Health Care Ethics Finals Reviewer
Ethical Consideration in
Leadership and Management
Ethical Leadership involved
creating and supporting a
working environment for the
provision of high quality and cost
effective healthcare and ensuring
ethical behaviors among nurses.
Character is the possession of
skills and making visible ethical
acts, recognizing ethical issues
and demonstrating features of
role modelling, motivation and
authenticity. Conduct convey the
relationship between the ethical
standards and high quality care,
supporting ethical acts in daily
practice and implementing
sanctions in the case of ethics
violation while performing
nursing care.
Ethical leaders are described in
nursing literature as altruistic,
honest, disciplined, efficient, fair,
and able to navigate moral
distress experienced by her
department to arrive at a
harmonious decisions. They serve
as role models of ethical behavior.
Florence Nigthingale is one of
the first nursing leaders who
demonstrated high regard for the
ethical dimension of nursing
practice through her writings in
1860 on the ethical guidelines for
nursing leaders.
 By creating an ethical climate,
ethical leadership leads to
positive and effective
outcomes, professional
progress and development of
the nursing profession.
 Perceived ethical climate
takes place in moral
sensitivity and is related to
moral courage. Also, there
was a significant positive
correlation between nurses
ethical climates and their
moral courage.
Moral Decision- Making
 It is imperative to arrive at an
ethical action or intervention.
It would require an ethical
judgement and such
judgement needs a basis a
specific reference point, a
criteria or, condition so we
can examine, evaluate the
judge and consequently act
ethically.
Ethical decision-making
confidence develops from clinical
experience and is a core
competency for nurse leaders. No
tool exists to measure confidence
levels in nurse leaders based
upon an ethical decision-making
framework.
Phases of Competency
1. Knowledge development-Moral
sensitivity
2. Knowledge application
3. Creating an Ethical Environment
4. Promoting Social Justice within
the health care system
Health Care Ethics Finals Reviewer
18 Indicators in the
Development of ethical
decision-making confidence
scale:
1. Recognize a genuine ethical
dilemma in practice
2. Make a sound ethical decision
3. Explain ethical decisions using
correct ethical terminology and
language
4. Provide a clear statement of the
personal values that guide your
ethical decision-making and practice.
5. Articulate legal guidelines related
to complex ethical issues in patient
care.
6. Articulate the difference between
ethical dilemmas, moral distress,
issues related to interprofessional
collaboration and communication,
difficult patients.
7. Articulate the definition of moral
distress and provide an example of
your experience of moral distress in
your practice.
8. Identify ethical issues in complex
patient care.
9. Apply ethical decision-making
models or structured processes to
complex ethical problems.
10. Participate in and/or guide
mediation related to complex clinical
problems involving ethical
dilemmas or moral distress.
11. Recognize and manage moral
distress in self and others.
12. 12. Role model collaborative
problem solving in complex clinical
problems involving ethical
dilemmas and moral distress.
13. 13.Engage in preventive ethics
initiatives to address the ethical
environment in your practice area.
14. 14. Mentors others to develop
ethical practice behavior.
15. 15. Address barriers to ethical
practice through system changes.
16. 16. Use in preventive ethical
practice through system changes.
17. 17. Engage in health policy
initiatives supporting social justice.
18. 18. Provide leadership at the unit,
organizational, local, state and
federal level for policy change
initiatives to address social justice
issues in the health care.
ETHICAL DECISION
- is one that engenders trust,
and thus indicates
responsibility, fairness, and
caring. come from a place of
conscience. For many,
conscience is simply an internal
source of reward and
punishment. It should be based
on ethical principles and codes
rather than on emotions,
thoughts, fixed policies
ETHICAL DECISION
MAKING
- requires a review of different
options, eliminating those with an
unethical standpoint, and then
choosing the best ethical alternative.
The process is the process of
choosing the best alternative for
achieving the best results or
outcomes compliance with
individual and social values, moral,
and regulations. Also a process
provides a method for nurses to
answer key questions about ethical
dilemmas and to organize their
thinking in a more logical and
sequential manner.
Health Care Ethics Finals Reviewer
The process of making ethical
decisions requires:
Commitment
Consciousness
Competency
Good decisions are both
ethical and effective:
 Ethical decisions generate and
sustain trust; demonstrate
respect, responsibility, fairness,
and caring; and are consistent
with good citizenship.
 Effective decisions are effective
if they accomplish what we want
accomplished and if they
advance our purposes. A choice
that produces unintended and
undesirable results is ineffective.
PRINCIPLE OF MORAL
DISCERNMENT
 To make a conscientious ethical
decision one must do the
following:
 Proceed on the basis of a
fundamental commitment to God
and to human persons (including
oneself) according to their God-given
and graced human nature.
 Among possible actions that might
seem to be means of fulfilling that
commitment, exclude any that are
contradictory to it (or those that are
intrinsically evil)
 Consider how one’s own motives and
other circumstances may contribute
to or nullify the effectiveness of these
other possible actions as means to
fulfill one’s fundamental
commitment.
