5 Ethics and Professional Responsibilities
A guide to ethical nursing principles, patient rights, confidentiality, advocacy, and professional accountability in care decisions.
in practice
Ethical nursing practice means making care decisions that respect each person’s dignity and rights while meeting professional standards and legal obligations. The American Nurses Association (ANA) Code of Ethics for Nurses, revised in 2025, provides a professional framework; laws, regulations, and workplace policies also apply.
Core principles
help nurses recognize and reason through concerns:
: Respect a person’s capacity and right to make informed choices, including refusing treatment.
Beneficence: Act to promote the patient’s well-being.
Nonmaleficence: Avoid causing preventable harm and reduce foreseeable risks.
Justice: Treat people fairly and distribute care and resources equitably.
Veracity: Communicate truthfully.
Fidelity: Keep professional commitments and follow through on responsibilities.
These principles may conflict. A nurse may believe a treatment could benefit a patient while the patient declines it. Respecting means listening, checking that the patient has understandable information and an opportunity to ask questions, and communicating the decision to the care team—not pressuring the patient to agree.
Patient rights and informed decisions
Patients should be treated with dignity and receive respectful, nondiscriminatory care. In U.S. hospitals, federal regulations recognize rights that include participating in care planning, making informed decisions, requesting or refusing treatment, and having clinical records kept confidential. They also recognize rights to personal privacy and care in a safe setting. Applicable details can depend on state law, the care setting, and the patient’s circumstances.
To support informed decision-making, nurses communicate relevant information within their role, use language the patient can understand, invite questions, and identify when the patient needs an interpreter or another accommodation. If a patient appears unsure about a proposed intervention, the nurse can pause when safe, clarify the patient’s concern, and contact the appropriate clinician to address unanswered questions. A capable patient’s refusal should be taken seriously and reported according to policy.
and privacy
is the duty to protect information learned through professional care. Privacy concerns a person’s control over access to their body, personal space, and information.
In the United States, the applies to covered entities and establishes safeguards and limits for using and disclosing protected health information. It also gives individuals rights concerning their records, including access and requests for correction.
Nurses should access only information needed for their work, share it only with authorized people for an appropriate purpose, and use secure systems and communication methods. Avoid discussing identifiable patient details in public areas or posting them on social media. is not absolute: laws and rules may permit or require particular disclosures. When uncertain, follow organizational policy and consult a supervisor or privacy officer rather than making an informal disclosure.
For example, if a relative calls asking for a patient’s test results, the nurse checks the patient’s preferences and applicable policy before sharing information. Being related to the patient does not, by itself, establish permission to disclose information.
Advocating for patients
means supporting patients’ rights, informed choices, safety, and access to appropriate care. It is part of nursing’s ethical responsibilities. can include helping a patient express preferences, requesting an interpreter, clarifying a confusing plan, raising a concern about a possible safety risk, or connecting the patient with support.
Effective is respectful and specific: state the concern, share relevant observations, communicate the patient’s wishes, and use the appropriate escalation process. If a patient says they do not understand a procedure, the nurse can relay that concern and request further explanation before the patient is asked to decide.
means being answerable for nursing decisions and actions. Nurses are responsible for practicing within their education, competence, role, and applicable scope-of-practice rules; following standards and policies; and seeking guidance when a task or situation exceeds their ability or authority.
Accountability also includes documenting care accurately and promptly, protecting confidential information, communicating important changes, and reporting errors or unsafe conditions through established channels. If an error occurs, the nurse should promptly address immediate patient safety, notify the appropriate clinician or supervisor, and follow reporting and disclosure policies. Honest, factual documentation supports continuity of care and accountability; records should not be altered to conceal an error.
Responding to ethical concerns
In a concern or conflict, gather relevant facts, listen to the patient, consult appropriate colleagues or policies, and document and escalate concerns as required. Apply while protecting patient rights and confidential information, supporting patient choices and safety, and remaining accountable for actions.