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Code of Ethics for Nurses in Australia

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This Code of Ethics has been developed for nursing in the Australian context and is relevant to all nurses in all practice settings.
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Code of Ethics for Nurses in Australia
Code of Ethics for Nurses in Australia
Developed under the auspices of Australian Nursing Council Inc, Royal College of Nursing Australia, Australian Nursing Federation
Background Introduction Interpretation of Terms
Code of Ethics
Bibliography
Background
Background
Introduction
Introduction
This Code of Ethics has been developed
The nurse’s primary professional
for nursing in the Australian context and
responsibility is to people requiring nursing
is relevant to all nurses in all practice
care. In fulfilling this responsibility nurses
settings.
provide care and support before and during
birth and throughout life, and alleviate pain
The impetus for its development came at
and suffering during the dying process.
the Australasian Nurse Registering Authorities
Nurses enable individuals, families and
Conference (ANRAC) of 1990, when the
groups to maintain, restore or improve their
research arising from the ANRAC Nursing
health status, or to be cared for and
Competencies Assessment Project indicated
comforted when deterioration of health
that there was not a clear focus on the ethical
has become irreversible.
standards expected and required of nurses
practising in the cultural context of Australia.
A traditional ideal of nursing is the concern
for the care and nurture of human beings
The Code of Ethics for Nurses in Australia was
giving just and due consideration to their
first developed in 1993 under the auspices
ethnicity, culture, gender, spiritual values,
of the Australian Nursing Council Inc. ,
sexuality, disability, age, economic, social or
Royal College of Nursing, Australia and the
health status, or any other grounds. Nurses
Australian Nursing Federation. In 2000 these
respect and uphold the rights of Australian
peak organisations agreed to undertake a joint
Indigenous peoples. The profession also
project to review the Code of Ethics. It is
acknowledges the cultural diversity in
recognised that the Code of Ethics could not
contemporary Australian society.
have been realised without the participation of
nurses and nursing organisations in Australia,
Nursing care is based on the development
whose many submissions and comments are
of a therapeutic relationship and the
acknowledged and appreciated.
implementation and evaluation of therapeutic
processes. Therapeutic processes include
The Code of Ethics outlines the nursing
health promotion and education, counselling,
profession’s intention to accept the rights
nursing interventions and empowerment of
of individuals and to uphold these rights in
individuals, families or groups to exercise
practice. The Code of Ethics is complementary
maximum choice in relation to their
to the International Council of Nurses (ICN)
health care.
Code of Ethics for Nurses (2000).
Nursing practice is undertaken in a variety
Thus, the purpose of this Code of Ethics is to:
of settings. Any particular setting will be
affected to some degree by processes which
• identify the fundamental moral
are not within a nurse’s control or influence.
commitments of the profession,
The processes affecting nursing practice can
include government policies, laws, resource
• provide nurses with a basis for professional
constraints, institutional policies,
and self reflection on ethical conduct,
management decisions, and the practice
• act as a guide to ethical practice, and
of other health care providers. Nurses also
• indicate to the community the moral values
recognise the potential for conflict between
which nurses can be expected to hold.
one person’s needs and those of another,
or of a group or community.
1

Such factors may affect the degree to which
Employers and colleagues have a
nurses are able to fulfil their moral
responsibility to ensure that such nurses are
obligations and/or the number and type
not overtly or covertly discriminated against
of ethical problems they may face.
in their workplace.
The Code contains six broad value
The Code of Ethics is supported by the
statements. Nurses are encouraged to use
Code of Professional Conduct for Nurses in
these statements as a guide in reflecting on
Australia. While the Code of Ethics focuses
the degree to which their practice
on the ethics and ideals of the profession,
demonstrates those values. As a means of
the Code of Professional Conduct identifies
assisting in interpretation of the six values,
the minimum requirements for practice in the
a number of explanatory statements are
profession, and focuses on the clarification of
provided. These explanatory statements are
professional misconduct and unprofessional
not intended to cover all the aspects a nurse
conduct. The two Codes, together with
should consider, but can be used to assist
published practice standards, provide
further exploration and consideration of
a framework for nursing.
ethical concerns in nursing practice.
Nurses are also encouraged to undertake
Interpretation of Terms
discussion and educational opportunities
Accountability: the state of being
in ethics in order to clarify for themselves
answerable for one's decisions and actions.
issues related to the fulfilment of their moral
It cannot be delegated (ANRAC 1990).
obligations. This Code of Ethics is not
intended to provide a formula for the
Individual/individuals: refers to a person /
resolution of ethical problems, nor can it
persons receiving nursing care.
adequately address the definitions and
Moral Agent: a person who acts morally /
exploration of terms and concepts which are
ethically on his or her own authority.
part of the study of ethics.
Responsibility: the obligation that an
Nurses are autonomous moral agents and
individual assumes when undertaking to
sometimes may adopt a personal moral
carry out planned/ delegated functions.
stance that would make participation in
The individual who authorises the delegated
certain procedures morally unacceptable
function retains accountability
to them. Nurses have a right to refuse
(ANRAC 1990).
(conscientious objection) to participate in
Ethics: the moral practices, beliefs, and
procedures, which they judge on strongly
standards of an individual/s and/ or a group.
held moral beliefs to be unacceptable. In
exercising their conscientious objection
Ethical problem: a situation that requires
nurses must take all reasonable steps to
ethical consideration or ethical decision
ensure that quality of care and patient safety
making, or a conflict of moral values.
is not compromised.
Nurses accepting employment positions
where they foresee they may be called on
to be involved in situations at variance with
their sincerely held beliefs, have a
responsibility to acquaint their employer
or prospective employer with this fact within
a reasonable time. Nurses, however, should
consider seriously whether it is appropriate
for them to accept employment positions
where they see these situations may arise,
particularly if this is likely to be more than
a rare occurrence.
Back to Index
2