 Among the possible means not
excluded or nullified, select one by
which one is most likely to fulfill that
commitment and act on it.
PRINCIPLE OF WELL-
FORMED CONSCIENCE
 To attain the true goals of human life
by responsible actions, in every free
decision involving an ethical question,
people are morally obliged to do the
following:
 Informed themselves as fully as
practically possible about the facts
and the ethical norms.
 Form a morally certain judgement of
conscience on the basis of this
information.
 Act according to this well-formed
conscience
 Accept responsibility for their actions
CONSCIENCE FORMATION
 The word conscience arises from the
Latin, conscienta, and French,
conscience and was defined as the
internal sense of what is right or
wrong, and one’s ability to choose
between, as well as act upon, what
one perceives to be the right thing to
do.
 Conscience is in nursing practice is
the cornerstone for ethics relevant to
ethical nursing care.
 In nursing, conscience is broadly
perceived as an authority, a warning
signal, demanding sensitivity, an
asset, a burden, inherent in nursing,
and culturally dependent.
 When nurses can follow their
conscience guiding them to provide
quality care, conscience is positively
perceived. Nurses who can follow
their conscience are less likely to
encounter conflicts of conscience in
practice. Nurses who can not follow
their conscience report having a
troubled conscience.
 Nurses’ troubled conscience have
been associated with feelings of guilt
when
 Nurses’ core beliefs conflict with
social or professional beliefs.
 Nurses can not fulfill their care
obligations to patients due to time
constraints
Health Care Ethics Finals Reviewer

 Nurses are placed in scenarios where Ethical Issues in Nursing

they feel they are working against
their conscience.
Leadership and Management
Nurses frequently encounter
difficult situations involving
Key Points on Conscience decisions about the best course of
Formation action. Nurses are expected to
 Making moral decisions demand provide not only expanding nursing
mature responsibility care but also ethical and legal client
 A fully mature and responsible care that demonstrates respect for
conscience should be free, others. Nurses confront not only the
correct, clear, and certain expanding role and ever changing
 Discern what is right and what is clinical environment but also various
wrong ethical or moral problems and
 We must follow our decision concerns.
only after we have done our best
to search for the truth regarding Three Categories of Ethical
the issue facing us Competence of Nursing
Leaders
Qualities of conscience Empathetic Interactions- solution of
problems and wishes; establishing
Personal Freedom- should be free confidence and assurance; mutual
from some obstacles such as fear and liking and respect; establishing the
anger human and ethical interaction
empathy; cooperation
Conscience can be described Ethical Behavior- supportive
behavior; contributory behavior; fair
in terms of:
behavior; ethical behavior toward
 Objective Value
wrongdoers; ethical behavior toward
-correct
patients.
-objective
Exalted Manners- honesty; humility;
-erroneous
sincerity; decisiveness and
-culpable
determination good-temperedness;
-inculpable
patience and tolerance
 Moral attitude
-Lax
-Strict Three main obstacle
-Scrupulous 1. Ethical problems
-Pharisaical 2. Cultural Problems
-Clear 3. Managerial Problems
-Callous
Moral Distress- in 1984 Adrew Jameton
 Degree of Certitude
first coined the term.it is defined as the
-perplexed physical or emotional anguish that is
-doubtful experienced when we are prevented from
-probable the following course of action that we
-certain believe is right.
Health Care Ethics Finals Reviewer
Moral Outrage- occurs when nurse
knows the morally correct action and feels
a responsibility to the patient, but
institutional or other restraints make it
nearly impossible to follow through with
appropriate action. Occurs with someone
else in the health care setting performs an
act the nurse believes to be immoral.
The Main Categories of
Ethical Problems Identified by
Nurse Managers:
Conflicts in practical situations-
conflicts in practical situations included
situations where there were at least two
different opinions as to what was the
right way to act. Situations where
conflicts exists are obvious and conflicting
values are easily found, and there usually
is open discussion between two or more
parties.
Lack of appreciation-
nurse managers have perceived some
participants being undervalued or not
taken into account when making
decisions. The values included are
equality, respect and regarding to patients
human dignity.
Disregard of problems-
consisted of matters that nurse managers
considered wrong but somehow accepted
as existing in the organization culture, or
at least there was nothing active going on
to correct them. These problems are
perceived commonly in the organization
also by other professionals.
Experienced Inadequacy-
nurse managers described situations
where they did not have enough ways to
do the best possible thing. There were
many kinds of obstacles which are very
difficult to impact: legislative, financial,
and cultural.
Meaning and service value of
medical care
 Another important area of
concern for nursing leaders is
the medical care that is often
rendered to patients in need of
medical attention based on
urgency. The value that
underlies the implementation of
medical care can be measured by
the improvement of patients’
outcomes for the cost of
achieving the said desired
outcome. With that being said,
the concept of VALUE- BASED
HEALTH CARE is introduced.
This concept and strategy was a
result of decades of research into
organizations that have achieved
better outcomes while often
lowering costs.
The goal of value-based care
transformation is to enable the
health care system to add more
value to patients’ lives. Because
value is created only when a
person’s health outcomes improve,
cost cutting descriptions of value-
based health care are inadequate.
