Code of Ethics for Nurses in Ethiopia

Ethiopian Nurses Association

(ENA)

January 2021

1|Page
Code of Ethics for Nurses in Ethiopia
Table of Contents
Permeable .................................................................................................................................................... 3
Introduction ................................................................................................................................................. 5
Section I- Nurses and their profession ...................................................................................................... 7
Section II- Nurses and their clients/ patients ............................................................................................ 8
Section III- Nurses duty in managing contagious disease ..................................................................... 10
Section IV – Nurses and public/ community health ............................................................................... 11
Section V- Nurses and health sciences education training .................................................................... 11
Section VI - Nurses for quality and safety improvement ...................................................................... 14
Section VII- Nurses and collaborative practice ...................................................................................... 16
Section VIII- Nurses and research .......................................................................................................... 19
Section IX- Nursing Services and Commercial Interests ...................................................................... 22
Section X- Nurses and Leadership .......................................................................................................... 23
Section XI- Nurses and theirs Practice ................................................................................................... 24
Section XII- Nurses and emerging issues ................................................................................................ 28
Section XIIII- Nurses and specific ethical Issues ................................................................................... 33
References:................................................................................................................................................. 35

2|Page
Code of Ethics for Nurses in Ethiopia
Permeable
This code “code of ethics for nurses in Ethiopia” is prepared by the Ethiopian Nurses Association
in collaboration with FMoH, and Jhpiego. The code identifies core values for the nursing
profession and establishes the standards of conduct that are reasonably expected of all nurses in
practice. It is the detailed revision of the first nursing code of conduct which was developed in
2009. This code takes effect for all nurses in Ethiopia starting from 25 February 2021. Nurses must
study and reflect on the code’s standards and applies them to everyday nursing and healthcare
amid a changing society.
The code serves as a guide to assist the ethical decisions faced by practicing nurses and provides
a framework for the regulation of nursing practice in Ethiopia. It also acts as the basis for
continuing education, self-evaluation, and peer review. The code is elaborated and divided into
fourteen sections with seven core value statements:
 Nurses and their profession: Professionalism is the conduct aims or qualities that
characterize or mark a profession. It reflects the act of providing quality patient care
while honoring the values of respect, humanism, altruism, advocacy, and responsibility.
Nurses should act at all times under ethical healthcare practices, actively promote nursing
ethics, and foster public trust and confidence in the nursing profession.
 Nurses and their clients/ patients: The nurse’s primary responsibility is to the clients they
care for. Nurses should provide care according to their clients’ individual needs,
regardless of their gender, ethnicity, religion, age, social or economic status. Nurses shall
respect their clients’ values and autonomy and need to advocate on the patient’s behalf
as needed.
 Nurses and their Practice: Nurses are responsible for providing the highest standards of
nursing care and ethical practice possible within any given situation. They should be
familiar with the profession’s ethical stance on such issues as practice accountability,
preservation of confidentiality, skills competency, and the maintenance of client privacy
and dignity.
 Nurses and public/ community health: Nurses are responsible for providing the highest
standards of Health Promotion, Disease Prevention and Control, and other Community-
Based health practices. They should be familiar with the profession’s ethical stances
during public health interventions.
 Nurses and health sciences education training: All nurses are responsible for maintaining
and enhancing the reputation of the profession. They are accountable for improving
quality nursing education through implementing and participating in different activities.
 Nurses and Research: Nurses should develop the body of knowledge of nursing through
conducting research and utilizing evidence for clinical decision making. In conducting
research, the health professional shall comply with the legal and ethical principles of the
land and the profession respectively.

3|Page
Code of Ethics for Nurses in Ethiopia
 Nurses and Leadership: Nurse leaders everywhere need the right professional, political,
and policy leadership skills to operate effectively in tough policy arenas. Nurses need to
apply ethical leadership. Nurse leaders need to apply ethical decision making in how they
treat and interact with their followers. Leaders also need to have an ethical influence on
how they interact with their organization and people that interact with their organization.

The Ethiopian nurses association highly recommend to use this code by every nurse practicing in
the country for maintaining the standard and quality of care, solve the dilemmas related to
clinical decision making, and to protect the public and nurses.

4|Page
Code of Ethics for Nurses in Ethiopia
Introduction
The Ethiopian Nurses Association (ENA) was established in1952 and is legally recognized
professional association that represents more than 86,000 nurses in Ethiopia. It is the first
professional association in Ethiopia. It striving to standardize, and promote quality nursing
services to the society through research, education, leadership and good governance. It was
registered on the International Council of Nurses (ICN) in 1957. ENA is a not-for-profit which
exists to represent the profession of nursing in Ethiopia, to promote excellence in the nursing
practice and protect the public as well as the rights of nurses.

Modern nursing in Ethiopia started in the later part of the 19th century by Swedish Missionaries
who came to Eritrea in 1866. Years later the nursing service was extended to other parts of the
country still by expatriate nurses from Sweden, Russia, and France. During this time some clinics
and hospitals were opened in some parts of the country. Thus the need for nurses was felt more
than ever. Around 1928 elderly women were recruited and were given short term training to serve
as nurses and midwives. In 1949 the first School of Nursing (The Ethiopian Red Cross) was opened
in the former Haile Selassie I Hospital (Now Yekatit 12 Hospital beginning of the modern nurses
education). Students were recruited from 8th grade and the training duration was 3 Vi years. In the
following years other schools of nursing were opened. One of the schools (Gonder) was training
community nurses who were basically working in the community while the other schools train bed
side nurses who work mainly in hospital settings.

In 1977, three years after the downfall of the Emperors regime, the nurse training was revised at a
national level and a decision was made to train one category of nurse namely "Comprehensive
nurse" who can function at all levels of health institutions. Thus the training of community nurses
was discontinued. The academic entry requirement at this time was raised to 12th grade completion
and the duration shortened to two years.

The training of different types of nurses then started for two years in most training institutions and
begins to train clinical nurses, public health nurses & midwives. However this fragmented form
of training is not appreciated by most faculty members of the respective institutions. A remarkable
event to be mentioned in the history of nursing in Ethiopia is the launching of post basic
baccalaureate program in nursing in 1994 in the former Jimma institute of health science (now

5|Page
Code of Ethics for Nurses in Ethiopia
Jimma University). The annual average output of baccalaureate program trainees were not more
than 30 and deployed in schools and management positions.

At present, there are a number of government owned and NGO and private owned
schools/Colleges of nursing that are offering nursing program in the country. At the end of the
training period, Ministry of health of Ethiopia registered and licensed them to practice the
profession in the country through the health professionals' council. The health Professional council
established is 2002 by the Ministers act Number 72/2002. The council is a" regulatory & advisory
body & that is accountable directly to the Minister, of Ministry of Health. The council comprises
chairman, V/chairman, registrar, assistant registrar and professional associations as a member. The
council has got different committee with a specified function for each committee.

