Between mandatory and aspirational ethics in nursing codes: a case study of the Italian nursing code of conduct.

Aspirational ethics Code of ethics Codes of conduct Mandatory ethics Nurse Professionalism

Journal

BMC nursing
ISSN: 1472-6955
Titre abrégé: BMC Nurs
Pays: England
ID NLM: 101088683

Informations de publication

Date de publication:
10 Jan 2024
Historique:
received: 17 11 2023
accepted: 01 01 2024
medline: 11 1 2024
pubmed: 11 1 2024
entrez: 10 1 2024
Statut: epublish

Résumé

Over the years, national and international nurses' organisations have drawn up Codes of Conduct and Codes of Ethics. A new differentiation has emerged over time between mandatory and aspirational approaches underlying how nurses can be supported by documents with rules to be respected (mandatory ethics) or by incentives (aspirational ethics). However, to date, no research has applied these approaches to analyse available Codes and to identify which approach are predominantly used. In this case study, the Italian Nursing Code of Conduct (NCC), published in 2019, composed of 53 articles distributed in eight chapters, was first translated, and then analysed using a developed matrix to identify the articles that refer to mandatory or aspirational ethics. A nominal group technique was used to minimise subjectivity in the evaluation process. A total of 49 articles addressing the actions of the individual nurse were considered out of 53 composing the NNC. Articles were broken down into 97 units (from one to four for each article): 89 units (91.8%) were attributed to a unique category, while eight (8.2%) to two categories according to their meaning. A total of 38 units (39.2%) were categorised under the mandatory ethics and 58 (59.8%) under the aspirational ethics; however, one (1.0%) reflected both mandatory and aspirational ethics. According to the findings, the Italian Professional Body (FNOPI) has issued a modern code for nursing professionals in which an aspirational perspective is dominant offering a good example for other nursing organisations in the process of updating their codes when aimed at embodying an aspirational ethics.

Sections du résumé

BACKGROUND BACKGROUND
Over the years, national and international nurses' organisations have drawn up Codes of Conduct and Codes of Ethics. A new differentiation has emerged over time between mandatory and aspirational approaches underlying how nurses can be supported by documents with rules to be respected (mandatory ethics) or by incentives (aspirational ethics). However, to date, no research has applied these approaches to analyse available Codes and to identify which approach are predominantly used.
METHODS METHODS
In this case study, the Italian Nursing Code of Conduct (NCC), published in 2019, composed of 53 articles distributed in eight chapters, was first translated, and then analysed using a developed matrix to identify the articles that refer to mandatory or aspirational ethics. A nominal group technique was used to minimise subjectivity in the evaluation process.
RESULTS RESULTS
A total of 49 articles addressing the actions of the individual nurse were considered out of 53 composing the NNC. Articles were broken down into 97 units (from one to four for each article): 89 units (91.8%) were attributed to a unique category, while eight (8.2%) to two categories according to their meaning. A total of 38 units (39.2%) were categorised under the mandatory ethics and 58 (59.8%) under the aspirational ethics; however, one (1.0%) reflected both mandatory and aspirational ethics.
CONCLUSIONS CONCLUSIONS
According to the findings, the Italian Professional Body (FNOPI) has issued a modern code for nursing professionals in which an aspirational perspective is dominant offering a good example for other nursing organisations in the process of updating their codes when aimed at embodying an aspirational ethics.

Identifiants

pubmed: 38200503
doi: 10.1186/s12912-024-01697-3
pii: 10.1186/s12912-024-01697-3
doi:

Types de publication

Journal Article

Langues

eng

Pagination

30

Subventions

Organisme : PROMOCON 2022-1-IT-02-KA220-HED-000087544
ID : PROMOCON 2022-1-IT-02-KA220-HED-000087544
Organisme : Assegni MSCA 737 funded by the European Union. DM737COFIN_HEU_ASSEGNI_BUDGET_DAME_GALAZZI
ID : DM737COFIN_HEU

Informations de copyright

© 2024. The Author(s).