Cost reduction is important, but it is
not sufficient: if the true goal of
value-based health care was cost
reduction, pain relievers and
compassion would suffice.
Value-based health care is
frequently confused with quality, a
nebulous concept that implies a
plethora of virtues and, in health
care, frequently focuses on inputs
and process compliance.
Health Care Ethics Finals Reviewer
Allocation of resources
 Health care requires resources,
and resources in turn entails
cost and budgetary
requirements, therefore as a
value-based health care is to
be promoted it is imperative
to allocate adequate resources
that are cost-effective to meet
the patients’ outcome.
 Value aligns care with how
patients experience their
health by focusing on the
outcomes that matter most to
patient. Health outcomes can
be described in terms of:
 Capability is the ability of
patients to do the things that
define them as individuals
and enable them to be
themselves. It is often tracked
with functional measures.
 Comfort is relief from
physical and emotional
suffering. In addition to
reducing pain, improving
patients’ comfort requires
addressing the distress and
anxiety that frequently
accompany or exacerbate
illness.
 Calm is the ability to live
normally while getting care. It
encompasses freedom from
the chaos that patients often
experience in the health care
delivery system, and it is
especially important for
people with chronic and long
term conditions.
Issues involving access to care
 Access to health care means
having “the timely use of
personal health services to
achieve the best health
outcomes”.
 Elements of Access to Heath
Care
 Coverage- facilitates entry
into the health care system.
Uninsured people are less
likely to receive medical care
and more likely to have poor
health status.
 Services- having a usual
source of care is associated
with adults receiving
recommended screening and
prevention services.
 Timeliness- ability to provide
health care when the need is
recognized
 Workforce- capable, qualified,
culturally competent
providers.
Issues on access to healthcare
“Bahala na” mentality drains
our health care system.
Shortage of health care workers,
limited access to health care
facilities, and high out of
pocket expenses for
hospitalization and health care
needs are among the problems
that we face because of “Bahala
na” mentality.
Health Care Ethics Finals Reviewer

The Universal Health Care (UHC) . Health Human Resources

policy aims to resolve these issues. Development-
Three article: Increased Coverage of the law ensures that there will be
Philhealth, Clarification of roles of development of the health
Government Agencies, and Health system’s human resources
Human Resources Development.
through the formulation and
implementation of the National
 Increased Coverage of
Health Human Resource Master
Philhealth or the National
Plan, which ensures that all
Health Insurance Program
health professionals have
refers to the automatic
permanent employment and
inclusion of Filipino citizens
competitive salaries as well as the
to the health insurance
provision for the creation of
program. As compared before
national health workforce support
where there is a large portion
system that will aid local public
of high out of pocket health
health systems in addressing
care expenses of the people. It
human resource needs while
may not cover 100% of the
prioritizing deployment in the
hospital billbut it decreased
Geographically Isolated and
the high out of pocket
Disadvantaged areas (GIDAs).
expenses.
 Clarification of roles of
 The UHC law also tasks the
government agencies. The law
Education sector and the
addresses the overlapping
DOH to develop existing and
roles and responsibilities of
new allied and health-related
different health agencies due
degrees and training
to devolved set up. The law
programs, and to regulate the
clarified these roles wherein
number of its enrollees
the Department of Health
depending on the needs of the
(DOH) and local government
population. The law provides
units (LGU) will be
scholarship grants for
responsible for population-
graduate and undergraduate
based interventions and
allied and health-related
health services, which
programs, and in return
involves immunization and
graduates will be required by
health promotion programs,
law to render at least three
while Philhealth will be
years of return of service with
responsible for financing
compensation under the
individual-based health
supervision of the DOH.
services. This will now mean
Incentives will be given to
that people will be no longer
those who will render an
have to visit one charitable
additional two years of return
institution to another.
of service.
Health Care Ethics Finals Reviewer
ETHICAL ISSUES RELATED
TO TECHNOLOGY AND
DELIVERY OF HEALTH
CARE
Data Protection is the act of
protecting information, both
sensitive and personal sensitive
to unauthorized access and use.
Security is typically define by
three main attributes:
availability, integrity, and
confidentiality.
Availability relates to the
prevention of unauthorized
actors withholding information,
for as during a ransomware
assault. Confidentiality and
integrity are concerned with
information staying private,
undamaged, and undamaged
by malevolent actors.
Protection provides a
framework for controlling
access to data, processes,
programs, and other resources.
Implications to Practice
 Healthcare services rely
heavily on the open
exchange of information
among all participants-
whether the customer, the
healthcare professional, or
the health institution.
 Clients are more likely to
offer complete and accurate
data when they are
convinced that their
information is safe and
secure in the hands of their
healthcare practitioner.
 The majority of the data
you process as a healthcare
professional is classified as
sensitive personal
information. Data privacy
safeguards guarantee that
your client’s information is
safe and secure.
 It ensures that their data
is secure at all times and is
not vulnerable to risks and
vulnerabilities such as
unlawful access, processing,
sharing, and disclosure.