ENA as a member of the health professional council involved in registration & licensing of health
professionals in Ethiopia. The registration & licensing of nurses in particular is the responsibility
of the Ethiopian nurses association within the council. Nurses who graduated from recognized &
accredited training institution must pass the registration and licensing procedure in order to
practice the profession legally in the country

6|Page
Code of Ethics for Nurses in Ethiopia
Section I- Nurses and their profession
Professionalism is the conduct aims or qualities that characterize or mark a profession. It reflects
the act of providing quality patient care while honoring the values of respect, advocacy and
responsibility. The Principles of professionalism are Humanism (compassion, empathy, sympathy,
respect, and dignity), Accountability (responsibility), Excellence (lifelong learning) and Altruism
(selflessness behavior). Nursing professionalism means providing top-quality care to patients,
while also upholding the values of accountability, respect, and integrity.

The Nurse Shall:

Article 1

1.1. At all times behave herself/himself(attitude, language, manner and image) in such a
way that she/he may gain the respect and the confidence of her/his clients and
colleagues and maintain the dignity of her/his profession and professional values to
be effective role models.
1.2. Be honest and loyal to their professional oath
1.3. Demonstrate professional values and principles such as respect, justice,
responsiveness, compassion, empathy, trustworthiness, altruism, client advocacy and
integrity (eg. Professional dressing code, punctuality)
1.4. Be personally responsible/accountable for his/her own actions pertinent to his/her
defined duty
1.5. Maintain competence in one’s own profession appropriate to his/her scope of practice
and educational level through engagement of in continuing professional development
process and utilization of emerging scientific methods.
1.6. Respect the privacy and confidentiality of the patient/client for all matters which have
come to her/his knowledge in the course of her/his duties to the patients/clients except
in those situations clearly stipulated by the law or when the patient/client gives written
consent for the release of information.
 Avoid the use of any medium such as: film, videotapes, or recordings in
revealing patient information unless consented by the cent.
 Patient/client information shall be revealed to the patient’s/client’s relatives
when such a revelation would serve any useful purpose for the care of the
patient/client or (minors and unconscious patient/clients or patient/clients
of unsound mind),
 See to it that persons working with him respect health care secrecy to her/his
knowledge.
1.7. Not participate in the practice of torture or other cruel, inhuman or degrading
procedures; and not provide premises, instruments, substances or knowledge to
facilitate the practice of torture.
1.8. Not accept any direct and indirect gain from clients

7|Page
Code of Ethics for Nurses in Ethiopia
1.9. Not allow to obtain illegal or unjustified benefit for themselves, their colleagues and
patient/client.
1.10. Not promote legally prohibited substances, or be engaged in misuse of any mood
altering drugs and substance
1.11. Advise professionally to a colleague who practices drug/substance misuse, and if this
fails inform the appropriate authority.
1.12. Not perform or participate in illegal practice/procedure
1.13. Provide good quality of health care as set by available standards and protocols for
level of Nurses professionals and type of health facilities.

Section II- Nurses and their clients/ patients

The health of human life is constantly in the hands of the health care professionals. The principal
objective of Nurses is to render services (preventive, curative, rehabilitative, and palliative care)
for the wellbeing of clients, families and communities with full respect for life and dignity of
human beings. The nature of the Nurses- client /patient relationship is critical to good quality of
care and to better outcome of client’s, care interventions. Hence, Nurses should implement Nursing
standards with person centered care at all times, in the care process with special attention.

The Nurse Shall:

Article 2

2.1. Attend her/his client /patient with maximum dignified and respectful care with
devotion, empathetically and, friendly
2.2. Work within context of therapeutic relationship with their client/patients
2.3. Avoid situations where he/she has a personal or business relationship with the
patients/clients
2.4. Practice her/his profession without discrimination of any sort.
2.5. Make use of every opportunity to teach the patient/client and her/his family and the
community regarding the prevention of disease and the promotion of health.
2.6. Avoid resources wastage in professional practice
2.7. Be the defender of the vulnerable client/patient, when she/he judges that their health
is not protected.
2.8. Be obliged to consult colleagues when it is necessary to do so, and shall inform the
patient/client and/or the patient/client’s relatives about the consultations.

8|Page
Code of Ethics for Nurses in Ethiopia
2.9. Not abandon patients/clients in her/his immediate care until all appropriate measures
have been taken to secure the safety of the patients/clients, in the event of public
danger.
2.10. Respond to the best of her/his ability in case of emergency where first aid treatment is
essential. While the Nurse has the option of withdrawing from a case, she/he shall
ascertain that:
 The patient/client or the relatives or responsible person are notified
ahead of time.
 The patient/client will have adequate care based on the standards
 A colleague will replace her/him
 All necessary information will be conveyed to the replacement.
2.11. Not use the relationship with his/her client as a means of developing personal
intimacy.
2.12. Promote the presence of another health worker or client family, while performing
physical examination or bodily care to any patient/client, but especially so when the
patient is of the opposite gender to the care provider. It is preferable that the attending
observer/helper be of the same gender with the patient/client consent.
2.13. Help the client/patient make informed choices from among the therapeutic alternatives
methods, procedures available that is consistent with evidence based Nurses practice
in a culturally appropriate manner on which to base consent for care and related
treatment.
2.14. Respect the informed decision of a client having the necessary ability to accept or
refuse the care. But while doing so avoid any action,that violates ethical, legal or
religious violation.
2.15. Obtain informed consent from the patient/client about the health care intervention
(including surgical procedures), she/he intends to carry out when the Nurse is the one
who is perform the procedures.
2.16. Be patient/client advocate and witness that the client signed the consent with adequate
information regarding the procedures.
2.17. In the case of unconscious or unsound mind, the necessary consent should be obtained
from parents or legal guardians, if there is no other legal provision take the consent
with health care team.
2.18. Actively involve their clients to express their individual needs and values and consider
it the planning and delivery of care
2.19. In case of mistake in Nurses interventions, explain honestly to the immediate
supervisor and client / patient has to be communicated and proceed with truthfulness
and fairness in any circumstances.
2.20. Avoid any professional negligence
2.21. Promote an environment, in which the human rights, values, customs, religious and
spiritual beliefs of the individual, family and community are respected.

9|Page
Code of Ethics for Nurses in Ethiopia
2.22. Encourage a culture of safe health care and raise any concerns regarding the safety of
people and health services to reduce errors.
2.23. Nurse-patient/client relationship in long-term/chronic illness follow up has to remain
strictly professional and has to be terminated when the intended patient goal is met.

Section III- Nurses duty in managing contagious disease

Due attention needs to be provided for the identification of patients with contagious communicable
disease and take appropriate measures on timely basis to contain it and avoid further spread,
including providing guidance to trace contacts. Nurses are also susceptible to get infected with a
serious communicable disease in the line of duty. So they have clear role and responsibilities.

