INDEX PAGENO

SNO.
1. INTRODUCTION 02
2. DEFINITION & MEANING 03
3. PURPOSE 03
4. TERMINOLOGY 04
5. CODE OF ETHICS 05
6. EVOLUTION OF CODE OF ETHICS 06
7. ELEMENTS OF CODE OF ETHICS 07
8. USES 07
9. ETHICAL CONSIDERATION 07
10 ETHICAL PRINCIPLE 08
11 INDIAN CODE OF ETHICS 09-11
12 CODE OF PROFESSIONAL CONDUCT 11
13 ASSERTIVNESS 12-14
14 LEGAL CONSIDERATION 15-16
15 NURSING LIABILITES 16
16 LAW 16-17
17 LEGAL IMPLICATIONS 17-18
18 DO & DON`T 19
19 RIGHT OF CONSUMER 19
20 LEGAL RESPONSIBILITY 19
21 VISIBILITY OF NURSES 20
22 NURSE ROLE 23
23 SUMMARY 24
24 BIBLIOGRAPHY 25

1
 CODE OF ETHICS

INTRODUCTION
Nursing has a code of ethics that defines by which nurse provide care to the clients. In addition, nurse
incorporates their own values into practice.

The code of ethics for nurse with interpretive statements provide a guide for carrying out nursing
responsibility that provide quality nursing care and provides for the ethical obligations.

The word ethics comes from the Greek word ‘ethos’ meaning customs or guiding beliefs. Ethics are
characteristics of a profession and are called a ‘code’.

the code of ethics will state what kind of conduct is expected from the members of a profession , what
are the responsibilities of its members towards those whom they serve, their co workers , the
profession and the society as a whole.

When a person become a member of a profession, he accepts the responsibility of living up to the code
of that profession. It should be understood that a code of ethics is not a strict set of rules.

Ethic include personal behaviors and issues of characters, e g Kindness, tolerance and generosity.
ethics are distinct between right and wrong based on a body of knowledge, not just based on opinion.

Ethics in nursing is a set of guidelines formulated by the members of profession with the help of
profession with the help of specialist in the field of nursing leaders , advocate lawyers at times
members of the society.

An international code of ethics for nurses was first adopted by the (International council of nurses)
ICN in 1953. The need of nursing code is universal.

 Inherent in nursing is a aspect for human rights , the rights to life and choice to dignity and to
be treated with respect .Ethical codes are systematic guidelines for shaping ethical behavior
that answer question of what beliefs or values should be accepted.

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DEFINITION:

A Code of ethics is a formal statement of group`s ideas and values.

MEANING OF ETHICS

A Branch of philosophy, means different to all, originally ethics is the study of ideals human behavior
and ideal way of being.

A Ethics is a systematic approach to understand , analyzing and distinguishing matters of rights and
wrong , good and bad and admirable and deplorable as they exist along & related to well being.

PURPOSES
 Standards for the behaviors' of nurses & provide general guidelines for nursing action.
 Helps to distinguish between right and wrong.
 Enables a correct decision.
 Protect the rights of individuals.
 Guide professional behavior
 Helps teacher to teach what must be taught in the education of the nurse.
 Helps to prevent a nurse from practicing if his/her conduct is poor.
 To protect a nurse who is falsely accused of doing something wrong.
 Acknowledge the rightful place of individuals in health care delivery system
 Contributes towards empowerment of individuals to become responsible for their health and
well being.
 Contributes to quality care.
 Identifies obligation in practice, research and relationship.
 Informs the individuals, families, community and other profession about expectation of a
nurse.

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 TERMINOLOGY

1. PROFESSION
A Profession is derived from a word profess means to proclaim something publicly profession
means something better than people they serve & who need their services.

2. CODE OF ETHICS
Within any given profession, a code of ethics serves as a mean of self regulation and a source of
guidelines for individual behavior and responsibility.

3. PROFESSIONAL CODE OF ETHICS

They are a system rule and principles by which that profession is expected to regulate its
member and demonstrate its responsibility to society.

4. ETHICS:
Moral principles that govern a person`s behavior or the conducting of an activity or branch
of knowledge that deals with moral principles.
5. LAW:
Law is a system of rules that are created and enforced through social or governmental
institutions to regulate behavior.

6. LEGAL RESPONSIBLITIES:
A measure of mental capacity, used in deciding the extent to which a person can be held
accountable for a deed.

