Code of Ethics:: Presented by DR Nilima Sonawane

CODE OF ETHICS: The
Guiding Principles For Nursing Professionals
Presented by
Dr Nilima Sonawane
Institute of Nursing education, sir J J
Hospital campus , Mumbai India
Lets speak about nursing
“Nursing is an art; and if it is to be made an art, it
requires as exclusive a devotion, as hard a
preparation, as any painters or sculptors work;
for what is the having to do with dead canvas or
cold marble, compared with having to do with the
living body - the temple of Gods spirit? It is one
of the Fine Arts; I had almost said the finest of
the Fine Arts.”
- Florence Nightingale
Nursing …..
Universal.
Working for a noble cause.
Dealing with human life.
Respect for human rights, including cultural
rights.
Right to life.
Treating client with dignity.
Care to humanity.
Nursing is a noble profession
Based on the criteria that a profession must have
 Service provided is vital to humanity and welfare of society
 Special body of knowledge
 Intellectual activity
 Accountability
 Educated in institutions
 Relatively independent: autonomy.
 Motivated by job / service
 Code of ethics: to guide decisions
 Organization (association): to encourage and support
practice
Kelly: - 1981
Ethics : Greek word ethos’= character
Webster dictionary = The science of moral
duty or ideal human character’
 Ethics – Philosophical ideals of right and
wrong behavior.
Tells us how human beings should behave
Personal standards of conduct, or attitude
It is a science of ideal human behaviour

Essence of ethics is……
Personal goodness
Moral behaviour
Righteous
Justice
Honesty
Rules and Regulation of
conduct
Principles
Attitude
Values
Nursing
What …..
is Ethics
Universal.
“A system of rules or principles that are
used to guide human behavior”
Dealing with force
Guiding human life.
in the development,
implementation and evaluation of nursing
Respect for human
practice since therights, including
“Florence cultural
Nightingale
rights.Era”.
Right to life.
Care to humanity.
Why nursing code of ethics…
Nursing …..
• Ethics includes values, codes, and principles that
govern decisions in nursing practice.
Universal.
• Guide for action based on social values and needs.
• Provide means to professional standards
•Dealing
Formal with human
guidelines forlife.
the professional action
• Basis for Self regulation and relationship with
Respect
others.
for human rights, including cultural
rights.
• Evaluating the merits, risks, and social concerns.
•Right
Ethical
to principles
life. are necessary to guide to the
professional development
Care to humanity.
• Help in assessing the complex situations