The Nurse shall:

Article 3
3.1. Apply infection prevention control standards at all time of professional practi
3.2. Encourage patients/clients to have testing for HIV, Hepatitis and other contagious
communicable diseases voluntarily to enhance early diagnosis and treatment
3.3. Promote that testing for serious communicable disease is conducted in a way that
respects patient/client autonomy and assures patient/client confidentiality.
3.4. Advice the patient/client to get tested for HIV and other contagious infections, when
a health care provider is at risk of the infection due to puncture injury or mucosal
contact with potentially infected bodily fluids
3.5. Not disclose verbally or in writing information regarding a patient/client unless
believed that there is
3.5.1. A prominent health risk to the public demanding to do so,
3.5.2. It is ordered by a court
3.5.3. He/she gets written consent from a patient/client or the patient/Client’s
guardian or is demanded by relevant rules and regulations; and
3.5.4. If so only to the appropriate authority/officer in charge.
3.6. Encourage a patient/client with communicable diseases to disclose his status to
individuals with potential exposure to the infection.
3.7. Not refuse to provide health care to a patient/client whose condition is within the
health professional’s current realm of competence solely because the patient/client has
HIV/AIDS and other serious communicable infections.
3.8. Not engage in any activity that creates a significant risk of transmission of the disease
to others, if she/he get infected with serious contagious disease.
3.9. Seek independent objective advice when she/he needs medical car.
3.10. Participate in epidemic management as part of a team
3.11. Monitors and provides case management services to individuals with communicable
diseases such as tuberculosis, HIV or hepatitis using established medical protocols and
prevention control measures;

10 | P a g e
Code of Ethics for Nurses in Ethiopia
Section IV – Nurses and public/ community health
In public health, usually the initiative comes from the professional not the patient/client. Public
health interventions may be potentially pervasive requiring individuals to comply with demanded
action with active participation of Nurses. The Nurse is expected to maintain public trust,
acceptance & support for health action in order to effectively play a role in Health Promotion,
Disease Prevention and Control, and other Community Based health practices.

The Nurse shall:

Article 4
4.1. Build good rapport and close working relationship with community, and community
leaders, relevant institutions, and agencies; giving careful consideration to cultural,
linguistic and other sociopolitical dynamic
4.2. Promote active community involvements in identification, planning and mitigation of
common public health problems of priority concern based on reliable evidences
4.3. Promote public/community health action such on as provision of safe water,
sanitation, access to food supply & nutrition, prevention and control of communicable
diseases, group physical exercise (where appropriate), etc through community
education and inter-sectorial collaboration.
4.4. Advocate for equity of positive health actions and benefits to reach all sections of
society with priority to vulnerable groups like mothers, children, and disabled and
disadvantaged others.
4.5. Promote high coverage and proper use of health insurance to benefit all members of
the public; ensuring that the basic resources and necessary conditions for health care
are accessible to all people if and when needed.
4.6. Acts as a resource and provides consultation and health information to individuals,
families, health care providers, community agencies.
4.7. Advocate for equity and social justice in resource allocation, access to health care and
other social and economic services.

Section V- Nurses and health sciences education training

Nursing education in a university, college of higher education, and Specialization, fellowship
programs for the teaching of clinical competence relies largely on learning on patients or learning
from them.
The Nurse whether an educator or a learner should comply with the following manners and
etiquette about duties towards the patient, colleagues and other duties on the process of education
and learning on patients.

11 | P a g e
Code of Ethics for Nurses in Ethiopia
The Nurse Shall:
Article 5
5.1. Teach others
5.1.1. Not allow any student and trainee to take direct individual responsibility of patient’s
care.
5.1.2. Closely supervise the student in carrying out her/his duties and responsibilities
5.1.3. Not allow trainee to start to learn on patients until he/she has the required skills
through using the other educational alternatives, whenever possible, like medical
models/ manikins, simulations labs, and virtual learning with the use of computers.
5.1.4. Clearly informed that the trainee is in an educational institution and there is a need to
teach trainees; in the universities and colleges of higher education students must learn
in this way.
5.1.5. Inform the patient that the trainee is under the supervision of a senior or specialist
nurse ultimately responsible for providing the Nursing service.
5.1.6. Inform the Patient in an appropriate manner, the identity of those examining or treating
them, and that he/she is a trainee.
5.1.7. Sought permission of the patient first for trainee to take patient’s history, perform
investigations or curative procedures. The patient has the right to agree or refuse.
5.1.8. Provide teaching and learning opportunities for ethical issues, ethical principles,
professional values and decision making.
5.1.9. Ensure that the trainee should respect the patient’s rights, privacy as well as his/her
dignity, and not to disclose any of his/her secrets;
5.1.10. Be considerate about the patient’s private issues and those that are suitable for
discussion in front of trainees, while respecting the patient’s rights and confidentiality.
5.1.11. Not indulge patient’s private parts in direct training except in case of necessity, and this
should be substituted by using alternative educational alternatives, whenever possible.
5.1.12. Ensure the trainee not to harm (actual/anticipated) the patient in any kind of nursing
service.
5.1.13. Refrain from excessive training on one patient in a limited time, especially if this is
accompanied by repeated examinations or if the examination includes private parts of
the body

12 | P a g e
Code of Ethics for Nurses in Ethiopia
5.1.14. Consider the importance of being a role-model by his/her dedication, manners and
behavior.
5.1.15. Refrain from blaming, scolding, or rebuking trainees in front of patients, as this would
disrespect the trainees’ dignity on one side, and prevent/disturb the patient’s
understanding on the other; especially if everybody is talking in a language that the
patient does not understand.
5.1.16. Assign the patient’s care to trainees gradually and responsible for the patient to receive
full care and committed to provide the appropriate supervision of that care.
5.1.17. Aware the trainee that he/she is in charge of a patient within the limits of the tasks that
were assigned to him/her.
5.1.18. Aware the Trainee that he/she is responsible to stop at the limit of his/her abilities and
seek help and supervision from those who are more knowledgeable than him/her
whenever needed
5.1.19. Promote the trainee to actively engage in membership and professional associations’
journals, CPD, learning opportunities, conferences, generally assembly.
5.1.20. Support and work in collaboration with the nurse educators.
5.1.21. Promote the profession and enhance its image and public confidence.
5.1.22. Provide nursing service as per their level of specialization.
5.2. Professional development /Continuous Professional Development (CPD)
5.2.1. Recognize the need for lifelong learning, Promote and participate actively in
continued learning, professional development and advancement their competency.
5.2.2. Keep up-to-date of changes and developments in the field of nursing profession and
ensure that their practice is based on prevailing clinical practice guidelines abreast
with professional advances and developments.
5.2.3. Initiate, participate and engage in activities both within and between professions in
developing, integrating and improving patient care.
5.2.4. Provide and obtain honest and constructive feedback, formal and informal education
to colleagues in order to help them improve their practice and performance.
5.2.5. Actively participate in any activities contributing to the advancement of nursing
profession continuously to enhance competence.

13 | P a g e
Code of Ethics for Nurses in Ethiopia
5.2.6. Actively engage in membership and professional associations’ journals, CPD, learning
opportunities, conferences, and general assembly.