7. LEGAL ISSUES:
Issue of law is a legal question which is the foundation of a case or a point on which the
evidence is undisputed, the outcome of which depends on the court interpretation of law.

8. ACT: Taken action or to do something.

9. LEGISLATION:
The process of making or enacting law.

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CODE OF ETHICS

According to International council of nurses

TO ALLEVIATE
SUFFERING

TO PROMOTE ILLNESS

TO RESTORE HEALTH

TO PREVENT ILLNESS

NEED OF NURSING
 RESPRCT OF DIGNITY
 UNIVERSAL
 PROTECT RIGHTS OF MAN
 INHERENT IN RESPECT OF LIFE
 RESPECT OF DIGNITY

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NURSING CODE OF ETHICS
Nursing ethics states that duties & obligation of nurses to their clients, other
obligations of nurses to their clients, other health professional, the professionals, the profession and
the community.

Nursing ethics provide standards for professional behaviour & is the study of principles of right &
wrong conducted for nurses.

EVOLUTION OF ICN CODE OF ETHICS

Nursing profession uses codes for nurses ethical concepts applied to using as it guide for professional
conduct. This code is adopted & published by ICN.

The first such code of ethics, called the International code of nursing ethics

International Council of nurses at Sao Paulo, Brazil in 1953(first code was adopted).

 Later revised in Frankurt, Germany in 1965 & then become known as ICN code of ethics.
 Most recent revision in 1973 took place in Mexico & result in the presence code for nurses.
 It has been revised and reaffirmed at various time since, most recently with review & revision
completed in 2005.

ELEMENTS OF THE CODE

NURSE & PEOPLE

 Primary responsibilities of nurse is to provide care to needy.
 Nurse provides care; promote an environment in which values, costumes and spiritual beliefs
are respected.

NURSE & PRACTICE

 The nurses carries personal responsibility for nursing practice for maintaining competence
by continuing learning.
 The nurses uses judgment in relation to individuals competence when accepting &
delegating & delegating responsibilities.

NURSES & SOCIETY

 NURSES share the responsiblites for initating & supporting action to meet the
health and needs of the public

NURSES & COWORKERS

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 Nurses sustain a cooperative relation with coworkers in nursing & other field.
Nurses take appropriate action to safeguard individuals when his care is endanger.

USES:

 Acknowledge the rightful place of individuals in health care delivery system.

 Contribution towards empowerment of individuals to become responsible for
their health & well being.
 Contributes to quality care.
 Informs the individuals, families, community & other professional about
expectation of a nurse.

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 ETHICAL ISSUES

.
UNCERTAINITY: INDIVIDUAL IS UNSURE ABOUT WHICH IS
MORE APPLIED & PROBLEM IS UNCLEAR.

DISTRESS: INDIVIDUALS KNOW THE RIGHT THING BUT THE

ORGANIZATION CONSTRAINT MAKE DIFFICULT TO TAKE
THE RIGHT ACTION.

OUTRAGE: INDIVIDUAL WITTNESS IMMORAL ACT BUT FEELS

POWERLESS TO STOP IT.

ETHICAL DILEMMA: CHOOSING BETWEEN TWO OR MORE

UNDESIRABLE ALTERNATIVE & ATTEMPT TO SELECT LEAST
DAMAGING ONE.

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ETHICAL PRINCIPLES
AUTONOMY; FREEDOM OF VERACITY:OBLIGATION TO
CHOICE OR ACCEPTING TELL TRUTH
ONE`S CHOICE. INFORMED
CONSENT IS DIRECTLY
RELATED TO AUTONOMY
SO PATIENT CONSENT IS
REQUIRED FOR: ACTION
BENEFICENCE FIDELITY: KEEP PROMISE &
TREATMENT
TAKEN .
SHOULD BE IN COMMITMENTS
EFFORT TO PROMOTE THE
GOOD.

NON-MALIFECENCE JUSTICE: EQUALITY & FAIRLY

NO ONE SHOULD BE HARM

(HARM MEANS EMOTIONAL,
SOCIAL & PHYSICAL INJURY)

ACCOUNTABILITY CONFIDENTALITY:
A
ANSWERABLE FOR ACT DUTY TO RESPECT PRIVILGED
INFORMATION

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RESPECT FOR PERSON
 It direct individuals to treat themselves and other with a respect inherent to man`s
humanness.
 It requires recognition on a sense that all share a common human dignity.