• Better decision making
• Enhances interaction between the health
professionals and with the community
• Provide well defined policy and procedure in
resolving ethical dilemma.
• Unethical practices will be minimized
• Reflect the good image of the nurses and
the organization they work.
• Provide a sign of the profession’s
commitment to the public .
• Give a framework for the standards of
conduct.
• Provide general guidelines for professional
behavior.
• Helps to protect the rights of the individual,
family and the community
• Provide standard curriculum .
Nursing
Who …..the Code of Ethics for Nurses…
recommends
•Universal.
The International Council For Nurses (ICN)
• American Nurses Association
•Respect
Canadianfor
Nurses Association
human rights, including cultural
rights.
• Trained Nurses Association Of India (TNAI)
Right to life.
• Indian Nursing Council.(INC)
Care to humanity.
The ICN- Code of Ethics for Nurses
Nursing …..Preamble
Universal.
• Nurses have four fundamental
responsibilities:
•Dealing
To promote health,
with human life.
•Respect
To Prevent illness,rights, including cultural
for human
rights.
• To restore health and
•Right
To alleviate
to life. suffering.
Care to humanity.
The ICN-
Nursing ….. Code of Ethics for Nurses
Preamble……….
Universal.
• Nursing care is for all irrespective of
Working
age, for a noble
colour, cause.
creed, culture, disability or
illness, gender, sexual orientation,
nationality, politics, race or social
status.
rights.
• Nurses render health services to the
individual, the family and the community
Right to life.
Care to humanity.
NursingEthical
….. Principles
Universal.
• Autonomy • Justice
• Beneficence • Paternalism
• Nonwith
Dealing malfeasance
human life. • Respect for
• Confidentiality Persons
• Double Effect
rights. • Sanctity of Life
• Fidelity • Veracity
Right to life. • Informed consent
Care to humanity.
Nursing …..Autonomy
Definition: “autos” = self, “nomos” = rule
Universal.
– It is person’s independence and self reliance
Working for should
– People a noble
havecause.
control on their own lives
– Individual
Dealing rights
with human of self determination for
life.
making decisions.
Respect for human
– Freedom of choice rights, including cultural
rights.
– Informed consent. right to know procedure,
complications, other options.
Right– to life.
Nurse should respect client’s decision and
choices….
Care to humanity.
Beneficence
Nursing …..
Duty to do good, goodness, kindness,
Positive actions to help others
Universal.
forinterest
Client
Working a nobleiscause.
more important than
personal
Dealing
Carewith human
should be life.
beneficial to all
Respect for human
Treating rights,
client with including cultural
dignity.
rights.
Care to humanity.
Right to life.
NursingNon
….. malfeasance
Universal.
Commitment ……. Balance risk and benefits
Not to cause harm
Prevent harm
Respect for humanharm
Remove rights, including cultural
rights.
Right to life.
Care to humanity.
NURSING CONFIDENTIALITY
Maintain Confidentiality
Personal and medical
information of the client
will not disclosed to other
unless the the client gives
informed consent.
 Share information
selectively
Nursing …..
Confidentiality
Universal.
• Share or discuss patient information
only if it is necessary .
Dealing with share
• Never human life.
patient’s identification
number
Respect fororhuman
password with including
rights, anyone. cultural
• Follow the hospital’s or healthcare
rights.
provider’s policies.
Right to off
• Log life.your computer when you are not
by your workstation/
Treating client with dignity.nurses station
• Be careful about computer records
Care to humanity.
Nursing ….. Justice
Universal.
• Providing nursing care equally
to all asfor
Working peraneeds
noble cause.
• Fairness/ unbiased
• Giving equal treatment
Respect for humanofrights,
• Equal distribution including cultural
benefits,
rights.
costs and even risk.
•Right
Some totime
life. equality
distribution is not possible
Treating client with ,dignity.
during emergency the
services are
Care to humanity.based on priority.
Nursing …..Respect
Universal.
Call by name
Respect as an individual
Dealing
Respectwith human
their life.
opinion
Respect relatives
Especially
rights. respect the women
in labour/delivery room
Right to life.
Care to humanity.
Respecting Privacy
– Establish a culture of privacy to ensure
that personal information of patients is
kept as private as possible
– Provide space
– Ensure that the patient’s body is
appropriate covered
– Informed consent
Nursing Responsibility
…..
Universal.
 Remember you are taking
responsibility
Working for aofnoble
humancause.
life
 Willing to take responsibilities
Dealing
 Having with
to behuman life. for the
answerable
action
 Be accountable
rights.
 Need to remain competent-
 Knowledge
Right to life.
 Attitude
Practice client with dignity.
Treating

 Take those responsibility which are
Care to humanity.
Responsibility
Accountability
 Be answerable to oneself and others for
one’s own actions.
 Nurses are accountable for judgments made
and actions taken in the course of nursing
practice.
 It is all about justifying actions, explaining
why something was (or was not) done
 Account for their actions is therefore to
establish whether they had good enough
reasons for acting in the way they did.
Accountability
Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Advocacy
 Support for a cause
 As a nurse you support for the health

,safety, and rights of the clients.
 Follow institutional policy and procedure
 Report any unethical occurrence that

