 2019)
Sustainable
Development Goals
The Sustainable Development Goals are the blueprint to achieve a
better and more sustainable future for all people. They address the
global challenges we face, including those related to poverty,
inequality, climate change, environmental degradation, peace and
justice. The 17 Goals are all interconnected and, in order
to leave no one behind, it is important that we achieve them all by
2030. (UN n.d.)
Values Values in nursing are those ends sought by both the profession
and in nurse – patient relationships. These include, for example,
health, dignity, respect, compassion, equity, inclusivity.
Note that some values (ends) are also obligations (actions) and
attributes of character (virtues).

174. 28
REFERENCES
Institute of Business Ethics (2019). The Ethical Challenges and Opportunities of Social
Media Use. Business Ethics Briefing. 2 May 2019. Retrieved from:
https://www.ibe.org.uk/ resource/the-ethical-challenges-and-opportunities-of-social-
media-use.html
International Council of Nurses (1987). Definition of a nurse. Available at:
https://www.icn.ch/nursing-policy/nursing-definitions
Office of the High Commissioner for Human Rights (n.d.). What are human rights?
Retrieved from: https://www.ohchr.org/en/issues/pages/whatarehumanrights.aspx
United Kingdom Nursing & Midwifery Council (2021). What is fitness to practice?
Retrieved from: https://www.nmc.org.uk/concerns-nurses-midwives/dealing-
concerns/ what-is-fitness-to-practise/
United Nations (n.d.). About the Sustainable Development Goals. Retrieved from:
https://www.un.org/sustainabledevelopment/sustainable-development-goals/
Woodbury MG & Kuhnke JL (2014). Evidence-based practice vs Evidence-informed
practice. What’s the Difference? Wound Care Canada. Vol 12, Number q, Spring 2014.
Retrieved from:
https://torontocentreforneonatalhealth.com/wp-content/uploads/2019/09/ Article-
Whatsthedifference.pdf
World Health Organization (2019). Primary Health Care Key Facts. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/primary-health-care
World Health Organization (2020). Social determinants of health. Retrieved from:
https://www.who.int/gender-equity-rights/understanding/sdh-definition/en/#:~:text=
Social%20determinants%20of%20health%E2%80%93The,global%2C%20national%20
and%20local%20levels.

175. International Council of Nurses
3, Place Jean Marteau 1201
Geneva, Switzerland
[phone]
[email protected] www.icn.ch