ACCOUNTABILITY
 Accountability refers to ability to answer one`s own action. The nurses balance accountability
to client, the profession, the employer & the society.
 Accountability means being answerable for acts carried out in performance of one`s
professional role.
 Domain of accountability.
 Professional accountability
 Organizational accountability
 Legal accountability.
 Individual accountability.
 RESPECT FOR FREEFDOM

RESPECT FOR AUTONOMY

 Autonomy is defined as freedom to make prudent & binding decision consistent with
scope of one`s practice.
 Freedom to implement decision respect for another`s autonomy is fundamental to
respect /practice health care.
 Serve to justify the inclusion of client in all aspect of decision making regarding health
care.

 Nurses as a group believe that patient should have a greater freedom of choice within the
nations health care system.
 Principle should be observed by staff nurses when planning patient care, by nurse manager
when planning patient care, by nurse manager when leading sub –ordinates.

BENEFICENCE

 Beneficence refers to take positive reaction to help others. The practice of beneficence
encourage the urge to do good of others.
 Commitment to beneficence helps to guide difficult decision where in benefits to a
treatment may be challenged by risk to clients well being or dignity.

NON-MALEFICENCE

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 Non – maleficence is the avoidance of harm or hurt. In health care ethics it is important
to remember that ethical practice involves not only the will to do good , but also the
equal commitment to do no harm.
It promotes a continuing effort to consider potential harm even when it is necessary to
promote health.

VERACITY
 Veracity concern truth feeling & in- corporation concept that individuals should
always tell the truth.
 It requires professional care given to provide accurate, reality based information
about their health status & care of treatment.

JUSTICE
 Issues that person should be treated equally & fairly.
 Justice means that treating others fairly & giving persons their due.

FIDELITY

 Keeping one`s promise or commitment fidelity holds a person should faithfully fulfil his
duties & obligation

CONFEDENTALITY
 Care giver should respect a patient need for privacy & use personal information about
him or her to improper care.

CODE OF ETHICS FOR NURSES IN INDIA

THE nurses respect the uniqueness of individuals in provision of care.

 Provide care for individual without consideration of caste, creed, religion, culture,
ethnicity, gender, socioeconomic & political status, personal attributes or any other
ground.
 Individuals care considering the beliefs, values & cultural sensitivities.
 Develops and promotes trustful relationship with individuals.
 Recognizes uniqueness of response of individuals to intervention & adopts accordingly.
 Appreciates the place of individuals in family & community.
1. NURSES respect the right of individuals as partner in care & help in making informed choices.
 Appreciate individual rights to make decision about their care & therefore give adequate and
accurate information for enabling them to make informed choices.
 Respect the individual decision regarding care.
 Protect public from misinformation & misinterpretation.
 Advocate special provision to protect vulnerable individuals /group.

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 2. NURSES respect individual right to privacy, maintain confidentiality & information
judiciously.
 Respect the individual right to privacy of their professional information.
 Maintain confidentiality of privileged information except in life threatening
conditions.
 Take informed consent & maintain annoyminity when information is required for
quality assurance /academic /legal reason.
 Limit the access to all personal records written and computerized to authorized
person only.

4. Nurses maintains competence in order to render quality nurses care

 Only registered nurses must provide nursing care.

 Nurses strive to maintain quality nursing care & upholds standards of care.
 Nurse values continuing education, initiates & utilizes all opportunities for self development.
 Nurses values research as a means of development of nursing research adhering to ethical
principles.

5. Nurse is obliged to practice within the frame work of ethical, professional & legal
professional &legal boundaries.
 Adhere to code of ethics & code of professional conduct for nurses in India developed
by Indian nursing council
 Familiarizes with relevant laws& practice in accordance with the law of the state.

6. Nurse commits to reciprocate the trust invested in nursing profession by society.

 Demonstrate personal etiquettes in all dealings,

 Demonstrate professional attributes in all dealings.