Republic Act No. 10173 is also
known as Data Privacy Act of
2012 (DPA)
 It protects the privacy of
individuals while ensuring
free flow of information to
promote innovation and
growth.
 It regulates the collection,
recording, organization,
storage, updating, or
modification, retrieval,
consultation, use,
consolidation, blocking,
erasure or destruction of
personal data.
 It ensures that the
Philippines complies with
international standards set
for data protection through
NPC
Health Care Ethics Finals Reviewer
The National Privacy
Commission (NPC) is the
country’s privacy watchdog; an
independent body mandated to
administer and implement the
DPA, and to monitor and
ensure compliance of the
country with international
standards set for data
protection.
 The DPA applies to the
processing of all types of
personal information and to
any natural or juridical
person involved in personal
information processing,
including personal
information controllers and
processors who, while not
located or established in the
Philippines, use equipment
located in the Philippines,
or those who maintain an
office, branch, or agency in
the Philippines subject to
the immediately following
paragraph: Provided, that
the requirements of Section
5 are complied.
 Appointing a Data
Protection Officer (DPO) is
a legal requirement for
personal information
controllers (PICs) and
personal information
processors (PIPs), under the
Data Privacy Act of 2012.
 Appendix 1 of NPC
Circular 17-01 provides that
PICs or PIPs that are
involved in the processing
of personal data that are
likely to pose a risk to the
rights and freedoms of data
subjects and/or those who
processing are not
occasional are subject to
mandatory registration of
their DPO’s and data
processing systems.
 Privacy Notice is a
statement made to a data
subject that describes how
the organization collects,
uses, retains and discloses
personal information. It is
sometimes referred to as
privacy statement, a fair
processing statement, or
privacy policy.
 Privacy Impact Assessment
(PIA) is a process
undertaken and used to
evaluate and manage
impacts on privacy of a
particular program, project,
process, measure, system,
or technology product of a
PIC or PIP. It takes into
account the nature of the
personal data to be
protected, the personal data
flow, the risks to privacy
and security posed by the
processing, current data
Health Care Ethics Finals Reviewer
privacy best practices, the
cost of the security
implementation, and, where
applicable, the size of the
organization, its resources,
and the complexity of its
operations.
 Privacy Management
Program (PMP) refers to a
process intended to embed
privacy and data protection
in the strategic framework
and daily operations of a
PIC or PIP, maintained
through organizational
commitment and oversight
of coordinated projects and
activities.
 DPA, the consent of the
data subject is defined as
any freely given, specific
informed indication of will,
whereby the data subject
agrees to the collection and
processing of personal
information about and/or
relating to him or her.
CONSENT OF THE DATA
SUBJECT
- To protect privacy, the law
requires organizations to notify and
furnish their data subjects with the
following information before they
enter personal data into any
processing system, or at the next
practical opportunity:
1. Description of the personal data
to be entered into the system
2. Purposes for which data will be
processed
3. Basis for processing, especially
when it is not based on consent
4. Scope and method of the
personal data processing
5. Recipients to whom data maybe
disclosed
6. Methods used for automated
access by the recipient and the
extent to which such access is
authorized.
7. Identify and contact details of
the PIC or its representative
8. The duration for which data will
be stored
9. Existence of the rights of the
data subjects
GUIDELINES IN
COLLECTING & ASSESING
PERSONAL DATA
- As the commission has often said,
health practitioners and anyone
involved in the delivery of health
care services must gather only the
required personal information.
Recipients should not be saddled
with personal data obligations that
go beyond the bare minimum, since
this would simply slow the delivery
of relief in this time of need. Access
to health data must be granted solely
on a “need-to-know” basis, which
implies that only individuals on the
health team must have the minimum
and essential access to execute their
tasks.
Health Care Ethics Finals Reviewer
What do I need to keep in
mind when storing client’s
information?
- The DPA and its IRR provides
that personal data shall not be
retained longer than necessary:
1. For the fulfillment of the
declared, specified, and
legitimate purpose, or when
the processing relevant to the
purpose has been terminated,
2. For the establishment,
exercise or defense of legal
claims; or
3. For legitimate business
purposes, which must be
consistent with standards
followed by the applicable
industry or approved by
appropriate government
agency.
 Likewise, retention of
personal data shall be
allowed in cases provided
by law.
 For members of the Health
and Hospitals sector,
reference may be made to
DOH Memorandum
Circular No. 70, series of
1996for the Revised
Disposition Schedule of
Medical Records.
 Under the IRR, personal data
shall be disposed or
discarded in a secure manner
that would prevent further
processing, unauthorized
access, or disclosure to any
other party or the public, or
prejudice the interests of thee
data subjects. The DPA
penalizes improper disposal of
personal information and
sensitive personal information.
