Professional Ethics (Modern University) PDF

Prepared By Professor Dr. Nadia Yanni Seif Assist. Prof. Dr. Manal Mohamed Moselhy 1  List of Content: No. Shaper: Page 1. Introduction to Nursing Ethics 5 2....

Prepared By Professor Dr. Nadia Yanni Seif Assist. Prof. Dr. Manal Mohamed Moselhy 1  List of Content: No. Shaper: Page 1. Introduction to Nursing Ethics 5 2. Principles of Ethics. 14 3. Values in Nursing Profession. 24 4. Code of Ethics. 34 5. Critical Thinking. 41 6. Ethical Decision Making 49 7. Ethical Nursing Dilemmas. 64 8. Rights & Responsibilities of Clients & Nurses. 74 9. Ethics and Professional Conduct to Nursing Students. 84 10. Professionalism & Nursing 92 11. Nursing Legalities 104 12. References 116 2 3 4  Introduction to Nursing Ethics and Related Definitions Learning Objectives: On completion of this lecture the nursing student should be able to: ▪ Identify the historical background of professional nursing ethics. ▪ Define the professional ethics and related terms. ▪ Identify types of Ethics. ▪ Discuss the importance of ethics in nursing. ▪ Explain the three categories of human rights. Content Outlines: ▪ Historical background related to the beginning of professional nursing ethics. ▪ The professional ethics and related terms. ▪ Types of Ethics. ▪ The importance of ethics in nursing. ▪ The three categories of human rights. 5 Introduction: ▪ Historically, the beginning of professional nursing can be traced to the 19th -century, when the England School of nursing was established founded by Florence Nightingale, where profession-shaping ethical rules and values were communicated. ▪ Florence Nightingale was born of rich parents in the Italian city, where she received an advanced education. At the young age of 16, Florence believed that she heard God’s voice urging her to do something special to help others. As she grew older, she began to take an interest in how sick people were cared for and how they regained their health. In her twenties, Florence decided that she would become a nurse and fulfill her intense desire to help the sick. Her parents were greatly surprised and upset that Florence wished to be a nurse. In the time of Florence’s life, nursing was not considered an important or prestigious profession and one that was usually performed by poor men and women. ▪ Nightingale’s achievement was landmarks in nursing even though, performance of graduates were below the desired expectations in the early days. The prospective nurses were trained by male physicians because of the inadequate nursing teachers in the first 30 to 40 years Nightingale’s school. ▪ The focus on nurse’s obedience to physicians remained at the forefront of nursing responsibilities into the 1960s. Over the years most nurses have been women and most doctors have been men. ▪ Nurses and other health professional need to have, ethical moral and legal cultural knowledge to guide their care decision and action in justifiable, and defensible ways. 6 Definitions of Related Terms: Nursing: ▪ Nursing is the provision of care to enable people to improve, maintain, or recover health, as well as cope with health problems to achieve the best quality of life, either in disease or disability until death. ▪ Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy is also key nursing roles. Ethics: ▪ The term of ethics is derived from the Greek word “ethos”, which means customs, habitual usage, conduct and character. ▪ Ethics is a practical way of putting moral into practice, which leads to decision making and problem solving. ▪ Ethics are systems of valued beliefs and behaviors that direct proper act to ensure the protection of an individual's rights. ▪ Ethics help to differentiate the right conduct from the wrong or indicate how things should be. 7 Types of Ethics: 1. Descriptive 2. Normative 3. Analytical 1. Descriptive: ▪ It is the description of the values and beliefs of various cultural, religious or social groups about health and illness. ▪ Example: it means how societies regulate behavior (such as by punishing people for doing certain actions). 2. Normative: ▪ It is a study of human activities in a broad sense in an attempt to identify human actions that are right or wrong, good and bad qualities (What we ought to do). 