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CODE OF PROFESSIONAL CONDUCT;

MAINTAIN
PROFESSIO
NAL
STANDARD
IMPROVE
SELF
CURRENT
WORTH
PRACTICE
PROFESSIO
NAL
RESPONSIB
LITY &
ACCOUNTA
BILITY
AVOID
COMPASSI-
HARMFUL
ONATE
PRACTICE
FOLLOW
INDIAN
NURSING
COUNCIL

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 RESPECT
MUST PROVIDE INDIVIDUAL& CONSULT
RESPECT
CARE IN RELATED FAMILY ALONG ENSURE SAFE COORDINATE
HUJMAN
TO STANDARD WITH THE PRACTICE
DIGNITY COLLABORATION
PRACTICE CULTURE &
TRADITION

NURSING PRACTICE

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ASSERTIVNESS
Assertiveness is not a particular form of control .it is not a power. It is better described as art of
confident clear honest & direct communication.

Assertiveness is non-aggressive non-defensive &non –manipulative & do not interfere with other people
freedom to take decision.

CHARACTERISTICS

 Self presentable
 Ability to share
 Good attitude towards work
 Fearless expression
 Straight forwardness
 Self control

ASSERTIVNES COMMUNICATION

It is way of communication that allow people to express themselves, direct ,honest& appropriate way
that don’t infringe on another person`s right.

ASSERTIVE BEHAVIOUR
 Standing up for one`s right no matter what circumstances are.
 Correcting situation when one`s right are violated.
 Seeking respect & understand for one`s feeling about particular situation.
 Interacting in a mature manner with those found to be offensive, defensive, aggressive, hostile,
blaming attacking.
 Verbal ‘I’ statement, where individual tell others how they feel about others a situation,
circumstances or the behaviors of others.
 Taking risk of being misunderstood as aggressive, abrasive or attacking.
 Being able to protect ones right while protecting & respecting the rights of others.
 Risk Taking behavior that is not ruled by fear of rejection or disapproval but is directed by
rational belief that “ I deserve to stand up for my rights”.
 Rational thinking & self affirmation of personal worth respect & rights.

LEGAL ASPECTS IN NURSING:

Professional nurse understand the legal limits influencing daily practice. Nurse must
understand law to protect client`s right. It help to understand what is expected by our
society from nursing care providers. The purpose for legal knowledge for nurses are;
 To understand the legal responsibilities in nursing practice.
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  To understand what the legal responsibilities can be enforced.
 To understand what area of nursing practice can mostly create logical problems.

LAW: Law means body of rules to guide human action. Law defined as the sum total of manmade
rules and regulations by which society is governed in a formed or binding manner.

Sources of law

1. Constitutional law: It is a system of fundamental law or principles that govern a nation, society,
corporation or another aggregate of individual.
SATUTORY LAW: it is passed by legislative body or parliament of state in accordance with
constitutional law. It regularize, relationship between citizen and state, between individuals and
group and between individuals and other.
Ex. State statue are the nurse practice act. These nurse practice act describe and define the legak
boundaries of nursing practice with each other.

Types of statutory law:

 Criminal law
 Civil law
 Criminal law
It prevents harm to society and punishment for crimes
FELONY: felony is a crime of a serious nature that has penalty of imprisonment for greater than 1
year or even death.
MISDEMANOR:
Misdemeanor is a less serious crime that has a penalty of a fine or imprisonment for less than 1
year.
CIVIL LAW: It protect the rights of individual person with in our society and encourage fair and
equitable treatment among people.
2. REGULATORY LAW OR ADMINISTRATIVE LAW:
It is created by administrative bodies such as state boards of nursing when they pass rules and
regulations.
Ex, regulatory law is due to report in completed or unethical nursery conducted to the state board
of nursing.
3. COMMON LAW:

It is created by judicial decision made in the courts when individual legal cases are decided ex.
Common law is informed consent and the client right to refuse treatment.

LEGAL ASPECT RELATED TO NURSING

IN CENTRAL LEVEL:

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The Indian nursing council is only legislation related to nursing. It prescribes curriculum for nursing
education and recognize qualification of institution with teaching program for nursing

STATE LEVEL

The State government control through state nurses registration act . It prescribe rules of conduct to take
disciplinary action and to maintain registration for nurse, midwifes and others.

LEGAL CONSIDERATION

 FIRST nursing law, Nursing registration-1903

 Indian nursing council act enacted in 1947.
 Amended in 1957

LEGAL IMPLICATIONS
 TORTS: Torts are Legal wrong made against a person.
 TYPES OF TORT

It may be classified into intentional and unintentional torts.