Section VI - Nurses for quality and safety improvement

Quality is defined as the “the degree to which health services for individuals and populations
increase the likelihood of desired health outcomes and are consistent with current professional
knowledge.”1 Quality care is meant to be safe, effective, patient centered, timely, efficient, and
equitable. Patient safety is also defined as “the prevention of harm to patients.”2 Patient safety is
the cornerstone of high-quality health care. Valuing quality nursing care involves nurses accepting
accountability for the standard of nursing care they provide, helping to raise the standard of nursing
care, and taking action when they consider, on reasonable grounds, the standard of nursing care to
be unacceptable.
The Nurse shall:
Article 6
6.1. Provide safe and quality of care as set by standard of nursing practice.
6.2. Maintain the highest standards of nursing care possible, actually seeking
improvement on the existing service, within the reality of their working conditions
6.3. Maintain standards of personal conduct which reflect well on the profession and
enhance its image and public confidence.
6.4. Responsible for ensuring that the standard of practice is congruent with the standard
of the profession
6.5. Observe and verify the laws of Ethiopia relevant to nursing and health care practices.
6.6. Strive to provide safe and quality nursing care by improving communication between
facility collaborators, health team and patient (or patient proxy)
6.7. Update and adhere to current evidence-based practice so that safe and quality of care
are provided promptly
6.8. Participate in identifying, implementing and evaluating evidence-based practices and
quality improvement activities.
6.9. Actively participate in Continuous Professional Development (CPD) for provision of
safe and quality of car
6.10. Work diligently to improve competence for provision of safe and quality of care

14 | P a g e
Code of Ethics for Nurses in Ethiopia
6.11. Use judgment regarding individual competence when accepting and delegating
responsibility.
6.12. Ensures that use of technology and scientific advances are compatible with the safety,
dignity and rights of people in providing care.
6.13. Do not condone or connive at any action that may jeopardize the safety and appropriate
care of individuals.
6.14. Recognize that they are accountable for the decisions they make regarding a person’s
care; accept their moral and legal responsibilities necessary to provide safe and
competent nursing care; and practice within the boundaries of their professional role.
6.15. Be entitled to diligently refuse to participate in care and treatment they believe on
religious or moral grounds to be unacceptable (‘conscientious objection’) as per the
institutional guidelines considering the reality of working environment and employer
interests.
6.16. Participate in decisions regarding a person’s nursing care.
6.17. Nurses practice “within their own level of competence and seek appropriate direction
and guidance when aspects of the care required are beyond their individual
competence”.

15 | P a g e
Code of Ethics for Nurses in Ethiopia
Section VII- Nurses and collaborative practice
Collaborative practice
Nurses work collaboratively and respectfully with co-workers in nursing and in other related fields,
as the context or situation requires. To provide patients with the best care, nurses in care and
leadership roles should maintain the following teamwork and collaborative principles: Establish
team Goals, play proper Roles Within a Team, promote Open Communication, Promote Mutual
Respect, Handle Conflict Proactively. They contribute to a collaborative and supportive
environment that prioritizes the best interests of the People. Effective communication is the center
for collaborative practice.

The Nurse shall:

Article 7
7.1. Take a leading/advocating role of the collaborative care, management of patient and
team effectiveness.
7.2. Place the interests of patients and populations at center of inter-professional
collaboration, health care delivery, and design of programs and policies.
7.3. Respect the dignity and privacy of patients while maintaining confidentiality in the
delivery of team-based care.
7.4. Consider the socio economic, cultural diversity and individual differences of patients,
populations, and the health team during collaborative actions.
7.5. Advocate ethical and safe healthcare practices as a team.
7.6. Promote respectful interactions and mutual peer support.
7.7. Communicate one’s roles and responsibilities and maintain clear, concise and timely
communication with co-workers.
7.8. Share knowledge and experience to resolve ethical issues.
7.9. Recognize one’s gaps/limitations and seek appropriate support in skills, knowledge,
and abilities for successful team function
7.10. Respect the unique cultures, values, roles/responsibilities, skills and expertise of co-
workers and refer matters to them for advice when appropriate.
7.11. Work in cooperation with those who receive care, those who provide care, and others
who contribute to or support the delivery of prevention and health services and
programs

16 | P a g e
Code of Ethics for Nurses in Ethiopia
7.12. Develop a trusting relationship with patients, families, and other team members
7.13. Manage ethical dilemmas specific to inter-professional patient/ population centered
care situation
7.14. Maintain competence in one’s own profession appropriate to scope of practice in
team/collaborative professional practice.
7.15. Engage diverse professionals who complement one’s own professional expertise, as
well as associated resources, to develop strategies to meet specific health and
healthcare needs of patients and populations.
7.16. Use the full scope of knowledge, skills, and abilities of professionals from health and
other fields to provide care that is safe, timely, efficient, effective, and equitable
7.17. Communicate with team members to clarify each member’s responsibility in
executing components of a treatment plan or public health intervention.
7.18. Create interdependent relationships with other professions within and outside of the
health system to improve care and advance learning
7.19. Describe how professionals in health and other fields can collaborate and integrate
clinical care and public health interventions to optimize population health.
7.20. Choose effective communication tools and techniques, including information systems
and communication technologies, to facilitate discussions and interactions that
enhance team function.
7.21. Communicate information with patients, families, community members, and health
team members in a form that is understandable, avoiding discipline-specific
terminology when possible.
7.22. Express one’s knowledge and opinions to team members involved in patient care and
population health improvement with confidence, clarity, and respect, working to
ensure common understanding of information, treatment, care decisions, and
population health programs and policies.
7.23. Listen actively, and encourage ideas and opinions of other team members.
7.24. Give timely, sensitive, instructive feedback to others about their performance on the
team, responding respectfully as a team member to feedback from others.
7.25. Act in professional manner and use respectful language appropriate for a given
difficult situation, crucial conversation, or conflict.

17 | P a g e
Code of Ethics for Nurses in Ethiopia
7.26. Recognize how one’s uniqueness (experience level, expertise, culture, and hierarchy
within the health team) contributes to effective communication, conflict resolution,
and positive inter-professional working relationships.
7.27. Recognize the process of team development, communicate and advocate the
importance of teamwork in patient-centered care and population health programs and
policies.
7.28. Ensure the implementation of ethical principles to guide all aspects of team work.
7.29. Value the health of colleagues and foster supportive and constructive relationships.
7.30. Recognizing colleagues also have physical and psychological strengths and limitations
and respecting their need for care and personality.
7.31. Collaborate in resources allocation and prioritizing care for providing appropriate and
safe care that minimize harm to the recipients.
7.32. Work and collaborate toward preventing and minimizing all forms of violence to care
recipients and self by anticipating and assessing the risk of violent situations
7.33. Seek constructive and collaborative approaches, when differences among members of
the health-care team affect care, to resolve them and commit to conflict resolution.
7.34. Support each other in providing person-centered care.
7.35. Engage self and others to constructively manage disagreements about values, roles,
goals, and actions that arise among health and other professionals and with patients,
families, and community members.
7.36. Share accountability with other professionals, patients, and communities for outcomes
relevant to prevention and health care delivery.
7.37. Reflect responsibly on individual and team performance to improve performance.
7.38. Use available evidence to inform effective teamwork and team-based practices
7.39. Exercise in a loyal, fraternal and courteous, and respectful communication towards
other members of health care team.
7.40. When a nurse consulted health professionals about patient’s case shall not take over
the management of the patient without the knowledge of the regularly attending nurse
7.41. It shall be the duty and privileges of every health professional to attend free of charge
any sick colleague or her/his dependents.