BENEFITS AND CHALLENGES
OF TECHNOLOGY
 Technology has its
advantages on the health
care system primarily om
streamlining the services and
makes the workload of health
care professionals lighter and
more efficient. Specifically,
the three major benefits of
technology in healthcare are
as follows:
1. Improved Care Coordination-
improving coordination has a
long been a goal of
healthcare, serving as a
cornerstone of The Joint
Commission’s National Patient
Safety Goals program and a
component of meaningful
use attestation. Despite
increased focus, care
coordination remains a
difficulty for organizations,
particularly during transitions
of care, resulting in adequate
care quality and safety.
2. Improved Population Health
Management- population
health is a novel term that
may be described as “ the
health result of a group of
individuals, including the
Health Care Ethics Finals Reviewer
distribution of such outcomes
within the group.” “Without
data on the health
populations you serve”. “ Any
population health initiatives
become educated guesses
at best.” according to the
survey 35% of all respondents,
including hospital and health
system providers, physicians,
and other medical
professionals, did not have
adequate access to clinical
data from disparate systems.
3. Improved Patient Education-
patient education used to be
mostly based on written
information regarding illness
processes, medications,
medical management,
and self-care teaching
instructions. Patients may now
get health information
from anywhere, thanks to the
internet and mobile
technologies.
Telemedicine
advancements now allow
people to consult with a
healthcare expert anytime they
need one.
CHALLENGES OF TECHNOLOGY IN
HEALTHCARE
3 CATEGORIES
1. Healthcare Organization
- the expense of
technology is one of the most
significant difficulties for
enterprises in terms of
installation and subsequent
upkeep.
2. Healthcare Providers
- despite the fact that
healthcare technology offers
great opportunities to enhance
healthcare outcomes, improper
use must be addressed. The
technological imperative relates
to the inevitability of new
technology and its necessary
character, which indicates the
necessity for adoption for social
benefit.
3.Patients
- the implications of the
moral obligation bleed over into
the issues that patients face. The
necessity to assure appropriate
use of costly equipment ( at least
during the early adoption period)
and the moral obligation to use
new technology directly
contradicts the need to protect
patient autonomy, as drawn
from the application of
personalize to healthcare system.
CURRENT TECHNOLOGY:
ISSUES AND DILEMMA
1) Privacy and Security
- the issue of privacy and security
will always be in question once
technology is applied in
the healthcare setting.
2.) . Sociotechnical Health
- Sociotechnical health as
to the observation that issues
pertaining to technologies such
as applications of digital health
are never solely about the
material technology itself, but
about the mutual dependencies
between technologies and the
social arrangements in which
they are built and used.
Health Care Ethics Finals Reviewer
2.1 Application Software
- identified that ethical issues at
the level of application .
2.2 Material Devices and Supply
Chains
- the actual material used to
build and distribute the devices t
2.3 Infrastructures
- this refers to the hardware and
software required to operate
digital devices.
2.4 Individual Health- Related
Practices
- digital technologies are used in
a variety of health-related
applications
2.5 Interpersonal Relationship
- digital health technologies have
the potential to have a wide
range of effects on interpersonal
relationships.
2.6 Organizational Policies
- digital technologies have
the potential to
dramatically ;alter daily work
practices, and thus the structure
and function of organizations.
CONTINUING EDUCATION
PROGRAMS ON ETHICO-
MORAL PRACTICE IN
NURSING
A. Lobbying/Advocating for
Ethical Issues in Health Care
 According to Merriam-
Webster:
Advocacy- the act or process of
promoting a cause or proposal.
Lobbying- the act or process of
influencing public officials to
promote (something, such as
project) or secure the passage of
(legislation).
Advocacy and lobbying are
similar at their core- nurse
advocates or lobbies to raise
awareness of an issue- the actual
intent of the act is different.
To advocate is to raise and
publicize an issue within a
community, such as making
health care a topic of national
debate and media attention.
Lobbying is the process of
directing one’s efforts toward
individuals in positions of authority,
such as public officials, politicians,
government bodies, and
regulatory agencies.
 The code of ethics for nurses
requires nurses to treat all
patients fairly and equally,
respecting their “innate
dignity, worth, and individual
traits independent of the
elements that influence a
person’s health”. Illness, ability,
financial state, or proximity to
death have no bearing on a
person’s worth. These issues
must be considered in the
provision of just care since
they influence the need for
treatment and the allocation
of health care.
B. Code of Ethics for Nurses
1. International Code of Ethics
 The ICN Code of Ethics for
Nurses is a statement of the
ethical values, responsibilities
Health Care Ethics Finals Reviewer
and professional standards of
nurses. It guides everyday
ethical nursing practice and
can serve as a regulatory tool
to guide and define ethical
nursing practice.
 An international code of
ethics for nurses was first
adopted by the International
Council of Nurses (ICN) in
1953. it has been revised and
reaffirmed at various times
since, most recently with this
review and revision
completed in 2012.
 Nurses have four fundamental
responsibilities: to promote
health, to prevent illness, to
restore health and to alleviate
suffering. The need for nursing
is universal.
 Inherent in nursing is a respect
for human rights, including
cultural rights, the right to life
and choice, to dignity and to
be treated with respect.
Nursing care is respectful of
and unrestricted by
considerations of age, color,
creed, culture, disability or
illness, gender, sexual
orientation, nationality,
politics, race or social status.
