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The American Nurses Association Code of Ethics: a reflection on the ethics of respect and human dignity with nurse as expert.

The American Nurses Association Code of Ethics for Nurses calls for the nurse to practice with compassion and respect for every individual. What are the ethics and challenges of practicing professional nursing with expertise and educating a new generation of nurses while incorporating the interpretive statements into practice? This column differentiates the traditional biomedical views on human dignity and respect while exploring the embedded ethics of respect and self-determination and what it truly means to be an expert of nursing from the theoretical perspective of the human becoming school of thought.

American Nurses' Association↗

Evolution of the American Nurses' Association Code for Nurses with interpretive statements: explications for perioperative nurses.

Although the need for ethical standards in the nursing profession has been recognized since as early as 1903, not until 1950 was a code of ethical principles adopted by American Nursing Association (ANA) members. The AORN Special Committee on Ethics was formed in 1991 to identify ethical issues in perioperative nursing and recommend educational strategies for addressing them. Formulation, publication, and distribution of the ANA Code for Nurses with Interpretive Statements--Explications for Perioperative Nurses resulted from the work of this committee.

American Nurses' Association↗

Nursing and genetics: applying the American Nurses Association's Code of Ethics.

A professional code of ethics is essential for behaviors to be reinforced in any discipline. The American Nurses Association (ANA) has established a code of ethics for nurses to use as a framework for making ethical decisions with all aspects of health care delivered to the public. With the explosion of genetic discoveries, nurses and clients are facing new ethical dilemmas. It is important for nurses to understand how to use the ANA Code of Ethics when faced with the many complexities of ethical issues involving genetics and health care. This article illustrates how the ANA Code of Ethics can be applied in nursing practice to establish professional behaviors related to ethical issues and genetics.

Adolescent↗

Capital punishment and professional nursing.

This paper examines the issue of capital punishment and whether a professional nurse has the right to choose to participate in it. Capital punishment is an extremely emotional ethical issue, and there is abundant literature to support both viewpoints. Professional nursing upholds values and special moral obligations, as expressed in its code. The American Nurses Association Code for Nurses guides conduct in carrying out nursing responsibilities consistent with the ethical obligations of the profession.

Capital Punishment↗

The American Nurses' Association's Code for Nurses: purposes, content, and enforceability.

Using Levy's criteria of appraisal for a code of professional ethics, this article assesses the 1976 American Nurses' Association's Code for Nurses with Interpretive Statements in terms of purposes, specificity, inclusiveness, and enforceability. The assessment shows that the Code for Nurses meets generally accepted purposes for a code, contains enough specificity and inclusiveness to serve as a useful guide to professional conduct, and describes initial and follow-up action nurses can take when they witness questionable or inappropriate conduct that may adversely affect the patients' health care or safety. However, limited data are available regarding how the professional body has applied sanctions for violations of the Code. Further study on this matter is indicated and, fortunately, is forthcoming by ANA in an ongoing, planned survey.

American Nurses' Association↗

A case study of the death of an older woman in a nursing home: are nursing care practices in compliance with ethical guidelines?

This article presents a case study describing and analyzing ethical issues in the care during the last 11 weeks of life of a 101-year-old nursing home resident. The case presented here is part of a larger ongoing ethnographic study of death and dying in nursing homes. Two nursing care issues with ethical implications are discussed. First, the resident could not eat or drink independently, but she received no assistance with her meals. Second, she remained in a wheelchair for many hours and developed three pressure ulcers on her buttocks. Furthermore, she became tired when sitting in the wheelchair for long periods of time, fell out of the wheelchair, and subsequently was restrained "for her safety." Using selected principles from the International Council of Nurses and the American Nurses Association code for nurses, the resident's care is discussed and recommendations for improving the care of nursing home residents are presented.

Accidental Falls↗

Unreconciled inconsistencies: a critical review of the concept of social justice in 3 national nursing documents.

A critical review of the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, Nursing's Social Policy Statement, and Nursing: Scope and Standards of Practice provides evidence that these documents present an inconsistent, ambiguous, and superficial conceptualization of social justice, and do not offer an adequate framework for nurses to address underlying issues that affect health outcomes. Despite expansive references to the historic role of nursing in social reform, the documents implicitly reinforce nursing practice directed toward the individual nurse-patient relationship and give short shrift to nursing models that endorse broad systems change intended to improve health.

American Nurses' Association↗

The sources of a practice code of ethics for nurses.

Interviews with a convenient sample of 27 master's-prepared nurses working in two clinical settings revealed that none of them knew the content of the American Nurses' Association Code for Nurses. A content analysis developed four sensitizing experiences that were sources for their code of nursing practice. These were categorized as: (a) clinical, (b) personal, (c) research, and (d) professional socialization as a student.