Code of Ethics
Code of Ethics
VALUE STA
1
TEMENT 1
VALUE STA
2
TEMENT 2
Nurses respect individuals’ needs,
Nurses accept the rights of
values, culture and vulnerability in
individuals to make informed
the provision of nursing care.
choices in relation to their care.
Explanatory Statements
Explanatory Statements
1. Nurses acknowledge the diversity in
1. Individuals have the right to make
contemporary Australian society. Nursing
decisions related to their own health care,
care for any individual or group should not
based on accurate and complete
be compromised because of ethnicity,
information given by health care
culture, aboriginality, gender, spiritual
providers. Nurses must be satisfied that
values, sexuality, disability, age, economic,
they have the person’s consent for any
social or health status, or any other
care or treatment they are providing. If
ground.
individuals are not able to provide consent
for themselves, nurses have a role in
2. Respect for an individual’s needs includes
ensuring that valid consent is obtained
recognition of the person’s place in a
from the appropriate substitute decision-
family and community. Nurses should,
maker.
therefore, facilitate the participation of
significant others in the care of the
2. Nurses have a responsibility to inform
individual if, and as, the person and the
people about the nursing care that is
significant others wish.
available to them, and people are entitled
morally to accept or reject such care.
3. Respect for individual needs, beliefs and
Nurses have a responsibility to respect the
values includes culturally informed and
decisions made by each individual.
appropriate care, and the provision of as
much comfort, dignity, privacy and
3. Illness and/or other factors may
alleviation of pain and anxiety as possible.
compromise a person’s capacity for self-
determination. Where able, nurses should
4. Respect includes the development of
ensure such persons continue to have
confidence and trust in the relationship
adequate and relevant information to
between nurses and the people for whom
enable them to make informed choices
they care.
about their care and treatment and to
5. Nurses acknowledge that there is a power
maintain an optimum degree of self-
imbalance in the relationship between a
direction and self-determination.
person or group receiving nursing care
and a health care provider. To promote a
trusting and professional relationship, and
to prevent any exploitation of individuals,
nurses have an ethical responsibility
always to maintain appropriate
professional boundaries between
themselves and persons to whom they
provide care.
Back to Index
3

VALUE STA
3
TEMENT 3
VALUE STA
4
TEMENT 4
Nurses promote and uphold the
Nurses hold in confidence any
provision of quality nursing care
information obtained in a
for all people.
professional capacity, use
professional judgement where there

Explanatory Statements
is a need to share information for
1. Quality nursing care includes competent
the therapeutic benefit and safety
care provided by appropriately prepared
of a person and ensure that privacy
nurses.
is safeguarded.
2. Promotion of quality nursing care includes
valuing life long learning and engaging in
Explanatory Statements
continuing education as a means of
1. The nurse respects a person’s rights to
maintaining and increasing knowledge and
determine who will be provided with their
skills. Continuing education refers to all
personal information and in what detail.
formal and informal opportunities for
Exceptions may be necessary in
education.
circumstances where the life of the
3. Nurses research and evaluate nursing
individual may be placed in danger or
practice in order to raise standards of care,
where disclosure is required by law.
and to ensure that such standards are
2. When personal information is required for
ethical.
teaching, research or quality assurance
4. Research should be conducted in a
purposes, care must be taken to protect
manner that is ethically responsible and
the person’s autonomy, anonymity and
justified. Nurses should not participate in
privacy. Consent must always be obtained
any research or experimental treatment
from the person or their lawful advocate.
on human subjects, which has not been
3. Nurses protect persons in their care
approved by an institutional ethics
against breaches of privacy by confining
committee, and which is not conducted in
their verbal communications to
a manner consistent with the requirements
appropriate personnel and settings,
of the National Health and Medical
and for professional purposes.
Research Council’s national statements
relating to ethical conduct in research
4. Nurses have an obligation to adhere to
involving humans.
legislative guidelines limiting access to
personal records (whether paper
5. Nurses contribute to the development and
or electronic).
implementation of policy to make the best
use of available resources and to promote
quality care for individuals.
Back to Index
4