3. Analytical: ▪ It analyzes the meaning of moral terms. It seeks the reasons why these action or attitudes are either wrong or right. Nursing Ethics: Refers to ethical issues involved in nursing practice. Importance of Ethics in Nursing: ▪ Ethics provides us with the rules and principles for decision making and action to be taken in a complex situation. ▪ It provides a base for regulating the relationship between nurse, patient, co- workers, society and profession. 8  It gives us standards of practice and profession. Example: In case of Dilemma, Abortion and Euthanasia (mercy killing) ▪ Ethics in nursing promotes the sense of fundamental responsibilities of nursing care as to promote health, to restore health, to prevent illness and to alleviate suffering. ▪ It enhances the development of caring attitude, sense of responsibility and accountability. ▪ It promotes an environment in which the values, customs and religious beliefs are respected. Bioethics: ▪ They are applied to life (e.g. Abortion, Euthanasia). ▪ They are concerned with problems associated in the field of medicine, or nursing. 9 Moral: ▪ The word Moral is derived from the Latin “mores” means custom/ tradition/ practice or habit. ▪ Personal philosophy based on a standard of what is right and what is wrong, as well as good or bad. ▪ It is learned through socialization. ▪ It is usually based on religious beliefs. Morals are similar to ethics and many people use the two wards N.B. interchangeably (It is closely associated with the concept of ethics). Moral Distress: Possible Reasons for Moral Distress: ▪ It arises when individuals cannot fulfill ethical obligations. ▪ It happens when individuals fail to accomplish what they believe to be the right course of action and live up to their own expectations. ▪ It occurs when the nurses are unable to follow their moral beliefs because of institutional or other restriction. The distress occurs when the nurse violates a personal moral Example value and fails to fulfill perceived responsibility. It may result in feelings of guilt, concern or distaste. N.B. Values: they are: ▪ Concepts or ideas that give meaning to one's life. 10  ▪ Beliefs or attitudes about the worth of a person, object, idea or action. ▪ Provide a framework for one's decisions and actions. Student’s examples (Assignment). Behaviour: ▪ It is an observable action. ▪ The manner in which individual behaves. ▪ The action or reaction of person under given circumstances. Ethical behavior: ▪ It is day –by –day expression of person's commitment to another. ▪ The beliefs and practices of a certain group; such as nursing and medical ethics. ▪ The expected standard of moral behaviors of a particular group as described in their code of professional ethics. Attitude: (Positive or negative): ▪ Attitude is a person’s temper ‫المزجا‬towards an object /situation, or settled behaviours. ▪ Attitude can be a mental or emotional. ▪ Attitude can be positive or negative. ▪ Attitude is seen in behaviour and opinion. Example The unique function and responsibility of a nurse in her famous statement is the consciousness of the unconscious, the leg of the amputee, the eyes of the newly blind. Beliefs: ▪ They are ideas that individual accepts as true. ▪ A type of attitude, which is based more on faith than fact. 11  ▪ Interpretation or opinion that we accept as true. ▪ They are judged as correct or incorrect. Virtue: ▪ Moral excellence and righteousness; goodness. ▪ An example or kind of moral excellence. ▪ Virtues are cultivated traits of character that motivate a person to do: The right action. At the right time. With the right motivation. For the right reason. A person using this approach may ask themselves: N.B. “If I carry out these actions, what kind of person will I be?” Examples of virtues: a) Courage. b) Honesty. c) Compassion. d) Justice. e) Insight.‫فطنة‬ Laws: ▪ Laws are enforceable rules. ▪ Laws are necessary for social conduct. ▪ Laws are designed to prevent the actions of one group from infringing or attacking on the rights of another group. Rights: ▪ Rights are entitlements / the power that one deserves according to just claims (asking), legal guarantees, or moral principles. 12  ▪ ‫ والضمانات‬،)‫ السلطة أن أحد يستحق وفقا لمجرد المطالبات (طالبا‬/ ‫الحقوق هي استحقاقات‬.