Ethical frameworks for nursing and midwifery practice provide guidance on identifying ethical issues, making ethical decisions, and taking action.
The International Council of Nurses (ICN) Code of Ethics for Nurses is the guiding document for ethical decision-making for nurses in Australia (6). The code identifies ethical standards and values agreed to by the profession. It is a tool for nurses to reflect on how to apply ethics within their domains of practice. The elements within the code describe the human rights standards and ethical values nurses are expected to uphold. Similarly, The International Confederacy of Midwives Code of Ethics for Midwives guides the ethical practice of Midwives in Australia (7).
The ICN Code of Ethics contains four principal elements that provide a framework for ethical conduct:
- Nurses and patients or others requiring nursing care/services.
- Nurses and practice
- Nurses and the profession
- Nurses and global health
Under each element, standards and values guide practice.
The standards include:
- promotion of an environment in which the human rights, values, customs and spiritual beliefs of the individual, family, and community are acknowledged and respected.
- advocating for equity and social justice in resource allocation, access to health care and other social and economic services.
- holding in confidence personal information and respecting the privacy and confidentiality and interest of patients in the lawful collection, transmission storage and disclosure of personal information.
- using judgment regarding individual competence when accepting and delegating responsibility
- ensuring that the provision of care and use of technology is compatible with the safety, dignity, and rights of people.
- active participating in developing research-based professional knowledge that supports evidence-informed practice.
- contributes to an ethical organisational environment and challenges unethical practices and settings.
- sustaining collaborative and respectful relationships with co-workers (6)
Ethics is framed by the principles and standards of human rights and ‘the inherent dignity of all members of the human family’, recognised as ‘the foundation of freedom, justice and peace in the world’ (8, p.1). The Universal Declaration of Human Rights includes civil and political rights, such as the rights to life, liberty, free speech, and privacy. It also includes economic, social, and cultural rights – the rights to social security, health, and education (8).
Alongside the concept of human rights, nursing ethics appeals to the principles of justice, autonomy, beneficence (doing good) and non-maleficence (avoiding harm) when justifying ethical decision-making (3, p. 12). Midwifery ethics also appeals to these principles, acknowledges women as persons with human rights, and seeks justice for all people and equity in access to health care (7).