18 | P a g e
Code of Ethics for Nurses in Ethiopia
Section VIII- Nurses and research
Health Research is the process of knowledge development with the aim of understanding health
challenges and mounting an improved response to them. Health researches seek to generate
evidences that guide practices, policies, programs and interventions. In conducting research the
health professional shall comply with legal and ethical principle of the land and the profession
respectively. In any health research ensuring participants confidentiality, obtaining consent,
avoiding deceptive practices, avoid harm or discomfort and respecting participant’s right to
withdrawal must be the guiding principles of the researcher/s involving human subjects.
The Nurse shall:
Article 8
8.1. Conduct, support, engage and use research and other activities that promote safe,
competent, compassionate and ethical care
8.2. Use guidelines for ethical research operations that are in keeping with nursing values.
8.3. Nurses who are involved in research respect the well-being of persons receiving care
above all other objectives, including the search for knowledge. They pay attention to
the safety of persons receiving care and make sure proper informed consent taken, the
risk-benefit balance, the privacy and confidentiality of data and the monitoring of
research assured.
8.4. Value research and development for the promotion of nursing knowledge and skills.
8.5. Honesty and integrity must govern all stages of research, from the initial grant
application, to publication of results. Fabrication, falsification, plagiarism should be
avoided in proposing, conducting and reporting research.
8.6. Health professional’s research involving human subjects must conform to the
generally accepted current scientific principles, be based on a thorough knowledge of
the scientific literature, and supported with other relevant sources of information.
8.7. When conducting a clinical trial, a state of clinical equipoise must exist at the
inception of the trial, regarding the advantage and risks of the regimens to be tested
8.8. Benefits and risks of research must be distributed fairly, and particular care must be
taken to avoid exploitation of vulnerable populations. Careful assessment of any
predictable risks in comparison with foreseeable benefits to individuals and the

19 | P a g e
Code of Ethics for Nurses in Ethiopia
community at large should be done beforehand and the benefit-to-risk ratio must be
high enough to justify the research effort.
8.9. Before initiation of any study, all proposed research, should be approved by the
research ethics committee/ review board (National /Institutional/regional) in order to
assure that the research plans are reasonable and that research participants are
adequately protected. The protocol must abide to the national guidelines and
international norms and standards into consideration.
8.10. Informed consent must be obtained from the research participant or from an authorized
representative for those with diminished capacity to consent. The consent process
should reflect all the elements of consent: information, comprehension and
voluntariness.
8.11. The consent should be documented, by use of a consent form that has been approved
by the ethics committee, dated and signed by the study participant or legally authorized
representative. For participants who cannot read and write, a witness signature should
be obtained in addition to index finger print of the participant.
8.12. If the research participant is in a dependent relationship with the researcher, consent
should be obtained by another independent individual who is very familiar with the
study to avoid coercion.
8.13. Nurses shall protect participants from harm. Where there is the possibility that
participants could be harmed or put in a position of discomfort, there must be strong
justifications for this. Such scenarios will also require additional planning to illustrate
how participant harm (or discomfort) will be reduced, informed consent, and detailed
debriefing.
8.14. Nurse Researcher shall conduct research in a way that respects the rights of individuals
in the community.
8.15. Nurse researchers shall not conduct research for financial and other personal incentive
driven situation
8.16. The rationale and details of the inclusion of vulnerable population in research
(Children, pregnant women, prisoners, mentally disabled etc.) should be justified in
the research protocol.

20 | P a g e
Code of Ethics for Nurses in Ethiopia
8.17. Children shall include in research, only in cases where their participation is
indispensable for researches of diseases of childhood and conditions to which children
are particularly susceptible and when the risk is justified by the anticipated benefit
from participation.
8.18. If the potential subjects are children, the consent of a parent or legal guardian after a
full explanation of the aims of the experiment and of possible hazards, discomfort or
inconvenience, is always necessary, and to the extent that it is possible, which will
vary with age, the assent (willingness) of the child should be sought with due respect
to the dissent of the potential participant.
8.19. Special safeguards should be put in place when involving pregnant women in research.
Pregnant women should not be included in non-therapeutic research that carries any
possibility of risk to the fetus or neonate, unless this is intended to elucidate problems
of pregnancy or lactation. Scientifically appropriate preclinical studies and clinical
studies on non-pregnant women should be done so that to provide data to assess the
potential risk in pregnant women and fetuses.
8.20. All authors have a professional responsibility to make public their research findings
and be honest in their publications, make clear that research has been carried out in
accordance with the ethical principles.
8.21. Avoid plagiarism since it is unethical.
8.22. Ensure that any publications or published/submitted materials produced are accurate,
responsible, ethical and reflect their relevant skills, experience and qualifications.

21 | P a g e
Code of Ethics for Nurses in Ethiopia
Section IX- Nursing Services and Commercial Interests
In the pursuit of business success, it must be borne in mind that optimal patient care is more than
a market commodity. It must be remembered that patients will rely upon professionals to protect
their welfare. Trust is therefore an essential component of the health professionals-patient
relationship. Trust that health professionals will regard patients’ welfare to be their primary
concern. A conflict of interest exists when a health professional’s judgment concerning a patient’s
welfare might be, or might be seen to be, influenced by a secondary interest, such as financial gain.
The secondary interest itself may be legitimate, but its relative weight in professional decisions
must always be subsidiary to the interests of patients.

A conflict of interest occurs when a nurse’s personal, business, commercial, political,

academic or financial interests, or the nurse’s family or friends, interfere with the
nurse’s professional responsibilities or a client’s best interests.
The Nurse Shall:
Article 9

9.1. Avoid encouraging patients to give, lend or bequeath inducement (Including gifts or
hospitality) which may affect or be seen to affect their Judgment/ benefit them
directly or indirectly.
9.2. Provided information in advance about fees and charges wherever possible before
asking for their consent to treatment.
9.3. Not exploit/use unfairly patients vulnerability or lack of medical knowledge when
making charges for treatment or services
9.4. Not put pressure on patients or their families to make donations to other people or
organizations.
9.5. Avoid participating in deceptive or fraudulent business practices.
9.6. Not put inappropriate pressure on patients to accept private treatment
9.7. Not agree to a fee contingent upon the favorable outcome of the litigation in exchange
for testifying as a health professional expert.
9.8. Not accept or tender “rebates” or “split fees” for paying advertising or marketing
services by sharing a specified portion of the professional fees collected from
prospective or actual patients with the vendor providing the advertising or marketing
services is engaged in fee splitting.

