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Ethics and Human Rights

ANA successfully champions professional nursing excellence through standards, code of ethics and professional development, such as credentialing and lifelong learning. The Code of Ethics was initiated by the ANA Board of Directors and the Congress on Nursing Practice in 1995. The goal of ANA is to develop and disseminate the cornerstone work of ANA, such as standards, guidelines, principles, Code of Ethics for Nurses with Interpretive Statements, Nursing’s Social Policy Statement to the public and the profession.

Each position statement has a summary which is available to all site visitors. ANA members should click on the title of the statement to view the full version.

Position Statements

Documents

• Position Statement: Stem Cell Research - 1/10/07 (pdf)
  ANA Position: The American Nurses Association (ANA) supports the ethical use of stem cells for research and therapeutic purposes that impact health. Stem cell research is the foundation for cell-based therapies in which stem cells are induced to differentiate into the specific cell type required to repair damaged or destroyed cells or tissues. Stem cells have the ability to divide for indefinite periods in culture and they can give rise to specialized cells. Both embryonic and adult cells are used in this research. Embryonic cells have the potential to become a wide variety of specialized cell types. These undifferentiated cells are derived from a 5-day preimplantation embryo. Adult cells are undifferentiated cells found in a differentiated tissue. They can renew and differentiate (with certain limitations) to give rise to all the specialized cell types of the tissue from which they originated (National Institutes of Health (NIH), 2006).
• Position Statement: Privacy and Confidentiality - 12/08/06
  Summary: Advances in technology, including computerized medical databases, the Internet, and telehealth, have opened the door to potential, unintentional breaches of private/confidential health information. Protection of privacy/confidentiality is essential to the trusting relationship between health care providers and patients.
• Position Statement: Assuring Patient Safety: Registered Nurses’ Responsibility in All Roles and Settings to Guard Against Working When Fatigued - 12/08/06 (pdf)
  ANA Position: The American Nurses Association (ANA) takes the position that, regardless of the number of hours worked, each registered nurse has an ethical responsibility to carefully consider her/his level of fatigue when deciding whether to accept any assignment extending beyond the regularly scheduled work day or week, including a mandatory or voluntary overtime assignment.
• Position Statement: Assuring Patient Safety: The Employers’ Role in Promoting Healthy Nursing Work Hours for Registered Nurses in All Roles and Settings - 12/08/06 (pdf)
  ANA Position: Given the well-documented relationship between nurse fatigue and an increased risk of nurse error with the potential for compromising patient care and safety, it is the position of the American Nurses Association that all employers of registered nurses should ensure sufficient system resources to provide the individual registered nurse in all roles and settings with: 1. a work schedule that provides for adequate rest and recuperation between scheduled work; and 2. sufficient compensation and appropriate staffing systems that foster a safe and healthful environment in which the registered nurse does not feel compelled to seek supplemental income through overtime, extra shifts, and other practices that contribute to worker fatigue.
• Position Statement: Risk and Responsibility in Providing Nursing Care- 6/21/06 (pdf)
  ANA Position: The American Nurses Association (ANA) believes that nurses are obligated to care for patients in a non-discriminatory manner, with respect for all individuals. The ANA also recognizes there may be limits to the personal risk of harm nurses can be expected to accept as an ethical duty.
• Position Statement: Pain Management and Control of Distressing Symptoms in Dying Patients - 12/05/03 [pdf]
  Summary: In the context of the caring relationship (American Nurses Association, 2003), nurses perform a primary role in the assessment and management of pain and other distressing symptoms in dying patients. Therefore, nurses must use effective doses of medications prescribed for symptom control and nurses have a moral obligation to advocate on behalf of the patient when prescribed medication is insufficiently managing pain and other distressing symptoms. The increasing titration of medication to achieve adequate symptom control is ethically justified.
• Position Statement on Nursing Care and Do-Not-Resuscitate Decisions - 12/03 (pdf)
  Summary: Nurses face ethical dilemmas concerning confusing or conflicting DNR orders and this statement includes specific recommendations for the resolution of some of these dilemmas. Although cardiopulmonary resuscitation has been used effectively since the 1960s (Kouwenhoven et al., 1960), the widespread use and possible overuse of this technique and the presumption that it should be used on all patients has been the subject of ongoing debate (Hayward, 1999; Lederberg, 1997). The DNR decision should be directed by what the informed patient wants or would have wanted. This demands that communication about end of life wishes occur between all involved parties [patient, health care providers [HCPs], and family; the latter as defined by the patient], and that appropriate DNR orders be written before a life-threatening crisis occurs.
• Position Statement: Reduction of Patient Restraint and Seclusion in Health Care Settings - 10/17/01
  Summary: Dilemmas in patient care situations are an inevitable consequence of professional accountability. With regard to use of restraints, nurses struggle with conflicts stemming from patients' rights of freedom, nurses' feelings of obligation to "protect" patients, and family and peer pressure to use restraints. ANA believes only when no other viable option is available should restraint be employed. In those instances where restraint, seclusion or therapeutic holding is determined to be "clinically appropriate and adequately justified," registered nurses, who possess the necessary knowledge and skills to effectively manage the situation, must be actively involved in the assessment, implementation and evaluation of the selected intervention.
