Code of ethics for the nursing professionals

CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.

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

3. Lets speak about nursing

4. “Nursingisanart;andifitistobemadeanart,it
requiresasexclusiveadevotion,asharda
preparation,asanypaintersorsculptorswork;
forwhatisthehavingtodowithdeadcanvasor
coldmarble,comparedwithhavingtodowiththe
livingbody-thetempleofGodsspirit?Itisone
oftheFineArts;Ihadalmostsaidthefinestof
theFineArts.”
-Florence Nightingale

5. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.

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

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

8. Ethics–Philosophicalidealsofrightand
wrongbehavior.
Tellsushowhumanbeingsshouldbehave
Personal standards of conduct, or attitude
It is a science of ideal human behaviour

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

10. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
What is Ethics
“Asystemofrulesorprinciplesthatare
usedtoguidehumanbehavior”
Guidingforceinthedevelopment,
implementationandevaluationofnursing
practicesincethe“FlorenceNightingale
Era”.

11. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•Ethicsincludesvalues,codes,andprinciplesthat
governdecisionsinnursingpractice.
•Guideforactionbasedonsocialvaluesandneeds.
•Providemeanstoprofessionalstandards
•Formalguidelinesfortheprofessionalaction
•Basis for Self regulation and relationship with
others.
•Evaluatingthemerits,risks,andsocialconcerns.
•Ethical principles are necessary to guide to the
professional development
Why nursing code of ethics…

12. Why nursing code of ethics…
•Helpinassessingthecomplexsituations
•Betterdecisionmaking
•Enhancesinteractionbetweenthehealth
professionalsandwiththecommunity
•Providewelldefinedpolicyandprocedurein
resolvingethicaldilemma.
•Unethicalpracticeswillbeminimized
•Reflectthegoodimageofthenursesand
theorganizationtheywork.

13. Why nursing code of ethics…
•Provideasignoftheprofession’s
commitmenttothepublic.
•Giveaframeworkforthestandardsof
conduct.
•Providegeneralguidelinesforprofessional
behavior.
•Helpstoprotecttherightsoftheindividual,
familyandthecommunity
•Providestandardcurriculum.

14. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•TheInternationalCouncilForNurses(ICN)
•AmericanNursesAssociation
•CanadianNursesAssociation
•TrainedNursesAssociationOfIndia(TNAI)
•IndianNursingCouncil.(INC)
Who recommends the Code of Ethics for Nurses…

15. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
The ICN-Code of Ethics for Nurses
Preamble
•Nurses have four fundamental
responsibilities:
•To promote health,
•To Prevent illness,
•To restore health and
•Toalleviatesuffering.

16. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•Nursingcareisforallirrespectiveof
age,colour,creed,culture,disabilityor
illness,gender,sexualorientation,
nationality,politics,raceorsocial
status.
•Nursesrenderhealthservicestothe
individual,thefamilyandthecommunity
The ICN-Code of Ethics for Nurses
Preamble……….

17. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Ethical Principles
•Autonomy
•Beneficence
•Non malfeasance
•Confidentiality
•Double Effect
•Fidelity
•Justice
•Paternalism
•Respect for
Persons
•Sanctity of Life
•Veracity
•Informed consent

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

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

20. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Commitment ……. Balance risk and benefits
Not to cause harm
Prevent harm
Remove harm
Non malfeasance

21. MaintainConfidentiality
Personal and medical
informationoftheclient
willnotdisclosedtoother
unlessthetheclientgives
informedconsent.
Share information
selectively
NURSING CONFIDENTIALITY

22. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Confidentiality
•Shareordiscusspatientinformation
onlyifitisnecessary.
•Neversharepatient’sidentification
numberorpasswordwithanyone.
•Followthehospital’sorhealthcare
provider’spolicies.
•Logoffyourcomputerwhenyouarenot
byyourworkstation/nursesstation
•Becarefulaboutcomputerrecords

23. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Justice
•Providing nursing care equally
to all as per needs
•Fairness/ unbiased
•Giving equal treatment
•Equal distribution of benefits,
costs and even risk.
•Some time equality
distribution is not possible
during emergency , the
services are based on priority.

25. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Respect
Call by name
Respect as an individual
Respect their opinion
Respect relatives
Especially respect the women
in labour/delivery room

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

27. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Responsibility
Remember youaretaking
responsibilityofhumanlife
Willingtotakeresponsibilities
Havingtobeanswerableforthe
action
Beaccountable
Needtoremaincompetent-
Knowledge
Attitude
Practice
Takethoseresponsibilitywhichare
inyourjobdescriptions

28. Responsibility

29. Beanswerabletooneselfandothersfor
one’sownactions.
Nursesareaccountableforjudgmentsmade
andactionstakeninthecourseofnursing
practice.
Itisallaboutjustifyingactions,explaining
whysomethingwas(orwasnot)done
Accountfortheiractionsisthereforeto
establishwhethertheyhadgoodenough
reasonsforactinginthewaytheydid.
Accountability

30. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Accountability

31. Supportforacause
Asanurseyousupportforthehealth
,safety,andrightsoftheclients.
Followinstitutionalpolicyandprocedure
Reportanyunethicaloccurrencethat
maycauseharmtotheclients
Advocacy

32. Advocacy

33. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Veracity
“If you tell the truth , you don’t have to
remember anything”.
Truth is the basis for mutual trust between
clients and health professionals.
Provide all information truthfully

34. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Double Effect
Someactionscanbemorallyjustifiedeven
thoughconsequencesmaybeamixtureofgood
andevil
•Mustmeet4criteria:
–Theactionitselfismorallygoodorneutral
–Theagentintendsthegoodeffectandnottheevil
(theevilmaybeforeseenbutnotintended)
–Thereisnofavorablebalanceofgoodoverevil

35. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•Duty to be faithful to
one’s commitments
•Faithfulness
•Keep promises
•Don’t make promises you
cant keep;
Fidelity

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

37. Sanctity of Life
•Itdependsinwhichcontext,law,religion,
philosophy etc.
Butingeneralterms,it'sthebeliefthatalllife,
fromthemomentofconceptionissacredand,
thereforehastherighttolive
•Iflifeisthehighestgood,isitethicaltokeepa
braindeadpersonalive?

38. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
ELEMENTS OF CODE OF ETHICS

39. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
COMPONENTS OF NURSING ETICS

40. Nurses and the people

41. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•Thenurse’sprimaryprofessional
responsibilityistowards people
requiringnursingcare.
•nursepromotesanenvironmentinwhich
humanrights,values,customsand
spiritualbeliefsoftheindividual,family
andcommunityarerespected.
NURSES AND THE PEOPLE

42. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•Thenurseensuresthattheindividual
receivessufficientinformation
•Thenurseholdsinconfidencepersonal
informationandusesjudgmentin
sharingthisinformation.
•Thenurseshareswithsocietythe
responsibilityforinitiatingand
supporting
NURSES AND THE PEOPLE

43. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
•Action to meet the health and social
needs of the public, in particular those
of vulnerable populations.
•The nurse also shares responsibility to
sustain and protect the natural
environment from depletion, pollution,
degradation And destruction.
•Provide health education
NURSES AND THE PEOPLE

44. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Nurses and the practice
•Providecareaspersetstandards
•Maintainsstandardsofpersonal
conduct
•Respectindividualandfamily
•Enhance the competency
/knowledgeandskillwith
changingneeds.

45. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Nurses and Practice
•The nurse, in providing care, ensures
that use of technology and scientific
advances are compatible with the
safety, dignity and rights of people.
•Promote participation of individuals and
others in patient care

46. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
NURSES AND THE PROFESSION
•Develop professional knowledge
•Developing research based
professional knowledge.
•Work in the professional organization
•Developing equitable and social
working condition for nurses.

47. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
NURSES AND CO -WORKERS
•Co-operativerelationship
•Respect
•Collaborate
•Acceptance
•Respectpointofview

48. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.

49. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
ETHICS IN INDIA

50. Nursing …..
Caretohumanity.
Universal.
Workingforanoblecause.
Dealingwithhumanlife.
Respectforhumanrights,includingcultural
rights.
Righttolife.
Treatingclientwithdignity.
Respect Uniqueness of the person
Indian Nursing Council : Code Of Ethics
Respect rights
of the individual
Respect privacy and confidentiality
Maintain competency
to render quality
care
Practice within
framework of ethical,
legal and professional
boundaires
Demonstrate personal
etiquettes

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

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

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

54. Caretoallwithoutdiscrimination
Respecttotheclientsandrelatives
Usewordscarefully
Acceptpatientwithhis/herreligiousbelief
Take responsibility and delegate
responsibility carefully
Actasperinformeddecisionandchoices
Alwaysactinthebestinterestoftheclient
Beawareaboutlegalprecedents
Planandorganizein-serviceeducation
programme
Nurse’s Ethical Challenge

55. Rights of personal dignity:
Callingbyname.
Giveduerespectasperage.
Maintainprivacy.
Modesty:knockingdoors,pullingcurtains.
ProvideBestpossibleappearance,personal
hygieneandcare.
Listeningtothepatientcarefully.
Acceptingtheindividualsfeelingasreal
withoutjudgingrightorwrong.
Rights of the patients

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

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

58. •Righttoprivacyandconfidentialityoftheir
records–recordsaretobemaintainedinasafe
andsecureenvironment.
•Righttoknowtheprofessionalstatusofthe
person(s)treatingthem
•Righttoknow,inadvanceofservices,thecostof
servicesandanyapplicablepaymentpolicy.
•Righttoappointalegalrepresentativetomake
decisionsregardingtheirhealthcare.
•Right to refuse to participatein
research/experimentalactivities.
Rights of the patients

59. Motivateandbuildselfesteemforself
care
Assistinactivityofdailyliving
Helpingattitudeandshowinterestwhile
caring
Involvefamilymembers
Directorprovidenecessaryinformation
forselfcare
Bearound
Rights of the patients…
Rights to assistance towards independence

60. ProvideCarebasedonneeds
Respecttheclientwhileperformingthe
nursingprocedure
Allowfamilymembertobewiththeclientas
faraspossible
Plandietasperculturalbackground
Allowpersonalbelongings
Allowreligiousrituals,ifitisnotdisturbing
tootherandclientortreatment
Rights of the patients…
individual care

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

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

63. IsolemnlypledgemyselfbeforeGodandin
thepresenceofthisassembly,topassmylife
inpurityandtopracticemyprofession
faithfully.Iwillabstainfromwhateveris
deleteriousandmischievous,andwillnottake
orknowinglyadministeranyharmfuldrug.
Florence Nightingales Pledge

64. Iwilldoallinmypowertomaintainandelevatethe
standardofmyprofession,andwillholdin
confidenceallpersonalmatterscommittedtomy
keepingandallfamilyaffairscomingtomy
knowledgeinthepracticeofmycalling.With
loyaltywillIendeavortoaidthephysician,inhis
work,anddevotemyselftothewelfareofthose
committedtomycare.
Florence Nightingales Pledge