Magazine article American Nurse Today

Issues Up Close: ANA Center for Ethics and Human Rights: Addressing Ethical Issues for 25 Years

Magazine article American Nurse Today

Issues Up Close: ANA Center for Ethics and Human Rights: Addressing Ethical Issues for 25 Years

Article excerpt

THE YEAR IS 1989. The Hubble telescope is under construction for launch. The Cold War is ending with the fall of the Berlin Wall. And scientists are beginning to map the human genome.

Against this backdrop, a committee of nurses from diverse backgrounds at the American Nurses Association (ANA) recommends that ANA establish a Center for Ethics and Human Rights to better help nurses respond to the ethical issues of a changing world.

Twenty-five years later, the Center that opened its doors on Sept. 4, 1990, is recognizing its silver anniversary with the newly released 2015 Code of Ethics for Nurses with Interpretive Statements and a full mailbag--now mostly electronic--of questions and comments from nurses.

"Ethics is changing and nursing practice is changing. Our job is to keep up with the change," says Felicia Stokes, JD, RN, a member of the Ethics Advisory Board, which recommends policy about nursing ethics to ANA's Board of Directors.

In this "Year of Ethics," as ANA has designated 2015, the Center continues its 25-year commitment to the human-rights dimensions of health care through its focus on such issues as moral distress and courage, expert care at the end of life, and nurses' participation in the care of prisoners. Through its work, the Center advocates for nurses' right to make independent judgments and to refrain, without retaliation, from work they find ethically objectionable.

Early days

The Center traces its origin to a 1989 ANA House of Delegates meeting, where a committee was appointed to recommend how ANA should address ethics and human rights. Beverly Malone, PhD, RN, FAAN, past ANA president and now chief executive officer of the National League for Nursing, was chairperson of that committee and remembers the tenor of the times.

Advances in technology--such as the world's first artificial heart--posed new challenges to patient autonomy, and the HIV/AIDS crisis of the 1980s triggered questions about privacy and nurses' risk and responsibility. A rise in homelessness was linked to the closure of residential psychiatric facilities.

"Everyone was being challenged, and nurses frequently were caught in the middle of [life and death] decisions," Malone says. "How could we best advocate for patients?"

ANA was no stranger to thorny ethical questions. The association had long been steward of the Nursing Code of Ethics, which it adopted in 1950, and the profession's awareness of its ethical challenges dated back to the 1893 Nightingale Pledge. But more was needed.

"There were no standards nationally for how nurses approach this," Malone recalls. "ANA needed to step up to the plate."

Keeping up with the times

The Center's formation coincided with the development of the larger field of bioethics, according to Gladys White, PhD, MSN, RN, the Center's first director and today a professor of global bioethics and cyberethics at Georgetown University. "We were tapping into that broader stream of ethical topics," White says.

The Center established a network of ethics representatives from ANA's state nurses associations, whose discussions "lifted ethics and human rights as an area of focus and expectation," White says. "We had a snapshot of the nation."

With a plan underway to map the human genome at the National Institutes of Health, the Center obtained grant money that had been earmarked to study the ethical, legal, and social implications of the project, White recalls.

"It was a pioneering effort to begin to understand how nurses managed genetic information," says Colleen Scanlon, JD, MS, RN, who continued the project as the Center's second director in 1992. Scanlon is now senior vice president and chief advocacy officer at Catholic Health Initiatives in Colorado. In 1995, ANA published Managing Genetic Information: Implications for Nursing Practice, with guidelines for nurses on informed consent and privacy concerns. …

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