What is the Nursing Code of Ethics? (2023)


November 4, 2022

What is the Nursing Code of Ethics? (1)

By: Kathleen Gaines News and Education Editor, MSN, RN, BA, CBC

(Video) What is the Code of Ethics for Nurses?

According to the American Nurses Association (ANA), the nursing code of ethics is a guide for “carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.” Ethics, in general, are the moral principles that dictate how a person will conduct themselves. Ethical values are essential for ALL healthcare workers, but ethical principles in nursing are particularly important given their role as caregivers.

There are 4 main principles that are part of the nursing code of ethics. They are,

  1. Autonomy
  2. Beneficence
  3. Justice
  4. Non-maleficence

These principles are ideally what every nurse should be aware of in their daily nursing practice. While ethical principles are sometimes confusing and often taught briefly during undergraduate nursing -- they should be constants in nursing practice in order to provide the best, safest, and most humane care to all patients.

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History of the Nursing Code of Ethics

Interestingly, the nursing code of ethics is suggested to have been founded in 1893 and named the “Nightingale Pledge” after Florence Nightingale, the founder of modern nursing. As a modification of the Hippocratic Oath, taken by medical doctors, the Nightingale Pledge has been recited by nursing students at graduations with little changes since inception.

The formal code of ethics was developed in the 1950s by the American Nurses Association (ANA) and has undergone numerous modifications since. The most significant recent change was in 2015 when 9 interpretative statements or provisions were added to the code of ethics to help guide nursing practice in a more definitive way.

Many states include the ANA’s nursing code of ethics in their practice statements. Even though the code of ethics is primarily ethics-related, it also has legal implications. Given the importance of the code to the nursing profession, revisions continue on a regular basis.

(Video) Code of Ethics for Registered Nurses

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What is the Nursing Code of Ethics? (2)

(Video) Code of Ethics for Nurses

4 Principles of Ethics for Nurses

1. Autonomy

Autonomy is recognizing each individual patient’s right to self-determination and decision-making. As patient advocates, it is imperative that nurses ensure that patients receive all medical information, education, and options in order to choose the option that is best for them. This includes all potential risks, benefits, and complications to make well-informed decisions.

Once the patient has all the relevant information, the medical and nursing team can make a plan of care in compliance with the medical wishes of the patient.

It is important that nurses support the patient in their medical wishes and ensure that the medical team is remembering those wishes. Sometimes, nurses will need to continue to advocate for a patient despite the wishes being verbalized because the medical team might not agree with those wishes.

Many factors may influence a patient's acceptance or refusal of medical treatment, such as culture, age, gender, sexual orientation, general health, and social support system.

2. Beneficence

Beneficence is acting for the good and welfare of others and including such attributes as kindness and charity. The American Nurses Association defines this as “actions guided by compassion.”

3. Justice

Justice is that there should be an element of fairness in all medical and nursing decisions and care. Nurses must care for all patients with the same level of fairness despite the individual's financial abilities, race, religion, gender, and/or sexual orientation.

An example of this is when working at a free flu clinic or diabetes screening clinic. These are open to all individuals in the community regardless of the previously mentioned factors.

(Video) ANA Code of Ethics

4. Nonmaleficence

Nonmaleficence is to do no harm. This is the most well-known of the main principles of nursing ethics. More specifically, it is selecting interventions and care that will cause the least amount of harm to achieve a beneficial outcome

The principle of nonmaleficence ensures the safety of the patient and community in all care delivery. Nurses are also responsible to report treatment options that are causing significant harm to a patient which may include suicidal or homicidal ideations.

Nursing Code of Ethics Interpretive Statements

Revised in 2015 to include 9 provisions, the ANA’s nursing code of ethics now includes interpretative statements that can provide more specific guidance for nursing practice.

9 Provisions of the Nursing Code of Ethics

Currently, the nurse’s code of ethics contains 9 main provisions:

  1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.
  2. The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.
  3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.
  4. The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.
  5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.
  6. The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.
  7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.
  8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.
  9. The profession of nursing, collectively through its professional organization, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

The aforementioned nine provisions were implemented to help guide nurses in ethical decision-making throughout their practice.

Making Ethical Decisions as a Nurse

Unfortunately, nurses are often unable to make complex ethical decisions based solely on the four principles and nine provisions. In these instances, it is important to consult the ethics committee before making any major decisions. Often, other resources are needed when making major ethical decisions.

How Nurses Use the Nursing Code of Ethics

Knowing the nursing code of ethics is essential for nurses because it will help guide everyday practice and navigate the daily complexities of the healthcare profession. Nurses often use the four major ethical principles throughout a shift, even if not fully aware of them.

(Video) Ethical Issues

This may include,

  • Providing pain medication to a post-operative hip replacement
  • Holding the hand of a dying patient who is alone
  • Advocating for the patient that wants to end chemotherapy and enter hospice care

Nursing is consistently regarded as the most honest and ethical profession and practicing with the nursing code of ethics is essential to ensuring that patients and their families receive the care they have come to know and expect. Utilizing the ethical codes of justice, nonmaleficence, autonomy, and beneficence on a daily basis allows nurses to provide the safest and most compassionate care for their patients.


  • What are the five codes of ethics in nursing?

    • The 5 nursing ethic codes are: nonmaleficence, beneficence, autonomy, justice, and privacy/confidentiality.
  • What is the Professional Code of Ethics for Nurses?

    • The Professional Code of Ethics for Nurses is the guiding outline for how nurses should behave ethically within their profession and how they should decide to act if they encounter barriers that prevent them from fulfilling their professional obligations.
  • Why is the code of ethics important in nursing?

    • It can guide nurses’ professional behavior, provide a framework for decision-making when faced with challenges, and provide support and help prevent moral distress.
  • What is the code of ethics in healthcare?