ELEMENTS OF THE CODE
1. Nurses and people
 The nurse’s primary
professional responsibility is to
people requiring nursing care.
 In providing care, the nurse
promotes an environment in
which the human rights,
values, customs, and spiritual
beliefs of the individual, family
and community are
respected.
 The nurse ensures that the
individual receives accurate,
sufficient and timely
information in a culturally
appropriate manner on which
to base consent for care and
related treatment.
 The nurse holds in confidence
personal information and uses
judgement in sharing this
information.
 The nurse shares with society
the responsibility for initiating
and supporting action to
meet the health and social
needs of the public, in
particular those of vulnerable
populations.
 The nurse advocates for
equity and social justice in
resource allocation, access to
health care and other social
and economic services.
 The nurse demonstrates
professional values such as
respectfulness, responsiveness,
compassion, trustworthiness
and integrity.
CODE 1
a) Practitioners and Managers
 provide care that respects
human rights and is sensitive
to the values, customs and
beliefs of people.
 Provide continuing education
in ethical issues.
 Provide sufficient information
to permit informed consent to
nursing and/or medical care,
and the right to choose or
refuse treatment.
 Use recording and
information management
systems that ensure
confidentiality.
Health Care Ethics Finals Reviewer
 Develop and monitor
environmental safety in the
workplace.
b. Educators and Researchers
 In curriculum include
references to human rights,
equity, justice, solidarity as the
basis for access to care.
 Provide teaching and
learning opportunities for
ethical issues and decision
making.
 Provide teaching/learning
opportunities related to
informed consent, privacy
and confidentiality,
beneficence and
maleficence.
 Introduce into curriculum
concepts of professional
values.
 Sensitize students to the
importance of social action in
current concerns.
c. National Nurses Associations
 Develop position statements
and guidelines that support
human rights and ethical
standards.
 Lobby for involvement of
nurses in ethics committees.
 Provide guidelines, position
statements, relevant
documentation and
continuing education related
to informed consent to
nursing and medical care.
 Incorporate issues of
confidentiality and privacy
into a national code of ethics
for nurses.
 Advocate for safe and
healthy environment.
2. Nurses and Practice
 The nurse carries personal
responsibility and
accountability for nursing
practice, and for maintaining
competence by continual
learning.
 The nurse maintains a
standard of personal health
such that the ability to
provide care is not
compromised.
 The nurse uses judgement
regarding individual
competence when
accepting and delegating
responsibility.
 The nurse at all times
maintains standards of
personal conduct which
reflects well on the profession
and enhance its image and
public confidence.
 The nurse, in providing care,
ensures that use of
technology and scientific
advances are compatible
with the safety, dignity and
rights of people.
 The nurse strives to foster and
maintain a practice culture
promoting ethical behavior
and open dialogue.
Elements of the Code #2 to:
A. Practitioners and Managers
 Establish standards of care
and a work setting that
promotes quality care.
 Establish systems for
professional appraisal,
continuing education and
systematic renewal of
licensure to practice.
 Monitor and promote the
personal health of nursing
Health Care Ethics Finals Reviewer
staff in relation to their
competence for practice.
b. Educators and Researchers
 Provide teaching/learning
opportunities that foster life
long learning and
competence for practice.
 Conduct and disseminate
research that shows links
between continual learning
and competence to practice.
 Promote the importance of
personal health and illustrate
its relation to other values.
c. National Nurses Associations
 Provide access to continuing
education, through journals,
conferences, distance
education, etc.
 Lobby to ensure continuing
education opportunities and
quality care standards.
 Promote healthy lifestyles for
nursing professionals. Lobby
for healthy workplaces and
services for nurses.
3. Nurses and the Profession
 The nurse assumes the major
role in determining
acceptable standards of
clinical nursing practice,
management, research and
education.
 The nurse is active in
developing a core or
research-based professional
knowledge that supports
evidence-based practice.
 The nurse is active in
developing and sustaining a
core of professional values.
 The nurse, acting through the
professional organization,
participates in creating a
positive practice environment
and maintaining safe,
equitable social and
economic working conditions
in nursing.
 The nurse practices to sustain
and protect the natural
environment and is aware of
its consequences on health.
 The nurse contributes to an
ethical organizational
environment and challenges
unethical practices and
settings.
Elements of the Code #3 to:
 Practitioners and Managers
 Set standards for nursing
practice, research, education
and management.
 Foster workplace support of
the conduct, dissemination
and utilization of research
related to nursing and health.
 Promote participation in
national nurses’ associations
so as to create favorable
socioeconomic conditions for
nurses.
b. Educators and Researchers
 Provide teaching/learning
opportunities in setting
standards for nursing practice,
research, education and
management.
 Conduct, disseminate and
utilize research to advance
the nursing profession.
 Sensitive learners to the
importance of professional
nursing associations.
c. National Nurses Associations
 Collaborate with others to set
standards for nursing
Health Care Ethics Finals Reviewer
education, practice, research
and management.
 Develop position statements,
guidelines and standards
related to nursing research.