22 | P a g e
Code of Ethics for Nurses in Ethiopia
9.9. Not increase a fee to a patient solely because the patient is covered under health
professional benefits plan of third party like insurance, institution, donors.
9.10. Not recommend or performs unnecessary health services or procedures in order to
receive a greater payment.
9.11. Not announce to the public that he or she is certified in an area of spatiality which is
not recognized as a specialty area by Higher Education Relevance and Quality
assurance Agency (HERQA) of Ethiopia.
9.12. Have an ethical obligation to ensure that their commercial web sites are truth full and
do not present information in a manner that is false and misleading in a material
respect.
9.13. Should know that it’s unethical to accept any indirect gain based on a principle of
dichotomy or undisclosed division of professional fees for a medical act such as for
prescriptions of drugs, laboratory investigations, appliance with a medical partnership
publicly known to exist.
9.14. Protect patients from unnecessary payments and procedure intended to increase
financial gain from providers

Section X- Nurses and Leadership

Nurse leaders everywhere need the right professional, political and policy leadership skills to
operate effectively in tough policy arenas. Defined leadership as the process by which an
individual influence a follower to behave in a desired manner (ICN global nursing leadership).

The Nurses Shall:

Article 10

10.1. Apply leadership practices that support collaborative practice and team effectiveness
10.2. Nurses use health care resources effectively and efficiently through partnerships with the
community.
10.3. Nurses coordinate their services with those of medical and social groups in rendering
health services to individuals, families and the community.
10.4. Creates an ethical culture and safe work environment.
10.5. Supports policies and practice that reflect the Code of Ethics.
10.6. Communicates expectations for ethical behavior and actions in the workplace.
23 | P a g e
Code of Ethics for Nurses in Ethiopia
10.7. Helps individuals raise and resolve ethical concern in an effective and timely manner.
10.8. Facilitates review and evaluation of peers and other members of the healthcare team.
10.9. Evaluating adherence to standards of conduct: processes are in place to evaluate the
performance of individuals and teams against the entities expected standards of
conduct.
10.10. Provide leadership through informal and formal roles; take action to resolve conflict;
and advocate for clients, workplace and profession
10.11. Create an independent leadership in nursing profession
10.12. Ensure and monitoring application of Nursing care standard
10.13. Nurse shall involve in organizational ethics committee
10.14. Ensure participation in management decision making
10.15. Prepare nursing service organogram and issue inline of commands
10.16. Establish nursing council responsible to evaluate and resolve ethical issues in Nursing

Section XI- Nurses and theirs Practice

This section mainly consider Documentation and recordings nursing care plan, death and birth
certificates, legal evidences about patients and clients under their care, informed consent and
informed decision making. Clear, accurate, and accessible documentation is an essential element
of safe, quality, evidence-based nursing practice. Documentation of nurses’ work is critical as well
for effective communication with each other and with other disciplines.

The nursing record is where nurses write down nursing care the patient receives and the patient’s
response as well as any other events or factors which may affect the patient’s wellbeing. These
‘events or factors’ can range from a visit by patient, family and significant others to going to
procedural and legal operation. Keeping good nursing records allows identifying problems that
have arisen and the action taken to rectify.

Informed consent is a key ethical requirement in clinical practice involving patients and in health
care or biomedical research involving human participants. Policy on informed consent for nursing
procedures has been developed using the principles in Nurses code of conduct which outlines
clearly that patients must consent to all medical and nursing procedures. Consent is informed if,
before giving it:

24 | P a g e
Code of Ethics for Nurses in Ethiopia
(1) the person received the information about the treatment that a reasonable person in the same
circumstances would require to make a decision; and (2) the person received responses to his/her
requests for additional information about the treatment.
The information must include the: (1) nature of the treatment (2) expected benefits of the treatment
(3) material risks and side effects of the treatment (4) alternative courses of action and (5) likely
consequences of not having the treatment.
The Nurse shall:
Article 11.1: Documentation and Records
11.1.1. Complete all Nursing documentation/records at the time or as soon as possible after
an event as per their professional standard.
11.1.2. Promote event recording and reporting as soon as possible after an event
11.1.3. Keep accurate, up-to-date and legible records that report relevant details of nursing
assessment findings, nursing interventions and information given to patients
regarding his/her health problems.
11.1.4. Ensure that Nursing records show respect for his/her patients and do not include
undignified or offensive remarks.
11.1.5. Ensure that nursing records are sufficient to facilitate continuity of patient care as per
their professional standard.
11.1.6. Ensure their entries made are clear, dated, timed and signed
11.1.7. Do not use of unauthorized abbreviations, jargons or speculations in all nursing
documentation
11.1.8. Ensure that all records are kept securely and confidential.
11.1.9. Utilize the most recent and recommended professional standard formats for nursing
documentations
11.1.10. Consider legislative and institutional guidelines related to documentations
11.1.11. Recognize patients’ right to access information contained in their medical records
and facilitating that access.
11.1.12. Facilitate the transfer of health information when requested by the patient and
legal bodies.
11.1.13. Report at the right time for the right bodies with the right quality and format

25 | P a g e
Code of Ethics for Nurses in Ethiopia
11.1.14. Follow reporting of various actions to responsible authorities in the respective
institutes. They also have professional obligations to report to the CED/Chief clinical
director and Matron Office, statistics and significant others.
11.1.15. Be aware and comply with reporting obligations
The Nurse shall:
Article 11.2: Informed Consent
11.2.1. Provide information and verify patients understanding about all advantages and
disadvantages before signing consent.
11.2.2. Give care for patients who are legally incapacitated or unable to understand
information, decide or give valid consent, they must inform their legal representative
or families.
11.2.3. Insure verbal consent for routine nursing care
11.2.4. Witness and play advocacy role in the process of informed consent taking for major
surgical procedures
11.2.5. Express consent verbally and noted in the medical history.
11.2.6. When the proposed measures are likely to cause a significant risk, the patient's/ legal
representative’s written consent is obtained.
11.2.7. Take an informed consent for taking film, video tapes, or otherwise record patient
interactions with their health care providers requires the utmost respect for the
privacy and confidentiality of the patient.
11.2.8. Obtain an informed consent before she/he undertakes any nursing interventions, or
before involving patients in teaching or research except in an emergency (in which
the patient is unconscious or he/she is in a condition unable to give consent or there
is no any family or legal representative).
11.2.9. Respect the patient’s refusal, in whole or in part, to a diagnostic test, treatment and
nursing interventions. He/she must inform in an understandable and accurate way of
the possible consequences of persisting in his/her refusal, noting this in the
medical/nursing record.
11.2.10. Ensure that the patient is informed about his/her fees and charges early.
11.2.11. Support Patients decision making via promotion advocacy, coordination,
assisting, witnessing and insuring consideration of basic ethical principles.

