Ethics education is an essential component of academic programs that prepare nurses for advanced practice; the concept of respect for human dignity is integral to this education. Sixty-three graduate students enrolled in their first course of a nurse practitioner program completed a researcher-developed Ethics Questionnaire that was designed to elicit their baseline ethics-related knowledge, including their understanding of the concept "respect for human dignity." Qualitative analysis of data yielded findings that validate the importance of using the American Nurses Association Code of Ethics for Nurses with Interpretive Statements as an essential foundation for ethics content and as a framework for understanding the meaning of human dignity in advanced practice nursing. Assessment and learning strategies are recommended.
Key Words Advanced Practice - Code of Ethics - Ethics Education - Human Dignity - Respect for Human Dignity
ETHICS IS AN ESSENTIAL COMPONENT OF GRADUATE EDUCATION IN NURSING (1,2). The education of nurse practitioners for advanced practice must build upon students' prior academic and clinical experiences related to ethics. However, a review of the literature revealed that no studies have been published describing the baseline ethics-related knowledge of graduate students who are beginning their coursework for advanced practice as nurse practitioners. * This article reports on a study designed to address this gap. Students enrolled in their first graduate nursing course are asked to describe their understanding of the phrase "respect for human dignity" and provide examples of how they practice with respect for the inherent dignity, worth, and uniqueness of all individuals. The integration of ethics education in the graduate nursing curricula is discussed.
Review of Literature The importance of ethics in nursing is clearly documented in the nursing literature. A growing body of nursing knowledge reflects rich contributions of nurse ethicists, nurse theorists, nurse clinicians, and nurse educators. The importance of ethics in nursing is further substantiated by academic and professional standards, including the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, which establishes ethics as "an integral part of the foundation of nursing" (3).
The literature, however, does not present the specific content that is necessary to educate advanced practice nurses (APNs) about ethics. Furthermore, no studies have been published that describe the baseline ethics-related knowledge of students who are enrolled in master's degree programs, and none have recommended ethics content that intentionally builds upon and furthers prior academic and clinical experiences in ethics. This literature review considers the importance of integrating graduate students' baseline ethics and related knowledge in ethics education through the prism of the Code of Ethics for Nurses with Interpretive Statements (3), the concept of respect for human dignity, and the art of advanced practice nursing.
CODE OF ETHICS The ANA Code of Ethics for Nurses serves as the ethical standard for nursing education, practice, and research. Its first provision states, "The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems" (3, p. 7). This provision of the code enumerates five interpretive statements that encompass respect for human dignity, the nurse's relationships with patients, the nature of health problems, the right to selfdetermination, and the nurse's relationships with colleagues and others (p. 3). According to the code, "a fundamental principle that underlies all nursing practice is respect for the inherent worth, dignity, and human rights of every individual" (p. …