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.

These are the position statements from ANA regarding Ethics and Human Rights. Background information regarding each of these statements is available to ANA Members Only. Login required. 

In Support of Patients’ Safe Access to Therapeutic Marijuana - 12/12/08
The American Nurses Association supports:

  1. The education of registered nurses and other healthcare practitioners regarding appropriate evidence-based therapeutic use of marijuana including those non-smoked forms of delta-9-tetrahydrocannabinol (THC) that have proven to be therapeutically efficacious
  2. Protection from criminal or civil penalties for patients using medical marijuana as permitted under state laws
  3. Exemption from criminal prosecution; civil liability; or professional sanctioning, such as loss of licensure or credentialing, for healthcare practitioners who prescribe, dispense or administer medical marijuana in accordance with state law.
  4. Reclassification of marijuana’s status from a Schedule I controlled substance into a less restrictive category.
  5. Confirmation of the therapeutic efficacy of medical marijuana. Background Info

Stem Cell Research - 1/10/07
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). Background Info

Privacy and Confidentiality - 12/8/06
The American Nurses Association supports the following principles with respect to patient privacy and confidentiality:

  • A patient's right to privacy with respect to individually identifiable health information, including genetic information, should be established statutorily. Individuals should retain the right to decide to whom, and under what circumstances, their individually identifiable health information will be disclosed. Confidentiality protections should extend not only to health records, but also to all other individually identifiable health information, including genetic information, clinical research records, and mental health therapy notes.
  • Use and disclosure of individually identifiable health information should be limited.
  • A patient should have the right to access his or her own health information and the right to supplement such information so that they are able to make informed health care decisions, to correct erroneous information, and to address discrepancies that they perceive.
  • Patients should receive written, easily understood notification of how their health records are used and when their individually identifiable health information is disclosed to third parties.
  • The use or disclosure of individually identifiable health information absent an individual's informed consent should be prohibited. Exceptions should be permitted only if a person's life is endangered, if there is a threat to the public, or if there is a compelling law enforcement need. In the case of such exceptions, information should be limited to the minimum amount necessary.
  • Appropriate safeguards should be developed and required for the use, disclosure and storage of personal health information.
  • Legislative or regulatory protections on individually identifiable health information should not unnecessarily impede public health efforts or clinical, medical, nursing, or quality of care research.
  • Strong and enforceable remedies for violations of privacy protections should be established, and health care professionals who report violations should be protected from retaliation.
  • Federal legislation should provide a floor for the protection of individual privacy and confidentiality rights, not a ceiling. Federal legislation should not preempt any other federal or state law or regulation that offers greater protection. Background Info

Assuring Patient Safety: Registered Nurses’ Responsibility in All Roles and Settings to Guard Against Working When Fatigued - 12/8/06
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. Background Info

Assuring Patient Safety: The Employers’ Role in Promoting Healthy Nursing Work Hours for Registered Nurses in All Roles and Settings - 12/8/06
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
  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. Background Info

Risk and Responsibility in Providing Nursing Care - 6/21/06
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. Background Info

Pain Management and Control of Distressing Symptoms in Dying Patients - 12/5/03
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. Background Info

Nursing Care and Do-Not-Resuscitate Decisions - 12/2003
The appropriate use of DNR orders, together with adequate palliative end of life care, can prevent suffering for many dying patients who experience cardiac/pulmonary arrest. As the primary continuous HCP in health care facilities, the nurse must be involved in the planning as well as the implementation of resuscitation decisions. Clear DNR policies at the institutional level that include the basic features that ANA recommends will enable nurses to effectively participate in this crucial aspect of patient care. Background Info

Reduction of Patient Restraint and Seclusion in Health Care Settings - 10/17/01
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. Background Info

Human Cloning by Means of Blastomere Splitting and Nuclear Transplantation - 6/21/00 The American Nurses Association supports:

  • The current federal moratorium on the creation of human beings by cloning via blastomere splitting and nuclear transplantation in humans for both federally and privately funded research;
  • The cloning of DNA, cells, tissues, and non-human animals using somatic cell nuclear transfer and other cloning techniques for basic scientific research and pharmaceutical development;
  • A moratorium on the creation of animal/human hybrids through the use of cloning techniques;
  • A reconsideration of the current federal moratorium on human embryo research;
  • A vigorous national and international debate about the possible distinction between reproductive and therapeutic cloning as set forward by the Nuffield Council of the United Kingdom;
  • Mandatory presence of nurses on governmental and nongovernmental ethics and policy boards examining the scientific, ethical legal and social implications of advances in cloning and related technologies;
  • Well-constructed ethical analyses of the possible merits of cloning (e.g. to remedy human infertility), developed by scholarly and deliberative bodies in nursing such as the American Academy of Nursing, Sigma Theta Tau etc.;
  • Well-designed survey studies of nurses' views about the scientific merits and ethical aspects of cloning in humans as it could effect individuals and families. The viewpoint of nurses and nursing on this matter is currently not known;
  • Well-constructed scholarly examinations of core professional values in nursing and the implications of these values for cloning in humans;
  • Continuing education programs designed for nurses about the scientific and ethical intersections among cloning, gene therapy and stem cell advances. Background Info

Discrimination and Racism in Health Care - 3/26/98
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.  Background Info

Assisted Suicide - 12/8/94
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. Background Info

Nurses' Participation in Capital Punishment - 12/8/94
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. Background Info

The Nonnegotiable Nature of the ANA Code for Nurses with Interpretive Statements - 12/8/94
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. Background Info

Mechanisms Through Which SNAs Consider Ethical/Human Rights Issues - 12/8/94
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. Background Info

Active Euthanasia - 12/8/94
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. Background Info

Foregoing Nutrition and Hydration - 4/2/92
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. Background Info

Nursing and the Patient Self-Determination Acts - 11/18/91
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. Background Info

Ethics and Human Rights - 9/05/91
The individual nurse has at least three responsibilities: (1) the careful delivery of nursing care in a way that meets the needs of the individual, is consistent with the goals of the individual with respect to level of health and quality of life; (2) social action and reform to increase the availability of nursing care and to facilitate access to needed health care for all; and (3) patient education and advocacy to ensure that individuals are aware of all options and their consequences and can make informed choices about health care. In addition, nurses must advance and protect their own human rights, including the rights to be fairly compensated for services rendered, the right to control the quality of practice, the right to engage in "whistle-blowing" when necessary, without reprisal and the right to engage in independent practice. Background Info

Cultural Diversity in Nursing Practice - 10/22/91
Knowledge of cultural diversity is vital at all levels of nursing practice. Ethnocentric approaches to nursing practice are ineffective in meeting health and nursing needs of diverse cultural groups of clients. Knowledge about cultures and their impact on interactions with health care is essential for nurses, whether they are practicing in a clinical setting, education, research or administration. Cultural diversity addresses racial and ethnic differences, however, these concepts or features of the human experience are not synonymous. The changing demographics of the nation as reflected in the 1990 census will increase the cultural diversity of the U.S. population by the year 2000, and what have heretofore been called minority groups will, on the whole constitute a national majority (Census, 1990).  Background Info

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