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In 1995, the American Nurses Association (ANA) Board of Directors created the nursing code of ethics with the help of the Congress on Nursing Practice. The nursing code of ethics is a guide for individuals in the nursing profession to follow in order to make sound decisions regarding ethical issues.

Often times, nurses are faced with making independent decisions regarding a patient's care. Therefore, they must have a standard that will guide their conduct to act in the best interest of that patient. Proper behavior and conduct has been closely scrutinized since the days of Florence Nightingale, the most popular nurse of all time. Nightingale's observations were compiled in what became known as the Nightingale pledge vowing "to abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug."

Nursing has evolved over the last 100 years. Nursing professionals are faced with life and death decisions more frequently than before. New technology has potential benefits and harm to patients. This increases the need for a nursing code of ethics, not just on paper, but in practice. The nurse must exhibit the ability to think and act under the nursing code of ethics.

Ethics is derived from a Greek word which means customs, habitual usage, conduct and character. The study of ethics as it relates to nursing has identified basic concepts which include patients' rights, autonomy, beneficence, nonmaleficence, justice and fidelity. Nurses are better equipped to make the right decisions during difficult situations with an understanding of these concepts.

Patient Rights Federal legislation has been passed to protect patient rights. The American Hospital Association developed the Patient's Bill of Rights in 1973, and was revised in 1992. Upon admission to the hospital, all patients must be informed of these rights.

Autonomy Unless mentally impaired, individuals have the right to assist in their own decision making regarding healthcare treatment. This has become known as the need for informed consent.

Beneficence and Nonmaleficence Beneficence means to do good to other people. Nonmaleficence means to prevent intentional harm. Both relate directly to ethical practices in patient care. The nursing code of ethics requires nursing professionals to protect patients by reporting unsafe, illegal or unethical practice he or she may observe. When faced with decisions to extend life through using technology, nurses must weigh the potential benefit against potential harm. Also, they must consider the patient's wishes, if known.

Justice The nursing code of ethics requires fairness and justice for everyone, equally. Hospital resources are stretched to the limits, and economic decisions are generally made based on the number of patients who would benefit most. An ethical dilemma is created when considering the frail, elderly, poor, and disabled patients. Who has the right to decide preferential treatment? All healthcare professionals must be careful not to ration care.

Fidelity Fidelity deals with the concept of accountability and keeping commitments. The nursing code of ethics requires that nursing professionals be accountable to their responsibilities to their patient, employer and society. The nursing professional must remember that decisions concerning patient care are not necessarily independent ones. Those decisions create a ripple effect within the healthcare field. The nursing code of ethics will help nurses to keep the right perspective and balanced views when faced with a decision.

Organizational Ethics