Contributors: Deborah Lindell and Peggy Chinn
ANA Code of Ethics
ICN Code of Ethics for Nurses (PDF download)
Blogs related to ethical knowing
Excerpts from Marsha Fowler’s Nursing Ethics; 1880s to the Present
Ethical knowing is the moral component of nursing. Nursing ethics focuses specifically on the ethics of relationship, which is at the heart of what it means “to nurse.” While nurses need to understand common ethical codes considered in the broad field of healthcare, understanding what ought to be done that is right and just in any particular nursing care situation requires a specific understanding of the ethics of relationships in each particular situation. These situations can involve frontline RNs and APRNs providing direct patient care or nurses in indirect nursing roles such as administration, leadership, education, policy development, and research. Additionally, ethical issues can arise across the spectrum of healthcare settings from critical care to hospice to home care.
The book “Nursing Ethics, 1880s to the Present: An Anthology of Lost Wisdom and Identity” by Marsha Fowler provides a detailed history of the development of nursing’s relational ethics, and explanations that justify and define the nature of nursing ethics, including the distinction of nursing ethics from bio ethics. In addition, Dr. Fowler’s blog posts on Nursology.net provide explanations of nursing ethics relative to current social, political and professional challenges.
Several documents provide frameworks for nurses’ decision-making regarding ethical practice. These include the American Nurses Association recently updated Code of Ethics for Nurses, the International Council of Nurses’ The ICN Code of Ethics for Nurses (2021) and The American Nurses Association’s Code of Ethics for Nurses With Interpretive Statements (The Code) (2015). The ANA Code is described as “providing a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession” (ANA). Additional resources would be the journal Nursing Ethics and textbooks of nursing ethics.
General codes, such as those by the ANA and ICN, can be important for categories of situations, but nurses are responsible to do what is right for a particular situation, given the needs and preferences of the people in the situation. Nurses who practice through a lens of ethical knowing apply the principles of ethics to a specific situation by asking the questions: Is this right? and Is this responsible? The various dimensions of a situation are examined to explore and clarify the possible approaches and actions, using processes of dialogue that explores what is possible, and justifying the ultimate actions that might be taken.
Resources
American Nurses Association. The Code of Ethics for Nurses With Interpretive Statements (freely available for ANA members, non-members and the public). https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
Annual Nursing Ethics Conference
Nursology.net blogs related to ethical knowing: https://nursology.net/category/ethics/
Chinn, P. L. (2018). The evolution of nursing’s ethics of caring. In W. Rosa, S. Horton-Deutsch, & J. Watson (Eds.), A Handbook for Caring Science (1 edition, pp. 257–276). Springer Publishing Company. https://doi.org/10.1891/9780826133892.0003
Chinn, Peggy L., Kramer, Maeona K., & Sitzman, K. (2022). Knowledge Development in Nursing: Theory and Process (11th ed.). Elsevier.
Chinn, P. L., Canty, L., & Mkandawire-Valhmu, L. (2026). Knowledge Development in Nursing: Theory and Process (12th Edition). Elsevier.
Parker, R. S. (1990). Nurses’ stories: the search for a relational ethic of care. ANS. Advances in Nursing Science, 13(1), 31–40. https://doi.org/10.1097/00012272-199009000-00005
Fowler, M. (2024). Nursing ethics, 1880s to the present: An archaeology of lost wisdom and identity. Taylor & Francis.
Fowler, Marsha Diane Mary. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application. American Nurses Association. https://play.google.com/store/books/details?id=ftZnrgEACAAJ
Fowler, Marsha; Sheryl Reimer Kirkham; Rick Sawatzky; Elizabeth Johnston Taylor (2011). Religion, Religious Ethics and Nursing. Springer Publishing Company. https://play.google.com/store/books/details?id=YoNJVn2ihTwC
International Council of Nursing (2021) ICN’s Code of Ethics for Nurses. PDF freely available at https://www.icn.ch/system/files/2021-10/ICN_Code-of-Ethics_EN_Web_0.pdf
Nursing Ethics. Website https://journals.sagepub.com/home/nej
Thorne, S., & Sawatzky, R. (2014). Particularizing the general: Sustaining theoretical integrity in the context of an evidence-based practice agenda. ANS. Advances in Nursing Science, 37(1), 5–18. https://doi.org/10.1097/ANS.0000000000000011