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Nursing Code of Ethics Dictates Actions, ANA States

Vol. 7 •Issue 8 • Page 49
Nursing Code of Ethics Dictates Actions, ANA States

Congress and president have acted inappropriately, ANA president states

The Terri Schiavo case raises complex and emotional issues about the end of life. The American Nurses Association (ANA) recognizes the difficulty of the situation, however, ANA has consistently upheld the right of patients, or if the patient is incapacitated, the right of the designated surrogate, to decide whether to submit to or continue medical treatment.

The ANA believes it is the responsibility of nurses to facilitate informed decision-making for patients and families who are making choices about end-of-life care.

The Code of Ethics for Nurses specifically outlines the nurse's obligation to protect the patient's right to self-determination and the role of a designated surrogate in situations where the patient lacks capacity. In this case, Terri Schiavo's physicians, over many years, have declared her to be in a "persistent vegetative state." Furthermore, there is evidence that Schiavo expressed her wishes not to have her life artificially maintained under such circumstances.

ANA believes the Congress and the president have acted inappropriately in this case. However, the positive outcome from this case is that it raises the public's awareness of the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for healthcare, clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. ANA encourages everyone to have an advance directive in place.

Advance directives are controlled by state law and vary by state. A federal law, The Patient Self Determination Act of 1990, requires that most healthcare facilities provide patients with information about advance directives and ask patients about the existence of advance directives. Physicians, nurses, social workers and attorneys are often resource persons in the community who can provide information and guidance concerning advance directives.

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