26 | P a g e
Code of Ethics for Nurses in Ethiopia
11.2.12. Nurses should keep the following principles in mind when in doubt about how to
interpret the legislation.
11.2.12.1.1. Clients have a legal and ethical right to information about their care and
treatment, and a right to refuse that treatment.
11.2.12.1.2. Regardless of whether consent has been obtained by the nurse, nurses
should always explain to the client the treatment or procedure they are
performing.
11.2.12.1.3. Nurses should not provide a treatment if there is any doubt about whether
the client understands and is capable of consenting. This applies whether or
not there is an order, or even if the client has already consented. A substitute
decision-maker has the right to access the same information that a capable
client would be able to access.
11.2.12.1.4. Consent can be withdrawn at any time.
11.2.12.1.5. Nurses need to advocate for clients’ access to information about care and
treatment if it is not forthcoming from other care providers
11.2.12.1.6. Informed consent does not always need to be written, but can be oral or
implied.
The Nurse shall:
Article 11.3: Informed Decision-Making
11.3.1. Make informed decisions in relation to their practice within the constraints of their
professional role and in accordance with ethical and legal requirements.
11.3.2. Entitled to do this without undue pressure or coercion of any kind.
11.3.3. Responsible for ensuring their decision-making is based on contemporary, relevant
and well-founded knowledge and information.
11.3.4. Value the legal and moral right of people, including children, to participate whenever
possible in decision-making concerning their nursing and health care and treatment,
and assist them to determine their care on the basis of informed decision-making. This
may involve ensuring people who do not speak English have access to a qualified
health interpreter.
11.3.5. Recognize and respect the rights of people to engage in shared decision-making when
consenting to care and treatment.

27 | P a g e
Code of Ethics for Nurses in Ethiopia
11.3.6. Value the contribution made by persons whose decision-making may be restricted
because of incapacity, disability or other factors, including legal constraints.
11.3.7. Be knowledgeable about such circumstances and in facilitating the role of family
members, partners, friends and others in contributing to decision-making processes.
11.3.8. Respect the rights of colleagues and members of other disciplines to participate in
informed decision-making.
11.3.9. Make collaborative and informed decisions about person requiring or receiving
nursing care (or their representative) in decisions relating to their nursing or health
care, without being subject to coercion of any kind.
11.3.10. Value the contribution made by the community to nursing and health care decision-
making through a range of activities, including consumer groups, advocacy and
membership of health-related committees.
11.3.11. Assist in keeping the community accurately informed on nursing and health-related
issues.
11.3.12. Consider Ethical principles for resolving ethical dilemma

Section XII- Nurses and emerging issues

Multiple health challenges exist globally and in developing countries. These health problems range
from outbreaks of vaccine-preventable diseases like measles, increasing reports of drug-resistant
pathogens, growing rates of obesity and physical inactivity to the health impacts of environmental
pollution and climate change and multiple humanitarian crises. In developing countries in
particular there are still public health challenges like poor water quality, unavailability, of
sanitation; services, vector-borne diseases; poor ambient and indoor air quality; increased toxic
substances in agriculture and food production, increased mental illnesses and global environmental
changes
In addition to these, emerging health services like genetic screening, artificial insemination, in
vitro fertilization, use of surrogate mother hood and selection for organ transplantations are
becoming important for clients in urban areas.
The Nurses Shall:
Article 12.1: Emerging Issues:
12.1.1. Nurses prepare for and respond to emergencies, disasters, conflicts, epidemics and
conditions of scarce resources.

28 | P a g e
Code of Ethics for Nurses in Ethiopia
12.1.2. Shall support genetic screening activities consistent with the future developed ethical
guideline
12.1.3. Shall support biological sample collection, processing, handling; storage, transfer, and
making sure that these were conducted protecting client’s privacy and confidentiality.
12.1.4. Shall support artificial insemination, in vitro fertilization, surrogate mother hood the
future developed ethical guideline
12.1.5. Shall support disclosure of diagnosis, processes of clinical management, possible
disabilities, chronicity of illness and death of individual as per cultural context
12.1.6. Shall support disclosure to children consistent with parental consent and to age of
assent of the child with a capacity to comprehend fully as per established guideline
12.1.7. Nurses ensure that use of technology and scientific advances are compatible with the
safety, dignity and rights of people. In the case of devices, such as robots, nurses
ensure that care remains person-centered and that such devices support and do not
replace human relationships.
12.1.8. Not share any client information on social media sites, maintain professional
boundaries with clients, his/her family and use proper communication channels to
discuss, report and resolve workplace issues – not social media.
Article 12.2: Organ transplant

Organ transplant is sometimes the only therapeutic alternative. The nurse shall encourage and
promote organ donation preserving the anonymity of the donor. Nurses should not consent organs
or tissues to be traded.

The Nurses shall:

Article 12.2:
12.2.1. Support organ transplantation activities consistent with developed ethical
guidelines.
12.2.2. Advocate the declaration of human right in the organ transplantation procedure.
12.2.3. The nurse can involve in any organ transplantation procedure provided that the
donor and recipient have clear written agreement, the donor or his or her
significant others gives informed & written consent.

29 | P a g e
Code of Ethics for Nurses in Ethiopia
12.2.4. The nurse shall have moral and professional right to make ethical decision to
resolve the dilemma that arises from the procedure.
12.2.5. Act following a protocol agreed with all professionals involved in the process,
in consultation with the Clinical Ethics Committee of the institution.
12.2.6. Ensure that the reporting process is sufficiently clear and detailed, and that there
is no coercion, emotional or economic pressure or any other defect in the
consent.
Article 12.3: FERTILITY MATTER
The human being is an end in itself at all stages of the life cycle, from conception to death.
Nurses are obliged, in any proceeding, to safeguard the dignity and integrity of persons under
their care.
The Nurse shall:
12.3.1. The obligations of the nurse in the education and health prevention fields should
include creating individual and collective awareness on the benefits derived
from responsible procreation and safe sex practices in disease transmission.
12.3.2. The nurse shall respect autonomy of the client for contraception and other
fertility matter including artificial fertilization.
12.3.3. The nurse shall have moral and professional right to make ethical decision in a
situation of dilemma for the fertility matter.
12.3.4. On sexuality, it is not lawful to interfere in the conscience of couples from the
ideology of the nurse. He/she must intervene advising or recommending those
practices or measures that result in a benefit for patients or for future offspring.
He/she is obliged to inform patients about all the benefits to which they are
entitled in terms of procreation and pregnancy.
12.3.5. Nurses shall not participate directly or indirectly in any process of human
cloning and they cannot create new embryos for experimental purposes.
12.3.6. The Nurse must provide pregnant women adequate, reliable and complete
information on the evolution of pregnancy and fetal development. It is not in
accordance with medical ethics to deny, hide or manipulate information to
influence the mother's decision about continuing her pregnancy.