‫ أو المبادئ األخالقية‬،‫القانونية‬ Rights have three categories: A. Optional rights B. Welfare rights A. Ethics rights A. Optional Rights: ▪ It is the freedom of choice; that allows one to live one's life as one chooses within a set of prescribed boundaries. People can wear whatever clothes and colors, as long as they didn't Example infringe on the rights of others. B. Welfare Rights: ▪ It is the legal rights; they are based on legal entitlements to benefits that are granted by law. It is to freedom of speech, walk, swim, shopping, go to the Example cinema,…........................... etc. C. Ethical Rights: ▪ It is the moral right; it is just a claim to something based on a moral principle that may not have the power of law to back up the claim. In health care, nurse should protect patients' dignity and his Example privacy……etc. N.B. Two – three vides will be presented for more elaboration and understanding. 13.................................................................................................................................................... 14  “Principles of Nursing Ethics” Learning Objectives: After completion of this lecture the students should be able to: ▪ Define the key terms. ▪ Identify the eight main ethical principles in nursing. ▪ Discuss each principle supported with examples. ▪ Apply ethical and legal principles elated to patient education as an example. ▪ Implement ethical principles with different individuals such as colleagues, supervisors, patients, groups, families and other health care providers. Content Outlines: ▪ Definitions of the ethical principles. ▪ The eight main ethical principles in nursing. ▪ Examples of each ethical principle in nursing. ***************************** 15 Introduction: ▪ The ethical and legal responsibilities include Eight major principles, which are addressed throughout the American Nurse Association (ANA)'s Code of Ethics (2001). These principles cover the very issues that precipitated federal intervention into healthcare affairs. ▪ Ethical principles provide the foundation for moral values, and nursing practices, which are specific prescriptions for actions e.g. “People should not lie” (rule), it is based on the moral principle of respect and autonomy for people. ▪ Ethical principles are considered as basis for nurse’s decisions when making clinical judgments. Definition: Ethical principles refer to those general judgments that serve as a justification for ethical prescriptions and evaluations of human actions. The Eight Major Nursing Principles are: 1 2 3 4 Respect Autonomy Beneficence Non- malfeasance (self-governing) (to do good) (to do no harm) 5 6 7 8 Confidentiality Justice/ Fairness Veracity Fidelity 1. Respect: (Ethical rule) (telling the truth) 16  ▪ Its one of the main principle of ethics. ▪ It means treating people as unique, equal and responsible moral clients. ▪ This principle emphasizes people’s importance as members of the community and health services team. ▪ It is applied not only in clinical settings, but also in all life's' situations. ▪ This principle emphasize that all people should treat others as a worthy individual. ▪ Respect, specifically in nursing practice means consider the client's autonomy. ▪ Stand up when an older person enters the room. Example ▪ When an adult drops something, you should rush to pick it up. ▪ Speak in a soft tone of voice, especially in public places. 2. Autonomy (self-governing): ▪ The word of autonomy is derived from the Greek words Auto (self) and Nomo (law). ▪ Autonomy means freedom of choice. ▪ Autonomy is the right of self-determination/ self-governing..‫ الحكم الذاتي‬/ ‫الستقاللية هي حق تقرير المصير‬ ▪ Laws have been acted out to protect the patient's right to make choices independently. ▪ Respect of client’s rights, values and choices is synonymous to respecting a person’s autonomy. ▪ The nurse’s should respect patients’ rights to make their own decisions, even if the nurse does not agree with the patients’ decisions. ▪ Client's autonomy to make decision and action needs adequate information. ▪ By the law, either at the hospital admission or prior to care provision client should be informed in writing about the followings: 17 ▪ The right to refuse medical or surgical care (freedom of choice). ▪ Individualism and self-determination are dominant values underlying this principle. ▪ Documentation of such instruction must appear in the patient's record, which is the legal document validating that informed consent took place. ▪ ‘Informed Consent’ is an important outcome of this principle: the nurse should instruct client/patient about the followings: 18 3. Beneficence: ▪ Beneficence is defined as "doing good" for the benefit of others. ▪ Beneficence is the effort to save lives and relieve human suffering (do