may cause harm to the clients
Advocacy
Nursing …..Veracity
“If you tell the truth , you don’t have to
Universal.
remember anything”.
Working
Truth is for a noble
the basis cause. trust between
for mutual
clients and health professionals.
Provide all information truthfully
rights.
Right to life.
Care to humanity.
Nursing Double
….. Effect
Universal.
Some actions can be morally justified even
though consequences may be a mixture of good
Working
and evil for a noble cause.
•Dealing
Must meet
with4human
criteria:
life.
– The action itself is morally good or neutral
Respect for intends
– The agent human therights, including
good effect cultural
and not the evil
rights.
(the evil may be foreseen but not intended)
– There is no favorable balance of good over evil
Right to life.
Care to humanity.
Nursing ….. Fidelity
Universal.
• Duty to be faithful to
one’s commitments
• Faithfulness
• Keep promises
• Don’t make promises you
rights.
cant keep;
Right to life.
Care to humanity.
Nursing ….. Paternalism
To treat someone
paternalistically is to treat
the person in a way that
ignores or discounts his/her
wishes.
When one individual assumes
the right to make decisions
for another
• Limits freedom of choice
• Think about parents making
decisions for children
Sanctity of Life
• It depends in which context, law, religion,

philosophy etc.
But in general terms, it's the belief that all life,
from the moment of conception is sacred and,
therefore has the right to live
• If life is the highest good, is it ethical to keep a
brain dead person alive?
Nursing ….. OF CODE OF ETHICS
ELEMENTS
Universal.
rights.
Right to life.
Care to humanity.
Nursing …..
COMPONENTS OF NURSING ETICS
Universal.
rights.
Right to life.
Care to humanity.
Nurses and the people
Nursing ….. AND THE PEOPLE
NURSES
Universal.
• The nurse’s primary professional
Working for a noble is
responsibility cause.
towards people
requiring nursing care.
• nurse promotes an environment in which
rights.
human rights, values, customs and
Rightspiritual
to life. beliefs of the individual, family
and community are respected.
Care to humanity.
NURSES
Universal.
• The nurse ensures that the individual
Working for sufficient
receives a noble cause.
information
• Thewith
Dealing nurse holds
human in confidence personal
life.
information and uses judgment in
Respect forthis
sharing human rights, including cultural
information.
rights.
• The nurse shares with society the
Rightresponsibility
to life. for initiating and
supporting
Care to humanity.
NURSES
Universal.
• Action to meet the health and social
needsfor
Working of the public,
a noble in particular those
cause.
of vulnerable populations.
• The nurse also shares responsibility to
sustain
Respect forand protect
human the natural
rights, including cultural
environment from depletion, pollution,
rights.
degradation And destruction.
Right to life.health education
• Provide
Care to humanity.
Nurses
Nursing …..and the practice
Universal.
• Provide care as per set standards
Working• for a noblestandards
Maintains cause. of personal
conduct
• Respect individual and family
rights. • Enhance the competency
/knowledge and skill with
changing needs.
Right to life.
Care to humanity.
Nursing ….. and Practice
Nurses
Universal.
• The nurse, in providing care, ensures
Working
that for a noble
use of cause. and scientific
technology
advances are compatible with the
safety, dignity and rights of people.
Respect for participation
• Promote human rights, including cultural
of individuals and
rights.
others in patient care
Right to life.
Care to humanity.
Nursing
NURSES…..
AND THE PROFESSION
Universal.
• Develop professional knowledge
Working for a noble
• Developing cause. based
research
professional knowledge.
• Work in the professional organization
Respect for human
• Developing rights, and
equitable including
social cultural
rights. working condition for nurses.
Right to life.
Care to humanity.
Nursing ….. AND
NURSES CO-WORKERS
• Co-operative relationship
Universal.
• Respect
• Collaborate
• Acceptance
• Respect point of view
rights.
Right to life.
Care to humanity.
Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
ETHICS IN INDIA
Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Nursing …..
Indian Nursing Council : Code Of Ethics
Universal. Respect Uniqueness of the person

Maintain competency
to render quality
Respect rights
of the individual
care
Practice within Demonstrate personal
framework of ethical, etiquettes
rights.
legal and professional
boundaires
Right to life.
Respect privacy and confidentiality
Care to humanity.
Situations of ethical dilemma in nursing
• Abortions
• Disclosure of HIV/AIDS status to spouse
• Sterilization
• Genetic research and congenital
malformation in foetus
• Surrogacy and sperm donation
• Age for written consent
• Test tube baby
• Resuscitation
Situations of ethical dilemma in nursing
• Euthanasia (Physician Assisted Suicide)

