Nightingale's Ethical Principles

For the Patients

It is a known fact that nurses are the most trusted healthcare profession by the public. In fact, the altruistic element of nursing was rooted deeply from Christian principles. As each profession has its own Code of Ethics to guide the practice, the American Nurses Association [ANA] (n.d.) and the Office of Human Protections [OHP] (2017) narrated two historical events that influenced the development of the Code of Ethics for nurses and research regulations respectively: Florence Nightingale’s experience in the Crimean War and the Tuskegee syphilis study in 1932. Thus, it is important to look back at these historical events to understand the value of ethical principles entailed in the nursing profession.

From Nightingale’s legacy, nurses, under the Hippocratic Oath, were visible agents of care providers for the wounded soldiers and affected civilians during the war. In

truth, it was during the Crimean war in 1855- where Nightingale’s exposure to the unsanitary condition of wounded soldiers and her achievements in reducing the mortality rate of cholera, typhus, dysentery, and malaria- that the ethical principle of the nursing practice was founded.

As stated by the American Nurses Association [ANA] (n.d.), the Florence Nightingale’s pledge entails the nurses’ commitment to do no harm, self-preservation to purity, and loyalty to physicians and patients. Despite the intention to form an ethical guidance, Epstein and Turner (2015) informed that the American Nurses Association [ANA], established in 1896, had to prioritize the issues on the nurses’ well-being, registration, and school accreditation. Back then, nurses were overworked, underpaid, and their public image was marred by untrained, unlicensed women who filled in the nursing roles during the

shortages. In 1926, Epstein and Turner (2015) stated that the first code of ethics was introduced guiding the ethical relationship between the nurse and patient, nurse and doctors, and nurse and the profession. Even then, Epstein and Turner (2015) implied that the right action was based on the moral character of a nurse in respecting authority, being industrious, flexible to any situations, and tactful in words. By 1950, the ANA (n.d.) declared the definition of nursing and established the Code of Ethics. As society changes – technology advances, different cultures, healthcare system- the code of ethics were modified several times to emphasize integrity, cultural competency, healthy working environment, and patient-centeredness.
As the revised nurses’ Code of Ethics involved the nursing research, the Tuskegee syphilis study originated in 1932, was exposed by the Belmont report in 1974. During the study, the Centers for Disease Control and Prevention [CDC] ( 2017) reported the violation of ethical principles- lack of informed consent, ineffective result, and prolonged treatment- on the population of disadvantaged 600 black men. To compensate the victims and families, CDC (2017) included the $10 million, lifetime health benefits, and burial services granted by the government. In addition, CDC (2017) mentioned a public apology by President Clinton declared in 1997. From this hard lesson, OHP (2017) cited that the research guidelines added emphasis on respect, beneficence, and justice in the research practice.
The Professional Code of Ethics for nurses and the ethical principles of research are necessary to guide today’s clinical practice. Similarly, it is also important to understand historical contexts that led to the formation of these laws to value the insight and lessons in the professional practice.