good), only within reasonable limits. The Principle of Beneficence has three Components: ▪ Promote good. ▪ Prevent harm. ▪ Remove evil or harm. 4. Non-malfeasance: Non-malfeasance means "do no harm", which encompassing; Negligence Malpractice (1) Professional Negligence is defined as an individual ignores of basic responsibilities and that lack of action, which leads to hurt another individual or group. Thus when a professional (e.g., nurses, physicians, dentists, …etc) is negligent of their clients this means hurt, which include all improper and wrongful conduct that fall below a professional standard of due care. (2) The term Malpractice refers to a type of negligenc e, where a licensed professional fails to provide services a s per standards set by the governing body. 19  A doctor doesn't perform the duties in accordance with the Example medical standards, resulting in patient's harm. ▪ Here are the most common causes for malpractice claims against nurses: ▪ Failure to communicate. ▪ Failure to assess and monitor. ▪ Failure to follow standards of care, Examples ▪ Failure to use equipment in a responsible manner. ▪ Failure to delegate tasks properly. ▪ Failure to act as patient advocate. ▪ Failure to document. 5. Confidentiality: ▪ Confidentiality comes from Latin ward "Fide" mean (Trust), which means keep information private. ▪ Confide as to “show trust by keeping secrets”. ▪ So, confidentiality refers to personal information that is protected as private information. Such information may not be released by healthcare providers when acquired in a professional capacity without taking consent from a patient. 20  When a patient’ test is positive for HIV/AIDS and has no intention of telling his or her spouse about this diagnosis. In this instance, the physician is obligated to warn the spouse directly or indirectly of the risk or potential harm. Example "This area of legislation concerned with health care privacy and disclosure reveals the tension between what is good for the individual vis-a.-vis what is good for society". Can Nurses Violate Confidentiality? Yes, to protect the welfare of others, professionals are 6. Justice = Seeks fairness. ▪ It refers to treating people fairly. ▪ It is the fair distribution of goods and services, benefits and costs among society’s members. ▪ The law is the justice system. It focuses on the protection of society; the focus of health law is on the protection of the consumer. ▪ Nurses frequently face decisions in which a sense of justice should prevail (succeed). E.g. busy unit and new admission. 21  ▪ People demand justice when they consider themselves unfairly treated or not receiving a fair hearing. Example ▪ If a person doesn't receive a fair trial, the principle of justice allows an appeal to review the case. ▪ It is unjust to treat a person better or worse than another person in a similar condition or circumstance, unless a difference in treatment can be justified with good reason. ▪ Decision making for the fair distribution of resources includes the following criteria. ▪ Each group/community must have an equal share, which should be distributed according to: Need Effort Contribution Value Ability to afford The following nursing implications promote justice: ▪ Ensuring fair allocation of resources. (Example: appropriate staffing or mix of staff to all clients). ▪ Determining the order in which clients should be treated. (Example: priority treatments for the clients in pain). 22 7. Veracity: (Telling the Truth): ▪ The obligation to tell the truth and not to lie or deceive others, being honesty. ▪ Veracity is an important component of building trusting relationships. ▪ Veracity, or truth telling is closely linked to informed decision making and informed consent. 8. Fidelity: ▪ It refers to keep promises. ▪ “Fidelity means being faithful to one's commitments and promises” ▪ Fidelity is not only keeping commitment, but also keeping or maintaining our obligation. ▪ Nurses’ commitments to clients, which include providing safe care and maintaining competence in nursing practice. Example ▪ Nurse must use good judgment when making promises to client. ***************************** 23.................................................................................................................................................... 