• Inappropriate Medication Orders:
• Unsafe nurse-patient ratio:
• Life threatening patient’s decision:
• Inappropriate task: for floating nurse
• Unresponsive physician:
Nurse’s Ethical Challenge
• Be aware about yourself and your values
• Be Knowledgeable about professional
standards
• Know your job and develop skill to perform
• Develop effective interpersonal relationship
• Develop rapport with the clients and relatives
• Participate in the ethical committee meetings
• Perform what is been taught
• Work in policy framework
• Develop and implement Team of ethics
committee and actively participate in it.
Nurse’s Ethical Challenge
Care to all without discrimination
Respect to the clients and relatives
Use words carefully
Accept patient with his /her religious belief
Take responsibility and delegate
responsibility carefully
Act as per informed decision and choices
Always act in the best interest of the client
Be aware about legal precedents
Plan and organize in-service education
programme
Rights of the patients
 Rights of personal dignity:
 Calling by name.
 Give due respect as per age.
 Maintain privacy.
 Modesty : knocking doors, pulling curtains.
 Provide Best possible appearance, personal
hygiene and care.
 Listening to the patient carefully.
 Accepting the individuals feeling as real
without judging right or wrong.
• Right to receive timely and qualified care in a
setting appropriate to health care needs.
• Right to participate in decisions
• Right to refuse treatment
• Right to receive information regarding their
illness, the course of treatment, and prospects
for good health
• Right to approve and refuse the release of their
medical records.
• Patient has the right to access their medical
record.
• Right to express complaints and satisfaction
regarding services rendered without fear of
discrimination..
• Right to comment and make suggestions for

improvement of the quality of care and
services.
• Right to receive respectful care in a safe and

secure environment with respect and regard
for privacy, individuality, personal beliefs and
• Right to privacy and confidentiality of their
records – records are to be maintained in a safe
and secure environment.
• Right to know the professional status of the
person(s) treating them
• Right to know, in advance of services, the cost of
services and any applicable payment policy.
• Right to appoint a legal representative to make
decisions regarding their health care.
• Right to refuse to participate in
research/experimental activities.
Rights of the patients…
Rights to assistance towards independence
 Motivate and build self esteem for self
care
 Assist in activity of daily living
 Helping attitude and show interest while
caring
 Involve family members
 Direct or provide necessary information
for self care
 Be around
Rights of the patients…
individual care
 Provide Care based on needs
 Respect the client while performing the
nursing procedure
 Allow family member to be with the client as
far as possible
 Plan diet as per cultural back ground
 Allow personal belongings
 Allow religious rituals , if it is not disturbing
to other and client or treatment
“They may forgot your name; but they will
never forget how you made them feel.”
Proud to be a nurse ,
Practice safe , be safe
Thank You
“They may forgot your name; but they will
never forget how you made them feel.”
Proud to be a nurse ,
Practice safe , be safe
Thank You
Florence Nightingales Pledge
I solemnly pledge myself before God and in

the presence of this assembly, to pass my life
in purity and to practice my profession
faithfully. I will abstain from whatever is
deleterious and mischievous, and will not take
or knowingly administer any harmful drug.
Florence Nightingales Pledge
I will do all in my power to maintain and elevate the
standard of my profession, and will hold in
confidence all personal matters committed to my
keeping and all family affairs coming to my
knowledge in the practice of my calling. With
loyalty will I endeavor to aid the physician, in his
work, and devote myself to the welfare of those
committed to my care.

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CODE OF ETHICS: The

Guiding Principles For Nursing Professionals

Tells us how human beings should behave

Personal standards of conduct, or attitude

It is a science of ideal human behaviour

• Help in assessing the complex situations

 Support for a cause

 As a nurse you support for the health

 Follow institutional policy and procedure

 Report any unethical occurrence that

• It depends in which context, law, religion,

Universal. Respect Uniqueness of the person

Working for a noble cause.

• Euthanasia (Physician Assisted Suicide)

• Right to comment and make suggestions for

• Right to receive respectful care in a safe and

Practice safe , be safe

Practice safe , be safe

I solemnly pledge myself before God and in

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