1. INTENTIONAL TORTS

They are willful acts that violate another`s right .example are assault, battery, invasion of privacy
and defamation of character.

Assault: Assault occurs when a person put another person in fear of a harmful or offensive contact.
The law protects client who are afraid of harmful contact. It is an assault for a nurse to threaten to give a
client an injection or to threaten to restrain a client for an x-ray procedure when the client has refused
to do so.

A. BATTERY: Intentional touching of another`s body without other`s consent. The contact can be
harmful to client and cause an injury or it can be merely offensive to the client`s personal dignity.
Example; client give consent for appendectomy & physician perform tonsillectomy.

B. INVASION OF PRIVACY

The tort of invasion of privacy protect the client`s right to be free from unwanted intrusion into his or
her private affairs.

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Example; release of a clients medical information to an unauthorized person, such as member of the
press or the client`s employer.

C. DEFAMATION OF CHARACTER;

Defamation of character is the publication of false statements that result in damage to a person
reputation these are two types:

1. Slander defamation is in the form of spoken words.

2. Libel defamation is in the form of written words.

 UNINTENTIONAL TORTS

A. NEGLIGENCE: Negligence is conducted that fails below the standard of care. The standard of
care is established by law for the protection of other an unreasonably great risk of harm.
For examples:
 Medication error that result in injury to client.
 Intravenous therapy errors resulting in infiltrations or phlebitis.
 Burns to clients caused by equipment, bathing or spills of hot liquids and foods.
 Fails resulting in inquiry to clients.
 Failure to use antiseptic when required .
 Errors in sponge instruments or needle counts in surgical cases.
 Failure to give a report or giving an incomplete report, to an oncoming shift.
 Failure to adequately monitor a client`s conditions.
 Failure to notify a physician of a significant change in a client`s status.

B. MALPRACTICE: Failure to meet standards of acceptable care which result in harm to another
person.
C. BREACH OF IDEAS: Breach of duty may occurs when a nurse fails to act in accord with the
standards of care. An act of commission or omission of the nurse may constitute a breach of
the standard of care.
D. FRAUD: It result from a deliberated deception intended to produce unlawful gain.
E. FALSE IMPRISONMENT: Occur when a client is not allowed to leave a health care facility when
there is no legal justification to detain the client or when restraining devices are used. ex.
Telling a client not to leave the hospital until the bill is not paid.
F. FRAUD: fraud result from a deliberate deception intend to produce unlawful gain. Example
fraudulent billing practice include overcharging for services and billing services that were not
provided.
G. INVASION OF PRIVACY: Includes violation confidentiality, intruding on private client or family
matters & sharing client information with unauthorized person.

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 H. SAFETY:

The promotion of physical safety is one of the most important responsibilities of the nurse. There are
four areas regarding client safety in which nurse are legal

RISK

I. Failure to monitor client status.

 Medication errors
 Falls
 Use of restrain

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 SOME DO & DON`T
 Do document all unusual incidences.
 Do keep current year license to practice.
 Do follow policies & procedures.
 Do protect patient`s from injury themselves.
 Do not accept money or gift from patient`s.
 Do not give advice that is contrary to doctor`s or the nursing care plan.
 Do not witness a patient`s will.
 Do not work as a nurse without license.

LEGAL RIGHTS OF NURSE

 Right of appointing and assigning.
 Right of quality control.
 Right of using equipment.
 Right to care public.
 Right for observation and reporting.
 Right for record keeping.

RIGHTS OF A CONSUMER

 Right of safety.
 Right to be informed.
 Right to choose
 Right to be heard
 Right to consumer education
 Poison care
 Artificial human insemination
 Dying declaration.

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LEGAL DOCUMENTS

a) ADVANCE DIRECTIVE: Written document recognized by law that provide direction concerning
provision of care when a person is unable to make his or her own treatment of choices.
b) DO NOT RESUCITATE ORDERS. : Written orders by a physician when clients has indicated a desire
to allowed to die if client stops breathing or client`s stop breathing or client`s heart stop beating.
c) INFORMED CONSENT: It is client`s approval for that of client`s legal representation to have his
own or her body touched by a specific individuals.

LEGAL RESPONSIBILITY:

Legal responsibility in nursing means to practice nursing within the guidelines laid down by law of
centre/ state, statutory bodies and policy.

