HEALTH CARE ETHICS
Module 3.1: Continuing Programs on Ethico-Moral
Practice in Nursing
Health Care Ethics Team
Learning Objective:
• Explain how a nurse can continue to advocate for ethical
issues in healthcare.
• Differentiate between a nurse advocate and a nurse
lobbyist.
• Enumerate the ways a nurse can advocate and lobby for
ethical issues
• Identify the four fundamental responsibilities of the
nurse.
• Explain the principal elements of the ICN code of ethics.
• Give insights on one of the sections of the code of
ethics for Filipino nurses
Proposed Strategy:
• Lecture discussion: 60 minutes with catch-up every 20
minutes
• Video Interview presentations of Who’s Who activity (30
minutes) – Per section. Interview a nurse advocate and a
nurse lobbyist to answer the question prompt: How did
they advocate and lobby for ethico-moral issues in the
nursing profession?
• Open Forum: (60 minutes) The class is divided into small
groups so they can initially discuss their insights. Choose
a representative to echo to the class
A. Lobbying/Advocating for Ethical Issues in Health Care
• Advocacy - "the act or process of promoting a
cause or proposal,"
• Lobbying - "the act or process of influencing
public officials to promote (something, such as a
project) or secure the passage of (legislation).”
• While advocacy is the catalyst for a grassroots
movement, lobbying is the mechanism to achieve the
desired change.
A.
Lobbying/Advocating for Ethical Issues in Health Care
Advocacies of Nurses within the workplace
1. Pushing for reforms that improve care quality,
2. Campaigning for the adoption of technology to better
serve patients.
3. Addressing several ethical issues encountered in health
care.
A. Lobbying/Advocating for Ethical Issues in Health Care
Advocacies of Nurses outside the workplace
1. Nurses may also champion causes such as disease or
health issue awareness campaigns relating to their
specialty.
2. Standing up for patients' rights as consumers in light of
industry trends.
3. Communicate from a variety of platforms.
A. Lobbying/Advocating for Ethical Issues in Health Care
Initiatives to advocate for ethical issues in health care:
• nurses may advocate for ethical and just nursing
practice by building and maintaining environments that
promote established norms of professional behavior.
• Nurses may improve practice environments by refusing
to practice in ways that are detrimental to patient care
quality.
• Nurses may reinforce and strengthen nursing beliefs and
ideals through their professional organization,
A. Lobbying/Advocating for Ethical Issues in Health Care
Initiatives to advocate for ethical issues in health care:
•
Human rights abuses involving patients, nurses, healthcare
professionals, and others must be closely monitored by healthcare
institutions/organizations.
•
Healthcare institutions must support policies and practices that
actively maintain environments that ensure ethical nursing practice,
safeguard human rights, and means for reporting infractions, as well
as take action to prevent a recurrence.
•
Nurses from all practice settings may serve on ethics committees,
seek to encourage colleagues to consider ethics and human rights
and take political action to clarify and promote health policy that
improves access to and equality of treatment.
A. Lobbying/Advocating for Ethical Issues in Health Care
Initiatives to advocate for ethical issues in health care:
•
Nurses must examine the conflicts that arise between their own
personal and professional values and the values and interests of
others who are responsible for patient care and health-care
decisions, and they must resolve these conflicts in ways that ensure
patient safety and promote the patient's best interests.
•
Nurses may collaborate with other health care professionals to build
moral communities that promote, protect, and preserve ethical
practice and the human rights of all patients and professional
stakeholders.
A. Lobbying/Advocating for Ethical Issues in Health Care
Initiatives to advocate for ethical issues in health care:
•
Nurse educators must use the notions of justice and care as guiding
principles in teaching students about ethics and human rights in
health care settings all over the world, from local communities to
global communities.
•
Through material, clinical and field experiences, and critical
thinking, nurse educators must firmly anchor students in nursing
professional duty to challenge unjust systems and structures,
reflecting the profession's commitment to social justice and health.