24  “Values in Nursing and Professional Ethics” Learning Objectives: After completion of this lecture the students’ should be able to: ▪ Define values. ▪ Discuss types of values. ▪ Enumerate sources of value. ▪ Explain formation of value. ▪ Identify characteristics of values. ▪ Discuss important values in nursing profession. ▪ Identify methods of value transmissions. ▪ Explain essential Nursing Ethical Values and Behaviors. ▪ Identify the most common values in the nursing profession. ▪ Identify values statements, values Conflicts and resolution of values conflicts. Content outlines: ▪ Definition of values. ▪ Types of values. ▪ Sources of value. ▪ Formation of value. ▪ Characteristics of values. ▪ The important values in nursing profession. ▪ Methods of value transmissions. ▪ Essential Nursing Ethical Values and Behaviors. ▪ The most common values in the nursing profession. ▪ Values statements, values Conflicts and resolution of values conflicts. 25 Introduction: ▪ A value is derived from a person’s cultural, ethnic and religious background; from societal traditions, peer group and family. ▪ Values bring direct and indirect moral meaning to human existence. Definitions of Values: Values are Concepts or ideas that give meaning to one's life. ▪ Values: Provide a framework for one's decisions and actions. They are the personal aspects and foundation of social ethical living. ▪ Individuals feel most comfortable with Example: people who hold similar values. 26 Types of Values: Personal values Professional Values People need personal values to have They are acquired during socialization sense of individuality and to feel within the practice of nursing accepted. profession from: 1. Code of ethics. Personal values develop from: 2. Nursing experience. a. Individual social traditions. 3. Teachers. b. Cultural, ethnic religious norms. 4. Peers. ▪ People need social values to feel E.X.: Self-worth, Sense of humor, accepted, and they need personal Honesty, Fairness and Love values to produce a sense of individuality. ▪ Professional values often reflect and expand on personal values. As values are different from one to another as by principle; “No one set of values is right for everyone” N.B ▪ Therefore, nurses in their practice have to clarify their values, as well as patient’s /client’s values. 27 Sources of Value: 1. Values are rooted since human exist; the structure of human nature comes from both genetically & culturally. 2. Values are so fundamental to human; they rise above cultural boundaries. 3. Values are socializing influences; they come from community, peer culture, role models and experiences that challenge a way of thinking. Formation of Value: Observation Experience Reasoning Characteristics of Values: Values are: 1. Freely chosen. 2. They consist of beliefs or attitudes. 3. Learned through observation and experience. 4. Influenced by a person’s socio-cultural environment, tradition, ethnic, religion, as well as by family and peer group. Important Values in Nursing Profession: 1. Autonomy. 2. Commitment to education. 3. Strong commitment to service. 4. Belief in the dignity and worth of each person. 28  (1) Nurses should be nonjudgmental. N.B (2) Nurses should accept client’s values beliefs rather than assume their own are the “right ones. Remember: Never impose your personal values and never N.B offer an opinion. Methods of Value Transmissions: ▪ Modeling: Acting. ▪ Moralizing: Standard of right and wrong. ▪ Laissez-Faire: No restrictions or limitations. ▪ Response Choice: Balance. ▪ Reward and Punishment Essential Nursing Ethical Values: valuable modification and comments: ▪ Altruism: ‫اإليثار‬ Nurses and health care provider have spirit of for the welfare & helping the others. ▪ Autonomy in decision making: It is the right of self-determinant (right of independency). ▪ Integrity: It is the acting in accordance with code of ethics and standard of practice. 29 ▪ Social justice: Social justice defined as fair distribution of resources and provision of clients' equal treatment and nursing care. ▪ Human Dignity: Respecting patient's beliefs, maintaining of their dignity and privacy during clinical procedures, and communication. Example: cover patients’ body parts if exposed and keep patients’ secrets confidential. ▪ Precision and accuracy in caring: The nurse provide sort of care that is a precise, safe, appropriate, multidimensional This is also thoughtful, based on adequate clinical skills and nursing knowledge to fulfill clients’ needs, promote their health, and relieve their pain and suffering. ▪ Responsibility: It is defined with traits of commitment, feeling responsible for the duties toward patients, and respecting the patients’ rights for decision making. ▪ Human relationship: It can be verbal or non-verbal and defined through having honesty in words and practice, sympathy, courtesy, friendliness and effective relationship based on mutual respect and understanding. ▪ Individual and professional competency: Individual and professional competency has been defined with traits of struggling to make nursing as a profession, feeling the need to acquire up- to-date knowledge and promotion of clinical skills and practical abilities. 