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Nurses Code of Ethics in the Philippines

August 24, 2024 Modified date: August 24, 2024

As healthcare providers, nurses play a vital role in the delivery of patient care, requiring a strong ethical framework to guide their practice. The evolution of nursing as a profession has introduced numerous ethical dilemmas that require careful consideration and resolution. Each nation has developed its interpretation of nursing ethics, reflecting cultural values and healthcare practices, yet all are fundamentally derived from the International Code of Ethics for Nurses. This code serves as a universal benchmark, ensuring that nurses worldwide adhere to principles that prioritize patient welfare and uphold the integrity of the profession. As nursing becomes more complex, nurses must follow rules to build trust with patients, take responsibility for their actions, and show kindness and care to patients.

Historical Development of the Nurses Code of Ethics in the Philippines

The evolution of the nursing code of ethics in the Philippines began with the adoption of the International Council of Nurses (ICN) Code before 1984. In 1982, a special committee of the Philippine Nurses Association (PNA) attempted to develop a local code, which was not fully implemented. However, in 1984, the Board of Nursing officially adopted the ICN Code, adding a fifth responsibility focused on promoting a spiritual environment. In 1989, the PNA’s Code of Ethics was approved by the Professional Regulation Commission (PRC), and by 2004, a new Code of Ethics was adopted under Republic Act No. 9173, also known as the Philippine Nursing Act of 2002. This code serves as a framework for ethical nursing practice in the country. A highlight of the creation of the Nurses Code of Ethics was composed by a nursing instructor Lystra Gretter in 1893. She was the one who wrote the following words that best describe the code of ethics of nurses in the oath for nurses: “to abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug.”

More than 100 years have passed, yet these words still hold their purpose for every young nurse taking his or her oath in the profession. These words were carefully crafted to remind nurses that every hour of their practice, they are responsible for doing what is right for the patient and avoiding harm. To ensure universality in ethical nursing practice, the International Council of Nurses (ICN) created a code of ethics that serves as the basis for the standard of practice for nurses worldwide. This code was first adopted in 1953 and was recently revised in 2006.

The Code of Ethics for Filipino Nurses is structured around seven articles that feature the main points of the ethical principles guiding nursing practice in the Philippines. Here are the key principles derived from each article:

Article I – Preamble In the preamble, health is recognized as a basic human right and emphasizes the responsibility of nurses to promote health, prevent illness, alleviate suffering, and restore health. This article also highlights the obligation to assist in a peaceful death when necessary.

Article II – Registered Nurses and People Nurses must respect the values, customs, and spiritual beliefs of individuals, ensuring that personal information is kept confidential and that patients have the freedom to make informed decisions regarding their care.

Article III – Registered Nurses and Practice In this section, nurses affirm the sanctity of human life and the commitment to providing quality care. Nurses are advocates for their patients, ensuring their rights are safeguarded and that care is documented accurately.

Article IV – Registered Nurses and the Co-workers Article IV of the Code of Ethics for Registered Nurses in the Philippines addresses the relationship between registered nurses and their co-workers. This section emphasizes collaboration, respect, and ethical conduct among nursing professionals.

Article V – Registered Nurses, Society, and Environment This section emphasizes the importance of social responsibility among nurses. It highlights the role of nurses in contributing to the health of society. Nurses are called to advocate for social justice and to be involved in community health initiatives. Furthermore, this also recognizes the impact of the environment on health and encourages nurses to promote a healthy environment as part of their practice.

Article VI – Registered Nurses and the Profession This article focuses on the relationship between registered nurses and the nursing profession. It emphasizes the ethical responsibilities of nurses towards maintaining the integrity and standards of the profession. Nurses must engage in lifelong learning and adhere to the ethical standards set forth by the profession.

Article VII – Administrative Penalties, Repealing Clause, and Effectivity This article outlines the provisions related to administrative penalties, the repealing clause, and the effectivity of the Code. This section specifies that registered nurses who violate the provisions of the Code may face administrative penalties. These penalties are determined by the Board of Nursing and can include suspension or revocation of the nurse’s license.

Article VII also includes a clause that repeals any previous codes of ethics for nurses. This means that the newly promulgated Code of Ethics supersedes earlier regulations and guidelines that may have existed prior to its enactment.

These articles collectively establish a comprehensive ethical framework for Filipino nurses, guiding their professional conduct and ensuring the delivery of compassionate, respectful, and competent care to patients.

Basic Concepts of the Code of Ethics

1. Rights – According to Webster’s Dictionary, a right means “something to which one has a just claim or the power or privilege.” In nursing ethics, rights pertain to the fundamental entitlements and freedoms that patients have, such as the right to make informed decisions about their care, the right to privacy and confidentiality, and the right to refuse treatment. Nurses must be aware of and respect patients’ rights, even if it means the patient may refuse certain aspects of nursing care that the nurse believes would be beneficial. Nurses need to understand that patients have the autonomy to make decisions about their care based on their values, beliefs, and preferences.

2. Autonomy – Autonomy in nursing ethics means respecting the right of patients to make their own informed decisions about their care. This includes obtaining informed consent before performing procedures, even if they are routine. Nurses must be sensitive to the fact that patients’ decisions may be influenced by their cultural, religious, or personal beliefs. Obtaining written informed consent can help protect both the patient and the healthcare facility from potential legal issues related to respecting patient autonomy.

3. Beneficence and Nonmaleficence – These concepts are evident during the delivery of nursing care. It is crucial that nursing care promotes well-being (beneficence) and is safe for the patient. Likewise, nursing care must ensure that it does not lead to intentional harm (nonmaleficence). Patients nowadays are increasingly aware of these concepts, so nurses are challenged to provide quality nursing care every day.

4. Fidelity – Fidelity in nursing ethics means being faithful, loyal, and committed to the nursing profession and the patients it serves. This involves being accountable for one’s actions and fulfilling the responsibilities of the nursing role. Fidelity extends beyond just the nurse-patient relationship to include the nurse’s obligations to their employer, the community, and the nursing profession as a whole.

In the Philippines, the Professional Regulatory Board and Board of Nursing adopted the Philippine Code of Ethics for Nurses in 2004. Each nurse practicing in the Philippines must be aware of this code to provide the best nursing care possible to the Filipino people.