An obligation to intra-professional ethics.
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In today's rapidly changing healthcare environment, home care and hospice nurses face complex ethical dilemmas. Many result from situations with two opposing, but equally reasonable, solutions. Understanding how and why ethical dilemmas arise helps nurses recognize the potential for an ethical dilemma and formulate justifiable solutions. This article, the first of a new ethics column in Home Healthcare Nurse, sets the foundation for the nurse's understanding of these dilemmas by applying the American Nurses Association's Code for Nurses with Interpretive Statements to real case studies.
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If nurses are to remain central in restructuring efforts, their professional values must be at the core. Nurse administrators play a key role in promulgating values. The authors examined philosophy of nursing documents to identify professional values and found them to be lacking. They discuss their findings and their implications for nurse executives.
A convenience sample of 499 perioperative nurses was surveyed to determine what they perceive to be the most pressing ethical issues. Staffing patterns, informed consent, allocation of resources, and occupational risk were ranked as most important. Also surveyed were subjects' knowledge and application of the American Nurses Association (ANA) Code for Nurses with Interpretive Statements--Explications for Perioperative Nursing (ANA Code in AORN: Standards and Recommended Practices. Denver, CO, 1994.
PURPOSES/OBJECTIVES: To describe the importance of a professional code of ethics and values in guiding and supporting the practice of nurses and to present the proposed Oncology Nursing Society (ONS) Statement of Core Values. DATA SOURCES: Published articles and books on nursing ethics and bioethics, as well as authors' clinical experiences. DATA SYNTHESIS: Ethical quandaries are commonplace for nurses, and the contemporary context of health care has created new concerns and redefined others. Throughout its history, nursing has been an ethical endeavor, with nurses attempting to sift through complex ethical issues and fulfill their professional responsibilities. A professional code of ethics and values explicates the goals and norms of the profession and provides direction for practice. CONCLUSION: Together, the profession's code of ethics and the proposed ONS Statement of Core Values serve as a resource to guide oncology nurses as they develop an ethically competent practice and confront contemporary ethical challenges. IMPLICATIONS FOR NURSING PRACTICE: The goal of developing an ethically competent practice, maintaining professional integrity, and rendering quality patient care is of vital concern to oncology nurses. Familiarity with and commitment to the primary ethical precepts and values of the profession are essential to accomplishing this goal.
While ethical quandaries and dilemmas are commonplace for nurses, recent advances in human genetics have and will continue to create new challenges and controversies. Throughout time, nursing has been an ethical endeavour, with nurses viewing the ethical mandates of their responsibilities on a par with other core dimensions of their professional life. The (American) profession's code of ethics, Code for nurses with interpretive statements, provides direction for practice and for the fulfillment of ethical obligations. The explication of these ethical norms and values that shape professional practice is necessary as nurses confront the integration of genetic services into health care. The goal of preserving professional integrity and ethical soundness in the context of genetic health care mandates that nurses rely on and act upon the profession's national and international codes of ethics.
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Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care which includes the promotion of comfort and the relief of pain and, at times, forgoing life-sustaining treatments. The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession.
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This article has focused on the history of the code of ethics for nurses. The changes in the code intertwine with nursing's journey toward professionalism and reflect changes in nursing, society and health care. Over the years, however, the code has remained relatively stable. Six of the statements can be traced back to the 1926 code and five others to the revision of the code in 1960. The code of ethics has provided guidance for the profession, and has helped determine nursing's position as a profession in society.
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Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this third of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the fourth provision statement, which addresses nurses' accountability and responsibility.
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