A Comprehensive Guide to Nursing Ethics
Nurses work on the frontlines of the medical world. Because of the nature of their careers, nurses are constantly required to negotiate interactions with patients, families, and other hospital staff. In particular, the caring relationships established between a nurse and an ailing person are governed by distinct, well-defined codes of ethics. Included here are a wealth of resources to help nurses understand the complexities, details, and importance of these ethical issues.
Formal codes of ethics - Articles - Websites - Blogs - Forums and Message Boards - Books - Journals - Videos - Classes - Conferences
Formal codes of ethics
- The American Nurses Association publishes the most widely used and accepted Code of Ethics for Professional Nurses . Its nine major principles include: patient dignity, commitment to a patient, optimum care of patient, rights of patient, integrity and continued growth, advancement of nursing profession, improved health care environment and employment, professional and public collaboration, and maintenance of values and integrity and shaping social policy. (Nursing World)
- The International Council of Nurses publishes the Code of Ethics for Nurses and includes the four fundamental responsibilities: “to promote health, to prevent illness, to restore health, and to alleviate suffering.” The council discusses the ethics of being compassionate, respectful, nonbiased, working as an advocate, respecting spirituality, sustainability and more. (International Council of Nurses)
- The Australian Code of Ethics for Nurses sets a national standard of conduct for nurses, and is closely related to the American version. It addresses ethical issues like dignity, values, honesty, professionalism, culture, and beliefs. (Australian Nursing Council Inc.)
- The Canadian Code of Ethics for Nursing defines ethical nursing care in Canada, which is also related to the American and Australian Codes. Ethical issues covered also include safety, competence, and compassion, and issues in different scenarios such as pandemics, relationships, conflicts, or natural disasters. (Canadian Nurses Association)
- Professional nurses in the United Kingdom follow the Nursing and Midwifery Council's Code of Conduct. This discusses issues like the importance of the individual, confidentiality, collaboration, consent, boundaries, teamwork, accuracy, honesty, and reputation. (The Nursing and Midwifery Council)
Articles
- “Nurses Struggle with Ethical Dilemmas” discusses the difficulties nurses often face when it comes to a conflict between moral responsibility and hospital operating procedure. The article highlights several compelling real-life scenarios and examines how the nurses solved, or at least confronted, the ethical issues underlying them. (Nurse.com)
- “A Question of Nursing Ethics” examines several instances in past years where nursing students were caught cheating on exams. The author argues that harsher punishment is needed for these students in order to send a message that cheating is intolerable, and that ethics play a central role in any nursing career. (Workingnurse.com)
- “Nurses Bound by Ethics, Law to Maintain Privacy” highlights the recent phenomenon of nurses serving as informers to news media about high profile patients (the Michael Jackson and Farrah Fawcett being prime examples) in light of privacy and confidentiality mandates found in all nurses' Code of Ethics. The article clarifies the rules and explains what to do should a nurse be contacted by the media for information about a patient. (Nurse.com)
- “A Fighting Chance” explains how medical advances are increasing the odds of survival by premature babies, and simultaneously raising ethical questions for neonatal Registered Nurses. The authors illuminate issues of attachment, relationship formation, and end of life realities. (NurseWeek)
- “Daily News: Nurses Again Top Annual Honesty, Ethics Poll” sheds light on recent findings from a Gallup poll that shows that Americans voted nurses very highly in their annual Honesty and Ethics of professions survey. They ranked as the most ethical and honest profession for the past seven years in a row. (Nurse.com)
- “Ethical Issues Cause Dissatisfaction Among Nurses” discusses how nursing as a field can be discouraging given the high rate of stress and patient problems that pose frequent ethical quandaries. It exposes some of the negative feelings associated with nursing and ethics, such as powerlessness, confusion, and feeling overwhelmed. It also discusses the lack of training that sometimes occurs for nurses working in the field as regards ethics. (Nursezone.com)
- “Nursing Ethics: A Selected Bibliography, 1987 to Present” is a thorough document that catalogues books, articles, chapters, and additional readings that are helpful for becoming well versed in the specialized field of nursing ethics. It also discusses the philosophy of care, decision making, education, nurse-patient relationships, professional relationships, informed consent, Aids, and care of the dying, among other issues. (Georgetown University)