• Position Statement: Human Cloning by Means of Blastomere Splitting and Nuclear Transplantation - 6/21/00
  Summary: The possibility of using cloning techniques to create human embryos and possibly human beings raises profound ethical, social and health concerns. It is crucial that nurses understand the science of cloning techniques and appreciate the implications of related developments in germ line gene therapy and stem cell research. Nurses must be able to participate actively in the public debate about the possibility of cloning human beings by means of blastomere splitting or somatic cell nuclear transplantation. It is likely that there will be attempts to clone human beings in the near future and nurses must be able to speak to the ethical implications of such developments and point out possible advantages and disadvantages for the human species. In 1999, the ANA House of Delegates directed the ANA Board of Directors to develop and consider the possible adoption of a position statement on cloning.
• Position Statement: Discrimination and Racism in Health Care - 3/26/98
  Summary: Discrimination and racism continue to be a part of the fabric and tradition of American society and have adversely affected minority populations, the health care system in general, and the profession of nursing. Discrimination may be based on differences due to age, ability, gender, race, ethnicity, religion, sexual orientation, or any other characteristic by which people differ. The American Nurses Association (ANA) is committed to working toward the eradication of discrimination and racism in the profession of nursing, in the education of nurses, in the practice of nursing, as well as in the organizations in which nurses work. The ANA is further committed to working toward egalitarianism and the promotion of justice in access and delivery of health care to all people.
• Position Statement: Assisted Suicide 12/08/94
  Summary: The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession. Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care which includes the promotion of comfort and the relief of pain, and at times, foregoing life-sustaining treatments.
• Position Statement: Nurses' Participation in Capital Punishment - 12/08/94
  Summary: The American Nurses Association (ANA) is strongly opposed to nurse participation in capital punishment. Participation in executions is viewed as contrary to the fundamental goals and ethical traditions of the profession.
• Position Statement: The Nonnegotiable Nature of the ANA Code for Nurses with Interpretive Statements - 12/09/94
  Summary: The American Nurses Association's (ANA) Code for Nurses with Interpretive Statements (Code for Nurses) explicates the goals, values and ethical precepts that direct the profession of nursing. The ANA believes the Code for Nurses is nonnegotiable and that each nurse has an obligation to uphold and adhere to the code of ethics.
• Position Statement: Mechanisms Through Which SNAs Consider Ethical/Human Rights Issues - 12/08/94
  Summary: The American Nurses Association (ANA) believes that the State Nurses Association (SNA) is a vital resource for the nurse and the profession on matters related to ethics and human rights. The ANA supports the development of mechanisms by the SNAs to promote the ethical competence of nurses, the integration of the Code for Nurses with Interpretive Statements (Code for Nurses) into daily practice and human rights sensitivity. These mechanisms can take many forms and should be easily accessible to nurses.
• Position Statement: Active Euthanasia - 12/08/94
  Summary: The American Nurses Association (ANA) believes that the nurse should not participate in active euthanasia because such an act is in direct violation of the Code for Nurses with Interpretive Statements (Code for Nurses), the ethical traditions and goals of the profession, and its covenant with society. Nurses have an obligation to provide timely, humane, comprehensive and compassionate end-of-life care.
• Position Statement: Foregoing Nutrition and Hydration - 4/02/92
  Summary: The American Nurses Association, (ANA) believes that, the decision to withhold artificial nutrition and hydration should be made by the patient or surrogate with the health care team. The nurse continues to provide expert care to patients who are no longer receiving artificial nutrition and hydration.
• Position Statement: Nursing and the Patient Self-Determination Acts - 11/18/91
  Summary: The American Nurses Association (ANA) believes that nurses should play a primary role in implementation of the Patient Self-Determination Act, passed as part of the Omnibus Budget Reconciliation Act of 1990. It is the responsibility of nurses to facilitate informed decision-making for patients making choices about end-of-life care. The nurse's role in education, research patient care and advocacy is critical to implementation of the Patient Self-Determination Act within all health care settings.
• Position Statement: Ethics and Human Rights - 9/05/91
  Summary: The purpose of this statement is to describe some of the features of human rights and to indicate how human rights and ethics are related. Human rights are assertions that call for treating human beings as ends in themselves, rather than as means to the goals and purposes of others. The principle of justice is one point at which issues of ethics and human rights intersect. Human rights are assertions that call for treating human beings as ends in themselves, rather than as means to the goals and purposes of others. The principle of justice is one point at which issues of ethics and human rights intersect.
• Position Statement: Cultural Diversity in Nursing Practice - 10/22/91
  Summary: This statement describes the features of an operational definition of cultural diversity as it is expressed in nursing practice, education, administration and research.