Awareness↗

A study of values of baccalaureate nursing students and graduate nurses from a secular and a nonsecular program.

This study examined the relationship between professional values of senior baccalaureate nursing students and graduate nurses compared to the values reflected in the Code for Nurses. A questionnaire was completed by 199 students and graduates of a secular and a nonsecular university. Data were analyzed using content analysis, frequency distributions, and multivariate procedures. Findings indicated that values identified most frequently by all respondents related to patient care issues rather than social issues of the profession. Analyses showed no significant difference in value identification between respondents from the secular and the nonsecular institutions. Implications for nursing education, nursing service, and future research are also discussed.

Adult↗

Codes of ethics and scientific integrity: what relevance to outcomes activities?

Advanced practice nurses are involved in many activities that focus around "outcomes." As nurses participate in the public presentation of outcomes data and information, expectations for ethical and responsible behavior are heightened. This article examines dilemmas that exist for advanced practice nurses involved in outcomes activities within the context of the American Nurses Association code for nurses, the bioethics literature, and published guides to scientific integrity. Recommendations are made to address these dilemmas.

Ethics, Nursing↗

A concept analysis of dignity for older adults.

BACKGROUND: Human dignity is an essential value of professional nursing education as well as a component of the American Nurses Association Code of Ethics. Nurses are exhorted to treat patients with dignity, and older adults want to be treated with dignity and die with dignity. Although dignity, particularly the dignity of older adults, is often discussed in the health care literature, its meaning is not always clear. AIM: The aim of this paper is to describe a concept analysis to develop a definition of dignity in older adults. METHODS: Data were collected using a literature review and five focus groups composed of older adults. The literature provided data about professionals' ideas of dignity and the focus groups provided qualitative data about the nature of dignity in older people. The literature review and focus groups were carried out concurrently, followed by synthesis of the findings. FINDINGS: Dignity is an inherent characteristic of being human, it can be subjectively felt as an attribute of the self, and is made manifest through behaviour that demonstrates respect for self and others. Dignity must be learned, and an individual's dignity is affected by the treatment received from others. CONCLUSIONS: A behavioural definition of dignity was constructed and this could provide the theoretical basis for nurses to develop interventions that foster dignity for older people.

Aged↗

Commentary on "Waiting in Araf". Informed consent: issues and regulations.

Children have the right to safety and appropriate consideration of their physical, emotional, and psychological needs in regards to treatment or research decisions. Parents have an equal right to be honored in their parenthood and respected for what they would want as the best thing for their child as a member of the family. When children are mature enough, they should be offered the opportunity of assenting or dissenting to research participation. Until such time, parents may make what they feel to be the best decisions. If a nurse feels that these principles are being violated, he or she should attempt to seek further clarification. In order to obtain information about an ongoing research project, it would be appropriate to contact the IRB or a member of the hospital ethics committee. In most cases, a satisfactory explanation will be found. In the rare case that patient's rights are truly being violated, the American Nurses Association Code of Ethics requires that nurses report incompetent, unethical, or illegal practices (ANA, 1994). Nurses who "whistle-blow" may or may not be protected against retaliation. Some states in the U.S. have developed laws that prohibit the discharge of an employee who reports unethical practices. One might expect that in some countries a nurse might not only endanger her position for such reporting but endanger his or her life as well. Ulusoy reports on research done on children without knowledge or consent of parents. Although this case took place long ago, it is certain that there are still countries in which informed consent is undeveloped and such practices continue. Nurses in developed countries with established consent policies can be hopeful that such activity is no longer seen here. As international collaboration in nursing research grows, nurses in developed nations can work to provide educational opportunities regarding the consent process for colleagues across the globe.

Adult↗

Ethical issues surrounding informed consent: Part III. The crucial role of nursing in insuring valid consent.

Three ethical principles upon which informed consent is founded are respect for persons, promotion of the best consequences, and rights. A valid informed consent--that is, one given by a person who has been informed, is competent, and has not been coerced--is one way of respecting persons, of enabling their rights. Consent given in the absence of information and competence, or in the presence of coercion, does not achieve these ends. Hence, it is not valid. The nurse is in a unique position to ensure the validity of consent. Nurses do this both by enhancing patients' opportunities for becoming informed and by observing for signs of incompetence and coercion. When the ability of a patient to execute a valid consent is compromised, the nurse needs to act to restore the patient's decision making capacities to the greatest level possible. Nursing's efforts in promoting morally valid consents are one way the profession recognizes the importance of each individual. This importance has been formally acknowledged by the American Nurses Association Code of Ethics (6). It is informally acknowledged when individual nurses act to maximize their patients' understanding and participation in the decisions surrounding health care. In helping patients to participate to the fullest possible extent, nurses show respect for the very unique human nature we all share. It is for this reason that insuring informed consent is worth whatever time and effort it takes.

Ethics, Nursing↗