A. Lobbying/Advocating for Ethical Issues in Health Care
Initiatives to advocate for ethical issues in health care:
• Nurse researchers must ensure that human rights are
respected through obtaining ongoing informed
permission, assessing the risk vs benefit of research
participants, and avoiding damage.
• Nurse researchers may undertake research relevant to
communities of interest, are guided by community
participation in identifying research challenges, and
endeavor to improve patients, society, and professional
practice.
A. Lobbying/Advocating for Ethical Issues in Health Care
initiatives to advocate for ethical issues in health care:
● Nurse administrators must put ethical and human rights concepts into practice by
keeping an eye on the practice environment for actual or potential human rights
breaches by patients, nurses, and other healthcare employees.
● Nurse administrators must evaluate policy and practice to detect risks of diminished
care quality as a result of unrecognized human rights breaches.
• ·
In their organizations and beyond, nurse administrators may
actively foster a caring, just, inclusive, and collaborative environment.
The code of ethics for nurses
• The code of ethics for nurses requires nurses to treat all
patients fairly and equally, respecting their "innate
dignity, worth, and individual traits... independent of the
elements that influence a person's health" (ANA, 2016,
p. 1).
• Illness, ability, financial status, functional state, or
proximity to death have no bearing on a person's worth.
• Furthermore, these issues must be considered in the
provision of just care since they influence the need for
treatment and the allocation of healthcare.
International Code of Ethics
●
The ICN Code of Ethics for Nurses is a statement of the ethical
values, responsibilities and professional standards of nurses. It
guides everyday ethical nursing practice and can serve as a
regulatory tool to guide and define ethical nursing practice.
•
An international code of ethics for nurses was first adopted by the
International Council of Nurses (ICN) in 1953. It has been revised
and reaffirmed at various times since, most recently with this review
and revision completed in 2012.
•
Nurses have four fundamental responsibilities: to promote health,
to prevent illness, to restore health and to alleviate suffering. The
need for nursing is universal.
ELEMENTS OF THE CODE
Nurses and people
● The nurse’s primary professional responsibility is to people requiring
nursing care.
● In providing care, the nurse promotes an environment in which the
human rights, values, customs and spiritual beliefs of the
individual, family and community are respected.
●
The nurse ensures that the individual receives accurate, sufficient
and timely information in a culturally appropriate manner on which
to base consent for care and related treatment.
ELEMENTS OF THE CODE
Nurses and people
●
●
●
●
The nurse holds in confidence personal information and uses
judgement in sharing this information.
The nurse shares with society the responsibility for initiating and
supporting action to meet the health and social needs of the
public, in particular those of vulnerable populations.
The nurse advocates for equity and social justice in resource
allocation, access to health care and other social and economic
services.
The nurse demonstrates professional values such as
respectfulness, responsiveness, compassion, trustworthiness and
integrity.
ELEMENTS OF THE CODE
2. Nurses and practice
●
●
●
The nurse carries personal responsibility and accountability
for nursing practice, and for maintaining competence by continual
learning.
The nurse maintains a standard of personal health such that the
ability to provide care is not compromised.
The nurse uses judgment regarding individual competence when
accepting and delegating responsibility.
ELEMENTS OF THE CODE
2. Nurses and practice
●
●
●
The nurse at all times maintains standards of personal conduct
which reflect well on the profession and enhance its image and
public confidence.
The nurse, in providing care, ensures that use of technology and
scientific advances are compatible with the safety, dignity and
rights of people.
The nurse strives to foster and maintain a practice culture
promoting ethical behaviour and open dialogue.
ELEMENTS OF THE CODE
3. Nurses and the profession
●
●
●
The nurse assumes the major role in determining and
implementing acceptable standards of clinical nursing practice,
management, research and education.
The nurse is active in developing a core of research-based
professional knowledge that supports evidence-based practice.
The nurse is active in developing and sustaining a core of
professional values.
ELEMENTS OF THE CODE
3. Nurses and the profession
●
●
●
The nurse, acting through the professional organization,
participates in creating a positive practice environment and
maintaining safe, equitable social and economic working
conditions in nursing.