    • There is not one board ethical code for every healthcare professional, although it has been proposed. Instead, each branch of healthcare, from quality control to medical directors to physicians to nursing, has its own ethical codes.
  • What is scholarly ethics in nursing?

    • The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.


What are the 9 code of ethics for nurses? ›

What Are The 7 Ethical Principles On Which The Nursing Code Of Ethics Is Based? The 7 ethical principles the Nursing Code of Ethics is based upon include beneficence, nonmaleficence, justice, accountability, autonomy, fidelity, and veracity.

What is the purpose of the code of ethics for nurses? ›

The Code of Ethics for Nurses with Interpretive Statements (The Code) was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.

What are the 4 elements of the code of ethics for nurses? ›

This includes respect for autonomy, nonmaleficence, beneficence, and justice. Establish standards for ethics education and provide continuing ethics education for nurses.

What are the 7 principles of ethics in nursing? ›

The ethical principles that nurses must adhere to are the principles of justice, beneficence, nonmaleficence, accountability, fidelity, autonomy, and veracity.

What are the 10 nursing ethical values? ›

The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency.

What are four 4 common ethical issues faced by nurses today? ›

The following are some other examples of common ethical situations that nurse managers face:
  • Honesty vs. withholding information. ...
  • Science vs. spirituality. ...
  • Healthcare needs vs. resource allocation. ...
  • Autonomy vs. beneficence.
Jun 5, 2020

What is the importance of code of ethics? ›

It provides a common set of rules or standards for all in the profession to adhere to. It defines best practices for the profession. It provides a basis to meet compliance requirements for the profession. It provides a legal standard for the profession.

What is the conclusion of code of ethics in nursing? ›

Conclusion. The ethical code focuses largely on health care practice, although level of practice is dependent on availability of resources. Because of this relation, an ethical code concurrent to the nursing code of ethic should be designed, so that nurses are in a position meet their ethical obligations.

What is the code of ethics? ›

A code of ethics or ethical code refers to a set of guidelines, standards, and principles that a company adopts and that must be adhered to by its workers. A code of ethics is usually in a written form. It is a document that outlines the core values and ethics of a business that professionals must live by.

What are the five 5 codes of ethics? ›

It is divided into three sections, and is underpinned by the five fundamental principles of Integrity, Objectivity, Professional competence and due care, Confidentiality, and Professional behaviour.

What are the main parts of the code of ethics? ›

Codes typically divide into three distinct elements: 1) an introduction or preamble, 2) a statement of purposes and values, 3) specific rules of conduct which may be subdivided in various ways, and 4) implementation of the code, which will define administrative processes, reporting, and sanctions.

What are the four 4 basic rules of ethics? ›

The Fundamental Principles of Ethics. Beneficence, nonmaleficence, autonomy, and justice constitute the 4 principles of ethics. The first 2 can be traced back to the time of Hippocrates “to help and do no harm,” while the latter 2 evolved later.

What is the most important ethical principle in nursing? ›


Accountability is chief among the ethical principles in nursing. Each nurse must be responsible for his or her own choices and actions in the course of patient care. Nurses who hold themselves accountable often provide higher-quality patient care.

What are the top 5 ethical issues in healthcare? ›

5 Ethical Issues in Healthcare
  • Do-Not-Resuscitate Orders. ...
  • Doctor and Patient Confidentiality. ...
  • Malpractice and Negligence. ...
  • Access to Care. ...
  • Physician-Assisted Suicide.

What happens if a nurse violates the code of ethics? ›

As discussed earlier in this chapter, nurses can be reprimanded or have their licenses revoked for not appropriately following the Nurse Practice Act in the state they are practicing. Nurses can also be held legally liable for negligence, malpractice, or breach of patient confidentiality when providing patient care.

What are unethical behaviors in nursing? ›

According to the participants, instances of academic unethical behaviors in a nursing school included discrimination, violence, misuse, out-of-date instruction and knowledge, conflict of evaluation, hypocrisy, and disorganization. Discrimination refers to treating students and colleagues unequally and unjustly.

What are some examples of ethical issues in nursing? ›

Common Examples of Ethical Dilemma in Nursing
  • Pro-life vs. pro-choice.
  • Empirical knowledge vs. religious beliefs.
  • Autonomy vs. beneficence.
  • Parent refuses to vaccinate their child.
  • Being honest vs. withholding information.
  • Healthcare needs vs. resource allocation.
May 31, 2022

What is code of ethics examples? ›

Personal code of ethics examples. I will treat others as I wish to be treated. I will dedicate myself to acting courteously in my day-to-day interactions with others, despite my mood or current life situation. It is important to me to have a positive impact on the people I come into contact with.

What is the most important element of a code of ethics? ›

One of the most important things to include in your code of ethics is a list of the company's core values or ethical standards. These guide the entire document, setting the ethical and cultural tone for the company. You can use these values as an outline for the policy.

What is code of ethics in healthcare? ›

It contains standards of ethical behavior for healthcare executives in their professional relationships. These relationships include colleagues, patients or others served; members of the healthcare executive's organization and other organizations; the community; and society as a whole.

What are the 3 golden rules of ethics? ›

Do good to others as you would like good to be done to you. Regard bad for yourself whatever you regard bad for others. Accept that (treatment) from others which you would like others to accept from you ... Do not say to others what you do not like to be said to you.

What does provision 5 of the nursing code of ethics mean? ›

Provision 5

The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

What are the elements of the code in nursing? ›

The four elements of the ICN Code of Ethics for Nurses: nurses and people, nurses and practice, nurses and the profession, and nurses and co-workers, give a framework for the standards of conduct. The following chart will assist nurses to translate the standards into action.


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