30  ▪ Sympathy: Sympathy has been indicated as a nursing ethical value with traits of understanding patients’ and their families’ needs and giving care based on making a fair communication. In some cultures, such as Japanese, nurses share patients’ physical and mental pains and sufferings. ▪ Trust: Trust has been indicated as a nursing ethical value and is defined by traits of honesty in words and practice. The most Common Values in the Nursing Profession: Health Health Health Promotion Education Health Care Nursing Communication 1. Value of Health: ▪ It is a state of complete mental, physical & social well-being & not merely the absence of disease or infirmity. 2. Value of Health Care: ▪ Health care is constantly changing. ▪ The patients are free to choose which treatment to have, where and when. Therefore, the patients should be well informed about available choices. ▪ The patients are in a position mentally and emotionally to make these choices. 31 3. Value of Health Promotion: ▪ Nursing goals is to help clients establish health – protection or health – promoting behaviors, by modifying unhealthy habits to achieve optimal levels of wellness. 4. Value of Nursing: ▪ The most urgent task for people is to find meaning for their lives, so that it is important to find the meaning of nursing. Values of nursing is changes according to changes of society' values. 5. Value of Caring: ▪ It is the human mode of being and is a response to someone or something who or which matters. ▪ It is according to the human point of view and characterized by human feelings and behaviors. 6. Value of Communication: ▪ Be attentive, intelligent, reasonable, responsible, and committed. Values Statements: Examples: ▪ Faith in God. ▪ Respecting others. ▪ Being respected by others. ▪ Being open and receptive to others. ▪ Experiencing true friendship. ▪ Loving parents. Values Conflicts: ▪ Value conflict occurs when there is human interaction. ▪ Occurs when we must choose between two things, both of which are important to us. 32 Resolution of values Conflicts: ▪ Be constructive (rather than destructive) in the methods you choose to work toward resolving the differences ▪ Listen carefully without interruptions ▪ Seek clarification using gentle questioning ▪ Respect cultural differences ▪ Be attentive to body language ▪ Explain the context of your point of view and try to picture the other person’s expected of what you are saying. ▪ Clarifying or explaining process that aim at defining the relevant issue, attitudes and beliefs. ▪ Answering questions. ▪ Coming to decision or a determination for future action, client may have several treatment options. ***************************** 33 34  “Code of Ethics for Nurses” Learning Objectives:- By the end of this lecture, each student will be able to:- ▪ Define the code terms. ▪ Interpret code of ethics for nurses. ▪ List purposes of code of ethics. ▪ Enumerate the four kinds of the international codes of ethics. ▪ Discuss each one of the international codes of ethics. Content Outlines: ▪ Definition of the code terms. ▪ Purposes of code of ethics. ▪ The four kinds of the international codes of ethics. ▪ Elements of code of ethics. 