Websites
- This site discusses nursing ethics as guided by moral principles as well as theories, dilemmas, current issues, and decision-making. It highlights issues like autonomy, non-malfeasance, beneficence, fidelity, and justice. (Registered Nurse Canada)
- The International Center for Nursing Ethics is a place to learn, discuss, debate, and share information about issues regarding nursing ethics (both empirical and philosophical). It contains information about books, journals, events, classes, and conferences. (International Center for Nursing Ethics)
- Mrs. Lystra E. Gretter wrote the “Florence Nightingale Pledge” in 1893, which is an adapted form of the “Hippocratic Oath” taken by doctors. It is widely recognized as the first formal code of ethics for nursing. (American Nurses Association)
- This Nursing Ethics site is run by the Boston College Connell School of Nursing. It has a huge variety of resources on nursing ethics, with a literature review section, bibliography, dissertations, lectures, ethics tools database, and more. (William F. Connell School of Nursing)
- St. Catherine University maintains an excellent collection of resources on ethics in nursing. Their information includes finding books, finding journal articles, general web resources and overviews. Their helpful section on “web resources by topic” allows users to search within the topics of abortion, assisted suicide, euthanasia, genetic intervention, religion, spirituality, whistle-blowing, confidentiality, and more. (St. Catherine University Libraries)
- The Nursing Ethics Knowledge Database is a wiki with podcasts, case scenarios, information on ethical decision-making, and evaluation tools. The podcasts are must useful, and have been brought onto YouTube and made available from iTunes University as well as posted here. (E4 Wiki)
- The School of Nursing at Purdue University runs the Center for Nursing History, Ethics, Human Rights and Innovations, which maintains a collection useful for those interested in nursing ethics. The collection includes books, manuscripts, coursework, yearbooks, photographs, and more. (Purdue University)
Blogs
- Ethics Blog has a category on nursing, and many others on related subjects like the workplace, medical ethics, organizational ethics, feminist ethics, and more. The author includes articles and has resources to other sites as well.
- A Philosophy of Nursing Forum explores the ethics of nursing from a philosophical perspective – analyzing such writers as Kant, exploring theories of science and epistemology, and discussing such topics as neonatal circumcision and female genital mutilation. Class discussions led by professors are a helpful addition here as well.
- Vickie Milazzo is a Registered Nurse and holds both her Master's in Nursing and her Law degree. She runs Vickie's Legal Nursing Consulting Blog, which has many tips for legal nurses, but also explores issues of ethics in the field.
- Bioethics International's slogan is “Where Healthcare, Life Science, and Ethics Meet.” Their blog, Ethics Illustrated, is meant to be a resource for responsible healthcare and discusses issues of ethics for anyone involved in the medical field.
- The Art of Patient Care explores how to create better relationships between healthcare professionals and their patients, including the ethics involved in these interactions. They discuss issues like focus, continuity, palliative care, patient rights, and burnout.
- Allnurses.com hosts a number of blogs on different issues related to nursing. Searches can be sorted by post date, blog, or topic. Many posts discuss issues of confidentiality, ethical scenarios, liability, and other issues of interest to practicing nurses.
Forums and Message Boards
- The Student Nurse Forum has a wide variety of resources as well as a search feature for their forum. They help students interested in becoming nurses and provides support and information to help them get to understand the ins and outs of the field better.
- Allnurses.com hosts an active message board with discussions separated by topic. They cover all aspects of being a nurse, including ethical dilemmas and interactions and relationships with patients and other healthcare workers.
- Nursezone.com runs a message board for nurses where they can post their own questions, read through previous threads, or respond to other nurses' inquiries. The search function allows users to search for discussions related to ethics specifically.
- Nursechat.com hosts several message boards, the most popular of which is their general Lounge forum, open to any subject. You can search their boards by keyword such as ethics, ethical, confidentiality, trust, dilemma, patient-nurse dynamic, etc.