The nurse practices to sustain and protect the natural environment
and is aware of its consequences on health.
The nurse contributes to an ethical organizational environment
and challenges unethical practices and settings.
ELEMENTS OF THE CODE
4. Nurses and co-workers
●
The nurse sustains a collaborative and respectful
relationship with co-workers in nursing and other fields.
• The nurse takes appropriate action to safeguard
individuals, families and communities when their health
is endangered by a co-worker or any other person.
ELEMENTS OF THE CODE
4. Nurses and co-workers
●
The nurse takes appropriate action to support and
guide co-workers to advance ethical conduct.
• To achieve its purpose the Code must be understood,
internalized and used by nurses in all aspects of their
work. It must be available to students and nurses
throughout their study and work lives.
2. Code of Ethics for Filipino Nurses
•
BOARD OF NURSING
•
Board Resolution No. 220
•
Series of 2004
•
PROMULGATION OF THE CODE OF ETHICS FOR REGISTERED
NURSES
•
•
WHEREAS, the Board of Nursing has the power to promulgate
a Code of Ethics for Registered Nurses in coordination and
consultation with the accredited professional organization (Sec. 9,
(g), Art. III of R.A. No. 9173, known as the “Philippine Nursing Act
of 2002);
•
2. Code of Ethics for Filipino Nurses
•
BOARD OF NURSING
•
Board Resolution No. 220
•
Series of 2004
•
PROMULGATION OF THE CODE OF ETHICS FOR REGISTERED
NURSES
•
WHEREAS, in the formulation of the Code of Ethics for
Registered Nurses, the Code of Good Governance for the
Professions in the Philippines was utilized as the principal basis
therefore: All the principles under the said Code were adopted and
integrated into the Code of Ethics as they apply to the nursing
profession;
•
2. Code of Ethics for Filipino Nurses
BOARD OF NURSING
Board Resolution No. 220
Series of 2004
•
PROMULGATION OF THE CODE OF ETHICS FOR REGISTERED
NURSES
•
WHEREAS, the promulgation of the said Code as a set of
guidelines, regulations or measures shall be subject to approval by
the Commission (Sec. 9, Art. II of R.A. No. 9173); and
•
WHEREAS, the Board, after consultation on October 23, 2003
at Iloilo City with the accredited professional organization of
registered nurses, the Philippine Nurses Association, Inc (PNA), and
other affiliate organizations of Registered Nurses, decided to adopt
a new Code of Ethics under the afore-mentioned new Law;
•
•
2. Code of Ethics for Filipino Nurses
ARTICLE I. PREAMBLE
SECTION 1.
Health is a fundamental right of every individual. The Filipino
registered nurse, believing in the worth and dignity of each human
being, recognizes the primary responsibility to preserve health at all
cost. This responsibility encompasses promotion of health,
prevention of illness, alleviation of suffering, and restoration of
health. However, when the foregoing are not possible, assistance
towards a peaceful death shall be his/her obligation.
2. Code of Ethics for Filipino Nurses
ARTICLE I. PREAMBLE
SECTION 2.
To assume this responsibility, registered nurses have to gain
knowledge and understanding of man’s cultural, social, spiritual,
psychological, and ecological aspects of illness, utilizing the
therapeutic process. Cultural diversity and political and socioeconomic status are inherent factors to effective nursing care.
2. Code of Ethics for Filipino Nurses
ARTICLE I. PREAMBLE
SECTION 3.
The desire for the respect and confidence of clientele, colleagues,
co-workers, and the members of the community provides the
incentive to attain and maintain the highest possible degree of
ethical conduct.
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 4.
Ethical Principles
1. Values, customs, and spiritual beliefs held by individuals shall be
respected.
2. Individual freedom to make rational and unconstrained decisions
shall be respected.
3. Personal information acquired in the process of giving nursing care
shall be held in strict confidence.
4.
