Ethical codes in nursing practice: the viewpoint of Finnish, Greek and Italian nurses.
OBJECTIVE
This paper is a report of a study exploring the use of ethical codes and obstacles to their use in nursing practice as perceived by Finnish, Greek and Italian nurses.


BACKGROUND
In all European countries nurses are responsible for the well-being of patients, for their own technical and ethical competence and, for their own part, for the high standard of health care in society. These points illustrate the central content areas of nursing codes of ethics. Recent advances in medical technology have added to the complexity of nursing. Nurses today are increasingly confronted with ethical dilemmas, underlining the role and meaning of ethical codes in their decision-making. However, there is only very limited research literature on codes of ethics, their use in nursing practice and obstacles to their use.


METHODS
Twenty-three focus group interviews were conducted in 2003 with a total of 138 Registered Nurses: 35 in Finland, 54 in Greece and 49 in Italy. The data were content analysed.


RESULTS
Two main categories emerged from our analysis of the use of ethical codes: (1) conscious and (2) unconscious use. Seven main categories described the obstacles to the use of ethical codes: (1) the codes themselves, (2) nurses themselves, (3) multiprofessional teamwork, (4) patients' family members, (5) the organization, (6) the nursing profession and (7) society/healthcare policy. Participants in all three countries were firmly committed to the values expressed in ethical nursing codes. Nonetheless, continued efforts are needed in all these countries to remove the remaining obstacles so that nursing care can be provided in keeping with the requirements of ethical codes.


CONCLUSIONS
The use of codes is connected with the changes in nursing profession and in society at large. The core of nursing, however, has remained stable. Future studies should be conducted in order to generalize the findings to a broader population.
Heikkinen
Anne
A
Department of Nursing Science, University of Turku, Turku, Finland. anne.heikkinen@auriamail.net
Lemonidou
Chryssoula
C
Petsios
Konstantinos
K
Sala
Roberta
R
Barazzetti
Gaia
G
Radaelli
Stefania
S
Leino-Kilpi
Helena
H
D000328:Adult; D001291:Attitude of Health Personnel; D015400:Clinical Nursing Research; D032781:Codes of Ethics; D004993:Ethics, Nursing; D005260:Female; D005387:Finland; D017144:Focus Groups; D006115:Greece; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D009736:Nursing Process / Q000941:ethics*