35  Introduction: ▪ The Code of Ethics establishes the ethical standard for the nursing profession. ▪ Codes of ethics are usually higher than legal standards, and they can never be less than legal standards of the profession. Code of Ethics Definitions: ▪ It is a systematic comprehensive collection of laws or rules. ▪ It is a formal statement of a group of ideals and values. ▪ It is set of ethical principles that: o Shared by members of a group. o Reflect their moral judgment over time. o Serve as standard for their professional action. Nursing Code of Ethics written by professional organizations. Purposes of Code of Ethics are to: ▪ Inform the public about minimum standard of the profession ▪ Help to understand professional nursing code of conduct. ▪ Provide ethical standard for professional behavior. ▪ Guide the profession in self –regulation. ▪ Remind nurses of the special responsibility they assume when caring for the sick. 36 There are Four Formal Nursing Codes of Ethics: 1. The International Council of 2. The American Nurses Nurses (ICN) 1953. Association (ANA), which adopted the first code of ethics 3. The Australian Code of 4. The Canadian Code of Ethics for Nurses (ACN). Ethics for Nursing (CCN) adopted the first code of ethics in 1980. I- International Council of Nurses (ICN) 1953: The ICN 1953 established and published the first code of ethics for Nurses in which identified the four fundamental responsibilities of Nurse, which include: (1) Promoting health; (2) Prevent illnesses; (3) Restore health; and (4) Alleviate suffering. The ICN discusses the ethics of being compassionate ‫رحمة‬, respectful, nonbiased, working as an advocate, respecting spirituality, sustainability and more. 37 II- The American Nurses Association (ANA): It publishes the most widely used and accepted Code of Ethics for Professional Nurses. Its nine major principles that: 1. Patient dignity. 2. Commitment to a patient. 3. Optimum patient care. 4. Patient’s rights. 5. Integrity and continued growth. 6. Advancement of nursing profession. 7. Improved health care environment and employment. 8. Professional and public collaboration; ‫لمهنية والتعاون العام‬.and ‫ الحفاظ‬9. Maintenance of values and integrity and shaping social policy. ‫على القيم والنجاهة وتشكيل السياسة االجتماعية‬ ANA Code of Ethics Key Points: ▪ Primary commitment is to patient (individual, family or community) ▪ Demonstrates compassion and respect for all patients regardless of patient status. ▪ Promotes the health and welfare of patients. ▪ Accountable for individual practice. ▪ Maintains and increases own knowledge base. ▪ Works to improve healthcare environment for providers and patients. III- The Australian Code of Ethics for Nurses (ACN): It sets a national standard of conduct for nurses, and is closely related to the American version. It addresses ethical issues like: 38 (1) Dignity. (2) Values. (3) Honesty. (4) Professionalism. (5) Culture. (6) Beliefs. IV- The Canadian Code of Ethics for Nursing (CCN): It defines ethical nursing care in Canada, which is also related to the American and Australian Codes of Ethical issues covered; also include: 1. Safety. 2. Competence & Compassion; and 3. Issues in different scenarios such as: o Pandemics. o Relationships. o Conflicts or natural disasters. Elements of the ICN Code of Ethics: 1. Nurses and people. 2. Nurses and practice. 3. Nurses and the profession. 4. Nurses and co-workers. 5. Nurse and Society. 1. Nurses and People: The nurse: Her Primary professional responsibility is to: Provide care; and Promotes an environment in which the a. Human rights b. Values. c. Spiritual beliefs of the individual, family and community are respected. 39  ▪ Ensures that the individual receives sufficient information on which to base consent for care and related treatment. ▪ Shares responsibility to sustain and protect the natural environment from depletion, pollution, degradation and destruction. 2. Nurses and Practice: The nurse should: ▪ Carry personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. ▪ Maintain at all times the standards of personal conduct, which reflect well on the profession and enhance public confidence. ▪ Ensure when providing care that, use of technology and scientific advances are compatible with the safety, dignity and people’s rights. 3. Nurses and the Profession: The nurse should: Determine and implements acceptable standards of clinical practice, management, research and education. ▪ Be active in developing a core of research-based professional knowledge. ▪ Participate in creating and maintaining equitable social and economic working conditions in nursing. 4. Nurses and co-workers: The nurse should: ▪ Sustain a co-operative relationship with co-workers in nursing and other fields. ▪ Take appropriate action to protect individuals when their care is endangered by a co-worker or any other person. 5. Nurse and Society: ▪ The nurse shares with other citizens the responsibility for initiating and supporting actions to meet the health and social needs of the public. ***************************** 40