Code of Ethics: (ANA 1,2,3)

Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

1.1 Respect for Human Dignity

  • All individuals possess:

    • Dignity

    • Worth

    • Unique attributes

    • Human rights

  • Allyship is an ethical duty that requires intentional interventions, advocacy, and support to eliminate harmful acts, words, and deeds.

Significance / implications:

  • Upholds patient autonomy and intrinsic value of every person.

  • Requires proactive engagement to counteract stigma, bias, and discrimination in care settings.

  • Aligns with fundamental human rights and ethical obligations of nursing.

1.2 Relationships with Patients and Recipients of Nursing Care

  • Relationships of trust

  • Provide nursing services

  • Patient/Family-centered care

Significance / implications:

  • Trust is foundational to accurate assessment, disclosure of information, and adherence to care plans.

  • Care is oriented toward both the patient and their family, recognizing the broader social context of health.

1.3 The Nature of Health

  • Health is a universal right

  • Transcends all individual differences

Significance / implications:

  • Frames health care as a normative expectation, not a privilege.

  • Supports equity and access considerations in policy and practice.

1.4 The Right to Self-Determination

  • Recipients of care have moral and legal right to determine what care they receive

  • Right to be given accurate, complete, and understandable information for informed decision making

  • Opportunity to make decisions with family and persons they choose

Significance / implications:

  • Central to patient autonomy and informed consent.

  • Nurses must facilitate information sharing and respect care choices, including family involvement when appropriate.

Provision 2: A nurse’s primary commitment is to the recipient(s) of nursing care, whether an individual, family, group, community, or population.

2.1 Primary Commitment to Recipients of Nursing Care

  • Recipients of nursing care are the PRIORITY! (Patients are prioritized over institutions)

  • Nurses facilitate informed decision-making

  • Nurses act to preserve life and promote health as determined by the patient’s values

  • Must be within bounds of existing laws

Significance / implications:

  • Patient welfare guides all nursing actions, even when conflicts with institutional priorities arise.

  • Ensures respect for patient values and legal frameworks.

2.2 Conflicts of Interest and Conflicts of Commitment in Nursing

  • Conflicts of Interest:

    • Nurse’s financial, business, political interests interfere with the patient’s interest

    • Additional conflicts of interest can also be personal, entrepreneurial, commercial, academic, or research

  • Conflicts of Commitment:

    • Focus is not on recipient of care

Significance / implications:

  • Requires disclosure, management, or avoidance of conflicts to protect patient welfare.

  • Maintains professional integrity and public trust.

2.3 Professional Boundaries

  • Protect patients

  • Mitigate power imbalances with recipients of care

Significance / implications:

  • Preserves therapeutic relationship integrity and prevents exploitation or harm.

  • Enables safe, ethical interactions across clinical settings.

2.4 Issues of Safety in the Nurse-Patient Relationship

  • Safety in every interaction

  • Physiological

  • Physical

  • Psychological

  • Emotional

Significance / implications:

  • Safety is a comprehensive, ongoing duty across all domains of care.

  • Encourages proactive risk assessment and mitigation in daily practice.

Provision 3: The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care.

3.1 Privacy and Confidentiality

  • Privacy: Control information about oneself

  • Confidentiality: Nondisclosure of personal information communicated within nurse-patient relationship

  • Relevant information needs to be disclosed for clinical care

  • Mandatory reporting for certain contagious diseases, abuse, neglect

Significance / implications:

  • Balances patient confidentiality with public health and safety obligations.

  • Maintains trust and integrity of the therapeutic relationship.

3.2 Advocating for Persons Who Receive Nursing Care

  • Informed consent

  • Report practice concerns

  • State nurses’ associations and state boards of nursing – Resource to provide support

Significance / implications:

  • Empowers patients to participate in care decisions and raises professional accountability.

  • Provides channels for ethical oversight and peer support.

3.3 Responsibility in Promoting a Culture of Safety

  • Just culture

  • Important to not blame the individual

  • Encourage reports of errors to change systems and processes

Significance / implications:

  • Fosters learning from errors without fear of unwarranted punishment.

  • Systemic improvements reduce recurrence of harm.

3.4 Protection of Patient Health and Safety by Acting on Practice Issues

  • Knowledgeable about safety and practice standards

  • Report practice concerns

  • Escalate through chain of command

Significance / implications:

  • Continuous vigilance and escalation maintains high safety standards.

  • Clear reporting channels help address issues efficiently.

3.5 Protection of Patient Health and Safety by Acting on Impaired Practice

  • Impaired practice

    • Mental

    • Physical Fatigue

    • Substance misuse

    • Personal circumstances

  • Texas Board of Nurses has a program

  • Texas Peer Assistance Program (TPAPN)

Significance / implications:

  • Addresses impairment to safeguard patients and support nurses.

  • Provides structured pathways for assistance and rehabilitation while protecting patient safety.

Foundational Principles, Implications, and Real-World Relevance

  • Aligns with core ethical principles: autonomy, beneficence, nonmaleficence, justice, and respect for persons.

  • Emphasizes patient-centered care and dignity across all interactions.

  • Supports a systemic safety culture (Just Culture) to improve care quality and reduce harm.

  • Highlights the importance of clear communication, informed consent, and shared decision-making.

  • Connects to legal and professional regulatory frameworks (laws, boards, and associations).

  • Real-world relevance: guides daily nursing practice, policy development, and interprofessional collaboration; informs assessment, documentation, and reporting behaviors.