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CPNP 213 PP - Week 2 Class 1 (1)

Professional Ethics CPNP 213
History of the Code of Ethics
 This code has a long history not only with nurses but other health
professionals, such as Physicians. Members of professional bodies
have this obligation because their roles, missions and ethical
foundations focus not only on the individuals they serve but also on
society as a whole.
 They have changed over time but are deeply based on Ethical
 The evolution of the Code for Nurses has mirrored the growth of
nursing from a focus on character and behaviors of the nurse
(obedience, compliance, loyalty), independence and actions
(judgment, reflection and critical thinking).
 Early codes were also grounded in Christian morality and etiquette.
Legal Obligations
History of Canadian Law:
 The Canadian legal system (excluding Quebec) is derived
from English COMMON LAW, (rules often based on
common sense or common practices that had evolved
over the centuries)
 In the Common Law system many of the essential rules
and principles that govern day-to-day life (for healthcare
such as professional misconduct & malpractice) are
contained in an extensive body of precedent, referred to
as CASE Law.
Sources of Common Law
 Case law (precedent) – based on a body of judges
decisions rendered over centuries
 Statute law – formal written rules passed by a parliament
or other legislative body – highest degree of authority *
 Custom – less prominent source of law, which means that
in the absence of specific legal principles/rules/statutes
the courts will be guided by the longstanding practices of
a particular industry or trade
 Doctrine – least authoritative based on rules of a
particular trade
Regulation of Nursing
Nurses throughout Canada are held accountable for making
decisions that result in safe, effective and ethical practice
with the main focus on the safety and well being of the
In Alberta, Health Professionals are regulated by the Health
Professions Act. This Act established the healthcare
‘rules’ through legislation. This includes PT, OT, SW,
Pharmacy, RN’s, Doctors, etc.
Health professionals are then regulated by their own
Regulatory bodies (CLPNA). This Self-Regulation reflects
the trust the public has put in Health professional.
The CLPNA’s Purpose/roles includes:
 Monitors entry to practice education and testing which leads to
 Setting education and registration requirements to ensure only qualified
individuals are licensed.
 Setting and enforcing practice, conduct, and ethical standards that direct
how professional services are to be delivered and/or performed.
 Ensuring compliance with healthcare legislation and regulations.
 Setting continuing competency requirements and administering
mandatory continuing competency programs to ensure LPNs’
professional knowledge, skill and performance continually evolve.
 Investigating concerns regarding the conduct of an LPN.
 Maintaining a public database of LPN registrants who are licensed to
practice in the profession.
 Providing information about the practice of the profession, professional
standards, and guidelines.
To understand the disciplinary component
Professional disciplinary – designed to make sure the nurses’ conduct conforms
to the Code of Ethics, professional behavior, capacity (mental and physical or
dependencies) and competence for LPN’s. LPNs, other health care
professionals & employers have the obligation to report concerns of conduct or
practice behaviors of an LPN that affects client safety or puts clients at risk.
(CLPNA’s Duty to Report).
Some Examples include: repeated medication errors, theft of medication,
breaching confidentiality, practicing nursing without a license, falsification
of information on the health records, abandoning clients, patient abuse and
Criminal disciplinary – initiated against a nurse if it is alleged that he or she
has committed an offence under the Criminal Code. Charges would normally
be laid by the police following a complaint filed either by a member of the
public or by police investigating an offence.
Some Examples include: theft of narcotics, theft of patient or institutional
property, assisted suicide, criminal negligence, threatening or inflicting
bodily harm, and sexual assault.
Consent for Treatment
Consent can be given in writing, verbally or simply implied (by
holding out our arm for blood to be drawn, or a blood pressure to be taken).
Consent must be:
 Free of coercion (voluntary),
 Specific to the proposed treatment/procedure and
 Legally capable of that level of decision
 Patient must be told the risks inherent
 Specific to who will perform the treatment/procedure
Lack of consent is legally called Battery.
Client’s Autonomy is of utmost importance regarding consent – withdrawal
of consent.
One exception for the need for consent – when acting in an extreme
Strategies for nurses to ensure they respect the client’s
autonomy and right to informed consent:
 Ensure the environment is suitable
 Provide more time
 Ensure the patient understand the information and
Consider past experiences which may alter responses
Provide written material
If the patient chooses have a friend or family present
Be sensitive to cultural and language issues
Be aware of psychological and emotional responses
Consent issues
Types of Consent:
 Expressed – clear statement of consent from the
 Implied – inferred from a patient’s
Withdrawal of Consent
Record of the consent is critical
Competency, consent and substitute decision