Legal, Ethical and Professional Issues in Nursing

Critically analyse how ethical, professional and legal issues underpin nursing practice.

1. Introduction

Ethics regards standards of moral judgement and professional conduct. Nurses are highly accountable to patients, the public, employers, and the entire

profession. It is imperative they have a sound understanding of various ethical, legal and professional issues they will face during their careers. There

are three primary duties for nurses, among many others, which are the duty of autonomy, confidentiality, and duty of care to all patients. i These duties are supplemented by the principles of beneficence, meaning promoting or doing

good and acting in patients’ best interests, and non-maleficence, meaning to avoid harm. ii These are professional duties which become legal duties if any legislation or policies are

breached during practice. In 2001 a study found that there was a perceived need for more advice on ethical dilemmas within the health profession, after

increasing legal cases and public inquiries.iii As a result, various Clinical Ethics

Committees (CECs) and Research Ethics Committees (RECs) were established within the UK to provide comprehensive ethics support. Constantly changing values

in health, behavioural science, and society mean that medical practitioners must be aware of new ethical issues for the medical sector, and learn how to

respond appropriately.

2. Regulatory Bodies

The nursing practice upholds its own code of ethics and this is regulated by strict disciplinary guidelines, with the governing body having more influence

over its member than legislative entities in medical matters. The Department of Health issued a Health Service Circular 219.99, which mandated some

requirements of a new nursing education programme. In the Nursing and Midwifery Order 2001, the Nursing and Midwifery Council (NMC) must establish minimum

standards and requirements for nursing education in professional and ethical issues.iv The NMC

is an organisation established by parliament to protect the public and regulates the medical and nursing professional standards using the Register of

Medical Practitioners (RMP). The Register acts to allow the GMC to monitor entry to the profession only by achieving the standards required to become an

RMP, and also by monitoring ‘fitness to practice’ proceedings to ensure all practitioners maintain consistently high standards of conduct. The

NMC contains guidelines regarding the expectations of particular duties such as confidentiality, medical research obligations, consent rights, and

autonomy. The nursing practice is expected to comply at an individual level with these guidelines on a daily basis. The NMC’s ‘Code of

Professional Conduct: Standards for conduct, performance and ethics’ is widely adhered to in the profession. To be registered, it is a general rule

that nurses must undergo education in addition to personally indicating through performance and training that they intend to follow ethical standards to

retain a licence for nursing.v

The General Medical Council (GMC) is a statutory entity with the role of protecting the public by maintaining a register of medical practitioners fit to

practice, while also monitoring complaints about practitioners. There are fourteen key concepts which outline the ethical standards and responsibilities

expected of a doctor. The GMC has also provided guidance on particular areas such as consent, confidentiality, and withholding or withdrawing This guidance is not mandatory, but is recognised at law, and in the case of W v Egdell, the court referred to the GMC guidelines on confidentiality.vii The

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