 Lobby for fair social and
economic working conditions
in nursing. Develop position
statements and guidelines in
workplace issues.
4. Nurses and Co-workers
 The nurse sustains a
collaborative and respectful
relationship with co-workers in
nursing and other fields.
 The nurse takes appropriate
action to safeguard
individuals, families, and
communities when their
health is endangered by a
co-worker or any other person.
 The nurse takes appropriate
action to support and guide
co-workers to advance
ethical conduct.
 To achieve its purpose the
Code must be understood,
internalized and used by
nurses in all aspects of their
work. It must be available to
students and nurses
throughout their study and
work lives.
Elements of the Code #4 to:
 Practitioners and Managers
 Create awareness of specific
and overlapping functions
and the potential for
interdisciplinary tensions and
create strategies for conflict
management.
 Develop workplace systems
that support common
professional ethical values
and behavior.
 Develop mechanism to
safeguard the individual,
family or community when
their care is endangered by
health care personnel.
b. Education and Researchers
 Develop understanding of the
roles of other workers.
 Communicate nursing ethics
to other professions.
 Instill in learners the need to
safeguard the individual,
family or community when
care is endangered by health
care personnel.
c. National Nurses Associations
 Stimulate co-operation with
other related disciplines.
 Develop awareness of ethical
issues of other professions.
 Provide guidelines, position
statements and discussion for
a related to safeguarding
people when their care is
endangered by health care
personnel.
 Applying the Elements of
the ICN Code of Ethics for
Nurses- this four elements
of the ICN Code of Ethics
for Nurses: Nurses and the
people, nurses and
practice, nurses and the
profession, nurses and co-
works, give a framework
for the standards of
conduct.
Health Care Ethics Finals Reviewer
2. Code of Ethics for Filipino
Nurses
BOARD OF NURSING
Board Resolution No. 220
Series of 2004
PROMULGATION OF THE CODE OF
ETHICS FOR REGISTERED NURSES
WHEREAS, the Board of
Nursing has the power to
promulgate a Code of Ethics for
Registered Nurses in coordination
and consultation with the
accredited professional
organization (Sec.9, Art. III of R.A.
No. 9173, known as the
“Philippine Nursing Act of 2002);
WHEREAS, in the
formulation of the Code of Ethics
for Registered Nurses, the Code
of Good Governance for the
Professions in the Philippines was
utilized as the principal basis
therefore: All the principles under
the said Code were adopted
and integrated into the Code of
Ethics as they apply to the nursing
profession;
WHEREAS, the promulgation
of the said Code as a set
guidelines, regulations or
measures shall be subject to
approval by the Commission (Sec.
9,Art. II of R.A No. 9173); and
WHEREAS, the Board, after
consultation on October 23, 2003
at Iloilo City with the accredited
professional organization of
registered nurses, the Philippine
Nurses association, Inc. (PNA),
and other affiliate organizations
of Registered Nurses, decided to
adopt a new Code of Ethics
under the afore-mentioned new
Law;
NOW, THEREFORE, the
Board hereby resolved, as it now
resolves, to promulgate the
hereunder Code of Ethics for
Registered Nurses:
ARTICLE I. PREAMBLE
SECTION 1.
Health is a fundamental
right of every individual. The
Filipino registered nurse, believing
in the worth and dignity of each
human being, recognizes the
primary responsibility to preserve
health at all cost. This
responsibility encompasses
promotion of health, prevention
of illness, alleviation of suffering,
and restoration of health.
However, when the foregoing are
not possible, assistance towards a
peaceful death shall be his/her
obligation.
SECTION 2.
To assume this responsibility,
registered nurses have to gain
knowledge and understanding of
man’s cultural, social, spiritual,
psychological, and ecological
aspects of illness, utilizing the
therapeutic process. Cultural
diversity and political and socio-
economic status are inherent
factors to effective nursing care.
SECTION 3.
The desire for the respect
and confidence of clientele,
colleagues, co-workers, and the
members of the community
provides the incentive to attain
and maintain the highest possible
degree of ethical conduct.
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ARTICLE II. REGISTERED NURSES
AND THE PEOPLE
SECTION 4.
Ethical Principles
Values, customs, and spiritual
beliefs held by individual shall be
respected.
Individual freedom to make
rational and unconstrained
decisions shall be respected.
Personal information acquired in
the process of giving nursing care
shall be held in strict confidence.
SECTION 5. Guidelines to be
observed:
REGISTERED NURSES must:
a. Know the definition and scope
of nursing practice which are in
the provisions of R.A No. 9173,
known as the “Philippine Nursing
Act of 2002” and Board Res. No.
425, Series of 2003, the “Rules and
Regulations Implementing the
Philippine Nursing Act of 2002”.