Books
- Ethics and Issues in Contemporary Nursing is a textbook used in many nursing classes today. It discusses the importance of legal and ethical decision making as they apply to various issues. Real-world examples like the Terry Schiavo case and Hurricane Katrina are used to elucidate topics. (Amazon.com)
- Legal and Ethical Issues in Nursing is written for both students of nursing and practicing nurses. It explores how legal issues and the field of ethics are inseparable, and simultaneously impact nursing as a profession. (Amazon.com)
- Ethical Dilemmas in Contemporary Nursing Practice is written as ten case scenarios by nursing in several different healthcare settings. It explores these ethical dilemmas by defining the primary issues, posing questions, and offering helpful resolutions. (Amazon.com)
- Nursing Ethics: Holistic Caring Practice is written with the intent of helping nurses become better nurses. They develop a system of ethics specific to nursing that is not tied to the traditional method of applying philosophical ethics, and discuss how ethics, morality, and caring can make a nurse outstanding. (Amazon.com)
- Toward a Moral Horizon: Nursing Ethics for Leadership and Practice is aimed for practitioners in Canada, but is applicable to any country. The text's three sections highlight the moral landscape, moral climate, and moral horizons for nurses, and presses nurses to widen their perspective on how ethics is applied to their career. (Amazon.com)
- Nursing In Today's World: Challenges, Issues and Trends is a textbook for nurses and nursing students who want a comprehensive text on the full spectrum of concepts in the professional world of nursing. Because it is a recently updated edition, it helpfully provides insights into current issues and trends, including ethics. (Amazon.com)
Journals
- Nursing Ethics is a journal published by the International Center for Nursing Ethics. Appearing six times a year, it includes empirical studies, analyses of official documents, policy studies, company accountability reports, topical issues, and more. Recent articles discuss end-of-life issues, caring for undernourished patients, moral distress, conscience, and advance directives. (International Center for Nursing Ethics)
- Public Health Nursing focuses on caring for populations at risk across the life course. Ethical issues are discussed as they relate specifically for nurses to this group of patients. (Wiley)
Videos
- Nevcoeducation has made a series of well-known videos about the ethical issues of nursing. Their introduction explains to viewers the role that ethics plays in the career of any nurse, and highlights both how important a thorough understanding of ethics is. (Youtube)
- This Nevcoeducation video highlights Cultural Diversity in Healthcare, explaining that the cultural needs and beliefs of different groups mean that nurses should adapt their care procedures accordingly. The video explains effective methods at recognizing and coping with these special needs.
- This video highlights the ethical issue of Protection by Nevcoeducation. It explains how ethics committees are in place at every hospital, with nursing sitting on their boards. Nurses advocate for a patient's needs, and ensure that he or she is taken care of according to the code of ethics.
- The issue of respect is central to any nurse's role and ethical responsibilities. Nevcoeducation's video highlights the complexity that a seemingly simple issue like respect can entail, and how it varies from case to case.
Classes
- The New England Research Institutes offer a series of web-based courses through the Nursing Ethics Continuing Education website. Courses cover issues of advocacy related to patients with HIV or AIDS, the elderly, the dying, etc.
- The Center for Ethics at the University of Toronto offers a Nursing Ethics course. It uses ethical theory as a lens through which to examine the dilemmas and ethical issues that face nurses daily, and discusses issues like globalization, public health, policy, and the beginning and end of life.
- The University of Texas at Austin offers several classes in The Ethics of Healthcare. They explore the “contradictions, inconsistencies, and competing views that lead to dilemmas in healthcare,” and emphasize the use of ethical reasoning to solve problems.
- Marquette University, like many schools, requires that nursing students all take a class in ethics. Here, they require a philosophical Theory of Ethics class, giving students a grounding in the theorists who help define what ethics means in the modern age.
Conferences
- The International Center for Nursing Ethics plans an annual conference, this year being the 10 th -11 th annual meeting. This year it is organized by the University of Turku in Finland, and entitled “Clinical Ethics Across the Lifespan.”
- The 14 th International Philosophy of Nursing Society Conference focuses on the theme of “Philosophizing Social Justice in Nursing” this year. It takes place in Canada and will cover ethical issues from a philosophical perspective.
- The National Perinatal Association hosts a conference on “Bridging Gaps: Healthcare, Ethics, Technologies, and Politics in Neonatology and Perinatology.” Taking place in Washington D.C., this event will help nurses understand ethical issues as they relate to newborn children.
- The First Global Conference sponsored by H-Net (Humanities and Social Sciences Online) entitled “Making Sense of Suicide” will take place in the Czech Republic this year. It is an interdisciplinary conference, and nurses would find value in attending if they have an interest in end-of-life ethical issues as they relate to individuals who take their own lives.
- The International Council of Nurses are organizing a conference on “Nurses Driving Access, Quality, and Health,” to be held in Malta in May 2011. The aim of the conference is to demonstrate the contribution of nurses to their patients, families, and communities, and to exchange experiences and expertise.