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International Council of NursesRevised 2012THE ICNCODE OF ETHICSFOR NURSES

THE ICN CODE OF ETHICS FOR NURSESAn international code of ethics for nurses was firstadopted by the International Council of Nurses (ICN)in 1953. It has been revised and reaffirmed at varioustimes since, most recently with this review andrevision completed in 2012.PREAMBLENurses have four fundamental responsibilities: to promotehealth, to prevent illness, to restore health and to alleviatesuffering. The need for nursing is universal.Inherent in nursing is a respect for human rights, includingcultural rights, the right to life and choice, to dignity and tobe treated with respect. Nursing care is respectful of andunrestricted by considerations of age, colour, creed, culture,disability or illness, gender, sexual orientation, nationality,politics, race or social status.Nurses render health services to the individual, the family andthe community and coordinate their services with those ofrelated groups.All rights, including translation into other languages, reserved. This work maybe reprinted and redistributed, in whole or in part, without alteration and withoutprior written permission, provided the source is indicated.Copyright 2012 by ICN – International Council of Nurses,3, place Jean-Marteau, 1201 Geneva, SwitzerlandISBN: 978-92-95094-95-61

THE ICN CODEThe ICN Code of Ethics for Nurses has four principalelements that outline the standards of ethical conduct.ELEMENTS OF THE CODE1. Nurses and peopleThe nurse’s primary professional responsibility is to peoplerequiring nursing care.In providing care, the nurse promotes an environment in whichthe human rights, values, customs and spiritual beliefs of theindividual, family and community are respected.The nurse ensures that the individual receives accurate,sufficient and timely information in a culturally appropriatemanner on which to base consent for care and relatedtreatment.The nurse holds in confidence personal information and usesjudgement in sharing this information.The nurse shares with society the responsibility for initiatingand supporting action to meet the health and social needs ofthe public, in particular those of vulnerable populations.The nurse advocates for equity and social justice in resourceallocation, access to health care and other social andeconomic services.The nurse demonstrates professional values such asrespectfulness, responsiveness, compassion, trustworthinessand integrity.2

2. Nurses and practiceThe nurse carries personal responsibility and accountabilityfor nursing practice, and for maintaining competence by continuallearning.The nurse maintains a standard of personal health such that theability to provide care is not compromised.The nurse uses judgement regarding individual competence whenaccepting and delegating responsibility.The nurse at all times maintains standards of personal conductwhich reflect well on the profession and enhance its image andpublic confidence.The nurse, in providing care, ensures that use of technology andscientific advances are compatible with the safety, dignity andrights of people.The nurse strives to foster and maintain a practice culturepromoting ethical behaviour and open dialogue.3. Nurses and the professionThe nurse assumes the major role in determining andimplementing acceptable standards of clinical nursing practice,management, research and education.The nurse is active in developing a core of research-basedprofessional knowledge that supports evidence-based practice.The nurse is active in developing and sustaining a core ofprofessional values.The nurse, acting through the professional organisation,participates in creating a positive practice environment andmaintaining safe, equitable social and economic workingconditions in nursing.3

The nurse practices to sustain and protect the naturalenvironment and is aware of its consequences on health.The nurse contributes to an ethical organisational environmentand challenges unethical practices and settings.4. Nurses and co-workersThe nurse sustains a collaborative and respectful relationshipwith co-workers in nursing and other fields.The nurse takes appropriate action to safeguard individuals,families and communities when their health is endangeredby a co-worker or any other person.The nurse takes appropriate action to support and guideco-workers to advance ethical conduct.SUGGESTIONS FOR USEof the ICN Code of Ethics for NursesThe ICN Code of Ethics for Nurses is a guide for action basedon social values and needs. It will have meaning only as aliving document if applied to the realities of nursing andhealth care in a changing society.To achieve its purpose the Code must be understood,internalised and used by nurses in all aspects of their work.It must be available to students and nurses throughout theirstudy and work lives.4

APPLYING THE ELEMENTSof the ICN Code of Ethics for NursesThe four elements of the ICN Code of Ethics for Nurses:nurses and people, nurses and practice, nurses and theprofession, and nurses and co-workers, give a framework forthe standards of conduct. The following chart will assistnurses to translate the standards into action.Nurses and nursing students can therefore:l Study the standards under each element of the Code.l Reflect on what each standard means to you. Think abouthow you can apply ethics in your nursing domain: practice,education, research or management.l Discuss the Code with co-workers and others.l Use a specific example from experience to identify ethicaldilemmas and standards of conduct as outlined in the Code.Identify how you would resolve the dilemmas.l Work in groups to clarify ethical decision making and reacha consensus on standards of ethical conduct.l Collaborate with your National Nurses Association,co-workers, and others in the continuous application ofethical standards in nursing practice, education,management and research.5