VALUE STA
5
TEMENT 5
VALUE STA
6
TEMENT 6
Nurses fulfil the accountability and
Nurses value environmental ethics
responsibility inherent in their roles.
and a social, economic and
ecologically sustainable environment

Explanatory Statements
that promotes health and well being.
1. As morally autonomous professionals,
nurses are accountable for their clinical
Explanatory Statements
decision making and have moral and legal
1. Nursing includes involvement in the
obligations for the provision of safe and
detection of the ill effects of the
competent nursing care.
environment on the health of persons,
2. Nurses contribute with other health care
the ill effects of human activities on the
providers in the provision of
natural environment, and assisting
comprehensive health care, recognising
communities in their actions on
and respecting the perspective and
environmental health problems aimed
expertise of each team member.
at minimising these effects.
3. Nurses have a right to refuse to participate
2. Nurses value participation in the
in procedures, which would violate their
development, implementation and
reasoned moral conscience
monitoring of policies and procedures,
(ie. conscientious objection). In doing so,
which promote safe and efficient use of
they must take all reasonable steps to
resources.
ensure that quality of care and patient
3. Nurses acknowledge that the social
safety is not compromised.
environment in which a person resides
4. Nurses have an ethical responsibility to
has an impact on their health, and in
report instances of unsafe and unethical
collaboration with other health
practice. Nurses should support colleagues
professionals and consumers, initiate
who appropriately and professionally
and support action to meet the health
notify instances of unsafe and unethical
and social needs of the public.
practice.
Back to Index
5

Bibliography
Bibliography
American Nurses Association, 1985.
(under review) Code for Nurses. American Nurses
Australian Nursing Council Inc.
Association, Kansas City.
PO Box 873
Australian Nurse Registering Authorities Conference
DICKSON ACT 2602
(ANRAC), (now ceased),1990, Report to the
Australian Nurse Registering Authorities Conference
Phone: (02) 6257 7960
Vol 1pp 91-94, Australian Nursing Council Inc.
Fax: (02) 6257 7955
(ANCI).
Beauchamp, T & Childress, J, 1994. Principles of
Email: anci@anci.org.au
Biomedical Ethics. 4th Edition Oxford University
Website: www.anci.org.au
Press, New York.
Canadian Nurses Association, 1997. Code of Ethics
Australian Nursing Federation
for Registered Nurses. Canadian Nurses Association,
Ottawa.
PO Box 4239
Kingston ACT 2604
Coady, M. and Bloch, S. (Eds) 1996. Code of Ethics
and the Professions. Melbourne University Press,
Phone: (02) 6232 6533
Melbourne.
Fax: (02) 6232 6610
Fry, S.and Johnstone, M-J, 2002. Ethics in Nursing
Practice: a guide to ethical decision making.
Email: anfcanberra@anf.org.au
2nd edition. International Council of Nurses,
Website: www.anf.org.au
Geneva/Blackwell Publishing, Oxford.
Husted, G & Husted, J. 1981. Ethical Decision
Royal College of Nursing, Australia
Making in Nursing. Mosby, St Louis.
PO Box 219
International Council of Nurses, 2000. Code of Ethics
Deakin West ACT 2600
for Nurses: International Council of Nurses, Geneva.
Johnstone, M J. 1999. Bioethics: A Nursing
Phone: (02) 6282 5633
Perspective. 3rd Edition Harcourt Australia, Sydney.
Fax: (02) 6282 3565
Johnstone, M. J. 1998. Determining and Responding
Email: canberra@rcna.org.au
Effectively to Ethical Professional Misconduct in
Nursing: A Report to the Nurses Board of Victoria,
Website: www.rcna.org.au
Melbourne.
Kerridge, I. , Lowe, M. and McPhee, J. 1998. Ethics
The Code of Ethics for Nurses in
and Law for the Health Professions. Social Science
Australia was first published in July 1993
Press, Katoomba.
and revised in 2002.
National Health and Medical Research Council,
Australia. http://www.nhmrc.health.gov.au
The New Zealand Nurses Association,1995. Code
of Ethics. The New Zealand Nurses Association,
Wellington.
Royal College of Nursing, Australia, 1998. Position
Statement on Conscientious Objection. Royal
College of Nursing, Australia, Canberra.
Royal College of Nursing, Australia, 1997. Position
Statement on Ethics in Nursing Practice. Royal
College of Nursing, Australia, Canberra.
Royal College of Nursing, Australia,1996. Position
Statement on Voluntary Euthanasia/ Assisted
Suicide. Royal College of Nursing, Australia,
Canberra.
Woodruff A, 1991; Discussion Paper: Code of Ethics
and Code of Conduct.
Woodruff A, (unpublished) Feedback from Code of
Ethics Think Tank 1992. Adelaide. Feedback from the
Code of Ethics Think Tank, 1992. Australian Nursing
Council Inc. Canberra.
Back to Index
6

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