Ethical Foundations of Health Care: Responsibilities in Decision Making

1. The practice of nursing, midwifery and health visiting requires the application of knowledge and the simultaneous exercise of judgement and skill. Practice takes place in a context of continuing change and development. Such change and development may result from advances in research leading to improvements in treatment and care, from alterations to the provision of health and social care services, as a result of changes in local policies and as a result of new approaches to professional practice. Practice must, therefore, be sensitive, relevant and responsive to the needs of individual patients and clients and have the capacity to adjust, where and when appropriate, to changing circumstances.

2. Education and experience form the foundation on which nurses, midwives and health visitors exercise judgement and skill, these, naturally, being developed and refined over time. The range of responsibilities which fall to individual nurses, midwives and health visitors should be related to their personal experience, education and skill. This range or responsibilities is described here as the 'scope of professional practice' and this paper sets out the Council's principles on which any adjustment to the scope of professional practice should be based. The contents of this paper are set out on page 2.

3. Just as practice must remain dynamic, sensitive, relevant and responsive to the changing needs of patients and clients, so too must education for practice. Pre‐ registration education prepares nurses, midwives and health visitors for safe practice at the point of registration. The pre-registration curriculum will continue to change over time to absorb relevant changes in care as advances are made. Pre-registration education is, therefore, a foundation for professional practice and a means of equipping nurses, midwives and health visitors with the necessary knowledge and skills to assume responsibility as registered practitioners. This foundation education alone, however, cannot effectively meet the changing and complex demands of the range of modern health care. Post-registration education equips practitioners with additional and more specialist skills necessary to meet the special needs of patients and clients. There is a broad range of post-registration provision and the Council regards adequate and effective provision of quality education as a prerequisite of quality care.

4. The act of registration by the Council confers on individual nurses, midwives and health visitors the legal right to practise and to use the title 'registered'. From the point of registration, each practitioner is subject to the Council's Code of Professional Conduct and accountable for his or her practice and conduct. The Code provides a statement of the values of the professions and establishes the framework within which

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