The Nurse Practicioner

’Ethics’ is derived from the Greek word ethos, meaning spirit of a community; this is the collective belief and value system of any moral community, social or professional group (Reeves & Orford 2002). Morals and values are inter- related and integral to society. The study of ethics helps one to consider what kind of things are good or bad and how to decide whether actions are right or wrong. Ethics and the law are closely interwoven, as our laws are usually based on ethics (Holland 2004).

The role of codes of practice in ethical decision making is discussed in this chapter using examples from general practice. The reader will recognise many of the examples cited in the chapter, and will probably be able to describe many more.

In order to assess the effectiveness of codes of practice in making ethical decisions in nursing, one must first consider what is meant by an ethical decision. This chapter examines the codes of practice for nurses, following a brief description of ethical principles. The Code of Professional Conduct (Nursing and Midwifery Council 2004) will be referred to as ‘the Code’, the principles of which may conflict with issues relating to power and authority in the primary healthcare setting. The Code has been reviewed and mod- ernised, and is expected to be rolled out in January 2008 (Nursing and Midwifery Council 2007), but the main principles are unlikely to change.
Doctors and nurses may sometimes forget the rights of patients in the rush to ‘get the job done’, meet targets and appear efficient. This is an area that nurses can readily address and possibly share with their primary healthcare team colleagues. Informed consent, for both adults and minors, is essential if the patient is to be involved in their care and be autonomous. Patients with a learning disability pose a greater challenge in obtaining informed consent. The issues discussed within this chapter are pertinent to all areas of nursing care, and are referred to throughout the...