The Code of Conduct
The Code of Conduct is a set of rules and regulations for a particular work place or organisation. The Code of Conduct for nurses is set by the Nursing and Midwifery Councils, which briefly states; as a registered nurse you are personally responsible for actions and mistakes in your practice you must always be able to justify your decision, must always act according to the law whether those laws relates to your personal life or professional practice, you must respect your client as an individual and protect confidential information (www. nmc-uk. org)
Moonie et al, (2000), states that Ethics are the moral codes that form the grounds for decision making and therefore the performance workers in a given profession. An ethical dilemma comes up when two or more of the morals in the ethical values conflict (www. apa. org) The dilemma that is going to be discussed is about teenage pregnancy. Nurse Mary had just finished a phone call, when someone knocked on her office door. Standing in the door was Emma, a 14 year old girl. She looked a bit scared but resolute after some minutes of hope from Nurse Mary, that everything was alright, and that Emma could tell her anything, the girl opened up.
She told the nurse that she and her boyfriend, who was sixteen years old, were sexually active and she wanted contraception but she did not want her parents to know about it. Mary informed her that it was actually illegal for her boyfriend to have sexual intercourse with her. Emma replied that this was a confidential discussion so Mary could not tell anyone and that she was only there because she did not want to become pregnant. Mary informed Emma that having sexual intercourse at an early age could lead to increased risk of getting cervical cancer and that contraceptives did not protect against sexual transmitted diseases (Bartter, 2001).
But this did not put Emma off, who was firm in her decision Mary, who is committed by the part of the code of conduct that states that she must respect people’s right to confidentiality, can not inform Emma’s parents, although she is under age. The ethical dilemma in this scenario is whether the nurse should prescribe the contraceptive or not. Faced with this ethical dilemma, nurse Mary has to decide which of the possible options would be the right actions to take and how the choice of this action over any other can be justified.
She might find that her legal and moral responsibilities are in conflict, but she is bound by the code of conduct that says; she must treat people as individuals and respect their dignity, she must not discriminate in any way against those in her care, she must treat people kindly and considerately and she must respect the choices made by the client (www. nmc-uk. org). But according to the law in England Emma has to be sixteen years old before she can agree to sexual intercourse. Relating to this law the question of whether the nurse by prescribing or giving advice on contraceptive to girls under sixteen, could be seen as assistance to crime.
Because the law also states that a person is responsible as an accomplice if he or she aids, abides, councils or obtain the commission of a crime (cited in Bartter, 2001). On one hand if she does not prescribe the contraceptive, the result could be an unnecessary pregnancy for the young girl. It could also be argued that by having sexual intercourse Emma is putting herself at risk as mentioned before. In looking at the code of conduct there are two relevant places of guidance for Mary. “Confidentiality must respect people s right” and adhere to the laws of the country in which you are practicing.
Mary should discuss the case with her manager to make sure she follows the law. According to Black, (1991), many adults have a tendency to underestimate the maturity of under sixteen’s, and seem to forget that the under age girls, according to the 1959 Declaration of Rights of the Child, they are as free as adults to have their needs met and to have a free will (cited in Bartter, 2001) A lot of girls under sixteen years of age are able to give approval to contraceptive treatment and advice.
The important factor is the individual client’s capability to understand the nature and purpose of what was advised (Stauch, 1998 cited in Bartter, 2001). If the girl can understand the advice given to her (although under sixteen) and she can not be persuaded to let her parents know that she is seeking contraceptive advice, or she is likely to have sexual intercourse with or without contraception and that it is in the girls best interest to receive contraceptive treatment or advice or both without a parental consent, the nurse can provide contraceptive supplies and advice without the girls parents consent (Bartter, 2001).
This will also be applied by the code of conduct that states to respect peoples right to confidentiality (www. nmc-uk. org). Emma is aware that she is at risk of getting pregnant and she is also aware that her partner is committing a criminal offence, but since she has taken an independent decision to ask for contraceptive, she deserves to be treated with respect. The nurses who are bound by a duty of care and who wishe to act with good doing and not wrong doing ethical and legal values are in conflict.
In this case, respect for the independence of the young girl takes priority (Singleton and McLaren, 1995. cited in Bartter, 2001) in this dilemma it would be natural for Mary to override Emma’s independence but according to the deontological theory (Immanuel Kant, 1742) which can be linked to the part of the code of conduct that applies to this case, it states that a person has the right to decide over his/her own body (Cited in Kozier et. al. 2008), if an individual are to be morally responsible for what they do, they must be free to make up their own minds about what is right and wrong.
Good value ethics is more emphasized on the character of the decision maker (In this case nurse Mary). It refers to specific character qualities such as truthfulness, honesty, respectfulness, courage, integrity and compassion. These qualities become obvious through person s behaviour. Although the fact that a profession has a code of conduct, there is no guaranteeing that the members of the profession will act in an ethical manner.
The ability to respond to ethical dilemmas in the healthcare profession is dependant on the nurse’s own honesty, courage, integrity or other personal morals. Chitty and Black, 2007) This case can also be linked to the Utilitarianism theory (Mill, 1806) which is based on the views that a good act is one that brings the most good and least harm for the greatest number of people. (Moonie et. al. 2000) If Nurse Mary does prescribe the contraceptive, she will prevent an unwanted pregnancy and save the Government money, as it is less costly to provide counselling services than the health and social cost of unplanned pregnancy (Bartter, 2001)