30 | P a g e
Code of Ethics for Nurses in Ethiopia
12.3.7. The nurse should not promote artificial procreation in women who have
reached natural menopause
12.3.8. Permanent sterilization, both in men and women, is an act that belongs to the
intimate and personal sphere of patients. Nurses should only intervene
informing and advising loyally about that decision.
12.3.9. The nurse should keep secret patients’ genetic data. The nurse can never allow
that genetic data are used as a discriminatory element.
12.3.10. Parenthood tests should be performed with the consent of all parties
involved unless ordered by the court.
Section XII- Nurses and end of life care
End-of-life care refers to health care for a person with a terminal condition that has become
advanced, progressive, and/or incurable. The goal of end of life care is to control pain and other
symptoms so the patient can be as comfortable as possible. It helps a person to live as well as
possible until he/she die and to die with dignity. It involves psychological, social and spiritual
support for patient and family or care givers in a form of assisted living, in home care, palliative,
supportive care, and hospice care. Health professionals may face problematic situations when
patients are close to death, in which clinical problems, decision-making processes, and ethical
issues are often interconnected and dependent on each of them

The Nurses shall:

Article 13
13.1 Communicate bad news to patients and their families in a sensitive and compassionate
way and providing support for them while they deal with this information.
13.2 Takes steps to care and manage for patient’s symptoms and concerns in a manner
consistent with their values and wishes and arranges appropriate palliative care
13.3 Take into account the explicit will of patients to refuse treatment to prolong their life.
13.4 When the state of patients does not allow them to make decisions, the nurse will
consider and assess the indications previously made and the opinion of related
responsible persons.

31 | P a g e
Code of Ethics for Nurses in Ethiopia
13.5 Accept that patients have the right to refuse nursing care and medical treatment or to
request the withdrawal of care and treatment already started but the risk of
withdrawing treatment should be clearly communicated.
13.6 Assure all necessary requirements on Discharge Against Medical Advise (DAMA)
13.7 Respect different cultural, and religious practices related to death and dying.
13.8 Striving to communicate effectively with patients and their families, the nurse should
be able to help them understand the outcomes that can and cannot be achieved.
13.9 Provide comprehensive and compassionate end-of-life care, they should be providing
holistic care including physical, emotional, psychological and spiritual support.
13.10 Respect the patient’s autonomy while considering its limitation and carry out their
duties to benefit the patient without doing harm
13.11 Be responsible for recognizing patients’ symptoms, taking measures within their scope
of practice to administer medications, providing other measures for symptom
alleviation, and collaborating with other professionals to optimize patients’ comfort
and families’ understanding and adaptation.
13.12 When nurses care and treat patients who are legally incapacitated or unable to
understand information, decide or give valid consent, they must inform their legal
representative or families
13.13 Establish decision-making in collaboration with coworkers that reflect physiologic
realities, patient preferences, and the recognition of what, clinically, may or may not
be accomplished.
13.14 Set a plan of care for this patient in collaboration with experts in decision-making,
such as ethics committees or palliative care teams.
13.15 Encourage spiritual support services for the clients from different religion leaders and
other concerned bodies
13.16 Refrain from giving unnecessary hope
13.17 Provide counseling, teaching and guiding the patient
13.18 Make professional judgment about medication effect when administering pain reliving
medication at end of life care
13.19 Use sedation of patients for only relieving suffering and avoid using it for hastening
death

32 | P a g e
Code of Ethics for Nurses in Ethiopia
13.20 Advocate to ensure that their patients’ goals of care are met while following ethical
principles

Section XIIII- Nurses and specific ethical Issues

Different Ethical issues encountered in daily nursing practice draw little consideration but can
produce a stressful working environment for the nurses. Ethical dilemmas like Abortion,
Euthanasia, Suicide and Death confront nurses in their work environment and sometimes challenge
professional values. Nurses are accountable for their judgments, decisions, and actions; but, in
compromising circumstances, responsibility may be borne by both the nurse and the institution.
They may accept or reject specific role demands and assignments based on their education,
knowledge, competence, experience, and assessment of patient safety.

The Nurse shall:

Article 14.1: Abortion

14.1.1. Involve in abortion procedure for the purpose of saving the endangered life or health
of a woman as per national guideline.
14.1.2. Not attempt, participate, or carry out illegal abortion.
14.1.3. Have an obligation to treat a patient who is suffering from the effect of a criminal
abortion.
14.1.4. Preserve the life entrusted to him/her at any stage. If a woman chooses voluntarily to
terminate her pregnancy, this does not relieve the Nurse of the duty of informing her
about the social benefits to which she would be entitled if she continues the pregnancy
and about somatic and psychological risks that may reasonably arise of her decision.
The Nurse shall:
Article 14.2: Euthanasia
14.2.1 Never assist, collaborate or participate in taking life as an act of mercy even at the
direct request of the patient or patients' relatives.

33 | P a g e
Code of Ethics for Nurses in Ethiopia
The Nurse shall:
Article 14.3: Death
14.3.1. Note the time of cessation of vital signs and report to the attending health personnel
authorized to pronounce death.
14.3.2. Give due respect to the deceased taking into consideration religion and cultural
aspects.
14.3.3. Participate in or assist a medical team in taking out organ from a cadaver provided
there is an informed written consent of a patient and relatives.
The Nurse shall:
Article 14.4: Suicide
14.4.1. Remove all items that facilitate suicide, such as sharp instruments, ropes, belts,
drugs and make sure that the outlets are guarded while taking care of a patient with
the suicidal tendency.
14.4.2. The nurse shall not leave alone the patient who has a suicidal ideation.

34 | P a g e
Code of Ethics for Nurses in Ethiopia
References:
1. The ICN Code Of Ethics For Nurses, Revised 2020
2. The Code of Ethics For Nurses With Interpretive Statements American Nurses Association
2014
1. Code of Ethics And Professional Conduct For Nurses In Hong Kong, Updated In January 2015

2. Code of Ethics for nurses ENA 2009

3. Code of Ethics for Health Professionals In December/2019 Ethiopia (Cehpe)

4. American Nurses Association, “Recognition Of A Nursing Specialty,” Aug.
2017: Https://Www.Nursingworld.Org/~4989de/Globalassets/Practiceandpolicy/Scope-
Of-Practice/3sc-Booklet-Final-2017-08-17.Pdf
5. Code of Conduct For Medical Doctors In Ethiopia, October 2019
6. Richard, L. Mathias, T.Fostering Therapeutic Nurse-Patient Relationships. Nursing Made
Incredibly Easy!: May-June 2010 - Volume 8 - Issue 3 - P 4. Doi:
10.1097/01.NME.0000371036.87494.11
7. Code of conduct for Nurses and midwifes Singapore nursing bared 2018
8. Code of Ethics for Nurses in Australia the Nursing and Midwifery Board of Australia. 2008

35 | P a g e
Code of Ethics for Nurses in Ethiopia