(IRR).
b. Be aware of their duties and
responsibilities in the practice of
their profession as defined in the
“Philippine Nursing Act of 2002
and the IRR.
c. Acquire and develop the
necessary competence in
knowledge, skills, and attitudes to
effectively render appropriate
nursing services through varied
learning situations.
d. If they are administrators, be
responsible in providing favorable
environment for the growth and
developments of Registered
Nurses in their charge.
e. Be cognizant that professional
programs for specialty
certification by the BON are
accredited through the Nursing
Specialty Certification Council
(NSCC).
f. See to it that quality nursing
care and practice meet the
optimum standard of safe nursing
practice.
g. Insure that modification of
practice shall consider the
principles of safe nursing practice.
h. If in position of authority in a
work environment, be normally
and legally responsible for
devising a system of minimizing
occurrences of ineffective and
unlawful nursing practice.
i. Ensure that patients’ records
shall be available only if they are
to be issued to those who are
professionally and directly
involved in their care and when
they are required by law.
SECTION 8.
Ethical Principle
Registered Nurses are the
advocates of the patients: they
shall take appropriate steps to
safeguard their rights and
privileges.
SECTION 9.
Guidelines to be observed:
REGISTERED Nurses must
a) Respect the “ Patients’ Bill of
Rights” in the delivery of nursing
care.
b) Provide the patients or their
families with all pertinent
information except those which
may be deemed harmful to their
well-being.
c) Uphold the patients’ rights
when conflict arises regarding
management of their care.
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ARTICLE IV. REGISTERED

SECTION 10. Ethical Principle NURSES AND CO-WORKERS
Registered Nurses are
SECTION 12. Ethical Principles
aware that their actions have
1. The Registered Nurse is in
professional, ethical, moral, and
solidarity with other members
legal dimensions. They strive to
of the healthcare team in
perform their work in the best
working for the patient’s best
interest of all concerned.
interest.
2. The Registered Nurse
SECTION 11. Guidelines to be
maintains collegial and
observed:
collaborative working
REGISTERED Nurses must:
relationship with colleagues
a) Perform their professional
and other healthcare
duties in conformity with
providers.
existing laws, rules and
regulations, measures, and
SECTION 13. Guidelines to be
generally accepted principles
observed:
of moral conduct and proper
REGISTERED Nurses must:
decorum.
1. Maintain their professional
b) Not allow themselves to be
role/identity while working
used in advertisement that
with other members of the
should demean the image of
health team.
the profession (i.e. indecent
2. Conform with group activities
exposure, violation of dress
as those of a health team
code, seductive behavior,
should be based on
etc.).
acceptable, ethico-legal
c) Decline any gift, favor or
standards.
hospitality which might be
3. Contribute to the professional
interpreted as capitalizing on
growth and development of
patients.
other members of the health
d) Not demand and receive any
team.
commission, fee or other
4. d. Actively participate in
compensations to the one
professional organizations.
referring or recommending a
5. e. Not act in any manner
patient to them for nursing
prejudicial to other
care.
professions.
e) Avoid any abuse of the
6. f. Honor and safeguard the
privilege relationship which
reputation and dignity of the
exists with patients and of the
members of nursing and other
privilege access allowed to
professions; refrain from
their property, residence or
making unfair and
workplace.
unwarranted comments or
criticisms on their
competence, conduct, and
procedures; or not do
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anything that will bring
discredit to a colleague and
to any member of other
professions.
7. g. Respect the rights of their
co-workers.
ARTICLE V. REGISTERED NURSES,
SOCIETY, AND ENVIRONMENT
SECTION 14. Ethical Principles
a) The preservation of life,
respect for human rights, and
promotion of healthy
environment shall be a
commitment of a Registered
Nurse.
b) The establishment of linkages
with the public in promoting
local, national, and
international efforts to meet
health and social needs of
the people as a contributing
member of society is a noble
concern of a Registered
Nurse.
SECTION 15. Guidelines to be
observed:
REGISTERED Nurses must:
a) Be conscious of their
obligations as citizens and, as
such, be involved in
community concerns.
b) Be equipped with knowledge
of health resources within the
community, and take active
roles in primary health care.
c) Actively participate in
programs, projects, and
activities that respond to the
problems of society.
d) Lead their lives in conformity
with the principles of right
conduct and proper
decorum.
e) Project an image that will
uplift the nursing profession at
all times.
ARTICLE VI. REGISTERED
NURSES AND THE PROFESSION
SECTION 16. Ethical Principles:
1. Maintenance of loyalty to the
nursing profession and
preservation of its integrity are
ideal.
2. Compliance with the by-laws
of the accredited professional
organization (PNA), and other
professional organizations of
which the Registered Nurse is
a member is a lofty duty.
3. Commitment to continual
learning and active
participation in the
development and growth of
the profession are
commendable obligations.
4. Contribution to the
improvement of the socio-
economic conditions and
general welfare of nurses
through appropriate
legislation is a practice and
visionary mission.
SECTION 17. Guidelines to be
observed:
REGISTERED Nurses must:
1) Be members of the
Accredited Professional
Organization (PNA).
2) Strictly adhere to the nursing
standards.
3) Participate actively in the
growth and development of
nursing profession.
4) Strive to secure equitable
socio-economic and work
conditions in nursing through
appropriate legislation and
other means.Assert for the
implementation of labor and
work standards.