I. Introduction
The American Nurses Association (ANA) Code of Ethics is a foundational document that guides nurses in ethical decision-making and professional conduct.
First adopted in 1950, the Code has undergone multiple revisions, with the 2025 update reflecting modern challenges in healthcare, technology, and diversity.
It consists of 9 provisions, each with interpretive statements that clarify expectations and responsibilities.
II. Purpose and Importance
Serves as a moral compass for nurses.
Promotes patient-centered care, professional integrity, and social justice.
Helps navigate complex situations involving autonomy, confidentiality, and advocacy.
III. Structure of the Code
9 Provisions: Each provision addresses a core ethical principle.
Interpretive Statements: Provide context, examples, and guidance for applying each provision.
IV. Overview of the 9 Provisions
1. Compassion and Respect
Nurses must practice with compassion and respect for every individual, regardless of background, beliefs, or health status.
Emphasizes dignity, diversity, and nonjudgmental care.
2. Commitment to the Patient
The nurse’s primary commitment is to the patient—whether individual, family, group, or community.
Advocates for shared decision-making and patient autonomy.
3. Advocacy and Protection
Nurses must protect the rights, health, and safety of patients.
Includes maintaining confidentiality, reporting unsafe practices, and supporting vulnerable populations.
4. Accountability and Responsibility
Nurses are accountable for their own actions and must maintain competence.
Encourages lifelong learning, self-reflection, and ethical practice.
5. Self and Others’ Integrity
Nurses must preserve their own integrity and promote the well-being of colleagues.
Supports work-life balance, mental health, and ethical workplace culture.
6. Safe and Ethical Environment
Nurses must help create and maintain safe, ethical, and just environments.
Includes addressing bullying, discrimination, and systemic inequities.
7. Advancement of the Profession
Nurses should contribute to the advancement of nursing through research, education, and policy.
Encourages innovation, evidence-based practice, and mentorship.
8. Collaboration for Human Rights
Nurses must collaborate to protect human rights, promote health diplomacy, and reduce health disparities.
Emphasizes global health, equity, and social justice.
9. Articulation of Nursing Values
The profession must articulate and uphold core nursing values in policy, advocacy, and leadership.
Nurses are called to be ethical leaders and policy influencers.
V. Key Ethical Principles in the Code
Principle Definition
Autonomy Respecting patients’ rights to make decisions
Beneficence Acting in the best interest of the patient
Nonmaleficence Avoiding harm
Justice Fair and equitable treatment
Fidelity Keeping promises and commitments
Veracity Telling the truth
VI. Application in Practice
A. Clinical Scenarios
Informed consent, end-of-life care, cultural sensitivity, and patient advocacy.
Example: A nurse supports a patient’s decision to refuse treatment, even if it conflicts with medical advice.
B. Workplace Ethics
Reporting unsafe staffing, supporting whistleblowers, and promoting diversity.
Example: A nurse challenges discriminatory hiring practices in their unit.
C. Technology and Confidentiality
Managing electronic health records, social media use, and telehealth.
Example: A nurse avoids sharing patient details on personal social media.
VII. Challenges in Upholding the Code
Moral distress: When nurses know the right action but are constrained by systems.
Conflicting loyalties: Balancing patient needs with institutional policies.
Burnout and fatigue: Can impair ethical judgment and advocacy.
VIII. Strategies for Ethical Practice
Ethics education: Ongoing training and case studies.
Mentorship: Learning from experienced nurses.
Ethics committees: Institutional support for complex decisions.
Self-care: Preserving personal integrity and resilience.
IX. Relevance to Global Nursing
The ANA Code aligns with the International Council of Nurses (ICN) Code of Ethics.
Promotes universal values like human dignity, equity, and solidarity.
Encourages nurses to be global advocates for health and justice.
X. Conclusion
The ANA Code of Ethics is a living document that evolves with the profession.
It empowers nurses to act with courage, compassion, and conviction.
Upholding the Code strengthens trust, improves care, and elevates the nursing profession.