Element of the Code # 1:NURSES AND PEOPLEPractitioners andManagersEducators andResearchersNational NursesAssociationsProvide care thatrespects human rightsand is sensitive to thevalues, customs andbeliefs of people.In curriculum includereferences to humanrights, equity, justice,solidarity as the basisfor access to care.Develop positionstatements andguidelines that supporthuman rights andethical standards.Provide continuingeducation in ethicalissues.Provide teaching andlearning opportunitiesfor ethical issues anddecision making.Lobby for involvementof nurses in ethicscommittees.Provide sufficientinformation to permitinformed consent tonursing and/or medicalcare, and the right tochoose or refusetreatment.Provide teaching/learning opportunitiesrelated to informedconsent, privacyand confidentiality,beneficence andmaleficence.Provide guidelines,position statements,relevant documentationand continuingeducation related toinformed consentto nursing and medicalcare.Use recording andinformation management systems thatensure confidentiality.Introduce intocurriculum concepts ofprofessional values.Incorporate issues ofconfidentiality andprivacy into a nationalcode of ethics fornurses.Develop and monitorenvironmental safetyin the workplace.Sensitise students tothe importance ofsocial action in currentconcerns.Advocate for safe andhealthy environment.6

Element of the Code # 2:NURSES AND PRACTICEPractitioners andManagersEducators andResearchersNational NursesAssociationsEstablish standards ofcare and a work settingthat promotes qualitycare.Provide teaching/learning opportunitiesthat foster life longlearning and competence for practice.Provide access tocontinuing education,through journals,conferences, distanceeducation, etc.Establish systems forprofessional appraisal,continuing educationand systematic renewalof licensure to practice.Conduct and disseminateresearch that showslinks between continuallearning and competenceto practice.Lobby to ensurecontinuing educationopportunities andquality care standards.Monitor and promotethe personal health ofnursing staff in relationto their competencefor practice.Promote the importanceof personal health andillustrate its relation toother values.Promote healthylifestyles for nursingprofessionals. Lobby forhealthy workplaces andservices for nurses.7

Element of the Code # 3:NURSES AND THE PROFESSIONPractitioners andManagersEducators andResearchersNational NursesAssociationsSet standards fornursing practice,research, educationand management.Provide teaching/learning opportunitiesin setting standardsfor nursing practice,research, educationand management.Collaborate with othersto set standards fornursing education,practice, research andmanagement.Foster workplacesupport of the conduct,dissemination andutilisation of researchrelated to nursing andhealth.Conduct, disseminateand utilise research toadvance the nursingprofession.Develop positionstatements, guidelinesand standards relatedto nursing research.Promote participationin national nurses’associations so as tocreate favourablesocioeconomicconditions for nurses.Sensitise learners tothe importance ofprofessional nursingassociations.Lobby for fair socialand economic workingconditions in nursing.Develop positionstatements andguidelines in workplaceissues.8

Element of the Code # 4:NURSES AND CO-WORKERSPractitioners andManagersEducators andResearchersNational NursesAssociationsCreate awareness ofspecific and overlappingfunctions and thepotential forinterdisciplinarytensions and createstrategies for conflictmanagement.Develop understandingof the roles of otherworkers.Stimulate co-operationwith other relateddisciplines.Develop workplacesystems that supportcommon professionalethical values andbehaviour.Communicate nursingethics to otherprofessions.Develop awareness ofethical issues of otherprofessions.Develop mechanismsto safeguard theindividual, family orcommunity when theircare is endangered byhealth care personnel.Instil in learners theneed to safeguard theindividual, family orcommunity when careis endangered by healthcare personnel.Provide guidelines,position statements anddiscussion fora relatedto safeguarding peoplewhen their care isendangered by healthcare personnel.9

DISSEMINATIONof the ICN Code of Ethics for NursesTo be effective the ICN Code of Ethics for Nurses must be familiar tonurses. We encourage you to help with its dissemination to schools ofnursing, practising nurses, the nursing press and other mass media.The Code should also be disseminated to other health professions, thegeneral public, consumer and policy-making groups, human rightsorganisations and employers of nurses.GLOSSARY OF TERMS USEDin the ICN Code of Ethics for NursesCo-workerOther nurses and other health and non-health related workers andprofessionals.Collaborative relationshipA professional relationship based on collegial and reciprocal actionsand behaviour that aims to achieve certain jointly agreed goals.FamilyA social unit composed of members connected through blood,kinship, emotional or legal relationships.Nurse shares with societyA nurse, as a health professional and a citizen, initiates and supportsappropriate action to meet the health and social needs of thepublic.Personal informationInformation obtained during professional contact that is private toan individual or family, and which, when disclosed, may violate theright to privacy, cause inconvenience, embarrassment, or harm tothe individual or family.Personal healthMental, physical, social and spiritual wellbeing of the nurse.Related groupsOther nurses, health care workers or other professionals providingservice to an individual, family or community and working towarddesired goals.10

International Council of Nurses3, place Jean-Marteau1201 Geneva, SwitzerlandTel. 41 (22) 908 01 00Fax 41 (22) 908 01 01email: icn@icn.chwww.icn.ch

THE ICN CODE The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct. ELEMENTS OF THE CODE 1. Nurses and people