Code of Ethics for Nurses

Lettie Prins

Definition of Ethics

The principles of proper professional conduct concerning the rights and duties of nurses themselves, their patients, and their fellow practitioners, as well as their actions in the care of patients and in relations with their families-US National Library of Medicine Ethics, Nursing

Definition of Ethos The study of the philosophy, nature, social

foundations, history, law, composition, role, theories, Ethics & social relationships of nursing.

EACH section is a specific area of study in Nursing

Nursing is a science and an art

Purpose of Code of Ethics Nurses` declaration Foundation of ethical decision-making Own personal integrity Respect for Life, human dignity, rights of other persons Guidance for Professional conduct Guidance for Ethical committees Ethical Values and Principles

-SANC, 2013. Code of Ethics for Nursing Practitioners in SA.

Ethical Principles Social Justice- fairness, patient`s advocate Non-maleficence- no harm Beneficence- do good, best option Veracity- be truthful and honest, show integrity Fidelity- confidentiality, factual record keeping Altruism- Humanity, Unselfishness, Self-

lessness Autonomy- patients` rights Caring- nurturing and positive emotions

Value statements in Code= Patients` Rights

Nurses must: Value human life Have respect and dignity for yourself and others

Patients have the right to: Quality nursing care Accurate, informed consent Refusal of treatment Confidentiality & Privacy (POPI Act) A culture of Safety-SANC, 2013. Code of Ethics for Nursing Practitioners in SA.

  POPI Act – Protection of Personal Information

What could happen to you if you don’t comply?

Suffer reputational damage Lose customers and fail to attract new ones Pay out millions in damages to a civil class

action Be fined up to R10 million or face 10 years in jail

-PROTECTION OF PERSONAL INFORMATION ACT 4 OF 2013

Informed Consent

“A health service may not be provided to a user without the user`s informed consent”

-National Health Act., 2003. Section 7

Informed Consent (Children)

9.5.3.1 A minor over the age of 18 years can be treated as an adult and is legally competent to decide on all forms of treatment and medical procedures (Child Care Act).

9.5.3.2 Children of 12 years of age are legally competent to decide on medical treatment only (Child Care Act).

9.5.3.3 A child over the age of 12 years is legally competent to consent to a termination

of pregnancy (Choice on Termination of Pregnancy Act). -National Health Act., 2003. Section 7

The “Best Interests” Principle

The South African Constitution provides that “a child’s best interests are paramount in every matter concerning a child”.

Implied Consent Health care practitioners should be careful about

relying on a patient's apparent compliance with a procedure as a form of consent.

Submission in itself may not necessarily indicate consent. For example, the fact that a patient lies down on an examination couch does not indicate that the patient has understood what the health care practitioner proposes to do and why. Consent must at all times be expressed and not implied.

THE HEALTH CARE PROFESSIONS COUNCIL OF SOUTH AFRICA. GUIDELINES FOR GOOD PRACTICE. Booklet 9, 2008

Any condition or disease Diagnosis and prognosis Prognosis, if left untreated Pain management Side effects & Risks Life style changes Is it experimental?

THE HEALTH CARE PROFESSIONS COUNCIL OF SOUTH AFRICA. GUIDELINES FOR GOOD PRACTICE. Booklet 9, 2008

Patients have a right to information

“The nurse, as patient advocate, plays an important role in communicating and supporting the wishes of the patient, even when doing so may be against the opinions of the family and physician.

The ability to influence patient care outcomes also depends on the power a nurse has in relationships with physicians and other team members. A nurse gains power through establishing positive, collegial, working relationships with physicians, other nurses, and all the members of the health care team. Productive relationships increase a nurse’s power to base care decisions on ethical principles”

-Code of Ethics for nursing practitioners in SA (SANC, 2013)

Patient`s Advocate

Nurses must apply discreet “assertive push back”

This or This?

Nurses` responsibility for swab and instrument control (theatre)

Accurate Record keeping Restless patients must not be left alone Termination of treatment can only be lawful if no

quality of life remains (Living Will) Suspected drunken driving: blood may be taken

against patient's will In an emergency nurses must render whatever

assistance they can (what would a reasonable nurse have done?)

Nursing & the Law

Ethical Decision-making

Ethical Committee Some decisions need to be made within an

ethical committee The more diverse the ethical committee, the more

ethically & morally sound the decision will be Are we doing it because it is the right thing to do,

or are we doing it because we can?

Ethical Dilemmas Termination of pregnancy Trading products of conception and other

human parts Participation in and conducting clinical research Providing nursing to vulnerable persons Conflicting values (cultures, sexual orientation..) Euthanasia Intimidation and violent acts in the work place Participating in strikes

Important

Not adhering to the Code of Conduct of SANC attracts the same sanctions as non-adherence to the Act & Omissions and may bring our fitness to practice into question & endanger our registration to practice

Health Laws Nursing Act Health Professions Act, Ethical Rules National Health Act Mental health Act Children's Act Medicines control and related Substances Act Protection of Personal Information Act (POPI)

Ethics is the study of good and bad, of moral duty and obligations. Ethics is concerned with doing good and avoiding harm.

Bandman & Bandman, 2002

Revisit Ethics

REFERENCES Chally, P., & Loriz, L. (1998). Decision making in practice: A

practical model for resolving the types of ethical dilemmas you face daily. American Journal of Nursing, 98(6), 17 – 20.

National Health Act., 2003. Section 7. Protection of Personal Information Act 4 of 2013. SANC. (2013). Code of Ethics for Nursing Practitioners in South

Africa. The Health Care Professions Council of South Africa.

Guidelines for good practice. Booklet 9, 2008. Verschoor, T., et al. (2007). Nursing and the Law. Juta & Co

Limited.