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 5. Guidelines to be observed:
REGISTERED Nurses must
a. Know the definition and scope of nursing practice which are in the
provisions of R.A. No. 9173, known as the “Philippine Nursing Act of
2002” and Board Res. No. 425, Series of 2003, the “Rules and
Regulations Implementing the Philippine Nursing Act. of 2002”, (the
IRR).
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 5. Guidelines to be observed:
REGISTERED Nurses must
b. Be aware of their duties and responsibilities in the practice of their
profession as defined in the “Philippine Nursing Act. Of 2002” and the
IRR.
c. Acquire and develop the necessary competence in knowledge, skills,
and attitudes to effectively render appropriate nursing services
through varied learning situations.
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 5. Guidelines to be observed:
REGISTERED Nurses must
d. If they are administrators, be responsible in providing favorable
environment for the growth and developments of Registered Nurses in
their charge.
e. Be cognizant that professional programs for specialty certification
by the BON are accredited through the Nursing Specialty Certification
Council (NSCC).
f. See to it that quality nursing care and practice meet the optimum
standard of safe nursing practice.
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 5. Guidelines to be observed:
REGISTERED Nurses must
g. Insure that modification of practice shall consider the principles of
safe nursing practice.
h. If in position of authority in a work environment, be normally and
legally responsible for devising a system of minimizing occurrences of
ineffective and unlawful nursing practice.
i. Ensure that patients’ records shall be available only if they are to be
issued to those who are professionally and directly involved in their
care and when they are required by law.
•
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 5. Guidelines to be observed:
REGISTERED Nurses must
SECTION 8.
Ethical Principle
Registered Nurses are the advocates of the patients: they shall take
appropriate steps to safeguard their rights and privileges.
Guidelines to be observed:
REGISTERED Nurses must
a. respect the “Patients’ Bill of Rights” in the delivery of nursing care
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 8.
Ethical Principle
Registered Nurses are the advocates of the patients: they shall take
appropriate steps to safeguard their rights and privileges.
Guidelines to be observed:
REGISTERED Nurses must
a. respect the “Patients’ Bill of Rights” in the delivery of nursing care
b. provide the patients or their families with all pertinent information
except those which may be deemed harmful to their well-being
c. uphold the patients’ rights when conflict arises regarding the
management of their care
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 10. Ethical Principle
Registered Nurses are aware that their actions have professional,
ethical, moral, and legal dimensions. They strive to perform their
work in the best interest of all concerned.
SECTION 11. Guidelines to be observed:
REGISTERED Nurses must:
a. Perform their professional duties in conformity with existing laws,
rules regulations, measures, and generally accepted principles of
moral conduct and proper decorum.
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 11. Guidelines to be observed:
REGISTERED Nurses must:
a. Perform their professional duties in conformity with existing laws,
rules regulations, measures, and generally accepted principles of
moral conduct and proper decorum.
b. Not allow themselves to be used in advertisement that should
demean the image of the profession (i.e. indecent exposure,
violation of dress code, seductive behavior, etc.).
c. Decline any gift, favor or hospitality which might be interpreted as
capitalizing on patients.
2. Code of Ethics for Filipino Nurses
ARTICLE II. REGISTERED NURSES AND PEOPLE
SECTION 11. Guidelines to be observed:
REGISTERED Nurses must:
d. Not demand and receive any commission, fee or other
compensations to the one referring or recommending a patient to
them for nursing care.
e. Avoid any abuse of the privileged relationship which exists with
patients and of the privileged access allowed to their property,
residence or workplace.
In Summary
• The nursing profession will continue to face ethico-moral
issues because of the ever-changing healthcare system. The
nurse must be open to confront and respond to the needs
that these issues bring – that is open to stand up and speak
up through their professional affiliations to push for the
resolution of such issues for the benefit of the patient and the
society including the nurse.
• The code of ethics for nurses provides guidance on how the
nurse is to be an ethical nurse. As a beginning nurse, one
must exert effort to reflect on the stipulations of the code and
reflect on how one will apply them in the future.
THANK YOU!
My Dear Students J