Références

Moore WE. The professions: roles and rules. New York: Russel Sage Foundation; 1970.
Sasso L, Stievano A, González Jurado M, Rocco G. Code of ethics and conduct for European nursing. Nurs Ethics. 2008;15(6):821–36.
doi: 10.1177/0969733008095390 pubmed: 18849371
Snelling PC. The metaethics of nursing codes of ethics and conduct. Nurs Philos. 2016;17(4):229–49.
doi: 10.1111/nup.12122 pubmed: 27218833
American Psychological Association. Ethical principles of psychologists and code of conduct. Am Psyc. 1992;47:1597–611.
doi: 10.1037/0003-066X.47.12.1597
International Council of Nurses. The ICN Code of Ethics for Nurses. 2021. https://www.icn.ch/sites/default/files/2023-06/ICN_Code-of-Ethics_EN_Web.pdf . Accessed 11 Nov 2023.
Singer MG. Negative and positive duties. Philos Q. 1965;15(59):97–103.
doi: 10.2307/2218209
Lichtenberg J. Negative duties, positive duties, and the new harms. Ethics. 2010;120:557–78.
doi: 10.1086/652294
Murhpy LB. The demands of Beneficence. Philos Public Aff. 1993;22(4):267–92.
Darbyshire P. Nursing heroism in the 21st Century. BMC Nurs. 2011;10:4.
doi: 10.1186/1472-6955-10-4 pubmed: 21324152 pmcid: 3048573
Cox CL. Healthcare heroes’: problems with media focus on heroism from healthcare workers during the COVID-19 pandemic. J Med Ethics. 2020;46:510–3.
doi: 10.1136/medethics-2020-106398 pubmed: 32546658
Alexander GC, Hall MA, Lantos JD. Rethinking professional ethics in the cost-sharing era. Am J Bioeth. 2006;6(4):W17–W22.
doi: 10.1080/15265160600755813 pubmed: 16885085
Pitacco G, Urli N, Centonze S, Ferrazzano A, Santarossa S, Valentini MG, Ponton P. Questioni Etiche emergenti nella pratica clinica: risultati di un’indagine regionale [Emerging ethical issues in clinical practice: a regional survey]. Assist Inferm Ric. 2021;40(1):4–19.
pubmed: 33938539
Sato K, Suzuki M. Standards of conducts for biostaticians and stem cell researchers: a call for self-formulated aspirational ethics over built-in prohibitive ethics. Sci Eng Ethics. 2022;28:15.
doi: 10.1007/s11948-022-00366-5 pubmed: 35301619 pmcid: 8930940
Chen R. Do as we say or do as we do? Examining the hidden curriculum in nursing education. Can J Nurs Res. 2015;47(3):7–17.
doi: 10.1177/084456211504700301 pubmed: 29509469
Federazione Nazionale degli Ordini delle Professioni Infermieristiche. Codice deontologico delle professioni infermieristiche. 2019. https://www.fnopi.it/aree-tematiche/codice-deontologico/ . Assessed 11 Nov 2023.
Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach. BMC Med Res Methodol. 2011;11:100.
doi: 10.1186/1471-2288-11-100 pubmed: 21707982 pmcid: 3141799
Federazione Nazionale degli Ordini delle Professioni Infermieristiche. Ordini provinciali. 2023. https://www.fnopi.it/gli-ordini-provinciali/ . Assessed 11 Nov 2023.
Camera dei deputati e Senato della Repubblica. Istituzione dei Collegi delle infermiere professionali, delle assistenti sanitarie visitatrici e delle vigilatrici d’infanzia. 1954. https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=1954-11-15&atto.codiceRedazionale=054U1049&elenco30giorni=false . Accessed 11 Nov 2023.
Camera dei deputati e Senato della Repubblica. Disposizioni in materia di professioni sanitarie. 1999. https://www.gazzettaufficiale.it/eli/id/1999/03/02/099G0092/sg . Assessed 11 Nov 2023.
Maneesriwongul W, Dixon JK. Instrument translation process: a methods review. J Adv Nurs. 2004;48(2):175–86.
doi: 10.1111/j.1365-2648.2004.03185.x pubmed: 15369498
Walde P, Völlm BA. The TRAPD approach as a method for questionnaire translation. Front Psychiatry. 2023;14:1199989.
doi: 10.3389/fpsyt.2023.1199989 pubmed: 37398605 pmcid: 10309006
Federazione Nazionale degli Ordini delle Professioni Infermieristiche. Code of Conduct of the Nursing Professions. 2019. https://www.fnopi.it/wp-content/uploads/2023/10/codice-deontologico_2019_conversione_IT_revDEF.pdf Accessed 11 Nov 2023.
Humphrey-Murto S, Varpio L, Wood TJ, Gonsalves C, Ufholz LA, Mascioli K, Wang C, Foth T. The Use of the Delphi and Other Consensus Group Methods in Medical Education Research: a review. Acad Med. 2017;92(10):1491–8.