 Registration: licensing is mandatory, helps in protecting patients by providing qualified nurse. The
nurse should register as per state nursing act.
 Legal liability/ act of negligence: license of a nurse can be suspended or cancelled for any act of
negligence or malpractice.
 Medico legal cases: a patient admitted with some unnatural pathology and has to be taken care
of in concurrence with police/court.
 Road traffic accident
 Injuries due to fights, shooting, bombs, blast etc.
 Suicide
 Burn
 Poisoning
 Rape victim
 Assault
NURSE ROLE IN SUCH CASES:
 Obtain complete history.
 Inform police/ constable on duty.
 Record on patient sheet with red ink at right hand top
 When pt is discharge inform CMO.
 If patient abscond inform the CMO immediately and treating doctor.
 No patient can leave against medical advice.
 Document accurately & duly sign the nurses note.
 Record all document and carefully handled.
 Do not handle dead body to relatives In case of death of MLC patient
 CORRECT IDENTITY: all baby born in hospital are correctly labeld at birth and handed over
to right patient.
 Unknown pt should be labeld as soon as identity is known
 Site of operation should be marked correctly.
 LAMA: Inform medical officer incharge. signature of both patient and relative should be
taken.
 Patient`s property: inform pt that hodpital will not take care of their belonging. If pt is
unconscious make list of pt articles counter check by two nurse and the keep them safely.

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  DYING DECLARATION: nurse should not involve herself . it is done by magistrate. But in
emergency medical officer can record it with two nurses as witness.
 RAPE VICTIM: Female attendant should be present during examination.
 ARTIFICAL HUMAN INSEMINATION:
 Written consent from both donor & recipient.
 Same blood group
 Confidential & safe recording

 POISON CARE:
 Do not give verbal or written order.
 Do not allow for photos unless permission by authorities.
 Do not give information to public or press
 Preserve all evidence of nursing.
 Collect & preserve all excreta, vomits and aspirations & send them to forensic laboratory at
earliest.

NURSING LIABILITES & PREVENTIVE MEASURES

 All nursing observations should be noted carefully, accurately.
 Patient`s complaint should be recorded as accurately & specifically.
 Nurse must report through proper channel.
 Authorities must be informed regarding any kind of equipment, materials or supplies, which for
any reason less than safe for use in patient`s care
 Insurance protection

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VISIBLITY OF NURSES

 A quality or fact of degree of being visible.

 Degree of exposure to public notice.
 Nurse themselves are responsible when they don’t take a stand neither to correct the distorted
images not for visibility of role they have performed in health care

NURSES ROLE TO PREVENT COMPLICATIONS

 Review nursing practice periodically update knowledge & improve skill by attending short term
course.
 Should posses all knowledge and facts all rules & regulations of hospital & know descriptions.
 Follow nursing practice standards /protocol.
 Be a keen observer.
 Written instruction must have rules & code of practice to ensure safety & well being of patients.
 Maintain records & report of unit properly.
 Check the treatment order & use professional judgment.
 Follow all rights.

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 SUMMARY:
A code of ethics is a formal statement of group ideas and values. A branch of philosophy means
different to all, the study of ideas human behavior and ideal way of being.

24
BIBLIOGRAPHY:
1. Vestal k. w nursing management & issues 2nd ED. Philadelphia
Lippincott 1995 page no. 87-100.
2. Bowman Michael the professional nurse 1st edition. London
chap man & hall 1995 page no 64-84.
3. Potter , Patricia A. fundamental of nursing 7th edition Elsvier
2009 page no 9,315
4. Annzwemer professional adjustment for nurses in India 6th
edition (2006) page no 139-145.

5. Barbara kozier (2006) fundamentals of nursing, concept

process & practice 2nd edition New Delhi page no 111-118.
6. Suzzane c. smelter (2009) Brunner & suddharth`s text book of
medical surgical nursing 11th edition , New Delhi page no 27-
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7. http // www.ncbi.nin. nim. Ningov/pubmed.
8. http // www.bella online. Com / articles/art.
9. http // www.123 helpline. com / preview
10. http // www.slide share.net
11. http // www.scrib. Com
12. www. Nursing world. org// code of ethics for nurses.
13. www.icn ch/about-icn/ code of ethics for nurses.
14. www.ncbi nim.gov pubmed.
15. www dsrdk /ser document / icn code of English pdf.

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