doi: 10.1097/ACM.0000000000001812 pubmed: 28678098
Mullen R, Kydd A, Fleming A, McMillan L. A practical guide to the systematic application of nominal group technique. Nurse Res. 2021;29(1):14–20.
doi: 10.7748/nr.2021.e1777 pubmed: 33629547
Birt L, Scott S, Cavers D, Campbell C, Walter F. Member checking: a Tool to enhance trustworthiness or merely a nod to Validation? Qual Health Res. 2016;26:1802–11.
doi: 10.1177/1049732316654870 pubmed: 27340178
Doyle S. Member checking with older women: a framework for negotiating meaning. Health Care Women Int. 2007;28:888–908.
doi: 10.1080/07399330701615325 pubmed: 17987459
Bridgers FF, Kacinik N. How Linearity and Structural Complexity Interact and affect the recognition of Italian derived words. J Psycholinguist Res. 2017;46(1):175–200.
doi: 10.1007/s10936-016-9427-1 pubmed: 27086299
Camera dei deputati e Senato della Repubblica. Norme per la razionalizzazione del Servizio sanitario nazionale, a norma dell’articolo 1 della legge 30 novembre 1998, n. 419. https://www.gazzettaufficiale.it/eli/id/1999/07/16/099G0301/sg . Assessed 11 Nov 2023.
Camera dei deputati e Senato della Repubblica. Codice in materia di protezione dei dati personali. https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=2003-07-29&atto.codiceRedazionale=003G0218 . Assessed 11 Nov 2023.
Nursing and Midwifery Board. Code of conduct for nurses. 2018a. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx . Accessed 11 Nov 2023.
Nursing and Midwifery Board. (2018b). Code of conduct for midwifes. 2018b. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx . Accessed 11 Nov 2023.
Nursing Council of Hong Kong. Code of Ethics and Professional Conduct for Nurses in Hong Kong. 2015. https://www.nchk.org.hk/filemanager/en/pdf/conduct.pdf . Accessed 11 Nov 2023.
Nursing and Midwifery Board of Ireland. Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives. 2021. https://www.nmbi.ie/NMBI/media/NMBI/Code-of-Professional-Conduct-and-Ethics.pdf?ext=.pdf . Accessed 11 Nov 2023.
Tisdale D, Symenuk PM. Human rights and nursing codes of ethics in Canada 1953–2017. Nurs Ethics. 2020;27(4):1077–88.
doi: 10.1177/0969733020906606 pubmed: 32207370
Epstein B, Turner M. The nursing code of Ethics: its value. Its History OJIN. 2015;20(2):4.
pubmed: 26882423
Tognoni G. Opportunità-priorità Di innovazione metodologica nel tempo dopo covid [Methodological challenges for proactive post-covid care strategies]. Assist Inferm Ric. 2023;42(1):33–5.
pubmed: 37283137
Camera dei deputati e Senato della Repubblica. Regolamento concernente l’individuazione della figura e del relativo profilo professionale dell’infermiere. https://www.gazzettaufficiale.it/eli/id/1995/01/09/095G0001/sg . Assessed 11 Nov 2023.
Tognoni G. La Relazione come ‘evento sentinella’: un augurio di futuro [The human relationship as a sentinel event: a wish for the future]. Assist Inferm Ric. 2022;41(3):100–2.
Federazione Nazionale degli Ordini delle Professioni Infermieristiche. Codice deontologico dell’infermiere. 2019, in English version. https://www.fnopi.it/wp-content/uploads/2023/10/codice-deontologico_2019_conversione_IT_revDEF.pdf .
Federazione Nazionale degli Ordini delle Professioni Infermieristiche. Codice deontologico dell’infermiere. 2009. https://opi.roma.it/wp-content/uploads/2020/07/Codice-Deontologico-2009.pdf . Accessed 11 Nov 2023.
Kędra EM, Giza M, Gurowiec PJ. Pacjent odmienny kulturowo w praktyce pielęgniarskiej– wyzwania i ograniczenia w opinii badanych pielęgniarek. Piel Pol. 2022;1(83):32–8.
doi: 10.20883/pielpol.2022.3

Auteurs

Stefania Chiappinotto (S)

Department of Medicine, University of Udine, Udine, Italy.

Michael Igoumenidis (M)

Department of Nursing, University of Patras, Patras, Greece.

Alessandro Galazzi (A)

Department of Medicine, University of Udine, Udine, Italy.

Andjela Kokic (A)

Department of Medicine, University of Udine, Udine, Italy.

Alvisa Palese (A)

Department of Medicine, University of Udine, Udine, Italy. alvisa.palese@uniud.it.

Classifications MeSH